Assessment of All-Ceramic Dental Restorations Behavior by Development of Simulation-Based Experimental Methods

New dental materials are often introduced into the market and especially in the current practice, without a basic understanding of their clinical performance because long‐term controlled clinical trials are required, which are both time consuming and expensive. Ceramic materials are known for their relatively high fracture resistance and improved aesthetics, but brittleness remains a concern. The stressed areas of the materials are key factors for the failure analysis, and numerical simulations may play an important role in the understanding of the behavior of all‐ceramic restorations. Simulation‐based medicine and the development of complex computer models of biological structures are becoming ubiquitous for advancing biomedical engineering and clinical research. The studies have to be focused on the analysis of all‐ceramic restorations failures, investigating several parameters involved in the tooth structure–restoration complex, in order to improve clinical performances. The experiments have to be conducted and interpreted reported to the brittle behavior of ceramic systems. Varied simulation methods are promising to assess the biomechanical behavior of all‐ceramic systems, and first principal stress criterion is an alternative for ceramic materials investigations. The development of well‐designed experiments could be useful to help to predict the clinical behavior of these new all‐ceramic restorative techniques and materials

Masking Abilities of Dental Cad/Cam Resin Composite Materials Related to Substrate and Luting Material

An outstanding treatment challenge related to aesthetic monolithic materials is to mask discolored substrates in aesthetic areas. The purpose of the study is to evaluate the substrate masking ability of different resin composite materials and the influence of their association with luting agents and substrates. Five types of 2M2 HT (high translucency) resin composite materials were selected: Vita Enamic [E] and four types of nanoparticle-filled composites Lava Ultimate [L], Cerasmart [C], Shofu HC [S], and Hyramic [H]. Resin composite Vita VM LC with different shades was used for the substrates: 2M2, 3M2, and CP2. Variolink Esthetic Try-inpastes neutral, light+, and warm+ colors were chosen to simulate the luting agent color. Optical parameters (TP (translucency), CR (contrast ratio), and OP (opalesce)) and color differences ΔE (chromatic difference) were calculated. Statistical analyses were performed to evaluate the comparisons between the groups and establish correlations. TP average values for all materials were in the range of 21.49–24.53. OP average values were in the rage of 6.31–7.85. OP is moderate positive correlated to TP and CR is negative and strong correlated to TP. Related to materials, average color changes decrease as following: E > H > C > L > S. Referring to the tryin material, warm colors induce marked color changes of the restoration. The differences of the color changes determined by all studied substrates are significant. For the final aesthetic aspect of the restoration, it is essential to consider the underlying dental structure, luting agent, and restoration material as a whole unit. The masking ability of the investigated resin matrix ceramic materials materials shows differences, the best behavior demonstrated Shofu HC and Lava Ultimate. Marked color changes are related to high chroma substrates. For substrates with a darker color, the association with warm try-in pastes lead to marked color changes, but with neutral and light try-in pastes at most perceivable

Experimental Analyses for The Mechanical Behavior of Pressed All-Ceramic Molar Crowns with Anatomical Design

Ceramic restorations show considerable variation in strength and structural reliability regarding to the type of material, and design characteristics. The fracture of ceramics occurs with little or no plastic deformation, with cracks propagated in an unstable manner under applied tensile stresses. The aim of the study was to assess experimental analyses of pressed monolithic ceramic crowns with anatomical design used in the posterior areas in order to understand their mechanical behavior before following their clinical use. Experiments were conducted on a complete molar crown preparation. Experiments show different modes of fracture for the tested samples. Digital images from the fractured pieces of the crowns were used to verify the fragments in all cases final fracture occurred by splitting into two and often more parts. The graphically representation of the displacement depending on the load highlights a series of peaks that can be correlated with cracks occurred in crowns. The development of well-designed mechanical experiments could be useful to help to predict clinical survival of these new all-ceramic restorative techniques and materials. Because failure is often accompanied by complete cracking of the crowns, preliminary research should represents a compulsory goal

Experimental Analyses for The Mechanical Behavior of Pressed All-Ceramic Molar Crowns with Anatomical Design

Ceramic restorations show considerable variation in strength and structural reliability regarding to the type of material, and design characteristics. The fracture of ceramics occurs with little or no plastic deformation, with cracks propagated in an unstable manner under applied tensile stresses. The aim of the study was to assess experimental analyses of pressed monolithic ceramic crowns with anatomical design used in the posterior areas in order to understand their mechanical behavior before following their clinical use. Experiments were conducted on a complete molar crown preparation. Experiments show different modes of fracture for the tested samples. Digital images from the fractured pieces of the crowns were used to verify the fragments in all cases final fracture occurred by splitting into two and often more parts. The graphically representation of the displacement depending on the load highlights a series of peaks that can be correlated with cracks occurred in crowns. The development of well-designed mechanical experiments could be useful to help to predict clinical survival of these new all-ceramic restorative techniques and materials. Because failure is often accompanied by complete cracking of the crowns, preliminary research should represents a compulsory goal

Surface Characterisation of Dental Resin Composites Related to Conditioning and Finishing

Due to the little information related to surface processing and conditioning of resin matrix ceramic materials previous glazing, the main purpose of this in vitro study was to investigate the effect of different surface treatments on the surface morphology of different resin composite materials. Five types of resin composite CAD-CAM materials: a resin composite ceramic Vita Enamic (E) and four types of nanoparticle-filled resins, like Lava Ultimate (L), Cerasmart (C), Shofu HC (S), Hyramic (H) were taken into consideration. Specimens received the following surface treatment protocols: conventional polishing [p], polishing and glazing [pg], conditioning with CoJet [c], conditioning with CoJet and glazing [cg], sandblasting [s], sandblasting and glazing [sg], etching [e], etching and glazing [eg]. Surface roughness was analyzed for all samples and nanosurface topographic characterization was made by Atomic Force Microscopy. The highest roughness was registered for sandblasted surfaces [s], followed by tribochemical silica airborne particle abrasion [c], and etching [e]. A very strong correlated conditioning behavior of resin nanoceramic materials, like L, C and S samples was found. The microroughness decreased thus [s] > [c] > [e]. These are moderate correlated with H, and are moderate negative correlated to E, where e is more efficient. Three-dimensional images indicated visible grain boundaries after conditioning, for all materials. After polishing and glazing, surfaces became smoother. For all tested conditioning and finishing methods, surface roughness values were within clinically acceptable limits. Finishing by polishing was proved to be a good choice for all materials taken into consideration, polishing and glazing likewise, excepting Hyramic. For Enamic and Shofu HC sandblasting or tribochemical conditioning and glazing and for Hyramic polishing and glazing are not the best options, related to nanoroughness values. Referring to the nanosurface topography, for Enamic, Cerasmart and Hyramic, glazing would be the method of choice, associated with the adequate conditioning method for each material

Effect of Thermocycling, Surface Treatments and Microstructure on the Optical Properties and Roughness of CAD-CAM and Heat-Pressed Glass Ceramics

Dental ceramic restorations are widely spread nowadays due to their aesthetics and biocompatibility. In time, the colour and structure of these ceramic materials can be altered by aging processes. How does artificial aging affect the optical and surface roughness of ceramics? This study aims to assess the effect of thermocycling, surface treatments and microstructure upon translucency, opalescence and surface roughness on CAD-CAM and heat-pressed glass-ceramic. Forty-eight samples (1.5 mm thickness) were fabricated from six types of A2 MT ceramic: heat-pressed and milled glass-ceramic (feldspathic, lithium disilicate and zirconia reinforced lithium silicate). The samples were obtained respecting the manufacturer’s instructions. The resulted surfaces (n = 96) were half glazed and half polished. The samples were subjected to thermocycling (10,000 cycles) and roughness values (Ra and Rz), colour coordinates (L*, a*, b*) and microstructural analyses were assessed before and after thermocycling. Translucency (TP) and opalescence (OP) were calculated. Values were statistically analysed using ANOVA test (one way). TP and OP values were significantly different between heat-pressed and milled ceramics before and also after thermocycling (p < 0.001). Surface treatments (glazing and polishing) had a significant effect on TP and OP and surface roughness (p < 0.05). The heat-pressed and milled zirconia reinforced lithium silicate glass-ceramic experienced a loss in TP and OP. Ra and Rz increased for the glazed samples, TP and OP decreased for all the samples after thermocycling. Microstructural analyse revealed that glazed surfaces were more affected by the thermocycling and especially for the zirconia reinforced lithium silicate ceramic. Optical properties and surface roughness of the chosen ceramic materials were affected by thermocycling, surface treatments and microstructural differences. The least affected of the ceramics was the lithium disilicate ceramic heat-pressed polished and glazed

Optical Properties and Color Stability of Dental PEEK Related to Artificial Ageing and Staining

Considering that the processes of PEEK discoloration caused by either intrinsic or extrinsic factors require elucidation, the aim of this study was to investigate the long-term effect of the combined action of ageing and immersing solutions on the optical properties and color stability of PEEK material, related to surface processing (polishing or glazing). (2) Methods: This study aims to determine the influence of different ageing and staining protocols on optical properties, color changes, and surface roughness of a reinforced PEEK material (bioHPP, Bredent, Senden, Germany). For ageing, specimens were submitted to 5000 cycles in a 55 °C bath and a 5 °C bath filled with distilled water. For staining, thermal cycling was performed in a hot coffee bath (55 °C) and a bath filled with distilled water (37 °C) and in a cold juice bath (5 °C) and a bath filled with distilled water (37 °C). Translucency (TP) and opalescence (OP) parameters were determined, the total color change value (ΔΕ*) was calculated, specimens’ surface roughness was analyzed, and statistical analyses were performed. (3) Results: The mean TP values of the studied samples were in the interval of 1.25–3.60, which is lower than those reported for natural teeth or other aesthetic restoration materials. The OP values of PEEK were registered in the range of 0.27–0.75, being also lower than those of natural teeth or other aesthetic restoration materials. OP has a very strong positive relationship with TP. The mean registered Ra values for all subgroups were below 0.13 µm. Artificial ageing and staining in hot coffee proved to increase the roughness values. (4) Conclusions: The glazing of PEEK has a favorable effect on surface roughness and opalescence, irrespective of the artificial ageing or staining protocols. Artificial ageing damages the color stability and roughness of PEEK, regardless of surface processing, and decreases the translucency and opalescence of glazed surfaces. Immersion in hot coffee leads to perceivable discolorations