Journal of Advanced Prosthodontics最新文献

Purpose: This in vitro study aimed to evaluate the surface characteristics of a full veneer crown fabricated chairside (CS) from a (Y, Nb)-TZP zirconia block in response to conventional zirconia grinding and polishing.

Materials and methods: Zirconia crowns (n = 40) were first prepared and divided into two groups of materials: Labside (LS) and CS, after which each specimen went through a five-step grinding and polishing procedure. Following each surface treatment, surface characteristics were analyzed using confocal laser microscopy (CLSM), average surface roughness (Ra) values were processed from the profile data through Gaussian filtering, and X-ray diffraction pattern analysis was performed to evaluate the monoclinic (M) phase content. Then, a representative specimen was selected for field-emission scanning electron microscopy (FE-SEM), followed by a final analysis of the roughness and X-ray diffraction of the specimens using the independent t-test and repeated measures analysis of variance (RM-ANOVA).

Results: In every group, polishing significantly reduced the Ra values (P < .001). There was no significant difference in Ra between the polished state CS and LS. Furthermore, CLSM and FE-SEM investigations revealed that even though grain exposure was visible in CS specimens throughout the as-delivered and ground states, the exposure was reduced after polishing. Moreover, while no phase transformation was visible in the LS, phase transformation was visible in CS after every surface treatment, with the M phase content of the CS group showing a significant reduction after polishing (P < .001).

Conclusion: Within the limits of this study, clinically acceptable level of surface finishing of (Y, Nb)-TZP can be achieved after conventional zirconia polishing sequence.

Purpose: This study assessed the physical and mechanical properties of interim crown materials fabricated using various digital techniques after accelerated aging.

Materials and methods: Three groups of interim dental restorative materials (N = 20) were tested. The first group (CO) was fabricated using a conventional manual method. The second group (ML) was prepared from prefabricated resin blocks for the milling method and cut into specimen sizes using a cutting disc. The third group (3D) was additively manufactured using a digital light-processing (DLP) 3D printer. Aging acceleration treatments using toothbrushing and thermocycling simulators were applied to half of the specimens corresponding to three years of usage in the oral environment (N = 10). Surface roughness (Ra), Vickers microhardness, 3-point bending, sorption, and solubility tests were performed. A 2-way analysis of variance (ANOVA) and Fisher's multiple comparison test were used to compare the results among the groups.

Results: The mean surface roughness (Ra) of the resin after accelerated aging was significantly higher in the CO and ML groups than that before aging, but not in the 3D group. All groups showed reduced hardness after accelerated aging. The flexural strength values were highest in the 3D group, followed by the ML and CO groups after accelerated aging. Accelerated aging significantly reduced water sorption in the ML group.

Conclusion: According to the tested material and 3D printer type, both 3D-printed and milled interim restoration resins showed higher flexural strength and modulus, and lower surface roughness than those prepared by the conventional method after accelerated aging.

Purpose: This in vitro study aimed to evaluate the accuracy of 14 different intraoral scanners for the All-on-4 treatment concept.

Materials and methods: Four implants were placed in regions 13, 16, 23, and 26 of an edentulous maxillary model that was poured with scannable Type 4 gypsum to imitate the All-on-4 concept. The cast was scanned 10 times for each of 14 intraoral scanners (Primescan, iTero 2, iTero 5D, Virtuo Vivo, Trios 3, Trios 4, CS3600, CS3700, Emerald, Emerald S, Medit i500, BenQ BIS-I, Heron IOS, and Aadva IOS 100P) after the polyether ether ketone scanbody was placed. For the control group, the gypsum model was scanned 10 times with an industrial scanner. The first of the 10 virtual models obtained from the industrial model was chosen as the reference model. For trueness, the data of the 14 dental scanners were superimposed with the reference model; for precision, the data of all 14 scanners were superimposed within the groups. Statistical analyses were performed using the Kolmogorov-Smirnov, Shapiro-Wilks, and Dunn's tests.

Results: Primescan showed the highest trueness and precision values (P < .005), followed by the iTero 5D scanner (P < .005).

Conclusion: Some of these digital scanners can be used to make impressions within the All-on-4 concept. However, the possibility of data loss due to artifacts, reflections, and the inability to combine the data should be considered.

Purpose: The aim of this study was to evaluate the flexural strength of a 3D-printed denture base resin (Cosmos Denture), after different immediate repair techniques with surface treatments and thermocycling.

Materials and methods: Rectangular 3D-printed denture base resin (Cosmos Denture) specimens (N = 130) were thermocycled (5,000 cycles, 5℃ and 55℃) before and after the different repair techniques (n = 10 per group) using an autopolymerized acrylic resin (Jet, J) or a hard relining resin (Soft Confort, SC), and different surface treatments: Jet resin monomer for 180 s (MMA), blasting with aluminum oxide (JAT) or erbium: yttrium-aluminum-garnet laser (L). The control group were intact specimens. A three-point flexural strength test was performed, and data (MPa) were analyzed by ANOVA and Games-Howell post hoc test (α = 0.05). Each failure was observed and classified through stereomicroscope images and the surface treatments were viewed by scanning electron microscope (SEM).

Results: Control group showed the highest mean of flexural strength, statistically different from the other groups (P < .001), followed by MMA+J group. The groups with L treatment were statistically similar to the MMA groups (P > .05). The JAT+J group was better than the SC and JAT+SC groups (P < .05), but similar to the other groups (P > .05). Adhesive failures were most observed in JAT groups, especially when repaired with SC. The SEM images showed surface changes for all treatments, except JAT alone.

Conclusion: Denture bases fabricated with 3D-printed resin should be preferably repaired with MMA+J. SC and JAT+SC showed the worst results. Blasting impaired the adhesion of the SC resin.

Purpose: This study evaluated the relationship among translucency, crystalline phase, grain size, and fracture toughness of zirconia.

Materials and methods: Four commercial zirconia - Prettau^®Anterior^® (PA), Prettau^® (P), InCorisZI (ZI), and InCorisTZI (TZI)- were selected for this study. The bar specimens were prepared to determine fracture toughness by using chevron notched beam method with four-point bending test. The grain size was evaluated by a mean linear intercept method using a scanning electron microscope. X-ray diffraction and Rietveld refinement were performed to evaluate the amount of tetragonal and cubic phases of zirconia. Contrast ratio (CR) was measured to investigate the level of translucency.

Results: PA had the lowest fracture toughness among other groups (P < .05). In addition, the mean fracture toughness of P was significantly less than that of ZI, but there was no difference compared with TZI. Regarding grain size measurement, PA had the largest average grain size among the groups. P obtained larger grain size than ZI and TZI (P < .05). However, there was no significant difference between ZI and TZI. Moreover, PA had the lowest CR value compared with the other groups (P < .05). This means PA was the most translucent material in this study. Rietveld refinement found that PA presented the greatest percentage of cubic phase, followed by TZI, ZI, and P, respectively.

Conclusion: The different approaches are used by manufacturers to fabricate various types of translucent zirconia with different levels of translucency and mechanical properties, which should be concerned for material selection for successful clinical outcome.

Purpose: The purpose of this study was to investigate the effect of barium silicate filler contents on mechanical properties of resin nanoceramics (RNCs) for additive manufacturing (AM).

Materials and methods: Additively manufactured RNC specimens were divided into 4 groups depending on the content of ceramic fillers and polymers: 0% barium silicate and 100% polymer (B0/P10, control group); 50% barium silicate and 50% polymer (B5/P5); 60% barium silicate and 40% polymer (B6/P4); 67% barium silicate and 33% polymer (B6.7/P3.3). The compressive strength (n = 15) and fracture toughness (n = 12) of the specimens were measured, and scanning electron microscopy (SEM) with energy dispersive X-ray spectroscopy (EDS) analyses were performed. Independent sample Kruskal-Wallis tests were performed on the compressive strength and fracture toughness test results, and the significance of each group was analyzed at the 95% confidence interval through post-tests using the Bonferroni's method.

Results: B6/P4 and B6.7/P3.3 exhibited much higher yield strength than B0/P10 and B5/P5 (P < .05). Compared to the control group (B0/P10), the other three groups exhibited higher ultimate strength (P < .05). The fracture toughness of B6/P4 and B6.7/P3.3 were similar (P > .05). The content of barium silicate and fracture toughness showed a positive correlation coefficient (R = 0.582). SEM and EDS analyses revealed the presence of an oval-shaped ceramic aggregate in B6/P4 specimens, whereas the ceramic filler and polymer substrate were homogeneously mixed in B6.7/P3.3.

Conclusion: Increasing the ceramic filler content improves the mechanical properties, but it can be accompanied by a decrease in the flowability and the homogeneity of the slurry.

[This corrects the article on p. 160 in vol. 13, PMID: 34234926.].

Purpose: The purpose of this study is to evaluate translucency and masking ability of translucent zirconia compared to conventional zirconia and lithium disilicate materials.

Materials and methods: Three types of zirconia blocks with different yttria contents (3Y, 4Y, 5.5Y) and LS blocks (Rosetta SM) were used. Ten specimens for each group were fabricated with 10 mm diameter, with both 0.8 mm and 1.5 mm thicknesses (± 0.02 mm). All groups of zirconia specimens were sintered and polished according to the manufacturer's instructions. To calculate the translucency parameter (TP), CIELAB value was measured with a spectrophotometer on black and white backgrounds. To investigate the color masking abilities, background shades of A2, normal dentin, discolored dentin, and titanium were used. The color difference (ΔE) was calculated with the CIELAB values of A2 shade background as a reference compared with the values in the various backgrounds. One-way ANOVA and Bonferroni tests were conducted (P < .05).

Results: The TP values of zirconia specimens increased as the yttria content increased. All materials used in the study were able to adequately mask normal dentin shade (ΔE < 5.5), but were incapable of masking severely discolored dentin (ΔE > 5.5). On the titanium background, all materials of 1.5 mm thickness were able to mask the background shade, but with a thickness of 0.8 mm, only 3Y-TZP and 4Y-PSZ were able to mask titanium background.

Conclusion: All zirconia materials and lithium disilicate specimens used in this study were unable to adequately mask the shade of severely discolored dentin. It is recommended to use 3Y-TZP or 4Y-PSZ with a sufficient thickness of 0.8 mm or more to mask titanium.

Purpose: The purpose of this study was to evaluate the influence of different palatal vault configurations on the accuracy and scan speed of intraoral scans (IO) of completely edentulous arches.

Materials and methods: Three different virtual models of a completely edentulous maxillary arch with different palatal vault heights-Cl I moderate (U-shaped), Cl II deep (steep) and Cl III shallow (flat)-were digitally designed using CAD software (Meshmixer; Autodesk, USA) and 3D-printed using SLA-based 3D-printer (XFAB; DWS, Italy) (n = 30; 10 specimens per group). Each model was scanned using intraoral scanner (Trios 3; 3Shape™, Denmark). Scanning time was recorded for all samples. Scanning accuracy (trueness and precision) were evaluated using digital subtraction technique using Geomagic Control X v2020 (Geomagic; 3DSystems, USA). One-way analysis of variance (ANOVA) test was used to detect differences in scanning time, trueness and precision among the test groups. Statistical significance was set at α = .05.

Results: The scan process could not be completed for Class II group and manufacturer's recommended technique had to be modified. ANOVA revealed no statistically significant difference in trueness and precision values among the test groups (P =.959 and P =.658, respectively). Deep palatal vault (Cl II) showed significantly longer scan time compared to Cl I and III.

Conclusion: The selection of scan protocol in complex cases such as deep palatal vault is of utmost importance. The modified, adopted longer path scan protocol of deep vault cases resulted in increased scan time when compared to the other two groups.

Purpose: Computer-aided design and manufacturing (CAD-CAM) of implant abutments has been shown to result in surface contamination from site-specific milling and fabrication processes. If not removed, these contaminants can have a potentially adverse effect and may trigger inflammatory responses of the peri-implant tissues. The aim of the present study was to evaluate the bacterial disinfection and cleaning efficacy of ultrasonic reprocessing in approved disinfectants to reduce the microbial load of CAD-CAM abutments.

Materials and methods: Four different types of custom implant abutments (total N = 32) with eight specimens in each test group (type I to IV) were CAD-CAM manufactured. In two separate contamination experiments, specimens were contaminated with heparinized sheep blood alone and with heparinized sheep blood and the test bacterium Enterococcus faecium. Abutments in the test group were processed according to a three-stage ultrasonic protocol and assessed qualitatively and quantitatively by determination of residual protein. Ultrasonicated specimens contaminated with sheep blood and E. faecium were additionally eluted and the dilutions were incubated on agar plates for seven days. The determined bacterial counts were expressed as colony-forming units (CFU).

Results: Ultrasonic reprocessing resulted in a substantial decrease in residual bacterial protein to less than 80 µg and a reduction in microbiota of more than 7 log levels of CFU for all abutment types, exceeding the effect required for disinfection.

Conclusion: A three-stage ultrasonic cleaning and disinfection protocol results in effective bacterial decontamination. The procedure is reproducible and complies with the standardized reprocessing and disinfection specifications for one- or two-piece CAD-CAM implant abutments.