• The Journal of Advanced Prosthodontics
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• v.8 no.1
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• pp.43-52
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• 2016

PURPOSE. This study was conducted to evaluate the effects of full-coverage all-ceramic zirconia, lithium disilicate glass-ceramic, leucite glass-ceramic, or stainless steel crowns on antagonistic primary tooth wear. MATERIALS AND METHODS. There were four study groups: the stainless steel (Steel) group, the leucite glass-ceramic (Leucite) group, the lithium disilicate glass-ceramic (Lithium) group, and the monolithic zirconia (Zirconia) group. Ten flat crown specimens were prepared per group; opposing teeth were prepared using primary canines. A wear test was conducted over 100,000 chewing cycles using a dual-axis chewing simulator and a 50 N masticating force, and wear losses of antagonistic teeth and restorative materials were calculated using a three-dimensional profiling system and an electronic scale, respectively. Statistical significance was determined using One-way ANOVA and Tukey's test (P<.05). RESULTS. The Leucite group ($2.670{\pm}1.471mm^3$) showed the greatest amount of antagonist tooth wear, followed by in decreasing order by the Lithium ($2.042{\pm}0.696mm^3$), Zirconia ($1.426{\pm}0.477mm^3$), and Steel groups ($0.397{\pm}0.192mm^3$). Mean volume losses in the Leucite and Lithium groups were significantly greater than in the Steel group (P<.05). No significant difference was observed between mean volume losses in the Zirconia and Steel groups (P>.05). CONCLUSION. Leucite glass-ceramic and lithium disilicate glass-ceramic cause more primary tooth wear than stainless steel or zirconia.

• Restorative Dentistry and Endodontics
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• v.42 no.2
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• pp.95-104
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• 2017

Objectives: This study evaluated the influence of a multi-mode universal adhesive (MUA) containing silane (Single Bond Universal, 3M EPSE) on the bonding of resin cement to lithium disilicate. Materials and Methods: Thirty IPS e.max CAD specimens (Ivoclar Vivadent) were fabricated. The surfaces were treated as follows: Group A, adhesive that did not contain silane (ANS, Porcelain Bonding Resin, Bisco); Group B, silane (S) and ANS; Group C, hydrofluoric acid (HF), S, and ANS; Group D, MUA; Group E, HF and MUA. Dual-cure resin cement (NX3, Kerr) was applied and composite resin cylinders of 0.8 mm in diameter were placed on it before light polymerization. Bonded specimens were stored in water for 24 hours or underwent a 10,000 thermocycling process prior to microshear bond strength testing. The data were analyzed using multivariate analysis of variance (p < 0.05). Results: Bond strength varied significantly among the groups (p < 0.05), except for Groups A and D. Group C showed the highest initial bond strength ($27.1{\pm}6.9MPa$), followed by Group E, Group B, Group D, and Group A. Thermocycling significantly reduced bond strength in Groups B, C, and E (p < 0.05). Bond strength in Group C was the highest regardless of the storage conditions (p < 0.05). Conclusions: Surface treatment of lithium disilicate using HF and silane increased the bond strength of resin cement. However, after thermocycling, the silane in MUA did not help achieve durable bond strength between lithium disilicate and resin cement, even when HF was applied.

• Journal of dental hygiene science
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• v.13 no.3
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• pp.290-295
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• 2013

The purpose of this study was to investigate the shear bond strength between various commercial all-ceramic system core and veneering ceramics, and evaluate the clinical stability by comparing the conventional metal ceramic system. The test samples were divided into three groups: Ni-Cr alloy (metal bond), yttria-stabilized, tetragonal zirconia polycrystal (Y-TZP) (zirconia bond), lithium disilicate (lithium disilicate bond). The veneering porcelain recommended by the manufacturer for each type of material was fired to the core. After firing, the specimens were subjected to shear force in a universal testing machine. Load was applied at a crosshead speed of 0.50 mm/min until failure. Average shear strengths (mega pascal) were analyzed with a one-way analysis of variance and the Tukey test (${\alpha}$=0.05). The mean shear bond strength${\pm}$SD in MPa was $44.79{\pm}2.31$ in the Ni-Cr alloy group, $28.32{\pm}4.41$ in the Y-TZP group, $15.91{\pm}1.39$ in the Lithium disilicate group. The ANOVA showed a significant difference among groups (p<0.05). None of the all-ceramic system core and veneering ceramics could attain the high bond strength values of the metal ceramic combination.

• 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 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.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.5
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• pp.587-598
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• 2005

Statement of problem: Ceramic restorations should be made of porcelain layers of different opacity, shade, and thickness in order to provide a natural appearance. Lithium disilicate glass-ceramic system has superior color reproducibility, because it uses the ceramic ingot which is similar to teeth shade and uses the staining technique and layering technique. However, staining technique has a fault of discoloration. Also, porcelain is divided core and dentin layer, it is not enough to study about the influence of porcelain layer thickness and shade on the shade of ceramic restorations. Purpose: The purpose of this study was to evaluate the influence of porcelain layer thickness and color on the final shade of ceramic restorations. Materials and method: The CIE $L^*a^*b^*$(CIELAB) values of 72 assembled specimens, each consisting of 3 discs (enamel porcelain 0.2 mm/dentin porcelain -1.2, 0.9, 0.7, 0.5 or 0.3 mm/ceramic core -0.3, 0.5, 0.7, 0.9 or 1.2 mm, diameter is 1.0 mm) were evaluated with a spectrophotometer (Model Chromaview 300, Spectron Tech Co, Korea) for the shade A1, A2, A3 and A4. Distilled water (refractive index: 1.7) was used to attain optical contact between the layers. White, white gray, and white brown backgrounds were used to assess the influence of the background on the final shade. And the mean color difference value$({\Delta}E)$ was calculated. Results and conclusion: The results obtained from this study were as follows. 1. There was a significant correlation between the thickness ratio of the ceramic core/dentin porcelain system and $L^*,\;a^*\;and\;b^*$ values when the total thickness of specimen combination was smaller than 1.4 mm(P<0.05). 2. The specimen which the ceramic core thickness was more than 0.7 mm had the best masking effect against background colors. 3. The mean color difference value$({\Delta}E)$ is smaller than 2 $({\Delta}E<2)$ when the ceramic core thickness was larger than 0.7 mm and the total thickness of specimen was more than 1.4 mm.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.2
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• pp.149-159
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• 2006

Statement of problem. Porcelain repair mainly involves replacement with composite resin, but the bond strength between composite resin and all-ceramic coping materials has not been studies extensively. Purpose. The objective of this study was to investigate the influence of composite resin and ceramic etching pattern on shear bond strength of Empress2 ceramic and observe the change of microstructure of ceramic according to etching methods. Material and methods. Eighty-five cylinder shape ceramic specimens (diameter 5mm, IPS Empress 2 core materials) embeded by acrylic resin were used for this study. The ceramic were specimens divided into sixteen experimental groups with 5 specimens in each group and were etched with phosphoric acid(37%, 65%) & hydrofluoric acid (4%, 9%) according to different etching times(30s, 60s, 120s 180s). All etched ceramic surfaces were examined morphologically using SEM(scanning electron microscopy). Etched surfaces of ceramic specimens were coated with silane (Monobond-S) & adhesive(Heliobond) and built up composite resin using Teflon mold. Accomplished specimens were tested under shear loading until fracture on universal testing machine at a crosshead speed 1mm/min; the maximum load at fracture(kg) was recorded. Shear bond strength data were analyzed with one way ANOVA and Duncan tests.(P<.05) Results. Maximum shear bond strength was $30.07{\pm}2.41(kg)$ when the ceramic was etched with 4% hydrofluoric acid at 120s. No significant difference was found between phosphoric etchant group and control group with respect to shear bond strength. Conclusion. Empress 2 ceramic surface was not etched by phosphoric acid, but etched by hydrofluoric acid.

• Journal of Technologic Dentistry
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• v.39 no.2
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• pp.101-107
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• 2017

Purpose: The purpose of this study was to compare the shear bond strength of the metal-heat pressed glass ceramic bilayer structure. Methods: Metal framework specimens were prepared and surface is spreaded opaque(IPS InLine system opaque, IvoclarVivadent, Liechtenstein). There were 10 specimens for each bilayer dental ceramic group. The first group was porcelain fused metal, Press on metal IPS Inline press group, and press on metal HASS prototype group. Specimens measured for the shear bond strength on Schwickerath test by Instron universal testing machine(Instron3345, Instron Corp., USA). Mean average bond strength values of each specimen group were analyzed using a one-way ANOVA analysis of variance Saphiro-wilk's test. Statistical analysis were performed using IBM SPSS 23.0(IBM Co., Armonk, USA) Results: $RMS{\pm}SD$ The highest mean average HASS POM showed a bond strength value ($47.55{\pm}12.80Mpa$). The lowest mean average values Porcelain fused metal ($33.30{\pm}2.00Mpa$). Independent t-test was conduct to analysis the significant difference (p<0.05) (Table 3). Conclusion: Three kinds of Metal/ glass bilayer dental ceramics bond strength were clinical acceptability. Especially, as lithium disilicate containing represents higher bond strength.

• The Journal of the Korean dental association
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• v.58 no.7
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• pp.435-442
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• 2020

Porcelain is the first ceramic material to be introduced into dentistry. Porcelain jacket crown was introduced by Dr. Charles H Land in 1886, which was an excellent aesthetic dental restoration but has not been widely used due to high firing shrinkage and low tensile strength. Then metal-ceramic system, which combines the esthetic properties of ceramics and the mechanical properties of metals, was introduced and nowadays it is still used in dental clinical field. However, the metal-ceramic system has shown some problems, such as increased lightness by reflection of light at opaque layer, shadow beneath the gingival line due to the block-out of light by metal coping, exposure of metal in margin part, bond failure between metal and porcelain, oxidation of metal coping during firing the porcelain, etc. Recently, along with the advance of fabrication methods of dental ceramics, the all-ceramic restorations with high esthetic and mechanical properties has increased and gradually replaced metal-ceramic restorations. Especially, CAD/CAM technology has opened a new era in fabricating the dental ceramic restorations. This overview will take a look at the past, present and future possibility of the dental ceramic materials.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.6
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• pp.641-658
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• 2001

All-ceramic restorations have become an attractive alternative to porcelain-fused-to-metal crowns. In-Ceram, and more recently IPS Empress 2 were introduced as a new all-ceramic system for single crowns and 3-unit fixed partial dentures. But their strength and marginal fit are still an important issue. This study evaluated the fracture resistance and marginal fit of three systems of 3 unit all-ceramic bridge fabricated on prepared maxillary anterior resin teeth in vitro. The 3 all-ceramic bridge systems were: (1) a glass-infiltrated, sintered alumina system (In-Ceram) fabricated conventionally, (2) the same system with copy-milled alumina cores (copy-milled In-Ceram), (3) a heat pressed, lithium disilicate reinforced glass-ceramic system (IPS Empress 2). Ten bridges of each system with standardized design of framework were fabricated. All specimens of each system were compressed at $55^{\circ}$ at the palatal surface of pontic until catastrophic fracture occurred. Another seven bridges of each system were fabricated with standard method. All of the bridge-die complexes were embedded in epoxy resin and sectioned buccolingually and mesiodistally. The absolute marginal discrepancy was measured with stereomicroscope at ${\times}50$ power. The following results were obtained: 1. There was no significant difference in the fracture strength among the 3 systems studied. 2. The Weibull modulus of copy-milled In-Ceram was higher than that of In-Ceram and IPS Empress 2 bridges. 3. Copy-milled In-Ceram($112{\mu}m$) exhibited significantly greater marginal discrepancy than In Ceram ($97{\mu}m$), and IPS Empress 2 ($94{\mu}m$) at P=0.05. 4. The lingual surfaces of the ceramic crowns showed smaller marginal discrepancies than mesial and distal points. There was no significant difference between teeth (incisor, canine) at P=0.05. 5. All-ceramic bridges of three systems appeared to exhibit sufficient initial strength and accept able marginal fit values to allow clinical application.