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The purpose of this study was to characterize the homogeneity of the mechanical properties of commercial CAD-CAM composites between different blocks of the same material (interblock homogeneity) and within each block between the internal and external parts (intrablock homogeneity). Tetric CAD (TET); Katana Avencia (KAT); Cerasmart 270 (CER); Grandio (GRN) and Vita Enamic (ENA) were tested for flexural strength (σ f ), flexural modulus (E f ), flexural load energy (U r ) and hardness (HV). Results showed significant differences in interblock homogeneity of σ f , E f and U r for TET, KAT, CER and ENA. In addition, significant differences in interblock homogeneity of HV for TET, CER and GRN were found. Moreover, significant differences in intrablock homogeneity of σ f , E f and U r were found for KAT, CER, GRN and ENA, as well as for HV of all the tested materials except CER. Weibull modulus was highest for GRN, followed by ENA, KAT, TET then CER.

Objective: The mandible has various unnamed accessory foramina, and surgery is often performed in the symphyseal area. The aim of this study was to analyze the anatomical characteristics of mandibular lingual foramina with the objective of preventing clinical complications during implant surgery on an edentulous mandible., Study Design: A total of 100 cone beam computed tomography scans of completely edentulous patients were included in this study. For each canal, nine measurements were recorded in millimeters: seven length or height measurements and two diameter measurements. The placement of a standard implant was simulated and whether the implant passed through the canal was noted. The results were analyzed by t-test and chi-squared at a significance level of 0.05. Pearson correlation analysis was used to assess the relationship between variables., Results: We identified 309 foramina: 236 medial lingual foramina and 73 lateral lingual foramina. We found no significant relationship between the number of foramina and the age of the individuals, or between diameter and the age or gender of the individuals. The mandibular canal was injured in 32.7 % of implant placement simulations., Conclusion: The risk of injury to neurovascular bundles is increased in edentulous patients due to vertical bone resorption., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier GmbH. All rights reserved.)

Purpose: To compare the interfacial fracture toughness (IFT) of two MDP-based composite cements and a resin-modified glass-ionomer cement (RMGIC) with third-generation zirconia CAD-CAM restorations using two different airborne-particle abrasion (AB) pressures., Methods: Blocks were cut into prisms (n=60), split and sintered to the desired equilateral half prisms. Half-prisms were divided into two groups for AB at 0.5 or 2.5 bar with 50 µm Al 2 O 3 particles. Each group was then further divided into 3 subgroups, and half-prisms were bonded to their counterparts with Panavia V5 (V5), Panavia Self Adhesive Cement Plus (SA), or RMGIC Fuji Plus (n=10/group). The IFT was determined using the Notchless Triangular Prism test in a water bath at 36°C after thermocycling (10,000 cycles). Surface roughness and SEM analyses were performed for representative zirconia samples after AB, and composite cements were tested for flexural strength and wettability., Results: SA (2.5 bar) showed a significantly higher IFT. The 3 other groups with SA and V5 showed no significant difference in their IFT values regardless of the AB pressure (1-way ANOVA). Weibull analysis of SA was higher than V5. All RMGIC samples debonded while thermocycling, and were, therefore, not included in the statistical analysis. Surface roughness increased with increasing AB pressure, and both cements showed similar flexural strength values and good wettability., Conclusion: Contrary to RMGIC, composite cements show high performance with zirconia after AB. Increasing AB pressure enhances the micromechanical retention of composite cement. Future perspectives should include study of the effect of AB pressure on zirconia surface properties.

This study aimed at determining an optimum polymerization pressure for Polymer Infiltrated Ceramic Network (PICN) blocks by characterizing the conversion degree (DC) and the viscoelastic properties of experimental PICN blocks polymerized at 90 °C under various high pressures followed or not by post-cure treatment (PC). Near infrared analysis and dynamic mechanical analysis were used to characterize DC and viscoelastic properties of sixteen PICN: one control (thermo-cured) and fifteen experimental groups (one thermo-cured followed by PC and fourteen high pressure polymerized PICN, in the range of 50-350 MPa without and with PC). Conversion degree of high pressure polymerized PICN blocks without post curing displays an optimum between 100 and 150 MPa resulting in an improved E' and T g . Post curing induces a higher DC with a controversial effect on thermomechanical properties. The results suggested that 100-150 MPa without PC is an optimum polymerization parameter, resulting in PICN blocks with significantly better DC, T g , E'., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Purpose: The purpose of this study was to study the influence of high-pressure (HP) polymerization on the mechanical properties of denture base PMMA resins compared with conventional thermopolymerization and PMMA discs for digital dentures., Materials and Methods: Three groups of blocks were prepared: Probase Hot (Ivoclar Vivadent, Lichtenstein) conventionally heat polymerized at 100°C, Probase Hot heat polymerized at 100°C under HP (200 MPa) and Ivobase CAD (Ivoclar Vivadent, Lichtenstein). Samples for mechanical/physical (n = 30) and samples for viscoelastic (n = 10) characterizations were cut from the blocks. Flexural strength (σ f ), elastic modulus (E f ), hardness, density (ρ), flexural deformation at maximal flexural stress, flexural load energy (U r ) and viscoelastic properties (E', E'', Tanδ, T g ) were analyzed using one-way ANOVA (α = 0.05), Scheffé multiple means comparisons (α = 0.05) and Weibull statistics (for σ f ). SEM images of the fractured surfaces were obtained., Results: E f , E', E'' and density of HP polymerized Probase hot were significantly higher than conventional heat polymerized Probase Hot, whereas T g was significantly lower and σ f , Tanδ, hardness, flexural deformation at maximal flexural stress, U r were not significantly different. The highest values for σ f , flexural deformation at maximal flexural stress, U r and Weibull modulus were obtained with Ivobase CAD., Conclusion: HP polymerization does not significantly increase the mechanical properties of denture base resins., (© 2020 by the American College of Prosthodontists.)

Objectives: To evaluate silane influence on the interfacial fracture toughness (IFT) of composite cement, with the two sub-classes of CAD-CAM composites, polymer-infiltrated ceramic networks (PICN) and dispersed fillers (DF), after hydrofluoric acid etching (HF) or airborne-particle abrasion (AB). A secondary objective was to correlate results with developed interfacial area ratio (Sdr) and surface wettability., Methods: Experimental PICN and DF blocks were cut into equilateral half-prisms, which were treated with HF or AB, then treated with an experimental silane or not and bonded to their counterparts with an experimental light-cure resin cement. After thermocycling, samples (n=30 per group) were tested for IFT using the notchless triangular prism test in a water bath at 36°C. Moreover, profilometry and contact angle measurement were performed on rectangular samples of each group. Finally, bonding interface was analysed by SEM., Results: PICN-HF treated with silane showed the highest IFT significantly. Three-way ANOVA revealed the influence of silane, material class and surface pre-treatment (HF or AB) on IFT (p<0.05). When silane was used, IFT was correlated with Sdr, while surface wettability was increased. Silane application significantly increased IFT for PICN but not for DF, while PICN performed better with HF and DF with AB., Significance: Silane increases IFT of composite cement with PICNs, but not with DF materials. Results suggest that silane increases the micromechanical bond by promoting resin cement spreading and penetration in surface roughness. This roughness is significantly higher for pre-treated PICNs than for DF due to their specific honeycomb microstructure when etched, which explains their better bonding properties., (Copyright © 2019 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.)

The objective of this study was to introduce a functionally graded (FG) polymer-infiltrated ceramic network (PICN) block, characterized by a gradient of mechanical properties, as a biomimetic material for computer-aided design and manufacturing (CAD-CAM) prostheses. FG-PICN blocks were manufactured from a slurry of glass-ceramic powder, which was subsequently centrifuged and sintered. The ceramic network was infiltrated with urethane dimethacrylate and polymerized under high temperature-pressure. Blocks were sectioned into 9 layers, and each layer was subsequently cut into 3 samples. Samples were loaded into a 3-point bending device and tested for flexural strength, flexural load energy, and flexural modulus. The volume percentage of glass-ceramic, hardness, and brittleness index were also measured and scanning electron microscopy (SEM) observations were performed. Katana translucent zirconia (HT-ZIR) and e.max-CAD (EMX) were tested for comparison. Flexural strength, flexural load energy, and Weibull modulus of FG-PICN were shown to increase from the first (enamel-like zone) to the ninth layer (dentin-like zone), while, on the contrary, flexural modulus, hardness, brittleness index, and ceramic volume percentage decreased. SEM characterization highlighted a higher porosity in layer 9 than in layer 1. Flexural strength of the dentin-like zone (372.7 ± 27.8 MPa) was similar to EMX and lower than HT-ZIR. Flexural modulus was shown to vary from 41.9 ± 5.1 to 28.6 ± 2.0 GPa from surface to depth. Flexural load energy in the dentin-like zone (27.1 ± 4.9 mJ) was significantly superior to EMX and HT-ZIR. Hardness gradient was shown to be close to tooth tissues. This work introduces FG-PICN blocks, with a gradient of mechanical and optical properties through the entire thickness of the block designed to mimic dental tissues. FG-PICN demonstrated a favorable gradient of flexural strength, elastic modulus, and, most of all, flexural load energy and hardness compared to other CAD-CAM materials, which can promote the biomechanical behavior of single-unit restorations on teeth and implants.

Dental rehabilitation of acute cases of enamel renal syndrome is challenging due to the absence of clinical reports. In the present case history report, examination of an 18-year-old patient revealed a complete lack of permanent teeth, as well as irregular and swollen bone and gingival morphology. Radiographs showed multiple impacted teeth in both arches. Creating a 1.5- to 2-cm interarch space was necessary for setting complete dentures. The ideal occlusal plane was chosen by combining two techniques (cephalometric radiograph and modification of the mandibular occlusal rim according to anatomical guidelines). Extraction of impacted teeth and recontouring of the alveolar process were performed simultaneously. The mandibular denture was connected through Locator abutments to two symphyseal implants. This pioneering clinical report will provide guidance to practitioners in the surgical intervention of patients with FAM20A (family with sequence similarities 20 A) gene mutations.

The objective of this study was to evaluate the interfacial fracture toughness (IFT) of composite cement with dispersed filler (DF) versus polymer-infiltrated ceramic network (PICN) computer-aided design and computer-aided manufacturing (CAD-CAM) composite blocks after 2 different surface pretreatments using the notchless triangular prism (NTP) test. Two DFs (Cerasmart [CRT] and Lava Ultimate [LVA]), 2 PICNs (Enamic [ENA] and experimental PICN [EXP]), and e.max CAD lithium disilicate glass-ceramic (EMX, control) prism samples were bonded to their counterparts with Variolink Esthetic DC composite cement after either hydrofluoric acid etching (HF) or gritblasting (GR). Both procedures were followed by silanization. All samples ( n = 30 per group) were thermocycled (10,000 cycles) and tested for their IFT in a water bath at 36°C. Moreover, representative samples from each group were subjected to a developed interfacial area ratio (Sdr) measurement by profilometry and scanning electron microscopy (SEM) characterization. EXP-HF gave the highest IFT (1.85 ± 0.39 MPa·m 1/2 ), followed by EMX-HF and ENA-HF, while CRT-HF gave the lowest (0.15 ± 0.22 MPa·m 1/2 ). PICNs gave significantly better results with HF, and DF showed better results with GR. A 2-way analysis of variance indicated that there were significantly higher IFT and Sdr for PICNs than for DF. A positive correlation ( r² = 0.872) was found between IFT and Sdr. SEM characterization showed the specific microstructure of the surface of etched PICNs, indicating the presence of a retentive polymer-based honeycomb structure. Etching of the typical double-network microstructure of PICNs causes an important increase in the Sdr and IFT, while DF should be gritblasted. DF exhibited significantly lower Sdr and IFT values than PICNs. The present results show the important influence of the material class and surface texture, and consequently the micromechanical bond, on the adhesive interface performance of CAD-CAM composites.

Objective: The setting of resin-modified glass ionomer cements (RMGIC) involves the acid-base reaction and the polymerization of HEMA monomers. Each setting mechanism may compete with the other. The aim of this study was to determine an optimum polymerization after various delays of light-activation, to minimize the release of free HEMA and to better understand the setting mechanism of RMGICs. The null hypothesis tested was: increasing the delay before light-activation of an RMGIC has no effect on HEMA release and on its degree of conversion (DC)., Methods: Five groups were investigated: (a) control group with no light-curing; (b) light-curing delayed 1 min after mixing; (c) delayed 5 min; (d) delayed 10 min; (e) delayed 15 min. For each, HEMA release was analyzed with high performance liquid chromatography at 1 h, 6 h, 24 h, 7 days, 14 days and 28 days and the DC was tested by ATR-FTIR spectrometer. Data were analysed by one-way ANOVA, followed by Scheffe multiple mean comparisons., Results: A delay in light-activation caused a significant increase in the cumulative HEMA release. The highest release was determined for the group without light-curing. The DC increased significantly when the delay was increased, until a maximum value for 10 min delay, then decreased when the delay was more extended, with a minimum value for the group without light-curing., Significance: A short delay before light-curing could limit the HEMA release and could be more biocompatible. The results highlighted the competition between the acid-base and the polymerization reactions. They also showed there is no correlation between the monomer release and the DC., (Copyright © 2016 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study, part of our research to improve properties of resin composite blocks suitable for CAD/CAM and to better understand underlying mechanisms associated with high-temperature/high-pressure (HT/HP) polymerization, was to determine an optimum polymerization pressure of urethane dimethacrylate (UDMA) in the presence of an initiator (0.5% benzoyl peroxide) by determining the degree of conversion (DC) and viscoelastic properties of polymers obtained at 90°C under varying HP., Methods: DC and viscoelastic properties of 16 UDMA polymers, two controls (thermo-cured and thermo-cured followed by post-cure relaxation) and 14 experimental groups (HP polymers, in the range of 50-350 MPa, in 50 MPa increments, without and with post-cure relaxation) were determined via near infrared spectroscopic analysis and dynamic mechanical analysis, respectively., Results: The results have shown that HP UDMA polymers have DC superior to that of the control group. With regards to E' and E″, the results have shown no significant difference between control and HP polymers. The damping factor, tanδ, decreased with increasing pressure, while E'rub and Tg increased. Polymerization at 150 MPa or higher resulted in significantly higher E'rub and Tg., Significance: The results of this study suggested that HP polymerization at 90°C of UDMA reduced the number of defects and the free volume, leading to a more homogeneous polymer network. The results have also suggested that 200 MPa is an optimum polymerization pressure, resulting in polymers with significantly higher DC, E'rub, and Tg, while maintaining adequate damping capacity (tanδ)., (Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objective: This study was conducted to determine selected mechanical/physical properties of and monomer release from high-temperature high-pressure (HT/HP) polymerized urethane dimethacrylate (UDMA)., Methods: Flexural strength (σf), hardness, fracture toughness (KIC), and density (ρ) were determined for five UDMA resin blocks produced via different polymerization protocols. High performance liquid chromatography (HPLC) was used to determine monomer release from the five polymers. One way ANOVA, Scheffé multiple means comparisons (α=0.05), and Weibull statistics (for σf) were used to analyze the results., Results: The results showed that HT/HP polymerization resulted in a significant (p<0.05) increase in σf and ρ, along with an increase in Weibull modulus. No significant differences were found in hardness and KIC between the two HT/HP polymerized materials. A significantly lower (p<0.05) monomer release was detected for the HT/HP polymerized groups., Significance: The results of this study suggest that HT/HP polymerization affects the network structure and leads to UDMA polymers with improved mechanical/physical properties and with dramatically reduced monomer release. The low elution of monomers from HT/HP and HP polymerized materials suggests the achievement of a higher degree of conversion and a lesser degree of inhomogeneity with regards to microgel domains. The results, however, cannot fully explain the dramatic increase in mechanical/physical properties reported previously for RCB, improvements that may be due to a better filler-matrix interaction afforded by HT/HP polymerization., (Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

The aim of this study was to produce composite blocks (CB) for CAD/CAM applications by high-temperature-pressure (HT/HP) polymerization of resin-infiltrated glass-ceramic networks. The effect of network sintering and the absence/presence of initiator was investigated. Mechanical properties were determined and compared with those of Paradigm MZ100 (3M ESPE) blocks and HT/HP polymerized experimental "classic" CB, in which the filler had been incorporated by conventional mixing. The networks were made from glass-ceramic powder (VITA Zahnfabrik) formed by slip casting and were either sintered or not. They were silanized, infiltrated by urethane dimethacrylate, with or without initiator, and polymerized under HT/HP (300 MPa, 180°C) to obtain resin-infiltrated glass-ceramic network (RIGCN) CB. HT/HP polymerized CB were also made from an experimental "classic" composite. Flexural strength (σf), fracture toughness (KIC), and Vickers hardness were determined and analyzed by one- or two-way analysis of variance (ANOVA), Scheffé multiple-means comparisons (α = 0.05), and Weibull statistics (for σf). Fractured surfaces were characterized with scanning electron microscopy. The mechanical properties of RIGCN CB were significantly higher. Sintering induced significant increases in σf and hardness, while the initiator significantly decreased hardness. The results suggested that RIGCN and HT/HP polymerization could be used to obtain CB with superior mechanical properties, suitable for CAD/CAM applications.

Objectives: The aim of this study was to use high-pressure high-temperature (HP/HT) polymerization to produce urethane dimethacrylate (UDMA)-triethylene glycol dimethacrylate (TEGDMA) based resin composite blocks (RCB) suitable for dental computer-aided design/manufacture (CAD/CAM) applications and to compare their physical/mechanical properties to those of a commercial dental RCB. The null hypotheses tested were: (1) there are no differences in the physical/mechanical properties between HP/HT polymerized UDMA-TEGDMA RCB and a commercial RCB; (2) volume fraction filler (Vf) does not affect the physical/mechanical properties of HP/HT polymerized RCB., Methods: Four UDMA-based experimental RCB were manufactured under HP/HT conditions. A RCB manufactured under the same HP/HT conditions from a commercial resin composite (Z100) and its commercial counterpart CAD/CAM RCB (Paradigm MZ100) were used as controls. Flexural strength (σf), fracture toughness (KIC), and hardness were determined. The results were analyzed using one-way ANOVA, Scheffé multiple means comparisons (α=0.05), and Weibull statistics (for σf). Scanning electron microscopy was used to characterize fractured surfaces., Results: All HP/HT polymerized RCB had superior σf, KIC, and Weibull modulus compared to the commercial dental RCB. The experimental RCB had similar or superior properties compared to HP/HT polymerized Z100 RCB. Fewer and smaller porosities (not quantified) were apparent in HP/HT polymerized RCB. The experimental RCB that contained 65% Vf showed higher porosity, suggesting practical difficulties in filler incorporation beyond a certain Vf., Conclusions: The results of this study suggested that RCB suitable for dental CAD/CAM applications could be obtained by HP/HT polymerization of resin composites based on pure UDMA., (Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study was to thermo-polymerize under high pressure four commercially available dental resin composites to obtain and characterize composite blocks suitable for CAD/CAM procedures., Methods: Gradia (GC, Japan), Vita VM LC (Vita Zahnfabrik, Germany), Grandio (VOCO, Germany), and EsthetX (Dentsply, Germany), were selected for this study. Paradigm (3 M ESPE, USA), a CAD/CAM composite block, was included for comparison. Composite blocks were obtained through polymerization at high-temperature high-pressure (HT/HP). Samples for mechanical/physical characterizations were cut from Paradigm and HT/HP composite blocks while control samples were obtained by photo-polymerizing (PP) the materials in molds. Flexural strength (σ(f)), fracture toughness (K(IC)), hardness, and density (ρ) were determined and compared by pairwise t-tests (α=0.05). Fractured surfaces were characterized under a scanning electron microscope., Results: The results have shown that HT/HP polymerization resulted in a significant (p<0.05) increase in σ(f), hardness, and ρ for all composites investigated. Even if K(IC) of all materials was increased by HT/HP polymerization, significant increases were detected only for Gradia and EsthetX. The Weibull modulus of HT/HP polymerized composites was higher than that of PP counterparts. HT/HP materials had higher σ(f), Weibull modulus, and K(IC) compared to Paradigm. The most significant SEM observation of fractured K(IC) specimens from all the materials tested was the presence of fewer and smaller voids in HT/HP polymerized composites., Significance: The results of this study suggest that HT/HP polymerization could be used to obtain dental resin composite blocks with superior mechanical properties, suitable for CAD/CAM processing., (Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)