• The Journal of the Korean dental association
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• v.54 no.8
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• pp.651-657
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• 2016

Currently with the continuous development of ceramic and cementation materials, CAD-CAM(Computer-aided design/Computer-aided manufacture) restorations are becoming increasingly popular in esthetic dentistry. Preparation design is influenced by the selected restorative material, the fabrication method, and the ability to bond the restoration. For long-lasting CAD/CAM inlay/onlay restoration, clinicians should understand the basic knowledge of CAD/CAM restoration's cavity design to obtain the fracture resistance and proper fitting margin. This article gives an overview of preparation guidelines for CAD/CAM inlay/onlay restorations.

• Restorative Dentistry and Endodontics
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• v.26 no.6
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• pp.464-484
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• 2001

When restoring a tooth, the dentist tries to choose the ideal material for existing situation. One criterion that is considered is its suitability for restoring coronal strength. As more tooth structure is removed, the cusps are weakened and susceptible to fracture. Further, this increased deformation may cause the formation of intermittent gaps at the margin between the hard tissue and the restoration, facilitating marginal leakage. The improvements in ceramic materials now make it possible for alternatives to amalgams, composites, and cast metal to be of offered for posterior teeth. Of the materials used, ceramics most closely approximates the properties of enamel. The introduction of computer-aided design/computer-aided manufacture(CAD/CAM) systems to restorative dentistry represents a major technological breakthrough. It is possible to design and fabricate ceramic restorations at a single appointment. Additionally, CAD/CAM systems eliminate certain errors and inaccuracies that are inherent to the indirect method and provide an esthetic restoration. The aim of this investigation was to study the loading characteristics of CAD/CAM ceramic inlay and to compare the stress distribution and displacement associated with different designs of cavity(the isthmus width and cavity depth). A human maxillary left first premolar was prepared with standard mesio-occlusal cavity preparation, as recommended by the manufacturer Ceramic inlay was fabricated with CEREC 2 CAD/CIM equipment and cemented into the prepared cavity. Three dimensional model was made by the serial photographic method. The cavity width was varied $\frac{1}{3}$, $\frac{1}{2}$ and $\frac{2}{3}$ of intercuspal distance between buccal and lingual cusp tip. The cavity depth was varied 1.5mm and 2.3mm. So six models were constructed to simulate six conditions. A point load of 500N was applied vertically onto the first node of the lingual slope from the buccal cusp tip. The stress distribution and displacement were solved using ANSYS finite element program(Swanson Analysis System). (omitted)

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.702-709
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• 1997

To compare the marginal leakage of CAD/CAM-fabricated ceramic inlay, gold inlay and amalgam, forty extracted caries-free premolars were prepared with Class II MO cavity design. The teeth were divided into four groups of ten samples each. Group 1 was restored with CAD/CAM-fabricated ceramic inlays cemented with Scotchbond Resin Cement / Scotchbond Multi-purpose plus. Group 2 was restored with gold inlays cemented with Scotchbond Resin Cement / Scotchbond Multi-purpose plus. Group 3 was restored with gold inlays cemented with zinc phosphate cement. And, Group 4 was restored with amalgam. All samples were thermocycled, and stored in 1 % methylene blue. Marginal leakage was examined at four margins, that is, occlusal distal, priximal gingival, occlusal facial and occlusal lingual margins from sectioned samples under stereomicroscope(x15). The results were as follows : 1. Group 1 and 2 showed no statistically significant difference among marginal leakage at all four examined margins(p>0.05). 2. Group 3 and 4 showed significant marginal leakage at proximal gingival margin compared with other margins(p<0.05). 3. Significantly increased marginal leakage at priximal gingival, occlusal facial and occlusal lingual margins in group 3 were observed compared with other groups (p<0.05).

• 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.

• Journal of dental hygiene science
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• v.18 no.1
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• pp.42-49
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• 2018

The computer-aided design/computer-aided manufacturing (CAD/CAM) system was introduced to shorten the production time of all-ceramic restorations and the number of patient visits. Among these types of ceramic for dental CAD/CAM, they have been processed into inlay, onlay, and crown shapes using leucite-reinforced glass-ceramics to improve strength. The purpose of this study was to observe the mechanical properties and microstructure of leucite-reinforced glass-ceramics for dental CAD/CAM. Two types of leucite-reinforced glass-ceramic blocks (IPS Empress CAD, Rosetta BM) were prepared with diameter of 13 mm and thickness of 1 mm. Biaxial flexural testing was conducted using a piston-on-three-ball method at a crosshead speed of 0.5 mm/min. Weibull statistics were used for the analysis of biaxial flexural strength. Fracture toughness was obtained using an indentation fracture method. Specimens were observed by field emission scanning electron microscopy to examine the microstructure of the leucite crystalline phase after acid etching with 0.5% hydrofluoric acid aqueous solution for 1 minute. The results of strength testing showed that IPS Empress CAD had a mean value of $158.1{\pm}8.6MPa$ and Rosetta BM of $172.3{\pm}8.3MPa$. The fracture toughness results showed that IPS Empress CAD had a mean value of $1.28{\pm}0.19MPa{\cdot}m^{1/2}$ and Rosetta BM of $1.38{\pm}0.12MPa{\cdot}m^{1/2}$. The Rosetta BM sample exhibited higher strength and fracture toughness. Moreover, the crystalline phase size and ratio were increased in the Rosetta BM sample. The above results are expected to elucidate the basic mechanical properties and crystal structure characteristics of IPS Empress CAD and Rosetta BM. Additionally, they will help develop leucite-reinforced glass-ceramic materials for CAD/CAM.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.1
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• pp.20-26
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• 2013

Purpose: The purpose of this study was to evaluate the bond strengths between the latest CAD/CAM ceramic inlay and various resin cements which are used primarily for esthetic restoration. Materials and methods: Cylindrical ceramic blocks(Height: 5 mm, diameter: 3 mm) were fabricated by using Cerec3 and bonded on the dentin of the ninety extracted caries-free molars using three different kinds of resin cement(Unicem$^{(R)}$, Biscem$^{(R)}$, and Variolink II$^{(R)}$) according to the manufacturer's instructions. Ninety specimens were divided into 3 groups according to three different kinds of resin cement. Half of each group were conducted thermocycling under the conditions of the $5-55^{\circ}C$, 5,000 cycle but the other half of them weren't. All specimens were kept in normal saline $37^{\circ}C$, for 24 hours before measuring the bond strength. The shear bond strength was measured by Universal testing machine with a cross head speed of 0.5 mm/min. The results were analyzed statistically by t-test and one-way ANOVA. Results: Unicem$^{(R)}$ group showed the highest shear bond strength despite a slight decline by thermocycling. The shear bond strength of Unicem$^{(R)}$ group and ValiolinkII$^{(R)}$ group were significantly influenced by thermocycling, whereas Biscem$^{(R)}$ group was not influenced (P<.05). There were no significant differences in the bond strength between the three groups without thermocycling, but there was significant differences between Unicem$^{(R)}$ group and Valiolink II$^{(R)}$ group with thermocycling(P<.05). Conclusion: It has been shown to be clinically effective when the self-adhesive resin cements Unicem$^{(R)}$ and Biscem$^{(R)}$ were used instead of the etch-and-rinse resin cement Valiolink II$^{(R)}$ during the bonding of CAD/CAM ceramic inlay restorations with teeth.

• Restorative Dentistry and Endodontics
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• v.23 no.1
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• pp.487-501
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• 1998

In the case of CAD/CAM ceramic inlay restorations, if isthmus width is widened too much, it may cause fracture of remaining tooth structure or loss of bonding at the luting interface because of excessive displacement of buccal or lingual cusps under occlusal loads. So to clarify the criterior of widening isthmus width, this study was designed to test the tensile bond strength and bond failure mode between dentin and ceramic cemented with luting composite resin cements. Cylindrical ceramic blocks(Vita Cerec Mark II, d=4mm) were bonded to buccal dentin of 40 freshly extracted third molars with 4 luting composite resin cements(group1 : Scotchbond Resin Cement/Scotchbond Multi-Purpose, group2 : Duolink Resin Cement/ All-Bond 2, group3: Bistite Resin Cement/Ceramics Primer, and group4:Superbond C&B). Tensile bond test was done under universal testing machine using bonding and measuring alignment blocks(${\phi}ilo$ & Urn, 1992). After immersion of fractured samples into 1 % methylene blue for 24 hours, failure mode was analysed under stereomicroscope and SEM. Results: The tensile bond strength of goup 1, 2 & 4 was $13.97{\pm}2.90$ MPa, $16.49{\pm}3.90$ MPa and $16.l7{\pm}4.32$ MPa, respectively. There was no statistical differences(p>0.05). But, group 3 showed significantly lower bond stregnth($5.98{\pm}1.l7$ MPa, p<0.05). In almost all samples, adhesive fractures between dentin and resin cements were observed. But, in group 1, 2 & 4, as bond strength increased, cohesive fracture within resin cement was observed simultaneously. And, in group 3, as bond strength decreased, cohesive fracture between hybrid layer and composite resin cement was also observed. Cohesive fracture within dentin and porcelain adhesive fracture were not observed. In conclusion, although adhesive cements were used in CAD/CAM -fabricated ceramic inlay restorations, the conservative priciples of cavity preparation must be obligated.

• Journal of Technologic Dentistry
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• v.42 no.1
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• pp.9-16
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• 2020

Purpose: The purpose of this study was to compare the marginal and internal fit of lithium disilicate ceramic inlay produced by heat pressing that inlay pattern made by subtractive manufacturing and additive manufacturing method. Methods: A mandibular lower first molar that mesial occlusal cavity (MO cavity) die was prepared. After fabricating an epoxy resin model using a silicone impression material, epoxy resin die was scanned with a dental model scanner to design an MO cavity inlay. The designed STL pile was used to fabricate wax patterns and resin patterns, and then lithium disilicate ceramic inlays were fabricated using hot-press method. For the measurement of the marginal and internal gap of the lithium disilicate, silicone replica method was applied, and gap was measured through an optical microscope (x 80). Data were tested for significant differences using the Mann-Whitney Utest. Results: The marginal fit was 103.56±9.92㎛ in the MIL-IN group and 81.57±9.33㎛ in the SLA-IN group, with a significant difference found between the two groups (p<0.05). The internal fit was 120.99±17.52㎛ in the MIL-IN group and 99.18±6.65㎛ in the SLA-IN group, with a significant difference found between the two groups (p<0.05). Conclusion: It is clinically more appropriate to apply the additive manufacturing than subtractive manufacturing method in producing lithium disilicate inlay using CAD/CAM system.

• The Journal of Advanced Prosthodontics
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• v.16 no.1
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• pp.57-65
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• 2024

PURPOSE. The aim of this stuldy was to compare the clinical marginal fit of CAD-CAM inlays obtained from intraoral digital impression or addition silicone impression techniques. MATERIALS AND METHODS. The study included 31 inlays for prosthodontics purposes of 31 patients: 15 based on intraoral digital impressions (DI group); and 16 based on a conventional impression technique (CI group). Inlays included occlusal and a non-occlusal surface. Inlays were milled in ceramic. The inlay-teeth interface was replicated by placing each inlay in its corresponding uncemented clinical preparation and taking interface impressions with silicone material from occlusal and free surfaces. Interface analysis was made using white light confocal microscopy (WLCM) (scanning area: 694 × 510 ㎛²) from the impression samples. The gap size and the inlay overextension were measured from the microscopy topographies. For analytical purposes (i.e., 95-%-confidence intervals calculations and P-value calculations), the procedure REGRESS in SUDAAN was used to account for clustering (i.e., multiple measurements). For p-value calculation, the log transformation of the dependent variables was used to normalize the distributions. RESULTS. Marginal fit values for occlusal and free surfaces were affected by the type of impression. There were no differences between surfaces (occlusal vs. free). Gap obtained for DI group was 164 ± 84 ㎛ and that for CI group was 209 ± 104 ㎛, and there were statistical differences between them (p = .041). Mean overextension values were 60 ± 59 ㎛ for DI group and 67 ± 73 ㎛ for CI group, and there were no differences between then (p = .553). CONCLUSION. Digital impression achieved inlays with higher clinical marginal fit and performed better than the conventional silicone materials.

• The Journal of Advanced Prosthodontics
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• v.7 no.6
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• pp.446-453
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• 2015

PURPOSE. To compare the push-out bond strength of feldspar and zirconia-based ceramic inlays bonded to dentin with different resin cements following simulated aging. MATERIALS AND METHODS. Occlusal cavities in 80 extracted molars were restored in 2 groups (n=40) with CAD/CAM feldspar (Vitablocs Trilux forte) (FP) and zirconia-based (Ceramill Zi) (ZR) ceramic inlays. The fabricated inlays were luted in 2 subgroups (n=20) with either etch-and-bond (RelyX Ultimate Clicker) (EB) or self-adhesive (RelyX Unicem Aplicap) (SA) resin cement. Ten inlays in each subgroup were subjected to 3,500 thermal cycles and 24,000 loading cycles, while the other 10 served as control. Horizontal 3 mm thick specimens were cut out of the restored teeth for push out bond strength testing. Bond strength data were statistically analyzed using 1-way ANOVA and Tukey's comparisons at ${\alpha}=.05$. The mode of ceramic-cement-dentin bond failure for each specimen was also assessed. RESULTS. No statistically significant differences were noticed between FP and ZR bond strength to dentin in all subgroups (ANOVA, P=.05113). No differences were noticed between EB and SA (Tukey's, P>.05) bonded to either type of ceramics. Both adhesive and mixed modes of bond failure were dominant for non-aged inlays. Simulated aging had no significant effect on bond strength values (Tukey's, P>.05) of all ceramic-cement combinations although the adhesive mode of bond failure became more common (60-80%) in aged inlays. CONCLUSION. The suggested cement-ceramic combinations offer comparable bonding performance to dentin substrate either before or after simulated aging that seems to have no adverse effect on the achieved bond.