Alvaro Della Bona

Weibull analysis and flexural strength of hot-pressed core and veneered ceramic structures

OBJECTIVE To test the hypothesis that the Weibull moduli of single- and multilayer ceramics are controlled primarily by the structural reliability of the core ceramic.Methods. Seven groups of 20 bar specimens (25 x 4 x 1.2 mm) were made from the following materials: (1) IPS Empress--a hot-pressed (HP) leucite-based core ceramic; (2) IPS Empress2--a HP lithia-based core ceramic; (3 and 7) Evision--a HP lithia-based core ceramic (ES); (4) IPS Empress2 body--a glass veneer; (5) ES (1.1 mm thick) plus a glaze layer (0.1 mm); and (6) ES (0.8 mm thick) plus veneer (0.3 mm) and glaze (0.1 mm). Each specimen was subjected to four-point flexure loading at a cross-head speed of 0.5 mm/min while immersed in distilled water at 37 degrees C, except for Group 7 that was tested in a dry environment. Failure loads were recorded and the fracture surfaces were examined using SEM. ANOVA and Duncans multiple range test were used for statistical analysis. RESULTS No significant differences were found between the mean flexural strength values of Groups 2, 3, 5, and 6 or between Groups 1 and 4 (p>0.05). However, significant differences were found for dry (Group 7) and wet (Groups 1-6) conditions. Glazing had no significant effect on the flexural strength or Weibull modulus. The strength and Weibull modulus of the ES ceramic were similar to those of Groups 5 and 6. SIGNIFICANCE The structural reliability of veneered core ceramic is controlled primarily by that of the core ceramic.

Failure analysis of resin composite bonded to ceramic

OBJECTIVE To use fractographic principles to classify the mode of failure of resin composite bonded to ceramic specimens after microtensile testing. METHODS A leucite-based ceramic (IPS Empress)-E1) and a lithia disilicate-based ceramic (IPS Empress2)-E2) were selected for the study. Fifteen blocks of E1 and E2 were polished through 1 microm alumina abrasive. The following ceramic surface treatments were applied to three blocks of each ceramic: (1) 9.5% hydrofluoric acid (HF) for 2 min; (2) 4% acidulated phosphate fluoride (APF) for 2 min; (3) Silane coating (S); (4) HF+S; (5) APF+S. An adhesive resin and a resin composite were applied to all treated surfaces and light cured. Twenty bar specimens for each group were prepared from the composite-ceramic blocks and stored in 37 degrees C distilled water for 30 days before loading to failure under tension in an Instron testing machine. Fracture surfaces were examined using scanning electron microscopy and X-ray dot mapping. Statistical analysis was performed using one-way ANOVA, Duncans multiple range test, and Weibull analyses. RESULTS Similar surface treatments were associated with significantly different bond strengths and modes of failures for E1 and E2. All fractures occurred within the adhesion zone. The microstructural difference between etched E1 and E2 ceramics was a major controlling factor on adhesion. SIGNIFICANCE The quality of the bond should not be assessed based on bond strength data alone. Mode of failure and fractographic analyses should provide important information leading to predictions of clinical performance limits.

Influence of surface treatments on the bond strength of repaired resin composite restorative materials.

OBJECTIVES The purpose of this study was to investigate the effect of different surface treatments on the bond strength (sigma) of repaired, aged resin composites (ARC). METHODS Forty blocks of Filtek Z250 (Z2) and Filtek Supreme (SU) were made, stored in deionized water for 9 days, and randomly assigned to different surface treatment groups: hydrofluoric acid etching (HA), abrasion using a coarse diamond bur (AB), sandblasting with alumina particles (AO), and silica coating (SC). The average roughness (Ra) of the treated surfaces was measured with a profilometer. An adhesive system (SB-Adper Single Bond Plus), a silane (SI) or a combination of both (SI+SB) were applied after each surface treatment. The blocks were restored with the same composite (RC) and cut to produce bars that were turned into dumbbell-shaped specimens (0.5mm(2)) using a precision grinding machine. The specimens (n=30) were tested in tension to fracture and the microtensile bond strength (sigma) values were calculated (MPa). Data were analyzed using three-way ANOVA/Tukey test (alpha=0.05) and Weibull statistics. RESULTS AO and SC produced similar Ra values, which were greater than the value produced by HA. The sigma values were statistically influenced by the type of RC (p<0.0001), by the surface treatment (p<0.0001) and by the surface coating (p<0.0001). Treating the surface of Z2 with SC+SB produced the greatest m value. SIGNIFICANCE AO and SC produced the greatest sigma values, irrespective of the primer (SI, SB or SI+SB) used. Yet, the RC microstructure influenced the mean sigma values, which were greater for Z2 than for SU. The HA should not be used for repairing ARC.

Work of adhesion of resin on treated lithia disilicate-based ceramic.

OBJECTIVE This study is to test the hypothesis that chemical etching and silane coating of a ceramic surface will influence the work of adhesion (WA) of adhesive resin to dental ceramic. METHODS A hot-pressed lithia disilicate-based ceramic was used as a model material to investigate the influence of probing media and surface treatments on WA using a dynamic contact angle analyzer. Eighty ceramic specimens were randomly divided into eight experimental groups and treated as follows: (1 and 3) as polished; (2 and 4) etched with 9.5% hydrofluoric acid (HF) for 1 min; (5) etched with 4% acidulated phosphate fluoride (APF) for 2 min; (6) silane coated; (7) etched with HF for 1 min and silane coated; (8) etched with APF for 2 min and silane coated. Advancing and receding contact angles (theta(a) and theta(r)) were measured using high purity water (gamma = 72.6 mN/m) for groups 1 and 2, and a liquid resin (gamma = 39.7) for groups 3-8 as probing liquids. RESULTS The liquid resin medium yielded a lower WA than water. Silanization produced a significantly lower WA (p < 0.001) than non-silanated surfaces. Etching alone consistently yielded a greater WA for all surface treatments (p < 0.001). SIGNIFICANCE The silanated ceramic surface exhibited a lower surface energy and did not enhance bonding to the liquid resin by work of adhesion.

Characterization of a polymer-infiltrated ceramic-network material

OBJECTIVES To characterize the microstructure and determine some mechanical properties of a polymer-infiltrated ceramic-network (PICN) material (Vita Enamic, Vita Zahnfabrik) available for CAD-CAM systems. METHODS Specimens were fabricated to perform quantitative and qualitative analyses of the materials microstructure and to determine the fracture toughness (KIc), density (ρ), Poissons ratio (ν) and Youngs modulus (E). KIc was determined using V-notched specimens and the short beam toughness method, where bar-shaped specimens were notched and 3-point loaded to fracture. ρ was calculated using Archimedes principle, and ν and E were measured using an ultrasonic thickness gauge with a combination of a pulse generator and an oscilloscope. RESULTS Microstructural analyses showed a ceramic- and a polymer-based interpenetrating network. Mean and standard deviation values for the properties evaluated were: KIc=1.09±0.05MPam(1/2), ρ=2.09±0.01g/cm(3), ν=0.23±0.002 and E=37.95±0.34GPa. SIGNIFICANCE The PICN material showed mechanical properties between porcelains and resin-based composites, reflecting its microstructural components.

Color difference thresholds in dentistry

PURPOSE The aim of this prospective multicenter study was to determine 50:50% perceptibility threshold (PT) and 50:50% acceptability threshold (AT) of dental ceramic under simulated clinical settings. MATERIALS AND METHODS The spectral radiance of 63 monochromatic ceramic specimens was determined using a non-contact spectroradiometer. A total of 60 specimen pairs, divided into 3 sets of 20 specimen pairs (medium to light shades, medium to dark shades, and dark shades), were selected for psychophysical experiment. The coordinating center and seven research sites obtained the Institutional Review Board (IRB) approvals prior the beginning of the experiment. Each research site had 25 observers, divided into five groups of five observers: dentists-D, dental students-S, dental auxiliaries-A, dental technicians-T, and lay persons-L. There were 35 observers per group (five observers per group at each site ×7 sites), for a total of 175 observers. Visual color comparisons were performed using a viewing booth. Takagi-Sugeno-Kang (TSK) fuzzy approximation was used for fitting the data points. The 50:50% PT and 50:50% AT were determined in CIELAB and CIEDE2000. The t-test was used to evaluate the statistical significance in thresholds differences. RESULTS The CIELAB 50:50% PT was ΔEab  = 1.2, whereas 50:50% AT was ΔEab  = 2.7. Corresponding CIEDE2000 (ΔE00 ) values were 0.8 and 1.8, respectively. 50:50% PT by the observer group revealed differences among groups D, A, T, and L as compared with 50:50% PT for all observers. The 50:50% AT for all observers was statistically different than 50:50% AT in groups T and L. CONCLUSION A 50:50% perceptibility and ATs were significantly different. The same is true for differences between two color difference formulas ΔE00 /ΔEab . Observer groups and sites showed high level of statistical difference in all thresholds. CLINICAL SIGNIFICANCE Visual color difference thresholds can serve as a quality control tool to guide the selection of esthetic dental materials, evaluate clinical performance, and interpret visual and instrumental findings in clinical dentistry, dental research, and subsequent standardization. The importance of quality control in dentistry is reinforced by increased esthetic demands of patients and dental professionals.

Flexural strength and failure modes of layered ceramic structures

OBJECTIVE To evaluate the effect of the specimen design on the flexural strength (σ(f)) and failure mode of ceramic structures, testing the hypothesis that the ceramic material under tension controls the mechanical performance of the structure. METHODS Three ceramics used as framework materials for fixed partial dentures (YZ--Vita In-Ceram YZ; IZ--Vita In-Ceram Zirconia; AL--Vita In-Ceram AL) and two veneering porcelains (VM7 and VM9) were studied. Bar-shaped specimens were produced in three different designs (n=10): monolithic, two layers (porcelain-framework) and three layers (TRI) (porcelain-framework-porcelain). Specimens were tested for three-point flexural strength at 1MPa/s in 37°C artificial saliva. For bi-layered design, the specimens were tested in both conditions: with porcelain (PT) or framework ceramic (FT) layer under tension. Fracture surfaces were analyzed using stereomicroscope and scanning electron microscopy (SEM). Youngs modulus (E) and Poissons ratio (ν) were determined using ultrasonic pulse-echo method. Results were statistically analyzed by Kruskal-Wallis and Student-Newman-Keuls tests. RESULTS Except for VM7 and VM9, significant differences were observed for E values among the materials. YZ showed the highest ν value followed by IZ and AL. YZ presented the highest σ(f). There was no statistical difference in the σ(f) value between IZ and IZ-FT and between AL and AL-FT. σ(f) values for YZ-PT, IZ-PT, IZ-TRI, AL-PT, AL-TRI were similar to the results obtained for VM7 and VM9. Two types of fracture mode were identified: total and partial failure. SIGNIFICANCE The mechanical performance of the specimens was determined by the material under tension during testing, confirming the study hypothesis.

Microstructural characterization and fracture behavior of a microhybrid and a nanofill composite

OBJECTIVES To characterize the microstructure and composition of two different composites, and to determine their influence on the physical properties and fracture behavior. METHODS The microstructure and composition of a microhybrid (Filtek Z250-Z2) and a nanofill (Filtek Supreme-SU) composite were analyzed using scanning electron microscopy (SEM) and electron dispersive spectroscopy (EDS). Filler wt% was determined by thermogravimetric analysis. Hardness (H) and degree of conversion (DC) were evaluated at top and bottom surfaces of 2-mm thick specimens, and the dynamic elastic modulus (E) was determined with ultrasonic waves. Bar specimens (n=30) were subjected to flexure loading and flexural strength (sigmaf) was calculated (MPa). Fractographic analysis (FA) was performed to determine the fracture origin (c) for calculation of fracture toughness (KIc), and these results were compared to those from the single edge notch beam (SENB) method. Results were statistically analyzed using two-way ANOVA, Students t-test and Weibull analysis (alpha=0.05). RESULTS Z2 had higher filler wt%, H, E and DC at 2-mm depth as compared with SU. The fracture behavior (sigmaf and KIc) and the structural reliability (m) of the composites were similar. Results of KIc tested by SENB or calculated from fracture surfaces from flexure testing were similar. SIGNIFICANCE The microstructural organization of the composites determines their physical properties, in spite of the similar filler content. In contrast, the microstructure did not influence the fracture behavior and the structural reliability of these highly filled composites. FA was shown to be a reliable method for determining the KIc of composites.

Tissue engineering: From research to dental clinics

UNLABELLED Tissue engineering is an interdisciplinary field that combines the principles of engineering, material and biological sciences toward the development of therapeutic strategies and biological substitutes that restore, maintain, replace or improve biological functions. The association of biomaterials, stem cells, growth and differentiation factors has yielded the development of new treatment opportunities in most of the biomedical areas, including Dentistry. The objective of this paper is to present the principles underlying tissue engineering and the current scenario, the challenges and the perspectives of this area in Dentistry. SIGNIFICANCE The growth of tissue engineering as a research field has provided a novel set of therapeutic strategies for biomedical applications. Indeed, tissue engineering may lead to new strategies for the clinical management of patients with dental and craniofacial needs in the future.

Adaptation of all-ceramic fixed partial dentures.

OBJECTIVES To measure the marginal and internal fit of three-unit fixed partial dentures (FPDs) using the micro-CT technique, testing the null hypothesis that there is no difference in the adaptation between the ceramic systems studied. METHODS Stainless steel models of prepared abutments were fabricated to design the FPDs. Ten FPDs were produced from each framework ceramic (YZ - Vita In-Ceram YZ and IZ - Vita In-Ceram Zirconia) using CEREC inLab according to the manufacturer instructions. All FPDs were veneered using the recommended porcelain. Each FPD was seated on the original model and scanned using micro-CT. Files were processed using NRecon and CTAn software. Adobe Photoshop and Image J software were used to analyze the cross-sections images. Five measuring locations were used as follows: MG - marginal gap; CA - chamfer area; AW - axial wall; AOT - axio-occlusal transition area; OA - occlusal area. The horizontal marginal discrepancy (HMD) was evaluated in another set of images. Results were statistically analyzed using ANOVA and Tukey tests (α=0.05). RESULTS The mean values for MG, CA, AW, OA and HMD were significantly different for all tested groups (p<0.05). IZ exhibited greater mean values than YZ for all measuring locations except for AW and AOT. OA showed the greatest mean gap values for both ceramic systems. MG and AW mean gap values were low for both systems. SIGNIFICANCE The ceramic systems evaluated showed different levels of marginal and internal fit, rejecting the study hypothesis. Yet, both ceramic systems showed clinically acceptable marginal and internal fit.