• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.3
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• pp.259-268
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• 2007

purpose: This study was to evaluate the shear bond strength of Lithium Disilicate Glass-Ceramic by removable method of temporary cement on the abutment tooth. Material and Method: Sixty molar teeth of human with the occlusal surface up were mounted in acrylic resin blocks. The 45 specimens were prepared to exposure dentin by diamond bur and the eugenol-containing temporary cement($Cavitec^{TM}$ ($KERR^{(R)}$, U.S.A)was applied to the dentin surfaces. After initial removal of the cement with a dental explorer, the specimens were divided into 4 groups of 15 specimens each. The dentin surfaces of the specimens were treated by rotary instrument with as follow pastes: $Zircate^{(R)}$ prophy paste(Dentsply, U.S.A), Radent Prophy Paste(Pascal company,inc. U.S.A), and Dental pumice(Wip mix corporation,U.S.A). An adhesive resin luting agent(Variolink $II^{(R)}$, Ivoclar Vivadent, Leichtenstein) including Monobond-S and $Excite^{(R)}$ was applied to all specimens. The ceramic specimens were made with an A1 ingot of IPS Empress $II^{(R)}$ (Ivoclar Vivadent, Leichtenstein). After the specimens were stored in distilled water for 48hr, the shear bond strength(MPa) was measured by a Universal testing machine(Zwick 145641, Zwick, Germany) at a 1mm/min cross-head speed. The data were statistically analyzed by one-way ANOVA and Duncan's multiple range test. Results: In all group, there were no significant differences in comparison with the control group(p>0.05). The pattern of most failure showed the mixed type of cohesive and adhesive failure. Conclusion: Resin bond strength of IPS Empress $II^{(R)}$ was not affected by removal method of the temporary cement.

• The Journal of Advanced Prosthodontics
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• v.10 no.4
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• pp.300-307
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• 2018

PURPOSE. To investigate the fatigue and fracture resistance of computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic molar crowns on dental implants and human teeth. MATERIALS AND METHODS. Molar crowns (n=48; n=8/group) were fabricated of a lithium-disilicate-strengthened lithium aluminosilicate glass ceramic (N). Surfaces were polished (P) or glazed (G). Crowns were tested on human teeth (T) and implant-abutment analogues (I) simulating a chairside (C, crown bonded to abutment) or labside (L, screw channel) procedure for implant groups. Polished/glazed lithium disilicate (E) crowns (n=16) served as reference. Combined thermal cycling and mechanical loading (TC: $3000{\times}5^{\circ}C/3000{\times}55^{\circ}C$; ML: $1.2{\time}10^6$ cycles, 50 N) with antagonistic human molars (groups T) and steatite spheres (groups I) was performed under a chewing simulator. TCML crowns were then analyzed for failures (optical microscopy, SEM) and fracture force was determined. Data were statistically analyzed (Kolmogorow-Smirnov, one-way-ANOVA, post-hoc Bonferroni, ${\alpha}=.05$). RESULTS. All crowns survived TCML and showed small traces of wear. In human teeth groups, fracture forces of N crowns varied between $1214{\pm}293N$ (NPT) and $1324{\pm}498N$ (NGT), differing significantly ($P{\leq}.003$) from the polished reference EPT ($2044{\pm}302N$). Fracture forces in implant groups varied between $934{\pm}154N$ (NGI_L) and $1782{\pm}153N$ (NPI_C), providing higher values for the respective chairside crowns. Differences between polishing and glazing were not significant ($P{\geq}.066$) between crowns of identical materials and abutment support. CONCLUSION. Fracture resistance was influenced by the ceramic material, and partly by the tooth or implant situation and the clinical procedure (chairside/labside). Type of surface finish (polishing/glazing) had no significant influence. Clinical survival of the new glass ceramic may be comparable to lithium disilicate.

• Journal of the Korean Ceramic Society
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• v.41 no.2
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• pp.143-150
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• 2004

Biaxial flexure strength (ball-on-3-ball) and fracture toughness (indentation microfracture) of heat-pressable glass-ceramics for dental use were investigated in this study. Crystal phase and microstructure of glass-ceramics were analyzed by XRD. SEM, and TEM. Crack propagation in specimens was not effectively arrested by dispersed crystalline particles. However, higher degree of crystallization probably contributes to strengthening of glass-ceramics. Better clinical reliability can be expected from lithium disilicate glass-ceramic because of its significantly higher biaxial flexure strength and fracture toughness.

• The Journal of Advanced Prosthodontics
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• v.9 no.3
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• pp.188-194
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• 2017

PURPOSE. This study was to evaluate the effect of repeated ultrasonic scaling and surface polishing with intraoral polishing kits on the surface roughness of three different restorative materials. MATERIALS AND METHODS. A total of 15 identical discs were fabricated with three different materials. The ultrasonic scaling was conducted for 20 seconds on the test surfaces. Subsequently, a multi-step polishing with recommended intraoral polishing kit was performed for 30 seconds. The 3D profiler and scanning electron microscopy were used to investigate surface integrity before scaling (pristine), after scaling, and after surface polishing for each material. Non-parametric Friedman and Wilcoxon signed rank sum tests were employed to statistically evaluate surface roughness changes of the pristine, scaled, and polished specimens. The level of significance was set at 0.05. RESULTS. Surface roughness values before scaling (pristine), after scaling, and polishing of the metal alloys were $3.02{\pm}0.34{\mu}m$, $2.44{\pm}0.72{\mu}m$, and $3.49{\pm}0.72{\mu}m$, respectively. Surface roughness of lithium disilicate increased from $2.35{\pm}1.05{\mu}m$ (pristine) to $28.54{\pm}9.64{\mu}m$ (scaling), and further increased after polishing ($56.66{\pm}9.12{\mu}m$, P<.05). The zirconia showed the most increase in roughness after scaling (from $1.65{\pm}0.42{\mu}m$ to $101.37{\pm}18.75{\mu}m$), while its surface roughness decreased after polishing ($29.57{\pm}18.86{\mu}m$, P<.05). CONCLUSION. Ultrasonic scaling significantly changed the surface integrities of lithium disilicate and zirconia. Surface polishing with multi-step intraoral kit after repeated scaling was only effective for the zirconia, while it was not for lithium disilicate.

• The Journal of Advanced Prosthodontics
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• v.10 no.1
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• pp.65-72
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• 2018

PURPOSE. The aim of this in vitro study was to investigate the fracture resistance under chewing simulation of implant-supported posterior restorations (crowns cemented to hybrid-abutments) made of different all-ceramic materials. MATERIALS AND METHODS. Monolithic zirconia (MZr) and monolithic lithium disilicate (MLD) crowns for mandibular first molar were fabricated using computer-aided design/computer-aided manufacturing technology and then cemented to zirconia hybrid-abutments (Ti-based). Each group was divided into two subgroups (n=10): (A) control group, crowns were subjected to single load to fracture; (B) test group, crowns underwent chewing simulation using multiple loads for 1.2 million cycles at 1.2 Hz with simultaneous thermocycling between $5^{\circ}C$ and $55^{\circ}C$. Data was statistically analyzed with one-way ANOVA and a Post-Hoc test. RESULTS. All tested crowns survived chewing simulation resulting in 100% survival rate. However, wear facets were observed on all the crowns at the occlusal contact point. Fracture load of monolithic lithium disilicate crowns was statistically significantly lower than that of monolithic zirconia crowns. Also, fracture load was significantly reduced in both of the all-ceramic materials after exposure to chewing simulation and thermocycling. Crowns of all test groups exhibited cohesive fracture within the monolithic crown structure only, and no abutment fractures or screw loosening were observed. CONCLUSION. When supported by implants, monolithic zirconia restorations cemented to hybrid abutments withstand masticatory forces. Also, fatigue loading accompanied by simultaneous thermocycling significantly reduces the strength of both of the all-ceramic materials. Moreover, further research is needed to define potentials, limits, and long-term serviceability of the materials and hybrid abutments.

• The Journal of Advanced Prosthodontics
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• v.8 no.3
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• pp.194-200
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• 2016

PURPOSE. The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS. 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS. Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION. Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.4
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• pp.407-418
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• 2007

Purpose: The objective of this study was to evaluate the effects of hydrofluoric acid concentration & etching time on the shear bond strength between IPS Empress 2 ceramic and resin cement. Material and methods: Thirty three rectangular shape ceramic specimens($20{\times}12{\times}5mm$ size, IPS Empress 2 core materials) were used for this study. The ceramic specimens divided into ten experimental groups with three specimens in each group and were etched with hydrofluoric acid(4%, 9%) according to different etching times(30s, 60s, 90s, 120s, 180s). Etched surfaces of ceramic specimens were bonded with resin cement(Rely X Unicorn) using acrylic glass tube. All cemented specimens were tested under shear loading until fracture on universal testing machine at a crosshead speed of 0.5mm/min and the maximum load at fracture(kg) was recorded. Collected shear bond strength data were analyzed with one way ANOVA and Duncan tests. All etched ceramic surfaces were examined morphologically using SEM(scanning electron microscopy). Results: Shear bond strength of etching group$(35.89{\sim}68.01MPa)$ had four to seven times greater than no-etching group$(9.53{\pm}2.29MPa)$. The ceramic specimen etched with 4% hydrofluoric acid for 60s showed the maximum shear bond strength$(68.01{\pm}11.78MPa)$. Ceramic surface etched with 4% hydrofluoric acid for 60s showed most retentive surface texture. Conclusion: It is considered that 60s etching with 4% hydrofluoric acid is optimal etching methods for IPS Empress 2 ceramic bonding.

• The Journal of Advanced Prosthodontics
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• v.12 no.1
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• pp.1-8
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• 2020

PURPOSE. To investigate the influence of crown material (lithium-disilicate, 3Y-TZP zirconia) and abutment type (rigid implant, resin tooth with artificial periodontium) on wear performance of their antagonist teeth and adjacent teeth. MATERIALS AND METHODS. A mandibular left first molar (#36) with adjacent human teeth (mandibular left second premolar: #35, mandibular left second molar: #37) and antagonistic human teeth (maxillary left second premolar: #25, maxillary left first molar: #26, maxillary left second molar: #27) was prepared simulating a section of the jaw. Samples were made with extracted human molars (Reference), crowned implants (Implant), or crowned resin tooth analogues (Tooth). Crowns (tooth #36; n = 16/material) were milled from lithium-disilicate (Li, IPS e.max CAD) or 3Y-TZP zirconia (Zr, IPS e.max ZirCAD, both Ivoclar Vivadent). Thermal cycling and mechanical loading (TCML) in the chewing simulator were applied simulating 15 years of clinical service. Wear traces were analyzed (frequency [n], depth [㎛]) and evaluated using scanning electron pictures. Wear results were compared by one-way-ANOVA and post-hoc-Bonferroni (α = 0.05). RESULTS. After TCML, no visible wear traces were found on Zr. Li showed more wear traces (n = 30-31) than the reference (n = 21). Antagonistic teeth #26 showed more wear traces in contact to both ceramics (n = 27-29) than to the reference (n = 21). Strong wear traces (> 350 ㎛) on antagonists and their adjacent teeth were found only in crowned groups. Abutment type influenced number and depth of wear facets on the antagonistic and adjacent teeth. CONCLUSION. The clinically relevant model with human antagonistic and adjacent teeth allowed for a limited comparison of the wear situation. The total number of wear traces and strong wear on crowns, antagonistic and adjacent teeth were influenced by crown material.

• The Journal of Advanced Prosthodontics
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• v.6 no.6
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• pp.434-443
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• 2014

PURPOSE. The purpose of this study was to evaluate and compare the effects of different surface pretreatment techniques on the surface roughness and shear bond strength of a new self-adhering flowable composite resin for use with lithium disilicate-reinforced CAD/CAM ceramic material. MATERIALS AND METHODS. A total of one hundred thirty lithium disilicate CAD/CAM ceramic plates with dimensions of $6mm{\times}4mm$ and 3 mm thick were prepared. Specimens were then assigned into five groups (n=26) as follows: untreated control, coating with $30{\mu}m$ silica oxide particles ($Cojet^{TM}$ Sand), 9.6% hydrofluoric acid etching, Er:YAG laser irradiation, and grinding with a high-speed fine diamond bur. A self-adhering flowable composite resin (Vertise Flow) was applied onto the pre-treated ceramic plates using the Ultradent shear bond Teflon mold system. Surface roughness was measured by atomic force microscopy. Shear bond strength test were performed using a universal testing machine at a crosshead speed of 1 mm/min. Surface roughness data were analyzed by one-way ANOVA and the Tukey HSD tests. Shear bond strength test values were analyzed by Kruskal-Wallis and Mann-Whitney U tests at ${\alpha}=.05$. RESULTS. Hydrofluoric acid etching and grinding with high-speed fine diamond bur produced significantly higher surface roughness than the other pretreatment groups (P<.05). Hydrofluoric acid etching and silica coating yielded the highest shear bond strength values (P<.001). CONCLUSION. Self-adhering flowable composite resin used as repair composite resin exhibited very low bond strength irrespective of the surface pretreatments used.

• The Journal of Advanced Prosthodontics
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• v.12 no.4
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• pp.181-188
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• 2020

PURPOSE. The effect of core design on the fracture resistance of zirconia-lithium disilicate (LS2) bilayered crowns for anterior teeth is evaluated by comparing with that of metal-ceramic crowns. MATERIALS AND METHODS. Forty customized titanium abutments for maxillary central incisor were prepared. Each group of 10 units was constructed using the same veneer form of designs A and B, which covered labial surface to approximately one third of the incisal and cervical palatal surface, respectively. LS2 pressed-on-zirconia (POZ) and porcelain-fused-to-metal (PFM) crowns were divided into "POZ_A," "POZ_B," "PFM_A," and "PFM_B" groups, and 6000 thermal cycles (5/55 ℃) were performed after 24 h storage in distilled water at 37 ℃. All specimens were prepared using a single type of self-adhesive resin cement. The fracture resistance was measured using a universal testing machine. Failure mode and elemental analyses of the bonding interface were performed. The data were analyzed using Welch's t-test and the Games-Howell exact test. RESULTS. The PFM_B (1376. 8 ± 93.3 N) group demonstrated significantly higher fracture strength than the PFM_A (915.8 ± 206.3 N) and POZ_B (963.8 ± 316.2 N) groups (P<.05). There was no statistically significant difference in fracture resistance between the POZ_A (1184.4 ± 319.6 N) and POZ_B groups (P>.05). Regardless of the design differences of the zirconia cores, fractures involving cores occurred in all specimens of the POZ groups. CONCLUSION. The bilayered anterior POZ crowns showed different fracture resistance and fracture pattern according to the core design compared to PFM.