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PURPOSE: This study evaluated the effect of coating traditional and translucent Y-TZP with an industrial nanometric colloidal silica or glaze before or after sintering on the adhesion of zirconia with various ytrria concentration. MATERIALS AND METHODS: Specimens of Y-TZP with 3% and 5% yttria were subdivided into 5 groups (n=10), according to the coating applied and moment of application (before or after Y-TZP sintering): Control (no coating), Colloidal Silica/Sintering, Sintering/Colloidal Silica, Glaze/Sintering, Sintering/ Glaze. Lithium disilicate (LD) was used as positive control. Except for Y-TZP controls, groups were conditioned with silane before cementation with a self-adhesive resin cement. After 24 hours, the shear bond strength and failure analysis were performed. Also, analysis of specimens' surface was accomplished with SEM-EDX. Kruskal-Wallis and Dunn tests were applied to analyze differences between groups (p⟨0.05). RESULTS: Overall, the worst and best values of shear bond strength test were control and glaze after sintering groups. Different morphological and chemical aspects were observed in SEM-EDX analysis. CONCLUSIONS: Coating Y-TZP with colloidal silica showed unsatisfactory results. In 3Y-TZP, the surface treatment associated with the best adhesion values was the application of glaze after zirconia sintering. However, in 5Y-TZP, glaze application can be performed before or after the zirconia sintering to optimize clinical steps.

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The aim of this study was to evaluate the influence of various opacities and thicknesses of lithium disilicate on the degree of conversion (DC) of two resin cements and on their bond strength (BS) to the ceramic. Two hundred and forty ceramic samples of lithium disilicate with high translucency (HT), low translucency (LT), and medium opacity (MO) were obtained from IPS e. max CAD in five different thicknesses. Light-cured and dual-cured resin cements were used for DC (n = 9) and BS (n = 8). Cement samples were light-cured under ceramic samples and analyzed using a Raman confocal spectrometer to determine the DC. For BS, resin cement cylinders were fabricated using ceramic samples which were thsen subjected to a microshear bond strength test. The mean values were provided for statistical analysis. The increase in thickness resulted in a decrease in DC for both cements under all experimental conditions, but only affected the BS of the light-cured cement for the MO ceramic. Comparing the opacities, the most translucent ceramics with particular thicknesses exhibited higher DC values than the less translucent ceramics. The LT and MO ceramics with certain thicknesses exhibited the highest BS values than the HT. The dual-cured cement generally showed highest values in both analyses than the light-cured cement. A thicker and more opaque ceramic material can reduce the DC of the cement. The BS decreases with the increasing thickness of the more-opaque ceramics.

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Tooth reduction guides allow clinicians to obtain the ideal space required for ceramic restorations. This case report describes a novel design (CAD) for an additive computer-aided manufactured (a-CAM) tooth reduction guide with channels that permitted access for the preparation and evaluation of the reduction with the same guide. The guide features innovative vertical and horizontal channels that permit comprehensive access for preparation and evaluation of the reduction with a periodontal probe, ensuring uniform tooth reduction and avoiding overpreparation. This approach was successfully applied to a female patient with non-carious lesions and white spot lesions, resulting in minimally invasive tooth preparations and hand-crafted laminate veneer restorations that met the patient's aesthetic demands while preserving tooth structure. Compared to traditional silicone reduction guides, this novel design offers greater flexibility, enabling clinicians to evaluate tooth reduction in all directions and providing a more comprehensive assessment. Overall, this 3D printed tooth reduction guide represents a significant advancement in dental restoration technology, offering clinicians a useful tool for achieving optimal outcomes with minimal tooth reduction. Future work is warranted to compare tooth reductions and preparation time for this guide to other 3D printed guides.

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The aim of this study was to investigate the influence of the quantity and positioning of feldspathic ceramic specimens inside the furnace on their flexural strength and translucency. The tested hypotheses were that the arrangement of specimens in the furnance would not influence 1) the translucency or 2) the biaxial strength of the porcelain. Methods: Ninety porcelain specimens were made (1.2 mm thickness and 13.5 mm diameter) and assigned into two main groups (n=15): G1 group - 15 firing cycles containing only one specimen each, always at the center of the refractory; and G5 group - 15 firing cycles containing five specimen each, where one specimen was at the center of the refractory and four specimens positioned equidistantly on the periphery. The translucency test was performed using a spectrophotometer, followed by the flexural strength test, according to ISO 6872:2015. T-student test was performed for both the mechanical and optical obtained data. Results: The flexural strength of the porcelain was not affected by the positioning (center x periphery) of the specimens inside the furnace (p =0.08), but the translucency was affected (periphery > center; p =0.009). Regarding to the number of feldspathic ceramic specimens, the biaxial flexural strength was affected (p =0.025), as well as the translucency (p <0.05). Conclusion: A higher quantity of feldspathic ceramic specimens for each firing cycle decreased its biaxial flexural strength and translucency. Also, specimens positioned at the center of the refractory became less translucent than those positioned at the periphery.

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Objective:This study evaluated the effect of immediate dentin sealing on the marginal adaptation of lithium disilicate overlays with three different types of resin-luting agents: preheated composite, dual-cure adhesive resin, and flowable composite. Materials and Methods: Forty-eight maxillary first premolars of similar size were prepared with a butt joint preparation design. The teeth were separated into two primary groups, each with twenty-four teeth: Group DDS: Delay dentin sealing (non-IDS) teeth were not treated. Group IDS: dentin sealing was applied immediately after teeth preparation. Each group was subsequently separated into three separate subgroups. Subgroups (DDS+Phc, IDS+Phc): cemented with preheated composite (Enamel plus HRi, Micerium, Italy), Subgroups (DDS+Dcrs, IDS+Dcrs): cemented with dual-cured resin cement (RelyX Ultimate, 3M ESPE, Germany) and Subgroups (DDS+Fc, IDS+Fc): Cemented with flowable composite (Filtek supreme flowable, 3M ESPE, USA). Using a digital microscope with a magnification of 230x, the marginal gap was measured before and after cementation at four different locations from each surface of the tooth, and the mean of measurements was calculated and analyzed statistically using the independent t-test, one-way ANOVA test, Bonferroni correction at a significance level of 0.05. Results: The samples that were immediately sealed with dentin bonding agent showed lower marginal gaps than delayed dentin sealing, both pre-and post-cementation for all subgroups, with a statistically significant difference (p˂0.01). The marginal gap was significantly lower in the IDS+Fc (48.888 ±5.5 µm) followed by the IDS+Dcrs group (53.612 ±5.8 µm) and IDS+Phc (79.19 9±6.9 µm) respectively, while the largest marginal gaps were observed in the DDS+Phc group (86.505 ±5.4 µm). Conclusion: Generally, the teeth with IDS showed better marginal adaptation than teeth without IDS. The marginal gap was smaller with flowable composite and dual-cure resin cement than with preheated composite (AU)

Objetivo:Esse estudo avaliou o efeito do selamento imediato da dentina na adaptação marginal de overlays em dissilicato de lítio com três tipos diferentes de agentes de cimentação resinosos: resina composta pré-aquecida, adesivo resinoso dual e resina fluida. Materiais e métodos: Quarenta e oito primeiros pré-molares maxilares com tamanho similar foram preparados com término em ombro. O dente foi separado em dois grupos primários, cada um com vinte e quatro dentes: Grupo DDS: retardado selamento da dentina (non-IDS) dente não foi tratado. Grupo IDS: selamento dentinário foi aplicado imediatamente após a preparação do dente. Cada grupo foi separado de modo subsequente em três subgrupos. Subgrupo (DDS+Phc, IDS+Phc): cimentado com resina pré-aquecida (Enamel plus HRi, Micerium, Italy), Subgrupo (DDS+Dcrs, IDS+Dcrs): cimentado com cimento resinoso dual (RelyX Ultimate, 3M ESPE, Germany) e Subgrupo (DDS+Fc, IDS+Fc): cimentado com resina fluida (Filtek supreme flowable, 3M ESPE, USA). Usando um microscópio digital com magnificação de 230x, o gap marginal foi medido antes e após a cimentação em quatro diferentes localizações de cada superfície do dente e a média das medidas foi calculada e estatisticamente analisada através do uso do teste ANOVA um-fator e teste independente de Tukey e correção Bonferroni com nível de significância de 0,05. Resultado: As amostras que foram imediatamente seladas com agente adesivo dentinário apresentaram menores gaps marginais do que o selamento dentinário retardado, ambos pré e pós cimentação para todos os subgrupos apresentaram diferença estatística significante (p˂0.01). O gap marginal foi significativamente menor para IDS+Fc (48.888 ±5.5 µm) acompanhado do IDS+Dcrs group (53.612 ±5.8 µm) e IDS+Phc (79.19 9 ±6.9 µm) respectividamente, enquanto o maior gap marginal foi observado no grupo DDS+Phc (86.505 ±5.4 µm). Conclusão:Geralmente, o dente com IDS apresentou melhor adaptação marginal do que o dente sem IDS. O gap marginal foi menor com resina fluida e cimento resinoso dual do que com a resina composta pré-aquecida (AU)

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BACKGROUND: This systematic review and meta-analysis aimed to evaluate the wear of the antagonist tooth in ceramic restorations. MATERIAL AND METHODS: This study was carried out based on Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) recommendations; it was also registered in PROSPERO (register number: CRD42022316252). Three databases were consulted in the literature search, Embase, Scopus, and Web of Science. The citation searching was conducted by two researchers independently. The clinical studies that evaluated wear in antagonist teeth concerning ceramic restoration were included. Twelve articles were selected after eliminating duplicates ones and applying the inclusion criteria, and two were chosen through citation. Fourteen articles were considered for the qualitative and quantitative analysis (meta-regression and meta-analysis). RESULTS: The mean linear wear of the antagonist tooth in relation to feldspathic was 8.914 µm, for lithium disilicate it was 0.018 µm, and for zirconia it was 0.257 µm. The mean volumetric wear of the antagonist tooth in relation to feldspathic was 0.273 mm3, for hybrid ceramic it was 0.030 mm3, for lithium disilicate it was 0.018 mm3, and for zirconia it was 0.014 mm3. The mean natural tooth wear was 0.7974 µm per month. Tooth wear caused by zirconia at six months was 31.755 µm, at 12 months it was 24.648 µm, and at 24 months it was 20.662 µm. CONCLUSIONS: Feldspathic produces greater wear of the antagonist tooth from ceramic restorations linearly and volumetrically. In addition, zirconia generates the least wear that will decrease over time, and it will be equal to or less than the natural wear in the tooth.

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PURPOSE: This double-blind randomized clinical trial (RCT) aimed to evaluate the 2-year survival rates of endocrowns and partial coverage ceramic restorations (PCCR) with fiber posts. MATERIAL AND METHODS: Forty (40) participants fulfilled the elegibility criteria, and they were randomly allocated in 2 groups: Endocrown or PCCR+post. The survival rates were assessed based on USPHS modified and radiographic examinations. A Chi-square test was used to assess the distribution of characteristics between groups. Kaplan-Meier and Log-rank tests were used to estimate the survival rate. To evaluate the association between survival of the restorations and the explanatory variables, the Multivariate Cox regression model was used. Only variables presenting p⟨0.20 were maintained in final model (α= 0.05). RESULTS: The highest 2-year survival rates were recorded for the Endocrown group (100%), whereas the PCCR+post group exhibited the lowest performance (66.7%). Most of the restoration failures was due to lack of marginal adaption, fracture, and recurrent caries. Cox Regression unadjusted analysis showed that only type of restoration presented a significant effect (p⟨0.20). Thus, adjusted analysis was not performed. CONCLUSIONS: Endocrowns appear to be a promising conservative restorative option and to be feasible and reliable approach restoring endodontically.

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OBJECTIVES: This study evaluated the effect of deep margin elevation (DME) and restorative materials (leucite-reinforced glass-ceramics [C] vs. indirect resin composite [R]) on the fatigue behavior and stress distribution of maxillary molars with 2-mm deep proximal margins restored with MOD inlay. METHODS: Fifty-two extracted human third molars were randomly assigned into four groups (n = 13): C; DME + C; R; and DME + R. Inlays were fabricated in CAD-CAM and bonded to all teeth. The fatigue behavior was assessed with the stepwise stress test (10,000 cycles/step; step = 50 N; 20 Hz; initial load = 200 N). Fatigue failure loads and the number of cycles were analyzed with 2-way ANOVA and Tukey's test (p < 0.05) and Kaplan-Meier survival plots. The stress distribution was assessed with finite element analysis. The models were considered isotropic, linear, and homogeneous, and presented bonded contacts. A tripod axial load (400 N) was applied to the occlusal surface. The stress distribution was analyzed with the maximum principal stress criterion. RESULTS: For fatigue, there was no difference for DME factor (p > 0.05). For the material factor, the load and number of cycles for failure were statistically higher in the R groups (p < 0.05). The finite element analysis showed that resin composite inlays concentrated more stress in the tooth structure, while ceramic inlays concentrated more stress in the restoration. Non-reparable failures were more frequent in the resin composite inlays groups. CONCLUSIONS: DME was not negative for fatigue and biomechanical behaviors. Resin composite inlays were more resistant to the fatigue test, although the failure mode was more aggressive. CLINICAL SIGNIFICANCE: DME does not impair mechanical behavior. Resin composite inlays failed at higher loads but with a more aggressive failure mode.

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O objetivo desse trabalho foi avaliar a influência de diferentes graus de opacidade e espessuras do dissilicato de lítio no grau de conversão de dois cimentos resinosos e na resistência de união dos mesmos à cerâmica. Duzentos e quarenta amostras cerâmicas de dissilicato de lítio (6x6 mm) foram obtidos a partir de blocos de IPS E-max CAD (Ivoclar Vivadent, Schaan, Liechtensten), nas opacidades HT (alta translucidez), LT (baixa translucidez) e MO (média opacidade), nas espessuras de 0,3 mm, 0,7 mm, 1,2mm, 1,7 mm, 2,0 mm. Para as análises do grau de conversão (n=9) e resistência de união (n=8) foram utilizados um cimento de ativação física (Variolink Esthetic LC) e um cimento dual (Multilink N). Para análise do grau de conversão, as amostras de cimento foram fotoativadas sob as amostras de cerâmica e levadas a um espectrômetro Raman confocal. Para o teste de resistência de união foram confeccionados cilindros de cimento resinoso sobre as amostras cerâmicas e submetidos ao ensaio de microcisalhamento. Os resultados mostraram que o aumento das espessuras causou diminuição no grau de conversão dos dois cimentos em todas as condições estudadas, porém só influenciou negativamente a resistência de união do cimento Variolink Esthetic LC quando unido à cerâmica na opacidade MO. Na comparação entre as opacidades, de maneira geral, a cerâmica de maior translucidez HT apresentou maiores valores de grau de conversão em comparação às outras opacidades. Já para resistência de união, em algumas espessuras as cerâmicas LT e MO apresentaram os maiores valores. O cimento dual Multilink N apresentou os maiores valores nas duas análises comparado ao cimento fotoativado Variolink Esthetic LC. Portanto, o aumento da espessura e da opacidade do material cerâmico podem promover uma diminuição no grau de conversão do cimento. A resistência de união também sofre uma diminuição com o aumento da espessura de cerâmicas mais opacas. No entanto, a maior translucidez do material não garante valores mais altos dessa mesma propriedade(AU)

This research aims to evaluate the influence of different degrees of opacity and thicknesses of lithium disilicate on the degree of conversion of two resin cements and on their bond strength to the ceramic. Two hundred and forty lithium disilicate ceramic samples (6x6 mm) were obtained from IPS E-max CAD (Ivoclar Vivadent, Schaan, Liechtensten), in HT, LT and MO opacities, with thicknesses of 0.3 mm, 0.7 mm, 1.2 mm, 1.7 mm, 2.0 mm. For degree of conversion (n=9) and bond strength analysis (n=8) a light cured (Variolink Esthetic LC) and a dual cured resin cement (Multilink N) were used. To analyze the degree of conversion, the cement samples were light cured under the ceramic samples and taken to a confocal Raman spectrometer. For the bond strength test, resin cement cylinders were made on the ceramic samples that were later subjected to a microshear. The results showed that the increase in thickness caused a decrease on degree of conversion of both cements in all the conditions studied, but it only had an influence on bond strength of Variolink LC cement for MO ceramic. Comparing the opacities, for the degree of conversion, the most translucent ceramics had higher conversion values compared to the less translucent ones in some thicknesses. As for bond strength, in some thicknesses the LT and MO ceramics showed the highest values. The dual cement Multilink showed the highest values of conversion degree and bond strength compared to Variolink Esthetic LC light-cured cement. The Multilink dual cement showed the highest values in both analyzes compared to the Variolink LC light-cured cement. Therefore, increasing the thickness and opacity of the ceramic material can promote a decrease in the degree of cement conversion. The bond strength also suffers a decrease with increasing thickness of more opaque ceramics and the greater translucency of the material does not guarantee higher values of this same property(AU)

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Abstract Objective: To compare porcelain and metal repair done with both nanocomposite and conventional composite. Material and Methods: A total of 30 cylinders were fabricated from Porcelain (I), Porcelain fused to metal (II), and metal (III) substrate each. Control group (A) was bonded with conventional micro-hybrid composite and experimental group (B) was bonded with nanocomposite in a 2 mm thickness. All specimens were thermocycled and stored in distilled water at 37 °C for 7 days. A universal testing machine was used to measure the Shear bond strength (SBS). The difference between bond strengths of the groups was compared using an independent t-test. Results: In all three groups, the SBS was higher in the experimental group as compared to the control group. The use of nanocomposite of metal alloy presented maximum shear bond strength, followed by samples of porcelain fused to metal and finally porcelain, showing the lowest values of SBS. Conclusion: Porcelain and alloys bonded with nanocomposite exhibit enhanced adhesiveness as well as aesthetic and mechanical properties. This subsequently would translate into providing higher clinical serviceability and durability and hence a cost-effective and accessible repair option for human welfare (AU).

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