An increasing demand for esthetic restorations has led to the development of new ceramic systems. In-Ceram, a glass-infiltrated alumina ceramic has three to few times greater flexural strength than other ceramic glass material. Because of its high strength, In-Ceram has been suggested as inlay, crown, laminate veneer and core material for resin bonded fixed partial dentures. This clinical application requires a stable resin bond to In-Ceram core. The purpose of this study was to evaluate the shear bond strength between In-Ceram core and resin cements according to various surface treatments and storage conditions. The surface of each In-Ceram core sample was subjected to one of the following treatments and then bonded to Panavia 21 or Variolink II resin cement. ; (1) sandblasting with $110{\mu}m$ aluminum oxide powder, (2) sandblasting and silanization, (3) sandblasting and Siloc treatment, (4) sandblasting and Targis link application. Each of eight bonding groups was tested in shear bond strengths after the following storage times and thermocycling. ; A) 24 hours storage in distilled water at $37^{\circ}C$, B) 5 weeks storage in distilled water at $37^{\circ}C$ C) 5 weeks storage in distilled water at $37^{\circ}C$ and thermocycled 2,000 thormocycling for every 10 days(totally 10,000 thermocycting) in $5^{\circ}C-55^{\circ}C$ bath. The bond failure modes were observed with scanning electron microscope(SEM). The results were as fellows : 1 The shear bond strengths of sandblasting group were significantly lesser than the other groups after 24 hours water storage. No significant difference of bonding strengths was found between storage time conditions(24 hours and 5 weeks). The shear bond strengths showed a tendency to decrease in Variolink II bonding groups and to increase in Panavia 21 bonding groups. 3. After thermocycling, the shear bond strengths of all groups were significantly decreased(p<0.01) and Targis link group exhibited significantly greater strengths than the other groups(p<0.05). 4. Panavia 21 bonding groups exhibited significantly greater bonding strengths in sandblasting group(p<0.01) and silane group(p<0.05) than Variolink II bonding groups. 5. In observation of bond failure modes, Targis link group showed cohesive failure in resin part and silane group and Siloc group showed complex failure and sandblasting group showed adhesive failure between In-Ceram and resin.
PURPOSE. To evaluate the effects of surface treatments on shear bond strength (SBS) between microwave and conventionally sintered zirconia core/veneers. MATERIALS AND METHODS. 96 disc shaped Noritake Alliance zirconia specimens were fabricated using YenaDent CAM unit and were divided in 2 groups with respect to microwave or conventional methods (n=48/group). Surface roughness (Ra) evaluation was made with a profilometer on randomly selected microwave (n=10) and conventionally sintered (n=10) cores. Specimens were then assessed into 4 subgroups according to surface treatments applied (n=12/group). Groups for microwave (M) and conventionally (C) sintered core specimens were as follows; $M_C$,$C_C$: untreated (control group), $M_1,C_1:Al_2O_3$ sandblasting, $M_2,C_2$:liner, $M_3,C_3:Al_2O_3$ sandblasting followed by liner. Veneer ceramic was fired on zirconia cores and specimens were thermocycled (6000 cycles between $5^{\circ}-55^{\circ}C$). All specimens were subjected to SBS test using a universal testing machine at 0.5 mm/min, failure were evaluated under an optical microscope. Data were statistically analyzed using Shapiro Wilk, Levene, Post-hoc Tukey HSD and Student's t tests, Two-Way-Variance- Analysis and One-Way-Variance-Analysis (${\alpha}$=.05). RESULTS. Conventionally sintered specimens ($1.06{\pm}0.32{\mu}m$) showed rougher surfaces compared to microwave sintered ones ($0.76{\pm}0.32{\mu}m$)(P=.046), however, no correlation was found between SBS and surface roughness (r=-0.109, P=.658). The statistical comparison of the shear bond strengths of $C_3$ and $C_1$ group (P=.015); $C_C$ and $M_C$ group (P=.004) and $C_3$ and $M_3$ group presented statistically higher (P=.005) values. While adhesive failure was not seen in any of the groups, cohesive and combined patterns were seen in all groups. CONCLUSION. Based on the results of this in-vitro study, $Al_2O_{3-}$ sandblasting followed by liner application on conventionally sintered zirconia cores may be preferred to enhance bond strength.
PURPOSE. Zirconia has been used in clinical dentistry for approximately a decade, and there have been several reports regarding the clinical performance and survival rates of zirconia-based restorations. The aim of this article was to review the literatures published from 2000 to 2010 regarding the clinical performance and the causes of failure of zirconia fixed partial dentures (FPDs). MATERIALS AND METHODS. An electronic search of English peer-reviewed dental literatures was performed through PubMed to obtain all the clinical studies focused on the performance of the zirconia FPDs. The electronic search was supplemented by manual searching through the references of the selected articles for possible inclusion of some articles. Randomized controlled clinical trials, longitudinal prospective and retrospective cohort studies were the focuses of this review. Articles that did not focus on the restoration of teeth using zirconia-based restorations were excluded from this review. RESULTS. There have been three studies for the study of zirconia single crowns. The clinical outcome was satisfactory (acceptable) according to the CDA evaluation. There have been 14 studies for the study of zirconia FPDs. The survival rates of zirconia anterior and posterior FPDs ranged between 73.9% - 100% after 2 - 5 years. The causes of failure were veneer fracture, ceramic core fracture, abutment tooth fracture, secondary caries, and restoration dislodgment. CONCLUSION. The overall performance of zirconia FPDs was satisfactory according to either USPHS criteria or CDA evaluations. Fracture resistance of core and veneering ceramics, bonding between core and veneering materials, and marginal discrepancy of zirconia-based restorations were discussed as the causes of failure. Because of its repeated occurrence in many studies, future researches are essentially required to clarify this problem and to reduce the fracture incident.
Statement of problem: At all times people have tried to fabricate tooth restorations using tooth colored materials. Recently, demands for esthetics, even in restorations requiring strength, has brought a revolution to dentistry and increased use of zirconia. The basic color of zirconia is white to ivory. The color can be partially adapted by veneering it with ceramic materials. However, it would be better if the substructure could already be adapted to the basic color shade of neighboring teeth. By adaptation to the basic shade, it can help to reduce the necessary layer thickness of the veneer ceramic to achieve the desired color. Purpose: The purpose of this study was to spectrophotometrically evaluate the influence of shading of zirconia core on the final shade of all-ceramic restorations using the CIE $L^{*}a^{*}b^{*}$ system. Material and methods: Core specimens (n = 20 per group) of Lava Frame Zirconia, KaVo Everest Zirconia, Digident CAD/CAM Zirconia were fabricated at 20 mm in diameter and 0.5 mm in thickness. Halves of each groups were shaded in A3 color. These core specimens were veneered with A3 porcelain of the recommended manufacturer at thickness of 0.5 mm. CIE $L^{*}a^{*}b^{*}$ coordinates were recorded for each specimen with a spectrophotometer (Model CM-2600d, Minolta, Japan) at 0.5 mm, 0.4 mm, 0.3 mm in thickness. Color differences were calculated using the equation ${\Delta}E^{*}=[({\Delta}L^{*})2+({\Delta}a^{*})2+({\Delta}b^{*})2]1/2$. Results: 1. In the case where porcelain layer has a thickness of 0.5 mm, Lava Frame Zirconia and KaVo Everest group did not show clinically perceived color difference, however Digident CAD/CAM Zirconia group showed clinically perceived color difference according to shade allowed on core. 2. When the thickness of porcelain layer decreased from 0.5 mm to 0.4 mm, Lava Frame Zirconia and KaVo Everest group did not show clinically perceived color difference, on the other hand Digident CAD/CAM Zirconia group showed clinically perceived color difference according to shade allowed on core. 3. When the thickness of porcelain layer decreased from 0.5 mm to 0.3 mm, clinically perceived color differences were observed from all three groups. Conclusions: Ziroconia system, which is possible to allow shade on core, are thought to be much more favorable to reproduce natural shade compared to systems that is impossible to give shade. Therefore, clinicians ought to choose adequate system for certain clinical situation by considering above specific character.
PURPOSE. The aim of this study was to evaluate the biaxial flexural strength (BFS) of one zirconia-based ceramic used with various veneering ceramics. MATERIALS AND METHODS. Zirconia core material (Katana) and five veneering ceramics (Cerabien ZR; CZR, Lava Ceram; LV, Cercon Ceram Kiss; CC, IPS e.max Ceram; EM and VITA VM9; VT) were selected. Using the powder/liquid layering technique, bilayered disk specimens (diameter: 12.50 mm, thickness: 1.50 mm) were prepared to follow ISO standard 6872:2008 into five groups according to veneering ceramics as follows; Katana zirconia veneering with CZR (K/CZR), Katana zirconia veneering with LV (K/LV), Katana zirconia veneering with CC (K/CC), Katana zirconia veneering with EM (K/EM) and Katana zirconia veneering with VT (K/VT). After 20,000 thermocycling, load tests were conducted using a universal testing machine (Instron). The BFS were calculated and analyzed with one-way ANOVA and Tukey HSD (${\alpha}$=0.05). The Weibull analysis was performed for reliability of strength. The mode of fracture and fractured surface were observed by SEM. RESULTS. It showed that K/CC had significantly the highest BFS, followed by K/LV. BFS of K/CZR, K/EM and K/VT were not significantly different from each other, but were significantly lower than the other two groups. Weibull distribution reported the same trend of reliability as the BFS results. CONCLUSION. From the result of this study, the BFS of the bilayered zirconia/veneer composite did not only depend on the Young's modulus value of the materials. Further studies regarding interfacial strength and sintering factors are necessary to achieve the optimal strength.
Purpose: This study was to observe the surface and interfacial characteristic of Zirconia by surface treatment. And it was observed the roughness and contact angle according to processing, and the interfacial properties by surface treatment on zirconia. Methods: The oxide formation and ion diffusion between core and veneer ceramic were determined by the X-ray Dot Mapping of EPMA(Electron probe micro analyzer). The roughness was measured by 3D Digital microscope and the contact angle according to processing of zirconia was observed using distilled water on the surface. Results: The surface roughness of the specimens Z04, Z12, Z15 was measured $0.67({\pm}0.03){\mu}m$, $0.50({\pm}0.12){\mu}m$, $0.35({\pm}0.09){\mu}m$, respectively. As results of contact angle test, Z04, Z12, Z15 of specimen group without binder treatment was measured $46.79({\pm}3.17)^{\circ}$, $57.47({\pm}4.83)^{\circ}$, $56.19({\pm}2.66)^{\circ}$, respectively. but, L04, L12, L15 of specimen group without binder treatment was measured $63.84({\pm}2.20)^{\circ}$, $66.08({\pm}0.16)^{\circ}$, $65.10({\pm}1.01)^{\circ}$, respectively. Average contact angle of L15 was measured $65.10({\pm}1.01)^{\circ}$. In X-ray Dot Mapping results, thickness of binder including Al element was measured that each of L04, L12, L15 were $20{\mu}m$, $15{\mu}m$, $10{\mu}m$. Conclusion: The more rough surface increases the wettability, but the sintered exclusive binder decreases the wettability.
PURPOSE. Veneering porcelain might be delaminated from underlying zirconia-based ceramics. The aim of this study was the evaluation of the effect of different surface treatments and type of zirconia (white or colored) on shear bond strength (SBS) of zirconia core and its veneering porcelain. MATERIALS AND METHODS. Eighty zirconia disks (40 white and 40 colored; 10 mm in diameter and 4 mm thick) were treated with three different mechanical surface conditioning methods (Sandblasting with $110{\mu}m$$Al_2O_3$ particle, grinding, sandblasting and liner application). One group had received no treatment. These disks were veneered with 3 mm thick and 5 mm diameter Cercon Ceram Kiss porcelain and SBS test was conducted (cross-head speed = 1 mm/min). Two and one way ANOVA, Tukey's HSD Past hoc, and T- test were selected to analyzed the data (${\alpha}=0.05$). RESULTS. In this study, the factor of different types of zirconia ceramics (P=.462) had no significant effect on SBS, but the factors of different surface modification techniques (P=.005) and interaction effect (P=.018) had a significant effect on SBS. Within colored zirconia group, there were no significant differences in mean SBS among the four surface treatment subgroups (P=0.183). Within white zirconia group, "Ground group" exhibited a significantly lower SBS value than "as milled" or control (P=0.001) and liner (P=.05) groups. CONCLUSION. Type of zirconia did not have any effect on bond strength between zirconia core and veneer ceramic. Surface treatment had different effects on the SBS of the different zirconia types and grinding dramatically decreased the SBS of white zirconia- porcelain.
Purpose: The purposes of this study was to evaluates shear bond strength between zirconia core and veneer-ceramic in order to examine the clinical practice of colored zirconia block fabricated by infiltration method into the metal chloride solution. Material and methods: CNU block and $Everest{(R)}$ ZS blank were used. VITA In-$Ceram{(R)}$2000 YZ Coloring liquid (LL1) and 3 aqueous metal chloride solutions containing chromium and molybdenum ingredients were used. 40 zirconia specimens were prepared into cuboid shape ($5{\times}5{\times}10 mm$). All specimens were divided into 5 groups by infiltrating into the coloring liquids. After that, porcelain was build up into the shape of $5{\times}5{\times}4mm^3$, followed by sintering. The maximum loading and shear bond strength was measured. Failure patterns and failure sites were examined. Results: 1. There were no statistical differences in shear bond strength between zirconia blocks (P > .05). 2. There were no statistically significant differences in shear bond strength between non-colored and colored zirconia blocks, while shear bond strength of non-colored zirconia blocks is higher than that of colored specimen (P > .05). 3. In the comparison with shear bond strength among colored zirconia blocks, there were no statistical differences according to kinds of coloring liquid (P > .05). 4. Mixed failure patterns were mainly observed in the failure between zirconia and veneering ceramic. The veneering ceramic failure of all specimens was observed in either interface of zirconia or veneering ceramic. Conclusion: Shear bond strength between colored zirconia and veneering ceramic shows lower tendency than non-colored zirconia, but there was clinically allowable value.
The digital impression technique has been developed for more precise restorations and convenient procedures in prosthodontic treatment compared to the conventional impression technique. Along with the utilization of CAD/CAM, the introduction of digital impression technique actualizes the digitalization of dental treatments. This case is to compare two different prostheses introducing each procedure in detail; one from CAD/CAM after taking digital impression and the other from the conventional technique. A 22-year-old female visited the clinic with the chief complaint of correction of discoloration and shape on maxillary right central incisor. Due to the trauma 8 years ago, the tooth was endodontically treated with post and resin core. The treatment was planned and the procedures were conducted under the patient's consent to treat the tooth with all ceramic crowns in two different ways for comparison. In conclusion, both prostheses presented clinically acceptable results with comparing the internal fitness of two all ceramic crowns. The prosthesis from digital impression, however, showed more errors in respect of internal fitness.
Objectives: This study aimed to evaluate the ability of lithium disilicate ceramics to reproduce the A2 shade and to mask A4 substrates. Materials and Methods: Twenty-four discs (8 mm in diameter, shade A2) of high translucency (groups 1-3) and low translucency (groups 4-6) of IPS e.max ceramic with different thicknesses (0.5, 0.75, and 1 mm) were fabricated as monolithic structures. In addition, discs of medium opacity (group 7-8) with different core/veneer combinations (0.3 mm/0.7 mm and 0.5 mm/0.5 mm) were fabricated as bilayer structures. Specimens were superimposed on an A4 substrate (complex). The color changes of the complex were measured using a spectrophotometer on a black background, and the ΔE values of the complex were compared with either the A4 substrate or the A2 shade tab. One-way analysis of variance, the Tukey honest significant difference test, and the Fisher test were used to analyze the data (p < 0.05). Results: Significant between-group differences were found for comparisons to both the A4 substrate and the A2 shade (p < 0.05). When compared with the A4 substrate, the ΔE values in all groups were in the non-acceptable range. When compared with the A2 shade, the ΔE values in all groups, except groups 2 and 3, were in the clinically acceptable range. Conclusions: All translucencies and thicknesses masked the underlying dark substrate. However, the low-translucency IPS e.max Press better reproduced the A2 shade.
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