• The Journal of Advanced Prosthodontics
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• v.13 no.1
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• pp.36-45
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• 2021

Purpose. To investigate the fracture resistance of monolithic CAD-CAM all-ceramic surveyed crowns with two different occlusal rest seat designs. Materials and Methods. Two maxillary first premolar were prepared for all-ceramic surveyed crowns with wide (2/3rd of buccolingual width of an unprepared tooth) or narrow (1/3rd of buccolingual width of an unprepared tooth) disto-occlusal rest seat (ORS) designs. Eighty monolithic CAD-CAM all-ceramic surveyed crowns were prepared and divided into 4 groups - Group CR, Composite resin material as a control; Group LDS, Lithium disilicate based material; Group ZIPS, zirconia-material (IPS ZirCAD); and Group ZLHT, zirconia- material (CeramillZolidht+). Crowns were cemented on an epoxy resin die with adhesive resin cement. The fracture resistance of crowns was tested with the universal machine. Univariate regression analysis was used. Results. The mean ± standard deviation of maximum failure force values varied from 3476.10 ± 285.97 N for the narrow ORS subgroup of group ZIPS to 687.89 ± 167.63 N for the wide ORS subgroup of group CR. The mean ± standard deviation of maximum force was 1075 ± 77.0 N for group CR, 1309.3 ± 283.9 N for group LDS, 3476.1 ± 285.97 N for group ZIPS, and 2666.7 ± 228.21 N for group ZLHT, with narrow occlusal rest seat design. The results of the intergroup comparison showed significant differences in fracture strength with various material groups and occlusal rest seat designs (P<.001). Conclusion. The zirconia-based all-ceramic surveyed crowns fractured at more than double the load of Lithium disilicate based crowns. The crowns with narrow base occlusal rest seat design had statistically significantly higher fracture resistance than surveyed crowns with wide occlusal rest seat design. The use of narrow occlusal rest seat design in CAD-CAM all ceramic surveyed crowns provides higher fracture resistance, and therefore narrow occlusal rest design can be used for providing esthetics with high strength.

• The Journal of Advanced Prosthodontics
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• v.15 no.1
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• pp.44-54
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• 2023

PURPOSE. To assess the clinical performance of monolithic CAD-CAM lithium disilicate glass-ceramic (LDGC) crowns and metal-ceramic (MC) crowns provided by predoctoral students. This study also assessed the effects of patient and provider-related factors on their clinical performance as well as patient preference for these types of crowns. MATERIALS AND METHODS. Twenty-five patients who received 50 crowns (25 LDGC CAD-CAM and 25 MC) provided by predoctoral students were retrospectively examined. LDGC CAD-CAM crowns were milled in-house using the CEREC Bluecam system and cemented with either RelyX Unicem or Calibra Esthetic resin cements. MC crowns were cemented with RelyX Unicem cement. Clinical assessment of the crowns and the supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Patients' preference was recorded using a visual analog scale (VAS). The results were statistically analyzed using log-rank test, Pearson Chi-squared test and Kaplan-Meier survival analysis. RESULTS. Twelve complications were observed in the MC crown group (9-esthetic, 2-technical and 1-biological). In comparison, 2 complications in the LDGC CAD-CAM crown group were observed (1-technical and 1-esthetic). The 6-year cumulative survival rates for MC crowns and LDGC CAD-CAM were 90.8% and 96%, respectively, whereas the success rates were 83.4% and 96%, respectively. Overall, patients preferred the esthetic outcomes of LDGC CAD-CAM crowns over MC crowns. CONCLUSION. The high survival and success rates, low number of complications, and the high level of patients' acceptance of monolithic LDGC CAD-CAM crowns lend them well as predictable and viable alternatives to the "gold standard" MC crowns.

• Restorative Dentistry and Endodontics
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• v.45 no.3
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• pp.41.1-41.7
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• 2020

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.

• The Journal of Advanced Prosthodontics
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• v.6 no.3
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• pp.151-156
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• 2014

PURPOSE. To investigate the microtensile bond strength between two all-ceramic systems; lithium disilicate glass ceramic and zirconia core ceramics bonded with their corresponding glass veneers. MATERIALS AND METHODS. Blocks of core ceramics (IPS e.max$^{(R)}$ Press and Lava$^{TM}$ Frame) were fabricated and veneered with their corresponding glass veneers. The bilayered blocks were cut into microbars; 8 mm in length and $1mm^2$ in cross-sectional area (n = 30/group). Additionally, monolithic microbars of these two veneers (IPS e.max$^{(R)}$ Ceram and LavaTM Ceram; n = 30/group) were also prepared. The obtained microbars were tested in tension until fracture, and the fracture surfaces of the microbars were examined with fluorescent black light and scanning electron microscope (SEM) to identify the mode of failure. One-way ANOVA and the Dunnett's T3 test were performed to determine significant differences of the mean microtensile bond strength at a significance level of 0.05. RESULTS. The mean microtensile bond strength of IPS e.max$^{(R)}$ Press/IPS e.max$^{(R)}$ Ceram ($43.40{\pm}5.51$ MPa) was significantly greater than that of Lava$^{TM}$ Frame/Lava$^{TM}$ Ceram ($31.71{\pm}7.03$ MPa)(P<.001). Fluorescent black light and SEM analysis showed that most of the tested microbars failed cohesively in the veneer layer. Furthermore, the bond strength of Lava$^{TM}$ Frame/Lava$^{TM}$ Ceram was comparable to the tensile strength of monolithic glass veneer of Lava$^{TM}$ Ceram, while the bond strength of bilayered IPS e.max$^{(R)}$ Press/IPS e.max$^{(R)}$ Ceram was significantly greater than tensile strength of monolithic IPS e.max$^{(R)}$ Ceram. CONCLUSION. Because fracture site occurred mostly in the glass veneer and most failures were away from the interfacial zone, microtensile bond test may not be a suitable test for bonding integrity. Fracture mechanics approach such as fracture toughness of the interface may be more appropriate to represent the bonding quality between two materials.

• The Journal of the Korean dental association
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• v.58 no.7
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• pp.413-434
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• 2020

Recently, there are much improvement in optical and mechanical properties of dental ceramic materials coupled with improved fabrication techniques, which have caused a considerable shift in the preference of the dentists to ceramic restorations. Because the chemical composition and microstructure of all-ceramic materials are different by the type, correct choice of cement type and surface treatment procedure, and cementation strategy is essential for the success of ceramic restorations with adequate retention and decreased incidence of complications. This manuscript reviews on the most often prescribed and some newly developed ceramic materials, and the selection criteria and usage guidelines of cement materials that are used in conjunction with various ceramic materials. This manuscript emphasizes that continuous updating the information of newly developed ceramic and cement materials and application techniques by the dentists and dental staffs are demanding in response to the constantly improving ceramic and cement materials and corresponding application protocol changes.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.226-233
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• 2016

Purpose: The purpose of this study was to evaluate the adaptation of lithium disilicate crowns fabricated by CAD-CAM (computer aided design-computer aided manufacturing) and heat-press technique to compare two different measurement methods in assessing fit of the ceramic crowns: micro CT and cross-section technique. Materials and methods: A prepared typodont mandibular molar for ceramic crown was duplicated and ten dies were produced by milling the PMMA (polymethylmethacrylate) resin. Ten vinyl polysiloxane impressions were made and stone casts were produced. Five dies were used for IPS e.max Press crowns with heat-press technique. The other five dies were used for IPS e.max CAD crowns with CAD-CAM technique. Ten lithium disilicate crowns were cemented on the resin dies using zinc phosphate cement with finger pressure. The marginal and internal fits in central buccolingual plane were evaluated using a micro CT. Then the specimens were embedded and cross-sectioned and the marginal and internal fits were measured using scanning electronic microscope. The two measurement methods and two manufacturing methods were compared using Mann-Whitney U test (SPSS 22.0). Results: The marginal and internal fit values using micro CT and cross-section technique were similar, showing no significant differences. There were no significant differences in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique. Conclusion: Both micro CT and cross-section technique were acceptable methods in the evaluation of marginal and internal fit of lithium disilicate crown. There was no difference in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique except occlusal fit.

• The Journal of the Korean dental association
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• v.56 no.3
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• pp.159-166
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• 2018

The zirconia-reinforced lithium silicate ceramic material is a material in which lithium silicate glass contains about 10% by weight of zirconia oxide (zirconia oxide). This material has both the advantages of glass ceramics and zirconia, and it is attracting attention as a CADCAM material for single tooth restoration. ZLS materials have improved strength compared to widely used e.max (lithium disilicate ceramic) materials. It can be used for single crown restoration and ensuring a thickness of 1.5 mm is very important for reliable treatment. In the case of Celtra Duo, heat treatment may be helpful in terms of strength and abrasion resistance. Hydrofluoric acid treatment is helpful for bonding and hydrofluoric acid for a short time may not help to improve the bonding strength. Although zirconia-reinforced lithium silicate ceramic materials have been continuously conducted and published in the laboratory, reliable clinical studies are still lacking. Additional clinical studies will be a very important part of establishing a scientific basis.

• The Journal of Advanced Prosthodontics
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• v.11 no.1
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• pp.23-31
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• 2019

PURPOSE. To investigate and compare the surface roughness (SR), weight and height of monolithic zirconia (MZ), ceramometal (CM), lithium disilicate glass ceramic (LD), composite resin (CR), and their antagonistic human teeth enamel. MATERIALS AND METHODS. 32 disc shaped specimens for the four test materials (n=8) and 32 premolars were prepared and randomly divided. SR, weight and height of the materials and the antagonist enamel were recorded before and after subjecting the specimens to 240,000 wear-cycles ($49N/0.8Hz/5^{\circ}C/50^{\circ}C$). SR, height, weight, and digital microscopic qualitative evaluation were measured. RESULTS. CM ($0.23+0.08{\mu}m$) and LD ($0.68+0.16{\mu}m$) exhibited the least and highest mean difference in the SR, respectively. ANOVA revealed significance (P=.001) between the materials for the SR. Paired T-Test showed significance (P<.05) for the pre- and post- SR for all the materials. For the antagonistic enamel, no significance (P=.987) was found between the groups. However, the pre- and post- SR values of all the enamel groups were significant (P<.05). Wear cycles had significant effect on enamel weight loss against all the materials (P<.05). CR and MZ showed the lowest and highest height loss of 0.14 mm and 0.46 mm, respectively. CONCLUSION. MZ and CM are more resistant to SR against the enamel than LD and CR. Enamel worn against test materials showed similar SR. Significant variations in SR values for the tested materials (MZ, LD, CM, and CR) against the enamel were found. Wear simulation significantly affected the enamel weight loss against all the materials, and enamel antagonist against MZ and CM showed more height loss.

• The Korean Journal of Ceramics
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• v.5 no.4
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• pp.363-367
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• 1999

New glass ceramics were investigated for the application as substrates to be used in hard disk devices. The glass system to precipitate lithium di-silicate was studied so as to optimize the composition to realize very high surface flatness. The addition of small amount of several metal oxides with high valences had very drastic effects on the microstructure, because they played a role of crystallization agents, and consequently it determined surface flatness even after the polishing process. The possible mechanism changes of crystal growth due to the addition of metal oxides were discussed in relation to the final micro-texture development. The glass ceramics with very high surface flatness(Ra=7.1 $\AA$) was obtained by the addition of the mixture of $P-2O_5 \;and \;MoO_3$ as crystallization agents.

• Journal of the Korean Ceramic Society
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• v.27 no.4
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• pp.521-528
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• 1990

Li2O.2SiO2 glass-ceramics were made from the melt by the nucleation and growth treatment. The optimum nucleation temperature and time were determined from DTA curves of as-quenched and thermally treated glasses, and found to be 44$0^{\circ}C$ and 3hrs. The optical microscopic technique was also used to support this result. The volume fractions of crystals present in the partially crystallized specimens were measured using the optical microscopy and the amorphous X-ray scattering methods. The degree of crystallization increased with increasing the crystallization temperature and time. The crystalline phase identified by X-ray diffraction was lithium disilicate. As the crystallinity increased up to 95%, the transmittance of glass-ceramics was decreased linearly. It was also found that for the same heat treatment condition (575$^{\circ}C$, 30min), a thicker specimen showed higher transmittance, presumably due to less crystallinity.