• The Journal of Advanced Prosthodontics
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• v.7 no.2
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• pp.151-159
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• 2015

PURPOSE. To describe and characterize the surface topography and cleanliness of CAD/CAM manufactured zirconia abutments after steaming and ultrasonic cleaning. MATERIALS AND METHODS. A total of 12 ceramic CAD/CAM implant abutments of various manufacturers were produced and randomly divided into two groups of six samples each (control and test group). Four two-piece hybrid abutments and two one-piece abutments made of zirconium-dioxide were assessed per each group. In the control group, cleaning by steam was performed. The test group underwent an ultrasonic cleaning procedure with acetone, ethyl alcohol and antibacterial solution. Groups were subjected to scanning electron microscope (SEM) analysis and Energy-dispersive X-ray spectroscopy (EDX) to verify and characterize contaminant chemical characterization non- quantitatively. RESULTS. All zirconia CAD/CAM abutments in the present study displayed production-induced wear particles, debris as well as organic and inorganic contaminants. The abutments of the test group showed reduction of surface contamination after undergoing an ultrasonic cleaning procedure. However, an absolute removal of pollutants could not be achieved. CONCLUSION. The presence of debris on the transmucosal surface of CAD/CAM zirconia abutments of various manufacturers was confirmed. Within the limits of the study design, the results suggest that a defined ultrasonic cleaning process can be advantageously employed to reduce such debris, thus, supposedly enhancing soft tissue healing. Although the adverse long-term influence of abutment contamination on the biological stability of peri-implant tissues has been evidenced, a standardized and validated polishing and cleaning protocol still has to be implemented.

• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.423-431
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• 2017

PURPOSE. The goal of this study was to evaluate the fracture resistances of various monolithic crowns fabricated by computer-aided design and computer-aided manufacturing (CAD/CAM) with different thickness. MATERIALS AND METHODS. Test dies were fabricated as mandibular molar forms with occlusal reductions using CAD/CAM. With different occlusal thickness (1.0 or 1.5 mm), a polymer-infiltrated ceramic network (Enamic, EN), and zirconia-reinforced lithium silicate (Suprinity, SU and Celtra-Duo, CD) were used to fabricate molar crowns. Lithium disilicate (e.max CAD, EM) crowns (occlusal: 1.5 mm) were fabricated as control. Seventy crowns (n=10 per group) were bonded to abutments and stored in water for 24 hours. A universal testing machine was used to apply load to crown until fracture. The fractured specimens were examined with a scanning electron microscopy. RESULTS. The type of ceramics and the occlusal thickness showed a significant interaction. With a recommended thickness (1.5 mm), the SU revealed the mean load similar to the EM, higher compared with those of the EN and CD. The fracture loads in a reduced thickness (1.0 mm) were similar among the SU, CD, and EN. The mean fracture load of the SU and CD enhanced significantly when the occlusal thickness increased, whereas that of the EN did not. CONCLUSION. The fracture loads of monolithic crowns were differently influenced by the changes in occlusal thickness, depending on the type of ceramics. Within the limitations of this study, all the tested crowns withstood the physiological masticatory loads both at the recommended and reduced occlusal thickness.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.27.1-27.9
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• 2018

Objectives: The aim of this in vitro study was to evaluate the effects of the thickness and shade of 3 types of computer-aided design/computer-aided manufacturing (CAD/CAM) materials. Materials and Methods: A total of 120 specimens of 2 shades (A1 and A3) and 2 thicknesses (1 and 2 mm) were fabricated using VITA Mark II (VM; VITA Zahnfabrik), IPS e.max CAD (IE; IvoclarVivadent), and VITA Suprinity (VS; VITA Zahnfabrik) (n = 10 per subgroup). The amount of light transmission through the ceramic specimens was measured by a radiometer (Optilux, Kerr). Light-cured resin cement samples (Choice 2, Bisco) were fabricated in a Teflon mold and activated through the various ceramics with different shades and thicknesses using an LED unit (Bluephase, IvoclarVivadent). In the control group, the resin cement sample was directly light-cured without any ceramic. Vickers microhardness indentations were made on the resin surfaces (KoopaPazhoohesh) after 24 hours of dark storage in a $37^{\circ}C$ incubator. Data were analyzed using analysis of variance followed by the Tukey post hoc test (${\alpha}=0.05$). Results: Ceramic thickness and shade had significant effects on light transmission and the microhardness of all specimens (p < 0.05). The mean values of light transmittance and microhardness of the resin cement in the VM group were significantly higher than those observed in the IE and VS groups. The lowest microhardness was observed in the VS group, due to the lowest level of light transmission (p < 0.05). Conclusion: Greater thickness and darker shades of the 3 types of CAD/CAM ceramics significantly decreased the microhardness of the underlying resin cement.

• Restorative Dentistry and Endodontics
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• v.23 no.2
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• pp.618-629
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• 1998

CAD/CAM-fabricated ceramic restorations nowadays are used as alternatives of amlagam and posterior composite resin restorations, especially in the cases of inlay restorations. But the reported results on marginal and internal fit of CAD/CAM-fabricated ceramic inlay have showed considerable difference. In this study, to evaluate the marginal and internal fit of CEREC2-fabricated ceramic inlay restoration and to compare with the fit of gold inlay and amalgam restoration, standardized Class II MO cavities were prepared in forty extracted caries-free human premolars. The teeth with prepared cavities were divided into 4 groups of ten teeth each. In group 1, CEREC2-fabricated ceramic inlays were treated with Scotchbond Multi-Purpose Plus(SMP plus) and cemented with Scotchbond Resin Cement. In group 2, casted gold inlays were cemented in the same method as in group 1. In group 3, casted gold inlays were cemented with zinc-phosphate cement. And in group 4, the prepared cavities were restored with amalgam. Restored teeth were thermocycled, stored in 1% methylene blue for 24 hours, and sectioned faciolingually and mesiodistally using EXAKT. Sectioned surfaces were observed with stereomicroscope and the gaps were measured at 9 points of mesiodistally sectioned surface and 7 points of faciolingually sectioned surface. The measured data were treated by Kruskal-Wallis one way ANOVA and Student-Newman-Keuls test. 1. The differences among measured gaps at each points were statistically significant for 4 experimental groups (P<0.05). 2. There were statistically significant differences in the measured gaps at each points between group 1 and group 2, group 1 and group 3, group 1 and group 4, group 2 and group 4, and group 3 and group 4 (P<0.05). 3. There were not statistically significant differences in the measured gaps at each points between group 2 and group 3 (P>0.05). 4. In the cases of inlay restorations(group 1, group 2, group 3), the gaps at internal line angle(distopulpal, axiogingival, faciopulpal, linguopulpal line angle) had a tendency to increase. In the cases of amalgam restorations(group 4), the gaps at occlusal margin, gingival margin and axiogingival line angle were greater than those at the other parts of cavities. 5. In CEREC2-fabricated ceramic inlays which were treated with Scotchbond Multi-Purpose Plus and cemented with Scotchbond Resin Cement, the mean gaps were $111{\mu}m$ at cavity margins, $168{\mu}m$ at vertical walls of cavities, $225{\mu}m$ at internal line angles and $123{\mu}m$ at cavity floors.

• The Journal of Advanced Prosthodontics
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• v.12 no.1
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• pp.22-32
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• 2020

PURPOSE. The aim of this study was to evaluate the microshear bond strength (µSBS) of four computer-aided design/computer-aided manufacturing (CAD/CAM) blocks repaired with composite resin using three different surface treatment protocols. MATERIALS AND METHODS. Four different CAD/CAM blocks were used in this study: (1) flexible hybrid ceramic (FHC), (2) resin nanoceramic (RNC), (c) polymer infiltrated ceramic network (PICN) and (4) feldspar ceramic (FC). All groups were further divided into four subgroups according to surface treatment: control, hydrofluoric acid etching (HF), air-borne particle abrasion with aluminum oxide (AlO), and tribochemical silica coating (TSC). After surface treatments, silane was applied to half of the specimens. Then, a silane-containing universal adhesive was applied, and specimens were repaired with a composite, Next, µSBS test was performed. Additional specimens were examined with a contact profilometer and scanning electron microscopy. The data were analyzed with ANOVA and Tukey tests. RESULTS. The findings revealed that silane application yielded higher µSBS values (P<.05). All surface treatments were showed a significant increase in µSBS values compared to the control (P<.05). For FHC and RNC, the most influential treatments were AlO and TSC (P<.05). CONCLUSION. Surface treatment is mandatory when the silane is not preferred, but the best bond strength values were obtained with the combination of surface treatment and silane application. HF provides improved bond strength when the ceramic content of material increases, whereas AlO and TSC gives improved bond strength when the composite content of material increases.

• The Journal of Advanced Prosthodontics
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• v.3 no.2
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• pp.57-62
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• 2011

MATERIALS AND METHODS. Ceramics have a long history in fixed prosthodontics for achieving optimal esthetics and various materials have been used to improve ceramic core strength. However, there is a lack of information on how color is affected by fabrication procedure. The purpose of this study was to evaluate the effects of various dentin ceramic thicknesses and repeated firings on the color of zirconium oxide all-ceramic system (LavaTM) fabricated using CAD/CAM technology. MATERIALS AND METHODS. Thirty disc-shaped cores, 12 mm in diameter with a 1 mm thickness were fabricated from zirconium oxide based all ceramic systems ($Lava^{TM}$, 3M ESPE, St Paul, MN, USA) and divided into three groups (n = 10) according to veneering with dentin ceramic thicknesses: as 0.5, 1, or 1.5 mm. Repeated firings (3, 5, 7, or 9) were performed, and the color of the specimens was compared with the color after the initial firing. Color differences among ceramic specimens were measured using a spectrophotometer (VITA Easyshade, VITA Zahnfabrik, Bad $S{\ddot{a}}ckingen$, Germany) and data were expressed in CIELAB system coordinates. A repeated measures ANOVA and Bonferroni post hoc test were used to analyze the data (n = 10, ${\alpha}=.05$). RESULTS. $L^{\ast}a^{\ast}b^{\ast}$ values of the ceramic systems were affected by the number of firings (3, 5, 7, or 9 firings) (P<.001) and ceramic thickness (0.5, 1, or 1.5 mm) (P<.001). Significant interactions were present in $L^{\ast}a^{\ast}b^{\ast}$ values between the number of firings and ceramic thickness (P<.001). An increase in number of firings resulted in significant increase in $L^{\ast}$ values for both 0.5 mm and 1.5 mm thicknesses (P<.01, P=.013); however it decreased for 1 mm thickness (P<.01). The $a^{\ast}$ values increased for 1 mm and 1.5 mm thicknesses (P<.01), while it decreased for 0.5 mm specimens. The $b^{\ast}$ values increased significantly for all thicknesses (P<.01, P=.022). As the dentin ceramic thickness increased, significant reductions in $L^{\ast}$ values (P<.01) were recorded. There were significant increases in both $a^{\ast}$ and $b^{\ast}$ values (P<.01) as the dentin ceramic thickness increased. CONCLUSION. The number of firings and dentin ceramic thickness have a definite effect on the final color of all ceramic system tested. The mean ${\Delta}E$ value increased as the dentin ceramic thicknesses increased for zirconium-oxide based all ceramic specimens tested. However, the mean ${\Delta}E$ values were less than 3.7${\Delta}E$ units which is rated as a match in the oral environment.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.4
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• pp.309-315
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• 2006

The availability of high-technology systems that use computer-aided design(CAD) and computer-aided machining(CAM) is on the increase. One such system is the Procera system, which fabricates an all-ceramic crown composed of a densely sintered, high-purity aluminum oxide coping combined with a compatible veneering porcelain. Strength, precision of fit, esthetics, cementation, and biocompatibility are among the many factors that concern clinicians when fabricating all-ceramic restorations with this system. This paper reviews the long history and background development of technical, laboratory and clinical applications and presents, in summary form, the data from the many studies on the Procera system.

• The Journal of Advanced Prosthodontics
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• v.10 no.4
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• pp.291-299
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• 2018

PURPOSE. To assess the degree of conversion (DC) and light irradiance delivered to light-cured and dual-cured cements by application of different light sources through various types of monolithic computer-aided design and computer-aided manufacturing (CAD/CAM) materials. MATERIALS AND METHODS. RelyX Ultimate Clicker light-cured and dual-cured resin cement specimens with 1.5-mm thicknesses (n=300, 10/group), were placed under four types of crystalline core structure (Vita Enamic, Vita Suprinity, GC Ceresmart, Degudent Prettau Anterior). The specimens were irradiated for 40 seconds with an LED Soft-Start or pulse-delay unit or 20 seconds with a QTH unit. DC ratios were determined by using Fourier transform infrared spectroscopy (FTIR) after curing the specimen at 1 day and 1 month. The data were analyzed using the Mann-Whitney U test (for paired comparison) and the Kruskal-Wallis H test (for multiple comparison), with a significance level of P<.05. RESULTS. DC values were the highest for RelyX Ultimate Clicker light-cure specimens polymerized with the LED Soft-Start unit. The combination of the Vita Suprinity disc and RelyX Ultimate Clicker dual-cure resin cement yielded significantly higher values at both timepoints with all light units (all, P<.05). CONCLUSION. Within the limitations of this study, we conclude that the DC of RelyX Ultimate Clicker dual-cure resin cement was improved significantly by the use of Vita Suprinity and the LED Soft-Start light unit. We strongly recommend the combined use of an LED light unit and dual-cure luting cement for monolithic ceramic restorations.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.231-241
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• 2015

As patients' esthetic expectations increase, there is an increase in demand for cosmetic restorations of anterior and posterior teeth that resemble the natural tooth morphology and color. An example of high-strength all-ceramic systems is zirconia with CAD/CAM application. This case report describes a full-mouth rehabilitation using zirconia all-ceramic crowns supported by upper and lower implants and by a minimal increase in the occlusal vertical dimension in a patient with severe abrasion due to loss of posterior teeth.

• The Journal of Advanced Prosthodontics
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• v.10 no.2
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• pp.101-112
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• 2018

PURPOSE. The purpose of this study was to investigate the effect of various surface treatments (ST) on the shear bond strength of resin composite to three bilayer dental ceramics made by CAD/CAM and two veneering ceramics. MATERIALS AND METHODS. Three different bilayer dental ceramics and two different veneering ceramics were used (Group A: IPS e.max CAD+IPS e.max Ceram; Group B: IPS e.max ZirCAD+IPS e.max Ceram, Group C: Vita Suprinity+Vita VM11; Group D: IPS e.max Ceram; Group E: Vita VM11). All groups were divided into eight subgroups according to the ST. Then, all test specimens were repaired with a nano hybrid resin composite. Half of the test specimens were subjected to thermocycling procedure and the other half was stored in distilled water at $37^{\circ}C$. Shear bond strength tests for all test specimens were carried out with a universal testing machine. RESULTS. There were statistically significant differences among the tested surface treatments within the all tested fracture types (P<.005). HF etching showed higher bond strength values in Groups A, C, D, and E than the other tested ST. However, bonding durability of all the surface-treated groups were similar after thermocycling (P>.00125). CONCLUSION. This study revealed that HF etching for glass ceramics and sandblasting for zirconia ceramics were adequate for repair of all ceramic restorations. The effect of ceramic type exposed on the fracture area was not significant on the repair bond strength of resin composites to different ceramic types.