Confiabilidade de coroas com infraestrutura em zircônia sob fadiga deslizante: efeito do tipo de tratamento interno para cimentação

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Internal fit of two all-ceramic systems and metal-ceramic crowns

Objectives: The aim of this study was to investigate the internal fit (IF) of glass-infiltrated alumina (ICA - In-Ceram Alumina), yttria-stabilized tetragonal zirconia polycrystals (Y-TZP - IPS e.max ZirCAD), and metal-ceramic (MC - Ni-Cr alloy) crowns. Material and Methods: Sixty standardized resin-tooth replicas of a maxillary first molar were produced for crown placement and divided into 3 groups (n=20 each) according to the core material used (metal, ICA or Y-TZP). The IF of the crowns was measured using the replica technique, which employs a light body polyvinyl siloxane impression material to simulate the cement layer thickness. The data were analyzed according to the surfaces obtained for the occlusal space (OS), axial space (AS) and total mean (TM) using two-way ANOVA with Tukey's multiple comparison test (p<0.05). Results: No differences among the different areas were detected in the MC group. For the Y-TZP and ICA groups, AS was statistically lower than both OS and TM. No differences in AS were observed among the groups. However, OS and TM showed significantly higher values for ICA and Y-TZP groups than MC group. Comparisons of ICA and Y-TZP revealed that OS was significantly lower for Y-TZP group, whereas no differences were observed for TM. Conclusions: The total mean achieved by all groups was within the range of clinical acceptability. However, the metal-ceramic group demonstrated significantly lower values than the all-ceramic groups, especially in OS.

Internal fit of two all-ceramic systems and metal-ceramic crowns

OBJECTIVES: The aim of this study was to investigate the internal fit (IF) of glass-infiltrated alumina (ICA - In-Ceram Alumina), yttria-stabilized tetragonal zirconia polycrystals (Y-TZP - IPS e.max ZirCAD), and metal-ceramic (MC - Ni-Cr alloy) crowns. MATERIAL AND METHODS: Sixty standardized resin-tooth replicas of a maxillary first molar were produced for crown placement and divided into 3 groups (n=20 each) according to the core material used (metal, ICA or Y-TZP). The IF of the crowns was measured using the replica technique, which employs a light body polyvinyl siloxane impression material to simulate the cement layer thickness. The data were analyzed according to the surfaces obtained for the occlusal space (OS), axial space (AS) and total mean (TM) using two-way ANOVA with Tukey s multiple comparison test (p<0.05). RESULTS: No differences among the different areas were detected in the MC group. For the Y-TZP and ICA groups, AS was statistically lower than both OS and TM. No differences in AS were observed among the groups. However, OS and TM showed significantly higher values for ICA and Y-TZP groups than MC group. Comparisons of ICA and Y-TZP revealed that OS was significantly lower for Y-TZP group, whereas no differences were observed for TM. CONCLUSIONS: The total mean achieved by all groups was within the range of clinical acceptability. However, the metal-ceramic group demonstrated significantly lower values than the all-ceramic groups, especially in OS.

Stiffness, Strength, and Failure Modes of Implant-Supported Monolithic Lithium Disilicate Crowns: Influence of Titanium and Zirconia Abutments

PURPOSE The objective of this study was to evaluate stiffness, strength, and failure modes of monolithic crowns produced using computer-aided design/computer-assisted manufacture, which are connected to diverse titanium and zirconia abutments on an implant system with tapered, internal connections. MATERIALS AND METHODS Twenty monolithic lithium disilicate (LS2) crowns were constructed and loaded on bone level-type implants in a universal testing machine under quasistatic conditions according to DIN ISO 14801. Comparative analysis included a 2 × 2 format: prefabricated titanium abutments using proprietary bonding bases (group A) vs nonproprietary bonding bases (group B), and customized zirconia abutments using proprietary Straumann CARES (group C) vs nonproprietary Astra Atlantis (group D) material. Stiffness and strength were assessed and calculated statistically with the Wilcoxon rank sum test. Cross-sections of each tested group were inspected microscopically. RESULTS Loaded LS2 crowns, implants, and abutment screws in all tested specimens (groups A, B, C, and D) did not show any visible fractures. For an analysis of titanium abutments (groups A and B), stiffness and strength showed equally high stability. In contrast, proprietary and nonproprietary customized zirconia abutments exhibited statistically significant differences with a mean strength of 366 N (Astra) and 541 N (CARES) (P < .05); as well as a mean stiffness of 884 N/mm (Astra) and 1,751 N/mm (CARES) (P < .05), respectively. Microscopic cross-sections revealed cracks in all zirconia abutments (groups C and D) below the implant shoulder. CONCLUSION Depending on the abutment design, prefabricated titanium abutment and proprietary customized zirconia implant-abutment connections in conjunction with monolithic LS2 crowns had the best results in this laboratory investigation.

Estruturas cerâmicas a base de zircônia e alumina utilizadas na confecção de infra - estruturas para coroas e pontes fixas

The continuous advances in ceramic systems for crowns and bridges infrastructure getting researchers and manufacturers looking for a material that has good mechanical properties and aesthetic. The purpose of this study was to verify in which composition and sintering temperature the ceramic system for infrastructure composed of alumina and zirconia would have the best mechanical properties. With this objective we made in UFRN laboratories 45 test bodies in the form of rectangular bars with the following dimensions: 30mm x 8mm x 3mm, where we separated by the sintering temperature: 1200°C, 1300ºC and 1400ºC, and by comp osition: 33% Zirconia + 67% Alumina; 50% Zirconia + 50% Alumina and 25% Zirconia + 75% Alumina, these test bodies were not infiltrated with glass. Also, were made nine test bodies by a technical from a laboratory with a commercial ceramic system: in the Ceram Zircônia (Vita - Zahnfabrik) with the following dimensions: 20mm x 10mm x 0.5mm, these test bodies following all recommendations of the manufacturer and were infiltrated with glass. Were realized optical and electronic microscopy analyses, hardness testing, resistance to bending in three points, porosity and bulk density. After analysis of the results we verified that with the increasing of sintering temperature, increased the value of resistance to bending, but with the same temperature there was no significant difference between the different compositions, samples made with the commercial ceramic that were infiltrated, presented a resistance to bending six times greater than the samples sintered to 1400°C and which have not been infiltra ted. There was no significant difference between the values of apparent porosity for the samples made in UFRN laboratories, but the samples of commercial ceramic obtained 0% in porosity apparent value. In tests of Rockwell Hardness there is an increase in the value of Hardness, with the increase of sintering temperature for the samples not infiltrated. Samples infiltrated showed similar values as the samples sintered in 1400°C. There was no significant difference between the values of apparent density among samples manufactured in UFRN laboratories and samples made with a commercial ceramic

Effect of framework design on crown failure

This study evaluated the effect of core-design modification on the characteristic strength and failure modes of glass-infiltrated alumina (In-Ceram) (ICA) compared with porcelain fused to metal (PFM). Premolar crowns of a standard design (PFMs and ICAs) or with a modified framework design (PFMm and ICAm) were fabricated, cemented on dies, and loaded until failure. The crowns were loaded at 0.5 mm min(-1) using a 6.25 mm tungsten-carbide ball at the central fossa. Fracture load values were recorded and fracture analysis of representative samples were evaluated using scanning electron microscopy. Probability Weibull curves with two-sided 90% confidence limits were calculated for each group and a contour plot of the characteristic strength was obtained. Design modification showed an increase in the characteristic strength of the PFMm and ICAm groups, with PFM groups showing higher characteristic strength than ICA groups. The PFMm group showed the highest characteristic strength among all groups. Fracture modes of PFMs and of PFMm frequently reached the core interface at the lingual cusp, whereas ICA exhibited bulk fracture through the alumina core. Core-design modification significantly improved the characteristic strength for PFM and for ICA. The PFM groups demonstrated higher characteristic strength than both ICA groups combined.

Estudo de sistemas vítreos para infiltração em alumina

The system in-Ceram Alumina, produced by VITA, consists in a technique of prepare of a substructure of ceramics to dental crowns. First burning is made in the alumina decanted by slip casting process under a stone die that reproduces the tooth prepared to receive a crown. In a second burning, alumina is infiltrated by vitreous system, giving to this set a high mechanic resistance. In this work, it s made a study of the composition of a new infiltrating material more used nowadays, giving to alumina desirable mechanics proprieties to its using like substructure of support to ceramic s crown used in the market today. The addition of Lanthanum oxide (frit A) and calcium oxide (frit B) was made in attempt to increase the viscosity of LZSA and to reduce fusion temperature. The frits were put over samples of alumina and took to the tubular oven to 1400ºC under vacuum for two groups (groups 1 and 2). For another two groups (groups 3 and 4) it was made a second infiltration, following the same parameters of the first. A fifth group was utilized like group of control where the samples of pure alumina were not submitted to any infiltrating process. Glasses manifested efficient both in quality and results of analysis of mechanic resistance, being perfectly compatible with oral environment in this technical requisite. The groups that made a second infiltration had he best results of fracture toughness, qualify the use in the oral cavity in this technical question. The average of results achieved for mechanic resistance to groups 1, 2, 3, 4 and 5 were respectively 98 MPa, 90 MPa, 144 MPa, 236 MPa and 23 MPa

Estudo da zircônia reforçado com alumina

Ceramics materials have good properties including chemical stability, high hardness and wear resistance. Moreover, due to its fragility, can suffer failure under relatively low levels of tension. Actually zirconia is the material of choice in metal free dental prostheses used in dentistry due its inertia in physiological environment, good bending strength, hardness and fracture toughness. The alumina and mixed tungsten and titanium carbides additions, acting as reinforcement elements in the zirconia matrix, have as their main objective the improvement of mechanical properties of this material. In this work, samples of zirconia, zirconia with 30% wt of alumina and zirconia with 30% wt mixed carbides were analyzed. The samples were sintered by uniaxial hot pressing on 30 MPa pressure, for 1 hour in an argon atmosphere. They were physically characterized by porosity and density measurements, and mechanically by 3-points bending strength and Vickers microhardness. The X-ray diffraction was used for the phase identifications and microstructure was examined by scanning electron microscopy (SEM). The addition of mixed carbides as reinforcement elements in zirconia matrix provides improvements in all properties analyzed in this work. The alumina addition has dropped the zirconia strength, although it caused improvement in other properties

Influence of Different Ceramics on Resin Cement Knoop Hardness Number

This study evaluated: 1) the effect of different ceramics on light attenuation that could affect microhardness, measured as the Knoop Hardness Number (KHN), of a resin cement immediately and 24 hours after polymerization and 2) the effect of different activation modes (direct light-activation, light activation through ceramics and chemical activation) on the KHN of a resin cement.Resin cement Rely X ARC (3M ESPE) specimens 5.0 mm in diameter and 1.0 nun thick were made in a Teflon mold covered with a polyester film. The cement was directly light activated for 40 seconds with an XL 2500 curing unit (3M ESPE) with 650 mW/cm(2), light activated through ceramic discs of Duceram Plus (DeguDent), Cergogold (DeguDent), IPS Empress (Ivoclar), IPS Empress 2 (Ivoclar), Procera. (NobelBiocare), In Ceram Alumina (Vita) and Cercon (DeguDent), having a 1.2 mm thickness or chemically activated without light application. The resin cement specimens were flattened, and KHN was obtained using an HMV 2 microhardness tester (Shimadzu) with a load of 50 g applied for 15 seconds 100 pin from the irradiated surface immediately and after storage at 37 degrees C for 24 hours. Ten measurements were made for each specimen, with three specimens for each group at each time. The data were submitted to ANOVA and Tukey's test (p=0.05). The KHN of the resin cement was not only affected by the mode of activation, but also by the post-activation testing time. The mean KHN of the resin cement for chemical activation and through all ceramics showed statistically significant lower values compared to direct activation immediately and at 24 hours. The KHN for 24 hours post-activation was always superior to the immediate post-activation test except with direct activation. The most opaque ceramics resulted in the lowest KHN values.

Comparison of two bond strength testing methodologies for bilayered all-ceramics

Objectives. This study compared the shear bond strength (SBS) and microtensile (MTBS) testing methodologies for core and veneering ceramics in four types of all-ceramic systems.Methods. Four different ceramic veneer/core combinations, three of which were feldspathic and the other a fluor-apatite to their respectively corresponding cores, namely leucitereinforced ceramic ((IPS)Empress, Ivoclar), low leucite-reinforced ceramic (Finesse, Ceramco), glass-infiltrated alumina (In-Ceram Alumina, Vita) and lithium disilicate ((IPS)Empress 2, Ivoclar) were used for SBS and MTBS tests. Ceramic cores (N = 40, n = 10/group for SBS test method, N=5blocks/group for MTBS test method) were fabricated according to the manufacturers' instructions (for SBS: thickness, 3 mm; diameter, 5 mm and for MTBS: 10 mm x 10 mm x 2 mm) and ultrasonically cleaned. The veneering ceramics (thickness: 2 mm) were vibrated and condensed in stainless steel moulds and fired onto the core ceramic materials. After trying the specimens in the mould for minor adjustments, they were again ultrasonically cleaned and embedded in PMMA. The specimens were stored in distilled water at 37 degrees C for 1 week and bond strength tests were performed in universal testing machines (cross-head speed: 1mm/min). The bond strengths (MPa +/- S.D.) and modes of failures were recorded.Results. Significant difference between the two test methods and all-ceramic types were observed (P < 0.05) (2-way ANOVA, Tukey's test and Bonferroni). The mean SBS values for veneering ceramic to lithium disilicate was significantly higher (41 +/- 8 MPa) than those to low leucite (28 +/- 4 MPa), glass-infiltrated (26 +/- 4 MPa) and leucite-reinforced (23 +/- 3 MPa) ceramics, while the mean MTBS for low leucite ceramic was significantly higher (15 +/- 2 MPa) than those of leucite (12 +/- 2 MPa), glass-infiltrated (9 +/- 1 MPa) and lithium disilicate ceramic (9 +/- 1 MPa) (ANOVA, P < 0.05).Significance. Both the testing methodology and the differences in chemical compositions of the core and veneering ceramics influenced the bond strength between the core and veneering ceramic in bilayered all-ceramic systems. (c) 2006 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

The influence of internal surface treatments on tensile bond strength for two ceramic systems

Statement of the Problem: the ceramic composition and surface microstructure of all-ceramic restorations are important components of an effective bonding substrate. Hydrofluoric acid and sandblasting are well-known procedures for surface treatment; however, surface treatment for high alumina-containing and lithium disilicate ceramics have not been fully investigated.Purpose: This in vitro study evaluated the tensile bond strength of resin cement to two types of ceramic systems with different surface treatments.Methods and Materials: Thirty specimens of each ceramic system were made according to the manufacturer's instructions and embedded in polyester resin. Specimens of In-Ceram Alumina [1] and IPS Empress 2 [E] were distributed to three groups with differing surface treatments (n=10): sandblasting with 50 jam aluminum oxide (APA); sandblasting with 110 pm aluminum oxide modified with silica particles (ROCATEC System-RS); a combination of sandblasting with APA and 10% hydrofluoric acid etching (HA) for two minutes on In-Ceram and for 20 seconds for IPS Empress 2. After the respective surface treatments, all the specimens were silanated, and Rely-X resin cement was injected onto the ceramic surface and light polymerized. The specimens were stored in distilled water at 37 degrees C for 24 hours and thermally cycled 1,100 times (5 degrees C/55 degrees C). The tensile bond strength test was performed in a universal testing machine at a 0.5 mm/minute crosshead speed.Results: the mean bond strength values (AWa) for IPS Empress 2 were 12.01 +/- 5.93 (EAPA), 10.34 +/- 1.77 (ERS) and 14.49 +/- 3.04 (EHA). The mean bond strength values for In-Ceram Alumina were 9.87 +/- 2.40 JAPA) and 20.40 +/- 6.27 (IRS). All In-Ceram specimens treated with 10% hydrofluoric acid failed during thermal cycling.Conclusion: the Rocatec system was the most effective surface treatment for In-Ceram Alumina ceramics; whereas, the combination of aluminum oxide sandblasting and hydrofluoric acid etching for 20 seconds worked more effectively for Empress 2 ceramics.

Effect of ceramic surface treatment on the microtensile bond strength between a resin cement and an alumina-based ceramic

Purpose: The objective of this study was to test the following hypothesis: the silica coating on ceramic surface increases the bond strength of resin cement to a ceramic. Materials and Methods: In-Ceram Alumina blocks were made and the ceramic surface was treated: G1 - sandblasting with 110-μm aluminum oxide particles; G2 - Rocatec System: tribochemicai silica coating (Rocatec-Pre powder + Rocatec-Plus powder + Rocatec-Sil); G3 - CoJet System: silica coating (CoJet-Sand) + ESPE-Sil. The ceramic blocks were cemented to composite blocks with Panavia F resin cement (under a load of 750 g/1 min). The cemented blocks were stored in distilled water at 37°C for 7 days and sectioned along the x and y axes with a diamond disk. Samples with an adhesive area of ca 0.8 mm 2 (n = 45) were obtained. The samples were attached to an adapted device for the microtensile test, which was performed in a universal testing machine (EMIC) at a crosshead speed of 1 mm/min. Results: The obtained results were submitted to ANOVA and Tukey's test. Mean values of tensile strength (MPa) and standard deviation values were: (G1) 16.8 ± 3.2; (G2) 30.6 ± 4.5; (G3) 33.0 ± 5.0. G2 and 63 presented greater tensile strength than G1. There was no significant difference between G2 and G3. All the failures took place at the ceramic/resin cement interface. Conclusion: The silica coating (Rocatec or CoJet systems) of the ceramic surface increased the bond strength between the Panavia F resin cement and alumina-based ceramic.

Fatigue resistance of the bond of a glass-infiltrated alumina ceramic to human dentin

Purpose: To evaluate the fatigue resistance of the bond between dentin and glass-infiltrated alumina ceramic, using different luting protocols. Materials and Methods: The null hypothesis is that the fatigue resistance varies with the luting strategy. Forty blocks of In-Ceram Alumina were prepared, and one surface of each block was abraded with 110-μm aluminum oxide particles. Then, the blocks were luted to flat dentin surfaces of 40 human third molars, using 4 different luting strategies (luting system [LS]/ceramic surface conditioning [CSC]) (n=10): (G1) [LS] RelyX-Unicem/[CSC] airborne abrasion with 110-μm Al2O3 particles; (G2) [LS] One-Step + Duo-Link (bis-GMA-based resin)/[CSC] etching with 4% hydrofluoric acid + silane agent; (G3) [LS] ED-Primer + Panavia F (MDP-based resin)/[CSC] Al2O 3; (G4) [LS] Scotchbond1+RelyX-ARC (bis-GMA-based resin)/[CSC] chairside tribochemical silica coating (air abrasion with 30-μm SiO x particles + silane). After 24 h of water storage at 37°C, the specimens were subjected to 106 fatigue cycles in shear with a sinusoidal load (0 to 21 N, 8 Hz frequency, 37°C water). A fatigue survivor score was given, considering the number of the fatigue cycles until fracture. The failure modes of failed specimens were observed in a SEM. Results: G3 (score = 5.9, 1 failure) and G4 (score = 6, no failures) were statistically similar (p = 0.33) and had significantly higher fatigue resistance than G1 (score = 3.9, 5 failures) and G2 (score = 3.7, 6 failures) (p < 0.03). SEM analysis of fractured specimens of G1 and G2 showed that almost all the failures were between ceramic and cement. Conclusion: The MDP-based resin cement + sandblasting with Al2O3 particles (G3) and bis-GMA-based resin cement + tribochemical silica coating (G4), both using the respective dentin bonding systems, were the best luting protocols for the alumina ceramic. The null hypothesis was confirmed.

Silica coating on alumina ceramic: comparison of three chairside air-abrasion devices working for different times and distances.

This study evaluated, by scanning electron microscope (SEM) and EDS, the effect of different strategies for silica coating (sandblasters, time and distance) of a glass-infiltrated ceramic (In-Ceram Alumina). Forty-one ceramic blocks were produced. For comparison of the three air-abrasion devices, 15 ceramic samples were divided in three groups (N.=5): Bioart, Microetcher and Ronvig (air-abrasion parameters: 20 s at a distance of 10 mm). For evaluation of the time and distance factors, ceramic samples (N.=5) were allocated in groups considering three applied times (5 s, 13 s and 20 s) and two distances (10 mm and 20 mm), using the Ronvig device. In a control sample, no surface treatment was performed. After that, the micro-morphologic analyzes of the ceramic surfaces were made using SEM. EDS analyzes were carried out to detect the % of silica on representative ceramic surface. ANOVA and Tukey tests were used to analyze the results. One-way ANOVA showed the silica deposition was different for different devices (P=0.0054). The Ronvig device promoted the highest silica coating compared to the other devices (Tukey test). Two-way ANOVA showed the distance and time factors did not affect significantly the silica deposition (application time and distance showed no statistical difference). The Ronvig device provided the most effective silica deposition on glass-infiltrated alumina ceramic surface and the studied time and distance for air-abrasion did not affect the silica coating.

Shear bond strength of resin cement bonded to alumina ceramic after treatment by aluminum oxide sandblasting or silica coating

Purpose: To evaluate the shear bond strength and bond durability between a dual-cured resin cement (RC) and a high alumina ceramic (In-Ceram Alumina), subjected to two surface treatments. Materials and Methods: Forty disc-shaped specimens (sp) (4-mm diameter, 5-mm thick) were fabricated from In-Ceram Alumina and divided into two groups (n = 20) in accordance with surface treatment: (1) sandblasting by aluminum oxide particles (50 μm Al 2O 3) (SB) and (2) silica coating (30 μm SiO x) using the CoJet system (SC). After the 40 sp were bonded to the dual-cured RC, they were stored in distilled water at 37°C for 24 hours. After this period, the sp from each group were divided into two conditions of storage (n = 10): (a) 24 h-shear bond test 24 hours after cementation; (b) Aging-thermocycling (TC) (12,000 times, 5 to 55°C) and water storage (150 days). The shear test was performed in a universal test machine (1 mm/min). Results: ANOVA and Tukey (5%) tests noted no statistically significant difference in the bond strength values between the two surface treatments (p= 0.7897). The bond strengths (MPa) for both surface treatments reduced significantly after aging (SB-24: 8.2 ± 4.6; SB-Aging: 3.7 ± 2.5; SC-24: 8.6 ± 2.2; SC-Aging: 3.5 ± 3.1). Conclusion: Surface conditioning using airborne particle abrasion with either 50 μm alumina or 30 μm silica particles exhibited similar bond strength values and decreased after long-term TC and water storage for both methods. © 2011 by The American College of Prosthodontists.