• The Journal of the Korean dental association
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• v.56 no.3
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• pp.167-174
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• 2018

The development of dental materials has widened the scope of materials by changes in processing methods. CAD/CAM processing enables the use of zirconia as a dental material. Recent esthetic materials development has been made. For aesthetic purposes, a block for CAD/CAM processing by mixing polymer and ceramic materials are fabricated. However there is no guideline of how these materials should be used in actual clinical practice. Mechanical properties, wear and clinical studies were reviewed.

• Restorative Dentistry and Endodontics
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• v.43 no.4
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• pp.40.1-40.10
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• 2018

Objectives: This study evaluated the microtensile bond strength (${\mu}TBS$) of polymer-ceramic and indirect composite resin with 3 classes of resin cements. Materials and Methods: Two computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated polymer-ceramics (Enamic [ENA; Vita] and Lava Ultimate [LAV; 3M ESPE]) and a laboratory indirect composite resin (Gradia [GRA; GC Corp.]) were equally divided into 6 groups (n = 18) with 3 classes of resin cements: Variolink N (VAR; Vivadent), RelyX U200 (RXU; 3M ESPE), and Panavia F2 (PAN; Kuraray). The ${\mu}TBS$ values were compared between groups by 2-way analysis of variance and the post hoc Tamhane test (${\alpha}=0.05$). Results: Restorative materials and resin cements significantly influenced ${\mu}TBS$ (p < 0.05). In the GRA group, the highest ${\mu}TBS$ was found with RXU ($27.40{\pm}5.39N$) and the lowest with VAR ($13.54{\pm}6.04N$) (p < 0.05). Similar trends were observed in the ENA group. In the LAV group, the highest ${\mu}TBS$ was observed with VAR ($27.45{\pm}5.84N$) and the lowest with PAN ($10.67{\pm}4.37N$) (p < 0.05). PAN had comparable results to those of ENA and GRA, whereas the ${\mu}TBS$ values were significantly lower with LAV (p = 0.001). The highest bond strength of RXU was found with GRA ($27.40{\pm}5.39N$, p = 0.001). PAN showed the lowest ${\mu}TBS$ with LAV ($10.67{\pm}4.37N$; p < 0.001). Conclusions: When applied according to the manufacturers' recommendations, the ${\mu}TBS$ of polymer-ceramic CAD/CAM materials and indirect composites is influenced by the luting cements.

• The Journal of Advanced Prosthodontics
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• v.11 no.2
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• pp.128-137
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• 2019

PURPOSE. The aim of this study was to compare the effect of different finishing and polishing techniques on water absorption, water solubility, and microhardness of ceramic or glass-polymer based computer-aided design and computer-aided manufacturing (CAD/CAM) materials following thermocycling. MATERIALS AND METHODS. 150 disc-shaped specimens were prepared from three different hybrid materials and divided into five subgroups according to the applied surface polishing techniques. All specimens were subjected up to #4000 grit SiC paper grinding. No additional polishing has been done to the control group (Group I). Other polishing procedures were as follows: Group II: two-stage diamond impregnated polishing discs; Group III: yellow colored rubber based silicone discs; Group IV: diamond polishing paste; and Group V: Aluminum oxide polishing discs. Subsequently, 5000-cycles of thermocycling were applied. The analyses were conducted after 24 hours, 7 days, and 30 days of water immersion. Water absorption and water solubility results were analyzed by two-way ANOVA and Tukey post-hoc tests. Besides, microhardness data were compared by Kruskal-Wallis and MannWhitney U tests (P<.05). RESULTS. Surface polishing procedures had significant effects on water absorption and solubility and surface microhardness of resin ceramics (P<.05). Group IV exhibited the lowest water absorption and the highest microhardness values (P<.05). Immersion periods had no effect on the microhardness of hybrid ceramic materials (P>.05). CONCLUSION. Surface finishing and polishing procedures might negatively affect physical properties of hybrid ceramic materials. Nevertheless, immersion periods do not affect the microhardness of the materials. Final polishing by using diamond polishing paste can be recommended for all CAD/CAM materials.

• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.439-446
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• 2017

PURPOSE. To evaluate the effects of different surface treatments on the bond strength of novel CAD/CAM restorative materials to resin cement by four point bending test. MATERIALS AND METHODS. The CAD/CAM materials under investigation were e.max CAD, Mark II, Lava Ultimate, and Enamic. A total of 400 bar specimens ($4{\times}1.2{\times}12mm$) (n=10) milled from the CAD/CAM blocks underwent various pretreatments (no pretreatment (C), hydrofluoric acid (A), hydrofluoric acid + universal adhesive (Scotchbond) (AS), sandblasting (Sb), and sandblasting + universal adhesive (SbS)). The bars were luted end-to-end on the prepared surfaces with a dual curing adhesive resin cement (Variolink N, Ivoclar Vivadent) on the custom-made stainless steel mold. Ten test specimens for each treatment and material combination were performed with four point bending test method. Data were analyzed using ANOVA and Tukey's test. RESULTS. The surface treatment and type of CAD/CAM restorative material showed a significant effect on the four point bending strength (FPBS) (P<.001). For LDC, AS surface treatment showed the highest FPBS results ($100.31{\pm}10.7MPa$) and the lowest values were obtained in RNC ($23.63{\pm}9.0MPa$) for control group. SEM analyses showed that the surface topography of CAD/CAM restorative materials was modified after treatments. CONCLUSION. The surface treatment of sandblasting or HF acid etching in combination with a universal adhesive containing MDP can be suggested for the adhesive cementation of the novel CAD/CAM restorative materials.

• The Journal of Advanced Prosthodontics
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• v.13 no.5
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• pp.281-291
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• 2021

PURPOSE. To evaluate the wear of computer-aided design/computer-aided manufacturing (CAD-CAM) dental ceramic materials opposed by enamel as a function of increased chewing forces. MATERIALS AND METHODS. The enamel cusps of healthy human third molar teeth (n = 40) opposed by materials from CAD-CAM dental ceramic groups (n = 10), including Vita Enamic^® (ENA), a polymer-infiltrated ceramic network (PICN); GC Cerasmart^® (CERA), a resin nanoceramic; Celtra^® Duo (DUO), a zirconia-reinforced lithium silicate (ZLS) ceramic; and IPS e.max ZirCAD (ZIR), a polycrystalline zirconia, were exposed to chewing simulation (1,200,000 cycles; 120 N load; 1 Hz frequency; 0.7 mm lateral and 2 mm vertical motion). The wear of both enamel cusps and materials was quantified using a 3D laser scanner, and the wear mechanisms were evaluated by scanning electron microscopy (SEM). The results were analysed using Welch ANOVA and Kruskal Wallis test (α = .05). RESULTS. ZIR showed lower volume loss (0.02 ± 0.01 mm³) than ENA, CERA and DUO (P = .001, P = .018 and P = .005, respectively). The wear of cusp/DUO [0.59 mm³ (0.50-1.63 mm³)] was higher than cusp/CERA [0.17 mm³ (0.04-0.41 mm³)] (P = .007). ZIR showed completely different wear mechanism in SEM. CONCLUSION. Composite structured materials such as PICN and ZLS ceramic exhibit more abrasive effect on opposing enamel due to their loss against wear, compared to uniform structured zirconia. The resin nano-ceramic causes the lowest enamel wear thanks to its flexible nano-ceramic microstructure. While zirconia appears to be an enamel-friendly material in wear volume loss, it can cause microstructural defects of enamel.

• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.423-431
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• 2017

PURPOSE. The goal of this study was to evaluate the fracture resistances of various monolithic crowns fabricated by computer-aided design and computer-aided manufacturing (CAD/CAM) with different thickness. MATERIALS AND METHODS. Test dies were fabricated as mandibular molar forms with occlusal reductions using CAD/CAM. With different occlusal thickness (1.0 or 1.5 mm), a polymer-infiltrated ceramic network (Enamic, EN), and zirconia-reinforced lithium silicate (Suprinity, SU and Celtra-Duo, CD) were used to fabricate molar crowns. Lithium disilicate (e.max CAD, EM) crowns (occlusal: 1.5 mm) were fabricated as control. Seventy crowns (n=10 per group) were bonded to abutments and stored in water for 24 hours. A universal testing machine was used to apply load to crown until fracture. The fractured specimens were examined with a scanning electron microscopy. RESULTS. The type of ceramics and the occlusal thickness showed a significant interaction. With a recommended thickness (1.5 mm), the SU revealed the mean load similar to the EM, higher compared with those of the EN and CD. The fracture loads in a reduced thickness (1.0 mm) were similar among the SU, CD, and EN. The mean fracture load of the SU and CD enhanced significantly when the occlusal thickness increased, whereas that of the EN did not. CONCLUSION. The fracture loads of monolithic crowns were differently influenced by the changes in occlusal thickness, depending on the type of ceramics. Within the limitations of this study, all the tested crowns withstood the physiological masticatory loads both at the recommended and reduced occlusal thickness.

• The Journal of Advanced Prosthodontics
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• v.12 no.1
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• pp.22-32
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• 2020

PURPOSE. The aim of this study was to evaluate the microshear bond strength (µSBS) of four computer-aided design/computer-aided manufacturing (CAD/CAM) blocks repaired with composite resin using three different surface treatment protocols. MATERIALS AND METHODS. Four different CAD/CAM blocks were used in this study: (1) flexible hybrid ceramic (FHC), (2) resin nanoceramic (RNC), (c) polymer infiltrated ceramic network (PICN) and (4) feldspar ceramic (FC). All groups were further divided into four subgroups according to surface treatment: control, hydrofluoric acid etching (HF), air-borne particle abrasion with aluminum oxide (AlO), and tribochemical silica coating (TSC). After surface treatments, silane was applied to half of the specimens. Then, a silane-containing universal adhesive was applied, and specimens were repaired with a composite, Next, µSBS test was performed. Additional specimens were examined with a contact profilometer and scanning electron microscopy. The data were analyzed with ANOVA and Tukey tests. RESULTS. The findings revealed that silane application yielded higher µSBS values (P<.05). All surface treatments were showed a significant increase in µSBS values compared to the control (P<.05). For FHC and RNC, the most influential treatments were AlO and TSC (P<.05). CONCLUSION. Surface treatment is mandatory when the silane is not preferred, but the best bond strength values were obtained with the combination of surface treatment and silane application. HF provides improved bond strength when the ceramic content of material increases, whereas AlO and TSC gives improved bond strength when the composite content of material increases.

• The Journal of Advanced Prosthodontics
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• v.10 no.1
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• pp.32-42
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• 2018

PURPOSE. The purpose of this study was to derive and compare the inherent color (hue angle, chroma), translucency ($TP_{SCI}$), surface gloss (${\Delta}E^*_{SCE-SCI}$), and surface roughness ($R_a$) amongst selected shades and brands of three hybrid CAD/CAM blocks [GC Cerasmart (CS); Lava Ultimate (LU); Vita Enamic (VE)]. MATERIALS AND METHODS. The specimens (N = 225) were prepared into square-shaped ($12{\times}12mm^2$) with different thicknesses and shades. The measurements of color, translucency, and surface gloss were performed by a reflection spectrophotometer. The surface roughness and surface topography were assessed by white light interferometry. RESULTS. Results revealed that hue and chroma values were influenced by the material type, material shade, and material thickness (P < .001). The order of hue angle amongst the materials was LU > CS > VE, whereas the order of chroma was VE > CS > LU. $TP_{SCI}$ results demonstrated a significant difference in terms of material types and material thicknesses ($P{\leq}.001$). $TP_{SCI}$ values of the tested materials were ordered as LU > CS > VE. ${\Delta}E^*_{SCE-SCI}$ and $R_a$ results were significantly varied amongst the materials (P < .001) and amongst the shades (P < .05). The order of ${\Delta}E^*_{SCE-SCI}$ amongst the materials were as follows $LU>VE{\geq}CS$, whereas the order of $R_a$ was $CS{\geq}VE>LU$. CONCLUSION. Nano-ceramic and polymer-infiltrated-feldspathic ceramic-network CAD/CAM materials exhibited different optical, inherent color and surface parameters.

• The Journal of Advanced Prosthodontics
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• v.15 no.3
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• pp.136-144
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• 2023

PURPOSE. The study objective was to evaluate the influence of the type of resin cement on the flexural strength and load to fracture of two chairside CADCAM materials after aging. MATERIALS AND METHODS. A polymer-infiltrated ceramic network (PICN) and a nanoceramic resin (RNC) were used to produce the specimens. Two types of dual-cure resin cements, a self-adhesive and a universal, were investigated. Bilayer specimens were produced (n = 10) and aged for 6 months in a humid environment before the biaxial flexural strength test (σ_f). Bonded specimens were subjected to a mechanical aging protocol (50 N, 2 Hz, 37℃ water, 500,000 cycles) before the compressive load test (L_f). σ_f and L_f data were analyzed using two-way ANOVA and Tukey tests (α = .05). Chi-square test was used to analyze the relationship between failure mode and experimental group (α = .05). RESULTS. The type of resin cement and the interaction between factors had no effect on the σ_f and L_f of the specimens, while the type of restorative material was significant. RNC had higher σ_f and L_f than PICN. There was a significant association among the type of cracks identified for specimens tested in L_f and the restorative material. CONCLUSION. The type of resin cement had no effect on the flexural strength and load to fracture of the two investigated CAD-CAM chairside materials after aging.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.193-202
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• 2016

Purpose: This study was performed in order to assess the effect of the surface treatment methods and the use of bonding agent on the shear bond strength (SBS) between the aged CAD-CAM (computer aided design-computer aided manufacturing) hybrid materials and added composite resin. Materials and methods: LAVA Ultimate (LU) and VITA ENAMIC (VE) specimens were age treated by submerging in a $37^{\circ}C$ water bath filled with artificial saliva (Xerova solution) for 30 days. The surface was ground with #220 SiC paper then the specimens were divided into 9 groups according to the combination of the surface treatment (no treatment, grinding, air abrasion with aluminum oxide, HF acid) and bonding agents (no bonding, Adper Single Bond 2, Single Bond Universal). Each group had 10 specimens. Specimens were repaired (added) using composite resin (Filtek Z250), then all the specimens were stored for 7 days in room temperature distilled water. SBS was measured and the fractured surfaces were observed with a scanning electron microscope (SEM). One-way ANOVA and Scheffe test were used for statistical analysis (${\alpha}=.05$). Results: Mostly groups with bonding agent treatment showed higher SBS than groups without bonding agent. Among the groups without bonding agent the groups with aluminum oxide treatment showed higher SBS. However there was no significant difference between groups except two subgroups within LU group, which revealed a significant increase of SBS when Single Bond Universal was used on the ground LU specimen. Conclusion: The use of bonding agent when repairing an aged LAVA Ultimate restoration is recommended.