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To evaluate two-body wear (2BW) and three-body wear (3BW) of different CAD/CAM and direct restorative materials against zirconia using a dual-axis chewing simulator and an ACTA wear machine.3 CAD-CAM resin-based composite or polymer infiltrated ceramic network blocs, 1 lithium disilicate CAD-CAM ceramic (LS2BW and 3BW have a different impact on material surfaces. Similar wear resistance was observed for direct and indirect resin based materials with analogous filler configurations in both methods. Bovine enamel exhibited the best wear resistance in 2BW, but the least wear resistance in 3BW against zirconia. Regarding 2BW, a direct/indirect composite material pair of the same manufacturer showed the significantly highest mean volume losses (2.72/2.85 mm³), followed by LSDental restorative materials behave differently in 2BW and 3BW laboratory testing. Vickers hardness testing alone cannot hold for a correlation with wear behavior of materials. Micromorphological investigation of material composition can reveal insights in wear mechanisms related to variations in filler technologies.

The relationship between fracture toughness and Yttria content in modern zirconia ceramics was revised. For that purpose, we evaluated here 10 modern Y2O3-stabilized zirconia (YSZ) materials currently used in biomedical applications, namely prosthetic and implant dentistry. The most relevant range between 2-5 mol% Y2O3 was addressed by selecting from conventional opaque 3 mol% YSZ up to more translucent compositions (4−5 mol% YSZs). A technical 2YSZ was used to extend the range of our evaluation. The bulk mol% Y2O3 concentration was measured by X-Ray Fluorescence Spectroscopy. Phase quantification by Rietveld refinement considered two tetragonal phases or an additional cubic phase. A first-account of the fracture toughness (KIc) of the pre-sintered blocks is given, which amounted to 0.4 – 0.7 MPa√m. In the fully-densified state, an inverse power-law behavior was obtained between KIc and bulk mol% Y2O3 content, whether using only our measurements or including literature data, challenging some established relationships. A linear relationship between KIc and the fraction of the transformable t-phase was established within the range of 30–70 vol%.

To carry out a morphometric analysis of small oval root canals prepared with different instruments (part 1) and filled with different sealers (part 2).Ninety extracted mandibular incisors with small oval root canals were instrumented with Self-Adjusting File (n = 45), XP-endo Finisher (n = 15), GentleFile (n = 15), or Reciproc (n = 15). All groups of part 1 were filled with AH Plus (n = 15 each). For part 2 (including group Self-Adjusting File/AH Plus) teeth instrumented with Self-Adjusting File were additionally filled with GuttaFlow Bioseal (n = 15) or Total Fill BC sealer (n = 15). All sealers were placed with a lentulo and filled with master point and additional points. Serial cuts were made at 1-mm intervals up to 10 mm. Total root canal area, percentage of gutta-percha filled area (PGFA), sealer, voids, and debris were evaluated using interactive image analysis software.Preparation with Reciproc caused significantly wider canals than with Self-Adjusting File, GentleFile, or XP-endo Finisher, but also resulted in the greatest PGFA and lowest percentage of sealer (P ≤ .05). Following XP-endo Finisher, the significantly greatest percentage of debris (30%) was found 1 mm from the apex (P ≤ .05). Regarding different sealers, only minor differences were found (GuttaFlow Bioseal: less percentage of sealer at 2 and 3 mm levels [P ≤ .05]).Within the limits of this study Reciproc caused the greatest substance loss, but also the most favorable PGFA. The apical debris accumulation with XP-endo Finisher needs further investigation. The sealers under investigation performed equally well.

Purpose Here we aimed to compare two machining strategies regarding the marginal strength of CAD/CAM materials using a hoop-strength test in model sphero-cylindrical dental crowns, coupled with finite element analysis. Materials and Methods Five CAD/CAM materials indicated for single posterior crowns were selected, including a lithium disilicate (IPS e.max® CAD), a lithium (di)silicate (Suprinity® PC), a polymer-infiltrated ceramic scaffold (Enamic®), and two indirect resin composites (Grandio® Blocs and Lava™ Ultimate). A sphero-cylindrical model crown was built on CAD Software onto a geometrical abutment and machined using a Cerec MC XL system according to the two available protocols: rough-fast and fine-slow. Specimens were fractured using a novel hoop-strength test and analyzed using the finite element method to obtain the inner marginal strength. Data were evaluated using Weibull statistics. Results Machining strategy did not affect the marginal strength of any restorative material tested here. Ceramic materials showed a higher density of chippings in the outer margin, but this did not reduce inner marginal strength. IPS e.max® CAD showed the statistically highest marginal strength, and Enamic® and Lava™ Ultimate were the lowest. Grandio® Blocs showed higher performance than Suprinity® PC. Conclusions The rough-fast machining strategy available in Cerec MC XL does not degrade the marginal strength of the evaluated CAD/CAD materials when compared to its fine-fast machining strategy. Depending on the material, resin composites have the potential to perform better than some glass-ceramic materials.

Objectives To investigate the impact of the interventionalist’s experience and gender on radiation dose and procedural time in CT-guided interventions. Methods We retrospectively analyzed 4380 CT-guided interventions performed at our institution with the same CT scanner from 2009 until 2018, 1287 (29%) by female and 3093 (71%) by male interventionalists. Radiation dose, number of CT fluoroscopy images taken per intervention, total procedural time, type of intervention, and degree of difficulty were derived from the saved dose reports and images. All 16 interventionalists included in this analysis performed their first CT-guided interventions during the study period, and interventions performed by each interventionalist were counted to assess the level of experience for each intervention in terms of the number of prior interventions performed by her or him. The Mann-Whitney U test (MWU test), multivariate regression, and linear mixed model analysis were performed. Results Assessment of the impact of gender with the MWU test revealed that female interventionalists took a significantly smaller number of images (p < 0.0001) and achieved a lower dose-length product per intervention (p < 0.0001) while taking more time per intervention (p = 0.0001). This finding was confirmed for most types of interventions when additionally accounting for other possible impact factors in multivariate regression analysis. In linear mixed model analysis, we found that radiation dose, number of images taken per intervention, and procedural time decreased statistically significantly with interventionalist’s experience. Conclusions Radiation doses of CT-guided interventions are reduced by interventionalist’s experience and, for most types of interventions, when performed by female interventionalists. Key Points • Radiation doses in CT-guided interventions are lower when performed by female interventionalists. • Procedural times of CT-guided interventions are longer when performed by female interventionalists. • Radiation doses of CT-guided interventions decrease with the interventionalist’s experience.

The present study investigated the influence of simulated intraoral conditions (increased temperature and humidity) on two different surface pretreatment methods to repair a lithium-disilicate glass-ceramic (LDS).A total of 540 rectangular lithium-disilicate glass-ceramic bars were manufactured (3 x 7 x 9 mm; IPS e.max CAD, Ivoclar Vivadent). Further specimen preparation was performed in an incubator with controlled relative humidity (RH) and temperature to simulate three different environmental settings: laboratory conditions (LC, n = 180, 23°C, 50% RH), rubber-dam conditions (RC, n = 180, 30°C, 50% RH) or oral conditions (OC, n = 180, 32°C, 95 ± 5% RH). One-third of the bars under each condition (n = 60) were grit blasted (GBL) with alumina (35 µm at 1 bar pressure for 10 s and a working distance of 4 ± 1 cm) and primed (60 s, Monobond Plus, Ivoclar Vivadent). Another third (n = 60) were pretreated with a self-etching glass-ceramic primer (MEP, Monobond EtchPrime, Ivoclar Vivadent). One group without surface pretreatment (n = 60, NoPT) served as a control. All pretreated surfaces were coated with Heliobond (Ivoclar Vivadent). Two bars from the same pretreatment method were luted perpendicular to each other with a resin composite to form a square adhesion area of 9 mm2 (TetricEvo Ceram, Ivoclar Vivadent), and light cured for 20 s on each side (1200 mW/cm2, Bluephase 20i, Ivoclar Vivadent). All specimens were stored for 24 h in distilled water at 37°C. Half of the specimens from each environmental setting and pretreatment method (n = 15) were thermocycled (TC, 5000 cycles, 5/55°C, 30-s dwell time), and tensile bond strength (TBS) testing was performed for all groups using an x-bar rope-assisted set-up. Data were statistically analyzed using two-way ANOVA (a = 0.05) with Bonferroni adjustment.Regardless of the environmental and storage conditions (24 h or TC), MEP showed a significantly higher mean TBS than GBL. A decrease in TBS was recorded in specimens under OC compared to RC and LC for both pretreatment methods independent of the storage condition. No significant difference in mean TBS was found between RC and LC within the MEP pretreatment group for the 24 h stored and thermocycled specimens. For all MEPs and GBLs, TC reduced the mean TBS in all environmental conditions. The NoPT groups showed no adhesion regardless of environmental or storage conditions.Increased temperature and high humidity significantly reduced TBS. However, MEP was less sensitive to environmental influences than GBL, which makes it a promising candidate for intraoral ceramic repair. These findings suggest that clinical intraoral repair of lithium-disilicate glass-ceramics should be performed using a rubber-dam, primarily when using GBL.

Lithium disilicate glass-ceramic (LS2) can be biomimetically textured by crystal orientation, mimicking the microstructure of dental enamel and inducing anisotropic mechanical responses to crack growth. The deliberate texturization of LS2 plays to the clinical advantage of reinforcing weak sites of typical fracture initiation in dental prosthetic constructs. Similar to enamel, adhesion of biomimetically textured LS2 could also show anisotropic behavior. Therefore, tensile bond strength (TBS) before and after thermocycling (TC) and interfacial characterization of biomimetically textured LS2 (parallel (PAR) or perpendicular (PER) crystal orientation) after different pre-treatment modes (hydrofluoric acid etching (HFE), grit blasting (GBL) and self-etching glass-ceramic primer (SGP)) were investigated. TC reduced significantly TBS for all specimens except for GBL. Biomimetic textured LS2 after HFE showed anisotropic behavior regarding adhesion. Crystal orientation reduced TBS for the PER HFE specimens after TC significantly. In general, the TBS of HFE specimens was still higher or not significantly lower compared to other pre-treatment modes like GBL or SGP. For the GBL and SGP specimens, crystal orientation had no influence on TBS and interfacial characteristics. In contrast HFE specimens showed different interfacial characteristics depending if they were PAR or PER texturized. Based on these findings, HFE of biomimetic textured LS2 can be recommended. For bonding, the PAR orientation is recommended as its adhesion potential is less prone to degrade.

As a predominantly lithium-metasilicate-containing glass-ceramic, Obsidian® (Glidewell Laboratories, USA) has a peculiar composition and microstructure among other dental lithium silicates, warranting an evaluation of the crystallization process to establish relationships between microstructural evolution and mechanical properties. Blocks of the pre-crystallized material were processed into slices measuring 12 × 12 × 1.5 mm

The relationship between fracture toughness and Yttria content in modern zirconia ceramics was revised. For that purpose, we evaluated here 10 modern Y2O3-stabilized zirconia (YSZ) materials currently used in biomedical applications, namely prosthetic and implant dentistry. The most relevant range between 2-5 mol% Y2O3 was addressed by selecting from conventional opaque 3 mol% YSZ up to more translucent compositions (4-5 mol% YSZs). A technical 2YSZ was used to extend the range of our evaluation. The bulk mol% Y2O3 concentration was measured by X-Ray Fluorescence Spectroscopy. Phase quantification by Rietveld refinement are supplied by considering only two tetragonal phases or an additional improbable cubic phase. A first-account of the fracture toughness (KIc) of the partly-sintered materials is given, which amounted to 0.4 – 0.7 MPaÖm. In the fully-densified state, an inverse power-law behavior was obtained between KIc and bulk mol% Y2O3 content, whether using only our measurements or including literature data, challenging some established relationships.

pObjectives: The aim of this study was to carry out a morphometric analysis of small oval root canals filled with GuttaFlow 2 sealer (Coltène/Whaledent) using different methods of sealer placement and different root canal filling techniques.br /Method and materials: Eighty extracted mandibular incisors with small oval root canals were instrumented with the Self-Adjusting File (Redent Nova). GuttaFlow 2 was placed using a lentulo spiral, paper point, master point, or sonically activated CanalBrush (Coltène/Whaledent), followed by the placement of a master point and accessory points (M?P+) (part 1). GuttaFlow 2 was placed using a lentulo spiral without a gutta-percha point, together with a single point, with a chloroform-dipped master point, or the latter with accessory points (ChMP+) (part 2). Serial cuts were made at 1-mm intervals up to 10nbsp;mm. The percentages of gutta-percha filled area (PGFA), sealer, voids, and debris were evaluated using interactive image analysis software.br /Results: For part 1 of the study (sealer placement), significant differences regarding PGFA at 2 and 5nbsp;mm from the apex were found, whereas for part 2 (filling technique), significant differences were found at all levels besides 2 and 4nbsp;mm (Kruskal-Wallis test, Pnbsp;=nbsp;.05). ChMP+ reached 85% PGFA at 3nbsp;mm from the apex, but only 30% near the apex. The MP+ groups showed a relatively equal distribution of PGFA by 60% to 80% at different levels. GuttaFlow 2 without a gutta-percha point exhibited significantly more voids and debris than the other groups (Kruskal-Wallis test, Pnbsp;=nbsp;.05).br /Conclusion: Within the limits of this study, MP+ could be recommended for clinical use. The presence of voids and debris for the group without a gutta-percha point needs further investigation./p.

Objective To investigate the influence of pre-heating different classes of dental resin composites on viscosity and stickiness at five different temperatures. Methods Six flowable, five conventional packable, and one thermo-viscous bulk-fill resin composites were heated up to 54 °C in a plate-plate rheometer to determine their complex viscosity. Normal force measurements were carried out for the six packable materials to determine the unplugging force and unplugging work (stickiness) over the same temperature range. Data were analyzed using Kolmogorov–Smirnoff test, one-way ANOVA and Tukey Post Hoc test with α = 0.05 as level of significance. Results At 23 °C packable composites showed viscosity between 6.75 and 19.14 kPa s, while flowable composites presented significantly lower viscosities between 1.31 and 2.20 kPa s. Pre-heating led to a drop of 30–82% in the viscosity of packable materials. The thermo-viscous material dropped to the level of flowables at 45 and 54 °C thus behaving as a packable composite at room temperature with flowable-like viscosity at higher temperatures. No statistically significant differences for viscosity were observed among flowable composites at any temperature. The unplugging force decreased for packable composites, while their unplugging work generally increased at elevated temperature. At 23 °C unplugging force was measured between 7.50 and 19.18 N, while pre-heating up to 54 °C led to values between 2.9 and 6.2 N. Regarding unplugging work at 23 °C the calculated values were between 3.0 and 8.9 × 10−3 J and at 54 °C between 8.8 and 13.0 × 10−3 J. Significance Pre-heating significantly reduced viscosity of highly viscous resin composites, while no influence was shown for flowable composites. In general stickiness, measured as unplugging work, increased at elevated temperatures. The thermo-viscous material showed low viscosity comparable to flowable composites at 45 and 54 °C, yet its stickiness did not increase significantly compared to the values at 23 °C.

The aim of this study was to evaluate the risk of pneumothorax and need for chest tube insertion in CT-guided lung biopsies and identify predictors focusing on pulmonary emphysema determined with quantitative computed tomography. To that end, we retrospectively analysed the incidence of pneumothorax and chest tube insertion in 371 CT-guided lung biopsies with respect to the quantitative emphysema score determined with the density mask technique. Other possible impact factors considered were lesion diameter, length of biopsy pathway within the lung parenchyma, lung lobe, needle size, puncture technique, patient positioning and interventionalist’s level of experience. Quantitative emphysema scores of the lung were significantly higher in patients who developed instant pneumothorax (27%, p

The testing of fracture toughness becomes problematic when only limited amount of material is available that hinders the production of typical beam specimens to be tested in bending. Here we explore fracture toughness testing methodologies that allow for small discs and plates having surface cracks to be tested in biaxial flexure using the Ball-on-3-balls (B3B) set-up, or sawed notches as in the Compact Tension geometry. The B3B-KIc test has shown to be versatile and account for a very small overestimation of the KIc-value in the order of 0.8–1.25% due to in-plane crack mispositioning, and a maximum of 4% if a worst-case scenario of additional out-of-plane mispositioning is assumed. The geometrical factor in the standard SCF method, derived by Newman and Raju, resulted in an overestimation of ∼8% of the KIc-value compared to the new calculation by Strobl et al. for materials with Poisson’s ratio

The aim of the study was to evaluate the mechanical stability of bisphenol A-glycidyl methacrylate (Bis-GMA) and Ormocer-based resin composites before and after water absorption and to examine water saturation. Disc-shaped specimens of the Bis-GMA (Grandio SO, Voco) and the Ormocer-based (Admira Fusion, Voco) dental resin composites were produced, stored in water, and weighed after pre-determined times to measure the absorbed water. Bend bars were produced and stored for 24 h in dry conditions as well as in distilled water for 14 days or 60 days at 37 °C. The initial flexural strength (FS) under quasi-static loading and flexural fatigue strength (FFS) under cyclic loading were determined under 4-point bending. Fracture toughness (KIc) of both composites was measured using the single-edge-V-notch-beam (SEVNB) technique after the same storage conditions under 3-point bending. Within the first 14 days, storage conditions did not affect the initial FS of Grandio SO, while a significant drop in initial FS was observed for Admira Fusion after 2 weeks in water and most of the water was absorbed within this time. FFS for the Bis-GMA composite was not reduced before 2 months in water, whereas for the Ormocer®-based composite, there has been a significant decrease in strength after cyclic fatigue already at 2 weeks of water storage. KIc of Admira Fusion decreased significantly after both storage periods, while KIc of Grandio SO decreased only significantly after 2 weeks of water storage. All mechanical properties of the Bis-GMA composite were superior to those of the Ormocer®-based material, except water sorption. Water storage seems to have a much more pronounced effect on the mechanical properties of Ormocer®-based dental composites in comparison to Bis-GMA-based composites.

Lithium disilicate glass-ceramics show great potential in the fabrication of anisotropic structures due to their high-strength needle-form crystalline phase subjective to processing-induced alignment. Here we explore this strategy by focusing on the mechanistic aspects of fracture. Through different variations of the fracture toughness test we demonstrate the effect of bulk crystal orientation on fracture energy, toughening mechanisms, crystal size and aspect ratio. Using the anisotropic Poisson's ratio of the Li2Si2O5 crystal phase obtained by Resonant Ultrasound Spectroscopy, we apply the new geometry factor developed by Strobl et al. to provide a more accurate insight into the anisotropic crack propagation behavior in LS2 glass-ceramics. Raman spectra and X-Ray Diffraction patterns are resolved for the Li2Si2O5 phase aligned at plane parallel, anti-plane and random orientations. We show that Li2Si2O5 crystallites oriented perpendicular to the crack growth plane tended to induce large scale crack deflection unless the crack was forced into a straight path, thereby promoting crystallite fracture, increased KIc-values and accentuated R-curve behavior. Crystal aspect ratio and residual stresses in the glass have been identified as important influencing factors on crack growth behavior and toughening mechanisms.

As a predominantly lithium-metasilicate-containing glass-ceramic, Obsidian® (Glidewell Laboratories, USA) has a peculiar composition and microstructure among other dental lithium silicates, warranting an evaluation of the crystallization process to establish relationships between microstructural evolution and mechanical properties. Blocks of the pre-crystallized material were processed into slices measuring 12 × 12 × 1.5 mm3 and subjected to the mandatory crystallization firing by interruption the heating ramp at temperatures between 700 °C and 820 °C (dwell time between 0 min and 10 min). The crystallization peaks of the base and the pre-crystallized glass were obtained by differential scanning calorimetry (DSC). The coefficient of thermal expansion and the glass transition temperature were derived from differential thermal analysis (DTA). X-ray diffraction (XRD) was performed to quantify and characterize the crystal phase fraction, whose microstructural changes were visualised using FE-SEM. The ball-on-three-balls surface crack in flexure method was used to track the evolution of fracture toughness. The microstructural evolution during crystallization firing was characterized by two regimes of growth: (i) the progressive revitrification (dissolution) of the 5 μm-sized Li2SiO3 polycrystals manifested at the boundaries of nanometric single coherent scattering domains (CSDs); (ii) the non-isothermal period is marked by an Ostwald ripening process characterized by the growth of the single crystalline structures into 0.5 μm polycrystals. The decrease in the crystal fraction of Li2SiO3 crystals from 41 vol.% to 37 vol.% is accompanied by the formation of a small amount of Li3PO4 (6 vol.%), maintaining the total crystal phase fraction mostly constant. The KIc accompanied the reverse trend of crystallinity, departing from 1.63 ± 0.02 MPa√m at the pre-crystallized stage to 1.84 ± 0.06 MPa√m after 10 min at 820 °C in a linear trend. Toughening appeared counter-intuitive in view of the decreasing crystal fraction and size, to rather relate to the relaxation of the residual stresses in the interstitial glass due to the spheroidization of the initially anisotropic, elongated Li2SiO3 crystals into round, nearly equiaxed particles, as let suggest from the disappearance of the extensive microcracking.

The aim of the present laboratory study was to mechanically characterize the interface between two dental resin-based composite (RBC) increments, and to investigate if elevated temperatures have an influence on the quality of the interface mimicking clinical filling procedure. Four RBCs (CLEARFIL MAJESTY™ Posterior, Kuraray (CMP)/Filtek™ Supreme XTE, 3M (FSX)/Grandio®SO, VOCO (GSO)/VisCalor® bulk, VOCO (VCB)) were tested with a fracture toughness test using Chevron notched beams (KI,CNB) at 23, 37 and 54 °C. KI,CNB specimens (3 × 4x25mm) with a V-shaped notch at the incremental interface were loaded until failure in a 4-point bending set-up. Failure modes were characterized using light microscopy, microstructural interface was analyzed using SEM. Statistical analysis was performed using Kolmogorov-Smirnoff test, two-way ANOVA and Tukey Post-Hoc test (p = 0.05). Mean KI,CNB ranged between 0.73 ±0.14 MPam0.5 (VCB, 23 °C) and 1.11 ± 0.11 MPam0.5 (FSX, 23 °C). The tested conventional highly filled RBCs presented fracture toughness at the incremental interface comparable to the cohesive strength of the bulk materials. VCB showed reduced interfacial fracture toughness at 23 and 37 °C, but performed well at elevated temperature of 54 °C.

Here we use the 3-point bending with eccentric notch test (3-PBEN) to investigate the fracture behavior of a pressable and a CAD/CAM lithium disilicate (LS2) glass-ceramics under combined mode-I and mode-II loading. The effect of the bulk texturization in the beams of the pressable LS2 is made visible through the fracture trajectory following the most energetically favorable path dictated by the crystallite alignment. The CAD/CAM LS2 shows an isotropic fracture mode but increasing fracture energy with mode-II contribution, similar to the pressable variant.

Objective Due to past failures of orthopedic 3Y-TZP femoral implants linked to accelerated tetragonal-to-monoclinic phase transformation (t → m), the susceptibility to ‘low-temperature degradation’ or ‘ageing’ of 3Y-TZP has been advertised as detrimental to its long-term structural stability. However, no systematic mechanistic experiments on the fatigue resistance of aged 3Y-TZP under cyclic loading can support such statement. In this study, we aim to clarify this issue. Methods Here we evaluate the subcritical crack growth behavior of 3Y-TZP under cyclic loading after 0–50 h of accelerated ageing in an autoclave at 134 °C. The same 3Y-TZP sintered at two different temperatures (1450 °C or 1650 °C) allows for the comparison of materials containing grains with different susceptibilities to transformation. The volume fraction of surface transformed grains was measured using Raman spectroscopy, and the depth of the transformed surface layer from trenches milled with a Focus-Ion Beam. The fracture toughness before and after ageing was determined using the Chevron-notch Beam method. The quasi-static flexural strength was measured in dry conditions and the cyclic lifetime in water at 10 Hz and R-ratio = 0.3 in 4-point-bending at different applied stresses. The fatigue parameter n was derived from 3 different methods, namely S N curves, crack velocity plots and Weibull distributions. Results The progression of transformation showed linear kinetics with higher rates for the 3Y-TZP sintered at 1650 °C. Accelerated transformation induced severe crack formation within the transformed layer with parallel orientation to the surface plane, which supposedly behaved as the critical crack size population governing fracture. The stress intensity factor within the transformed layer was increased due to compressive stresses. Consequently, the fatigue parameter n increased consistently from 5 to 50 h of ageing, regardless of the derivation method, suggesting an increased resistance against crack growth during cyclic loading in bending. Significance Our results do not support the long suggested negative clinical implications of LTD regarding mechanical performance, to the contrary, LTD seems to increase the resistance against subcritical crack growth in a humid environment in bending.

To investigate the tensile bond strength of silane-containing universal adhesives and self-etch glass-ceramic primer to lithium disilicate glass ceramics (LS2).960 rectangular LS2 bars (7 mm x 3 mm x 9 mm, IPS e.max CAD, Ivoclar Vivadent) were manufactured and divided into 4 groups (n = 240). Group 1 was etched with ~5% hydrofluoric acid (HF) for 20 s (VITA Ceramics Etch, Vita Zahnfabrik), group 2 was etched with ~5% HF for 20 s and silanized (ESPE Sil, 3M Oral Care), group 3 was pre-treated with a self-etching glass-ceramic primer (Monobond EtchPrime, Ivoclar Vivadent, and group 4 received no pre-treatment. Three universal adhesives (iBOND Universal, Heraeus Kulzer; Scotchbond Universal Adhesive, 3M Oral Care; Futurabond U, Voco) were applied to the differently pre-treated surfaces, with Heliobond (Ivoclar Vivadent) serving as control. The bars from each group were paired and luted perpendicularly, forming a square bonded area of 9 mm2, using Variolink II (Ivoclar Vivadent) with a constant pressure of 10 N, followed by light curing (40 s at 800 mW/cm2, Elipar Trilight, 3M Oral Care). The resulting specimens were stored for 24 h at 37°C in distilled water. Half of the specimens of each group were submitted to tensile bond strength testing, the other half were thermocycled ([TC] 5000 cycles, 5°C/55°C, 30-s dwell time) before testing. Data were analyzed using three-way ANOVA (α = 0.05).Group 2 (HF etched and silanized) and group 3 (self-etching glass-ceramic primer) reached significantly higher mean bond strengths than did groups 1 (only HF etched) and 4 (no pre-treatment).Additional silanization of HF-etched LS2 statistically signficantly improved the tensile bond strength of the silane-containing universal adhesive (Scotchbond Universal). The self-etching glass-ceramic primer Monobond EtchPrime achieved mean bond strengths that did not differ significantly from HF-etched and silanized specimens.

We investigate here the crystallization kinetics of two pre-crystallized multicomponent dental glass-ceramics (IPS e.max® CAD, Ivoclar-Vivadent; Suprinity® PC, Vita Zahnfabrik) by interrupting the heat treatment at different periods of the non-isothermal and isothermal stage at 840°C. Differential scanning calorimetry (DSC) was used to characterize the crystallization peaks of the pre-crystallized and the base glass, and dilatometry was used to determine the coefficient of thermal expansion and Tg after different times at the maximum temperature. The evolution of crystallinity was tracked by XRD, while the evolution of fracture toughness was obtained by the ball-on-three-balls surface crack in flexure method. The change in microstructural features was made visible using FE-SEM. We show that the isothermal stage is dominated by the transformation of Li2SiO3 in Li2Si2O5, inducing the impingement of nanocrystals into clusters. The residual glass became thereby less polymerized. The kinetics of toughening followed closely the evolution of crystallinity in both systems.

Objective Strength is one of the preferred parameters used in dentistry for determining clinical indication of dental restoratives. However, small dimensions of CAD/CAM blocks limit reliable measurements with standardized uniaxial bending tests. The objective of this study was to introduce the ball-on-three-ball (B3B) biaxial strength test for dental for small CAD/CAM block in the context of the size effect on strength predicted by the Weibull theory. Methods Eight representative chairside CAD/CAM materials ranging from polycrystalline zirconia (e.max ZirCAD, Ivoclar-Vivadent), reinforced glasses (Vitablocs Mark II, VITA; Empress CAD, Ivoclar-Vivadent) and glass-ceramics (e.max CAD, Ivoclar-Vivadent; Suprinity, VITA; Celtra Duo, Dentsply) to hybrid materials (Enamic, VITA; Lava Ultimate, 3M ESPE) have been selected. Specimens were prepared with highly polished surfaces in rectangular plate (12 × 12 × 1.2 mm3) or round disc (O = 12 mm, thickness = 1.2 mm) geometries. Specimens were tested using the B3B assembly and the biaxial strength was determined using calculations derived from finite element analyses of the respective stress fields. Size effects on strength were determined based on results from 4-point-bending specimens. Results A good agreement was found between the biaxial strength results for the different geometries (plates vs. discs) using the B3B test. Strength values ranged from 110.9 MPa (Vitablocs Mark II) to 1303.21 MPa (e.max ZirCAD). The strength dependency on specimen size was demonstrated through the calculated effective volume/surface. Significance The B3B test has shown to be a reliable and simple method for determining the biaxial strength restorative materials supplied as small CAD/CAM blocks. A flexible solution was made available for the B3B test in the rectangular plate geometry.

SUMMARY Purpose The aim of this in vitro study was 1) to analyze the influence of a double-layer application technique of four one-step self-etch adhesive systems on dentin and 2) to determine its effect on the stability of the adhesive interfaces stored under different conditions. Materials and Methods Four different one-step self-etch adhesives were selected for the study (iBondSE, Clearfil S3 Bond, XenoV+, and Scotchbond Universal). Adhesives were applied according to manufacturers' instructions or with a double-layer application technique (without light curing of the first layer). After bonding, resin-dentin specimens were sectioned for microtensile bond strength testing in accordance with the nontrimming technique and divided into 3 subgroups of storage: a) 24 hours (immediate bond strength, T0), b) six months (T6) in artificial saliva at 37°C, or c) five hours in 10 % NaOCl at room temperature. After storage, specimens were stressed to failure. Fracture mode was assessed under a light microscope. Results At T0, iBond SE showed a significant increase in microtensile bond strength when the double-application technique was applied. All adhesive systems showed reduced bond strengths after six months of storage in artificial saliva and after storage in 10% NaOCl for five hours; however at T6, iBond SE, Clearfil S3 Bond, and XenoV+ showed significantly higher microtensile bond strength results for the double-application technique compared with the single-application technique. Scotchbond Universal showed no difference between single- or double-application, irrespective of the storage conditions. Conclusion The results of this study show that improvements in bond strength of one-step self-etch adhesives by using the double-application technique are adhesive dependent.

Rapid Layer Technology (RLT) uses computer-aided design/computer-aided manufacturing (CAD/CAM) to manufacture a veneer layer that is adhesively bonded to the zirconia framework, avoiding firing steps during the fabrication process and thus preventing build-up of residual stresses. This work studied, using sliding contact fatigue, the in vitro lifetime of restorations produced using RLT compared with restorations produced using conventional veneering techniques. Zirconia copings were veneered with a conventional hand-layering method (VM9) using a fast (n = 16) or a slow (n = 16) cooling protocol, or with RLT. For the latter, the veneers were CAD/CAM fabricated using a feldspathic reinforced-glass (Vitablocs Mark II; n = 16) or a polymer-infiltrated reinforced-glass network (Enamic; n = 16) and adhesively bonded to the zirconia frameworks. Crowns thus obtained were submitted to sliding contact fatigue against a steatite indenter in a chewing simulator until failure. A Kaplan-Meier survival analysis was conducted. None of the hand-layered restorations survived after a 2 × 106 -cycle interval, whereas no fractures in the RLT groups were observed. Vitablocs Mark II veneers survived for a longer testing period (3.5 × 106 cycles) than their Enamic counterparts (2.5 × 106 cycles) owing to their superior wear behavior. The RLT represents an efficient method to veneer zirconia frameworks by reducing processing steps and, more importantly, increasing the lifetime of the restorations.

Processing-induced alignment of Li2Si2O5 crystals in biomedical lithium disilicate glass-ceramics have been shown to increase the monotonic resistance to fracture and better simulate the mechanical behavior of natural dental tissues. The (mis)orientation of the [001] direction in the Li2Si2O5 crystal phase relative to the crack growth plane was induced by injection-molding of a high aspect ratio composition in order to determine the effect of crystal alignment. The role of particulate geometry was assessed by comparing two compositions having randomly oriented Li2Si2O5 crystals of similar phase fraction but dissimilar crystal aspect ratios. Static and cyclic fatigue experiments in varying frequencies and R-ratios were conducted to clarify the degradation of crack bridging mechanisms induced by the crystal phase during repetitive opening and closure of the crack faces. Both crystal alignment and aspect ratio showed to play important roles in affecting the subcritical crack growth resistance the lifetime of lithium disilicate biomedical components.

Most dental ceramics are produced from partially crystallized glass. Even though these materials are hard, they are extremely susceptible to damage, especially due to the glass phase content. A strategy for strengthening these materials makes use of their microstructure to form reinforcing sites within the structural design. Such approach has potential for application with lithium disilicate (LS 2 ) glass–ceramics, which contain needle-form Li 2 Si 2 O 5 crystals that deflect oncoming cracks. By press injection of the glass melt through specifically oriented injection channels, crystals are aligned in patterns that lead to high mechanical anisotropy. Here we apply this approach in the context of monolithic dental bridges simulated by beams under 3-point bending. Notches at different distances from the midspan play the role of connectors, and the mixed-mode fracture toughness is measured at varying positions for a LS 2 and a 3Y-TZP material. A strong anisotropic fracture behavior is obtained with the LS 2 glass–ceramic through local crystal alignment, leading to fracture energies higher than for the isotropic 3Y-TZP ceramic. Further, the anisotropic nature of the LS 2 microstructure is successfully reproduced in dental bridge geometries, validating the use of bending beams for the study of the mechanical behavior of ceramic dental bridges.

GuttaFlow2 is a further development of the silicone sealer GuttaFlow, exhibiting a stiffer consistency. This is intended to overcome possible problems regarding retention of the apical part of the root canal filling when preparing for a fiber post. GuttaFlow2 is delivered within a capsule, like GuttaFlow, or within an automix syringe. This study compared apical dye leakage of GuttaFlow2 in comparison to GuttaFlow and AH Plus. The null hypothesis tested was that different sealers exhibited similar microleakage. Material and methods: Seventy extracted human lower premolars with fully mature apices were root canal prepared to 45/.04 and divided into seven groups: group 1: AH Plus sealer, group 2: “normal” setting GuttaFlow, group 3: “fast” setting GuttaFlow, group 4: GuttaFlow2 within a capsule, group 5: GuttaFlow2 within an automix syringe, group 6: positive control, group 7: negative control (n = 10 each). Root canals were filled with sealer (except group 7) and a master gutta-percha cone size 40/.04 using the non-compaction technique. A dye penetration test was carried out by centrifugation for 3 min at 30 G within 5 % methylene blue dye. Linear dye penetration was recorded. Statistical evaluation was carried out with IBM SPSS 19.0 (α = 0.05). Results: The positive control was significantly different from all other groups (ANOVA, p < 0.001; Student-Newman-Keuls post-hoc test p < 0.05). When the control groups were disregarded, no significant differences were apparent. Groups 1 to 5 showed low leakage values when compared with results of earlier studies using a similar methodology. Conclusion: All sealers tested exhibited low dye leakage values.

Objectives The present study evaluated the effect of the coefficient of thermal expansion (CTE) mismatch and the cooling protocol on the distribution of residual stresses and crack propagation in veneered zirconia bilayers. Methods Ceramic discs with two different CTEs (Vita VM9 and Lava Ceram) were fired onto zirconia plates and cooled following a slow (0.5 °C/s) or a fast (45 °C/s) cooling protocol. The residual stress distribution throughout the veneer thickness was assessed by means of depth-wise Vickers indentation after sequentially sectioning the bilayers parallel compared to normal to the interface. A mathematical solution for the residual stress distribution was used as reference. Additionally, Hertzian cone crack propagation in the veneers was induced by cyclic contact loading and measured at different number of cycles to estimate the crack growth rate. Results The higher CTE mismatch of the VM9 group generated an important stress gradient with high compressive residual stresses near the interface, hindering the crack propagation. The low CTE mismatch group (Lava Ceram) developed only a slight stress gradient and higher cone crack growth rates. No differences were observed between the two cooling protocols applied regarding stress magnitude and crack propagation behavior. Significance The CTE mismatch has a predominant role in the generation of residual stress gradients within the veneer, which directly influences contact-induced crack propagation. Based on the results, the cooling protocol had no significant effect on the residual stress distribution in zirconia-veneer bilayers.

The oral cavity with the teeth and the surrounding gingival epithelium, the periodontium, the salivary glands and other structures are open to the oral environment and thus exposed to multiple microbiological and pathogenic influences. To prevent permanent inflammatory processes such as gingivitis or periodontitis an efficient defense system is essential to ensure healthy and physiological function of the oral cavity and other interacting organic systems. Surfactant proteins (SPs), originally found in pulmonary tissue are important factors of the immune system and beyond this, support the stability and rheology of gas or fluid interfaces. This study aimed to analyze the distribution of surfactant proteins by means of Western blot and immunohistochemistry in salivary glands as well as in healthy and pathological saliva. The different expression patterns of SP-A, -B, -C and -D in healthy and pathological (periodontitis) saliva were determined using ELISA quantification. One further objective of the study was the first detection of two recent discovered proteins belonging to the surfactant protein family within human salivary glands and saliva. The results of the study reveal differences in protein expression of SP-A, -B, -C and -D within healthy and pathologic saliva. The concentration of the surfactant proteins SP-A, SP-C and SP-D is increased in saliva of people suffering from periodontal diseases, whereas by contrast, SP-B shows an opposite expression pattern. Furthermore, the results evidence the presence of SP-G and SP-H within saliva and salivary glands for the first time.

Objectives Chemical and mechanical degradation play a key role on the lifetime of dental restorative materials. Therefore, prediction of their long-term performance in the oral environment should base on fatigue, rather than inert strength data, as commonly observed in the dental material’s field. The objective of the present study was to provide mechanistic fatigue parameters of current dental CAD/CAM materials under cyclic biaxial flexure and assess their suitability in predicting clinical fracture behaviors. Methods Eight CAD/CAM materials, including polycrystalline zirconia (IPS e.max ZirCAD), reinforced glasses (Vitablocs Mark II, IPS Empress CAD), glass-ceramics (IPS e.max CAD, Suprinity PC, Celtra Duo), as well as hybrid materials (Enamic, Lava Ultimate) were evaluated. Rectangular plates (12 × 12 × 1.2 mm3) with highly polished surfaces were prepared and tested in biaxial cyclic fatigue in water until fracture using the Ball-on-Three-Balls (B3B) test. Cyclic fatigue parameters n and A* were obtained from the lifetime data for each material and further used to build SPT diagrams. The latter were used to compare in-vitro with in-vivo fracture distributions for IPS e.max CAD and IPS Empress CAD. Results Susceptibility to subcritical crack growth under cyclic loading was observed for all materials, being more severe (n ≤ 20) in lithium-based glass-ceramics and Vitablocs Mark II. Strength degradations of 40% up to 60% were predicted after only 1 year of service. Threshold stress intensity factors (Kth) representing the onset of subcritical crack growth (SCG), were estimated to lie in the range of 0.37–0.44 of KIc for the lithium-based glass-ceramics and Vitablocs Mark II and between 0.51–0.59 of KIc for the other materials. Failure distributions associated with mechanistic estimations of strength degradation in-vitro showed to be useful in interpreting failure behavior in-vivo. The parameter Kth stood out as a better predictor of clinical performance in detriment to the SCG n parameter. Significance Fatigue parameters obtained from cyclic loading experiments are more reliable predictors of the mechanical performance of contemporary dental CAD/CAM restoratives than quasi-static mechanical properties.

Here we use the 3-point bending with eccentric notch test (3-PBEN) to investigate the fracture behavior of a pressable and a CAD/CAM lithium disilicate (LS

Wear resistance is an important property of the dental materials, particularly for large restorations in the posterior regions and for the patients suffering from parafunctional activities. Additionally, the wear resistance of flowable composite resin materials is a clinical concern, although they are popular among dentists because of their easy handling. The aims of the present study were to evaluate the wear resistance of nine composite resins both condensable (G-aenial posterior, Venus, GrandioSO, Tetric EvoCeram, Ceram X duo, Filtek Supreme XTE) and new-generation flowable resin composites (G-aenial Universal Flo, GrandioSO Flow and GrandioSO Heavy Flow) and to compare these results with amalgam. Eight specimens of each material were subjected to two-body wear tests, using a chewing simulator. The wear region of each material was examined under profilometer, measuring the vertical loss (μm) and the volume loss (mm3) of the materials. Additionally, SEM analysis was performed to assess surfaces irregularities. The results showed significant difference of the vertical loss and the volume loss of the examined materials (p

This was to evaluate the wear resistance of different materials, compomers, resin-modified glass ionomer cements (RMGICs), glass ionomer cements (GICs), used for posterior restorations in primary teeth and to compare the results with the reference material, amalgam. Eight specimens of each material were subjected to two-body wear test, using a chewing simulator. The wear region of each material was examined under a profilometer, measuring the vertical loss (μm) and the volume loss (mm3) of the materials. The results showed significant differences of vertical loss and volume loss of the test materials (p

Objectives The aim of this study was to compare the microtensile bond strength (μTBS) and resin penetration into dentine of three universal adhesives (UAs) applied in two different etching modes (i.e. self-etch or etch-and-rinse). The effect of thermocycling on the μTBS was also evaluated. Methods The occlusal third of sound human molars was removed and the exposed surfaces were treated with three UAs (Futurabond Universal, Scotchbond Universal Adhesive and All-Bond Universal) in self-etch or etch-and-rinse mode. Two one-step self-etch adhesives (Futurabond DC and Futurabond M) were applied on additional teeth as reference. After composite build up, the specimens were stored for 24 h in distilled water at 37 °C or thermocycled for 5000 cycles. Composite/dentine beams were prepared (1 mm 2 ) and μTBS test was performed. Data was analyzed using three-way ANOVA and Tukey's test ( α = 0.05). One additional tooth was prepared for each group for evaluation of infiltration ability into dentine by dyeing the adhesives with a fluorochrome (Rhodamine B). After longitudinal sectioning, the generated interfaces were examined under confocal laser scanning microscopy. Results The addition of an etching step did not significantly affect the μTBS of none of the UAs, when compared to their self-etch application mode. All pre-etched specimens showed considerably longer resin tags and thicker hybrid layers. Thermocycling had no significant effect on the μTBS of the UAs. Conclusions Application of an etching step prior to UAs improves their dentine penetration, but does not affect their bond strength to dentine after 24 h or after thermocycling for 5000 cycles. Clinical significance Similar bond strength values were observed for the UAs regardless of application mode, which makes them reliable for working under different clinical conditions.

For posterior partial restorations an overlap of indication exists where either ceramic or resin-based composite materials can be successfully applied. The aim of this study was to compare the fatigue resistance of modern dental ceramic materials versus dental resin composites in order to address such conflicts.Bar specimens of five ceramic materials and resin composites were produced according to ISO 4049 and stored for 14 days in distilled water at 37°C. The following ceramic materials were selected for testing: a high-strength zirconium dioxide (e.max ZirCAD, Ivoclar), a machinable lithium disilicate (e.max CAD, Ivoclar), a pressable lithium disilicate ceramic (e-max Press, Ivoclar), a fluorapatite-based glass-ceramic (e.max Ceram, Ivoclar), and a machinable color-graded feldspathic porcelain (Trilux Forte, Vita). The composite materials selected were: an indirect machinable composite (Lava Ultimate, 3M ESPE) and four direct composites with varying filler nature (Clearfil Majesty Posterior, Kuraray; GrandioSO, Voco; Tetric EvoCeram, Ivoclar-Vivadent; and CeramX Duo, Dentsply). Fifteen specimens were tested in water for initial strength (σin) in 4-point bending. Using the same test set-up, the residual flexural fatigue strength (σff) was determined using the staircase approach after 10(4) cycles at 0.5 Hz (n=25). Weibull parameters σ0 and m were calculated for the σin specimens, whereas the σff and strength loss in percentage were obtained from the fatigue experiment.The zirconium oxide ceramic showed the highest σin and σff (768 and 440 MPa, respectively). Although both lithium disilicate ceramics were similar in the static test, the pressable version showed a significantly higher fatigue resistance after cyclic loading. Both the fluorapatite-based and the feldspathic porcelain showed equivalent initial and cyclic fatigue properties. From the composites, the highest filled direct material Clearfil Majesty Posterior showed superior fatigue performance. From all materials, e.max Press and Clearfil Majesty Posterior showed the lowest strength loss (29.6% and 32%, respectively), whereas the other materials lost between 41% and 62% of their flexural strength after cyclic loading.Dental ceramics and resin composite materials show equivalent fatigue strength degradation at loads around 0.5σin values. Apart from the zirconium oxide and the lithium disilicate ceramics, resin composites generally showed better σff after 10,000 cycles than the fluorapatite glass-ceramic and the feldspathic porcelain. Resin composite restorations may be used as an equivalent alternative to glass-rich-ceramic inlays regarding mechanical performance.

Objectives. Aim of the present prospective controlled clinical study was to compare the clinical performances of two different cementation procedures to lute IPS Empress inlays and onlays. Methods. Eighty-three IPS Empress restorations (70 class-II inlays, 13 onlays/47 premolars, 36 molars) were placed in 30 patients (19 females/11 males, mean age = 39 years). Two cementation procedures were tested: group 1: forty-three restorations were luted with a self-adhesive resin cement (RelyX Unicem, RX, 3M ESPE); group 2: forty restorations were luted with an etch-and-rinse multistep adhesive (Syntac Classic, Ivoclar-Vivadent) and Variolink II low (SV, Ivoclar-Vivadent). All restorations were evaluated after 2 weeks (baseline = 1st recall = R1, n = 83), 6 months (R2, n = 83), 1 year (R3, n = 82), and 2 years (R4, n = 82) by two independent blinded calibrated examiners using modified USPHS criteria. Results. From R1 to R4, one failure occurred in the SV group (at R2) due to marginal enamel chipping. After 2 years of clinical service (R4), better marginal and tooth integrity (p < 0.05) was found in group 2 (SV) compared to the use of the self-adhesive cement (RX, group 1), while no differences were found for all remaining investigated criteria (p > 0.05). The absence of enamel in proximal boxes (10% with no enamel and 51% of the restorations with less than 0.5 mm enamel width at the bottom of the proximal box) did not affect marginal performance (p > 0.05). Significance. The self-adhesive resin cement RelyX Unicem showed clinical outcomes similar to a conventional multi-step cementation procedure after 2 years of clinical service for most of the tested criteria. (C) 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Objective A deeper understanding of the mechanical behavior of dental restorative materials requires an insight into the materials elastic constants and microstructure. Here we aim to use complementary methodologies to thoroughly characterize chairside CAD/CAM materials and discuss the benefits and limitations of different analytical strategies. Methods Eight commercial CAM/CAM materials, ranging from polycrystalline zirconia (e.max ZirCAD, Ivoclar-Vivadent), reinforced glasses (Vitablocs Mark II, VITA; Empress CAD, Ivoclar-Vivadent) and glass-ceramics (e.max CAD, Ivoclar-Vivadent; Suprinity, VITA; Celtra Duo, Dentsply) to hybrid materials (Enamic, VITA; Lava Ultimate, 3M ESPE) have been selected. Elastic constants were evaluated using three methods: Resonant Ultrasound Spectroscopy (RUS), Resonant Beam Technique (RBT) and Ultrasonic Pulse-Echo (PE). The microstructures were characterized using Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDX), Raman Spectroscopy and X-ray Diffraction (XRD). Results Young’s modulus (E), Shear modulus (G), Bulk modulus (B) and Poisson’s ratio ( ν ) were obtained for each material. E and ν reached values ranging from 10.9 (Lava Ultimate) to 201.4 (e.max ZirCAD) and 0.173 (Empress CAD) to 0.47 (Lava Ultimate), respectively. RUS showed to be the most complex and reliable method, while the PE method the easiest to perform but most unreliable. All dynamic methods have shown limitations in measuring the elastic constants of materials showing high damping behavior (hybrid materials). SEM images, Raman spectra and XRD patterns were made available for each material, showing to be complementary tools in the characterization of their crystal phases. Significance Here different methodologies are compared for the measurement of elastic constants and microstructural characterization of CAD/CAM restorative materials. The elastic properties and crystal phases of eight materials are herein fully characterized.

The objective of the study was to investigate the relationship between pH-neutralization, hydrophilicity, and free hygroscopic expansion stress of self-adhesive resin cements (SARCs) after storage in artificial saliva. The SARCs RelyX Unicem Automix 2 (RX2, 3 M ESPE), iCEM (iCEM, Heraeus) and Maxcem Elite (MCE, Kerr) were under investigation in this study. Cylinders (height × diameter, 6 × 4mm) were prepared from each material and stored in artificial saliva (7d at 37 °C). Cylinder height was measured at baseline and after 7 days. After storage, the compression modulus was measured to calculate the free hygroscopic expansion stress. For pH-neutralization and hydrophilicity assessment, disks (height × diameter, 1 × 1.5 mm) were prepared, covered with electrolyte, and monitored over 24 h at 37 °C. Hydrophilicity was assessed using the static sessile drop technique at baseline and at different time intervals up to 24 h. Data were analyzed using one-way ANOVA and post hoc Student-Newman-Keuls test (S-N-K, α = 0.05). After 24 h, RX2 (pH24h 4.68) had a significantly higher (p

Residual stresses arising from inhomogeneous cooling after sintering have shown to play a preponderant role in the higher incidence of chippings observed for glass-zirconia dental prostheses. Still, current descriptions of their nature and distribution have failed to reconcile with clinical findings. Therefore, an axisymmetric sphero-cylindrical bilayer model was used in this study to determine the effect of the cooling rate on the final spatial distribution of residual stresses. Zirconia frameworks with two different radii (1.6 and 3.2mm) were CAD/CAM fabricated. Subsequent glass overlays with two different thickness ratios (1:1 and 2:1) were generated and heat pressed onto the zirconia substrates. The obtained structures were submitted to a last firing process and fast- (45°C/s) or slow-cooled (0.5°C/s) to room temperature. Unbonded bilayers were produced by firing glass overlays onto boron nitride coated zirconia. Thin sagittal and transversal sections were obtained from the specimens to assess residual stress distribution by means of light birefringence. The applied cooling rates did not affect distribution or magnitude of radial residual stresses (sagittal sections), whereas increased hoop stress magnitudes were measured (transversal sections) in fast-cooled specimens. A distinct stress nature was observed for the hoop stress component of unbonded overlays after fast cooling. Interaction between stress components seems to govern the final stress distribution, highlighting the importance of a multiaxial assessment of this problem in three-dimensional structures.

Objectives This study was intended to separate residual stresses arising from the mismatch in coefficients of thermal expansion between glass and zirconia (ZrO2) from those stresses arising solely from the cooling process. Slow crack growth experimentes were undertaken to demonstrate how cracks grow in different residual stress fields. Methods Aluminosilicate glass discs were sintered onto ZrO2 to form glass–ZrO2 bilayers. Glass discs were allowed to bond to the ZrO2 substrate during sintering or prevented from bonding by means of coating the ZrO2 with a thin boron nitrade coating. Residual stress gradients on “bonded” and “unbonded” bilayers were assessed using birefringence measurements. Unbonded glass discs were further tested under biaxial flexure in dynamic fatigue conditions in order to evaluate the effect of residual stress on the slow crack growth behavior. Results When fast-ccoling was induced, residual tensile stresses on the glass increased significantly on the side toward the ZrO2 substrate. By allowing the bond between glass and ZrO2, those tensile stresses observed in unbonded specimens are overwhelmed by the contraction mismatch stresses between the ZrO2 substrate and the glassy overlayer. Specimens containing residual tensile stresses on the bending surface showed a time-dependent strength increase in relation to stress-free annealed samples in the dynamic biaxial bending test, with this effect being dependent on the magnitude of the residual tensile stress. The phenomenon observed is explained here on the basis of the water toughening effect, in which water diffuses into the glass promoting local swelling. An additional residual tensile stress at the crack tip adds an applied-stress-independent (Kres) term to the total tip stress intensity factor (Ktip), increasing the stress-enhanced diffusion and the shielding of the crack tip through swelling of the crack faces. Significance Residual stresses in the glass influence the crack growth behavior of veneered-ZrO2 bilayered dental prostheses. The role of water in crack growth might be of higher complexity when residual stresses are present in the glass layer.

The purpose of this clinical study was to evaluate the correlation between tooth mobility (TM), crown-to-root ratio (CRR) and clinical attachment loss (CAL) in periodontally-compromised participants.While slowly biting on a load cell, the mobility of the upper incisors and canine teeth of 20 volunteers was measured using a photogrammetric measurement technique. An automated software program recorded the force-related three-dimensional TM at 3-N intervals. CAL was assessed clinically and CRR values were assessed radiographically. For each contralateral pair of teeth (central, lateral incisor, canine) and for each main level of force, the Pearson product-moment correlation coefficient between TM and CRR and between TM and CAL was computed. Correlations were considered statistically significant at p0.05.Statistically significant positive correlations were found between TM and CRR for incisors and canines for each main level of force, whereas canines had the lowest correlation. Statistically significant positive correlations were also found between TM and CAL for the central and lateral incisors at each main level of force. Canines showed no significant correlation between CAL and TM, regardless of force level.The loss of attachment and bone seem to have more influence on the mobility of incisors than canines.

Objective: This study evaluated sealing properties of root canal fillings with an additional composite barrier. The null hypothesis tested was that different sealers and different methods of sealer removal did not influence microleakage. Material and methods: Eighty extracted human molars with fully mature apices had root canal prepared to size 60 taper .02 and divided into eight groups: three experimental groups for each sealer and negative/positive control (n = 10 each). Teeth of experimental groups were mounted into the molar region of a training puppet to simulate clinical conditions. Root canals were filled with AH Plus or GuttaFlow and gutta-percha. Excess sealer was removed with: ethanol-moistened foam pellet only, additional preparation with a water-cooled diamond bur or additional etch-and-rinse procedure (37% phosphoric acid gel). All procedures were carried out until clean as judged by the naked eye. In all groups except the positive control Syntac was applied to the access cavity. Tetric flow was applied in two increments of 1 mm each. A dye penetration test was carried out by centrifugation for 3 min at 30 G within 5% methylene blue dye. Statistical evaluation was carried out with PASW 18.0 (α = 0.05). Results: Although the two sealers had different chemical composition, sealer exhibited no influence on the results, whereas technique of sealer removal did (Two-way-ANOVA, p < 0.001). Groups with “foam pellet” or “bur preparation” showed significantly more leakage than groups with “etch-and rinse” (SNK, p < 0.05). Conclusion:Applying an etch-and-rinse procedure prior to Syntac may be beneficial for the adhesive seal over root canal fillings.

We evaluated the effects of preliminary etching of dentine on the stability of the bond created by one-step self-etch adhesives under different storage conditions. Adper Easy Bond (3M ESPE) and iBond Self-Etch (iBond SE; Heraeus Kulzer) were applied with an etch-and-rinse (i.e. after preliminary phosphoric acid etching for 15 s) or a self-etch approach. Resin-dentine bonded specimens were sectioned perpendicularly to the adhesive interface according to the 'non-trimming technique'. Beams were stored in artificial saliva for 24 h, 6 months, or 1 yr at 37°C, or in 10% NaOCl for 5 h at room temperature, and then stressed until failure; the microtensile bond strengths were calculated. Interfacial nanoleakage of additional teeth was evaluated using light microscopy or transmission electron microscopy. Adper Easy Bond showed higher bond strength than iBond SE, regardless of the dentine treatment. Similar microtensile bond strength results were obtained for teeth subjected to artificial ageing in 10% NaOCl for 5 h at room temperature and for teeth stored in artificial saliva for 6 months at 37°C. The additional etching step increased the microtensile bond strength for Adper Easy Bond and iBond SE. This study supports the use of one-step adhesives on etched dentine because of the increased bond strength compared with their application onto smear-layer-covered dentine, regardless of storage conditions.