Paulo Francisco Cesar

Direct comparison of the bond strength results of the different test methods: A critical literature review

OBJECTIVE The goal of this paper is to undertake a literature search collecting all dentin bond strength data obtained for six adhesives with four tests (shear, microshear, tensile and microtensile) and to critically analyze the results with respect to average bond strength, coefficient of variation, mode of failure and product ranking. METHOD A PubMed search was carried out for the years between 1998 and 2009 identifying publications on bond strength measurements of resin composite to dentin using four tests: shear, tensile, microshear and microtensile. The six adhesive resins were selected covering three step systems (OptiBond FL, Scotch Bond Multi-Purpose Plus), two-step (Prime & Bond NT, Single Bond, Clearfil SE Bond) and one step (Adper Prompt L Pop). RESULTS Pooling results from 147 references showed an ongoing high scatter in the bond strength data regardless which adhesive and which bond test was used. Coefficients of variation remained high (20-50%) even with the microbond test. The reported modes of failure for all tests still included high number of cohesive failures. The ranking seemed to be dependant on the test used. SIGNIFICANCE The scatter in dentin bond strength data remains regardless which test is used confirming Finite Element Analysis predicting non-uniform stress distributions due to a number of geometrical, loading, material properties and specimens preparation variables. This reopens the question whether, an interfacial fracture mechanics approach to analyze the dentin-adhesive bond is not more appropriate for obtaining better agreement among dentin bond related papers.

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.

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.

The potential of novel primers and universal adhesives to bond to zirconia

OBJECTIVES To investigate the adhesive potential of novel zirconia primers and universal adhesives to surface-treated zirconia substrates. METHODS Zirconia bars were manufactured (3.0mm×3.0mm×9.0mm) and treated as follows: no treatment (C); air abrasion with 35μm alumina particles (S); air abrasion with 30μm silica particles using one of two systems (Rocatec or SilJet) and; glazing (G). Groups C and S were subsequentially treated with one of the following primers or adhesives: ZP (Z-Prime Plus), AZ (AZ Primer); MP (Monobond Plus); SU (ScotchBond Universal) and; EA (an Experimental Adhesive). Groups Rocatec and SilJet were silanized prior to cementation. Samples form group G were further etched and silanized. Bars were cemented (Multilink) onto bars of a silicate-based ceramic (3.0mm×3.0mm×9.0mm) at 90° angle, thermocycled (2.500 cycles, 5-55°C, 30s dwell time), and tested in tensile strength test. Failure analysis was performed on fractured specimens to measure the bonding area and crack origin. RESULTS Specimens from group C did not survive thermocycling, while CMP, CSU and CEA groups survived thermocycling but rendered low values of bond strength. All primers presented a better bond performance after air abrasion with Al2O3 particles. SilJet was similar to Rocatec, both presenting the best bond strength results, along with SMP, SSU and CEA. G promoted intermediate bond strength values. Failure mode was predominately adhesive on zirconia surface combined to cohesive of the luting agent. CONCLUSIONS Universal adhesives (MP, SU, EA) may be a considerable alternative for bonding to zirconia, but air abrasion is still previously required. Air abrasion with silica particles followed by silane application also presented high bond strength values.

Effect of the microstructure on the lifetime of dental ceramics

OBJECTIVES To evaluate the effect of the microstructure on the Weibull and slow crack growth (SCG) parameters and on the lifetime of three ceramics used as framework materials for fixed partial dentures (FPDs) (YZ - Vita In-Ceram YZ; IZ - Vita In-Ceram Zirconia; AL - Vita In-Ceram AL) and of two veneering porcelains (VM7 and VM9). METHODS Bar-shaped specimens were fabricated according to the manufacturers instructions. Specimens were tested in three-point flexure in 37°C artificial saliva. Weibull analysis (n=30) and a constant stress-rate test (n=10) were used to determine the Weibull modulus (m) and SCG coefficient (n), respectively. Microstructural and fractographic analyzes were performed using SEM. ANOVA and Tukeys test (α=0.05) were used to statistically analyze data obtained with both microstructural and fractographic analyzes. RESULTS YZ and AL presented high crystalline content and low porosity (0.1-0.2%). YZ had the highest characteristic strength (σ(0)) value (911MPa) followed by AL (488MPa) and IZ (423MPa). Lower σ(0) values were observed for the porcelains (68-75MPa). Except for IZ and VM7, m values were similar among the ceramic materials. Higher n values were found for YZ (76) and AL (72), followed by IZ (54) and the veneering materials (36-44). Lifetime predictions showed that YZ was the material with the best mechanical performance. The size of the critical flaw was similar among the framework materials (34-48μm) and among the porcelains (75-86μm). SIGNIFICANCE The microstructure influenced the mechanical and SCG behavior of the studied materials and, consequently, the lifetime predictions.

Porosity dependence of elastic constants in aluminum nitride ceramics

Aluminum nitride is a relatively new engineering ceramic and its mechanical properties have not been extensively studied. In this work, the effects of porosity (~0 to 38%) on sonic velocities, Poissons ratio, and elastic moduli of partially sintered A1N, both pure and with additives, were investigated. The elastic constants, determined by the ultrasonic pulse-echo method, were significantly influenced by the porosity, but not by the different types of additives used (2 wt. (%) of CaCO3, CaO, and Y2O3). All elastic constants evaluated decreased with increasing porosity, but the rates of decrease were higher for elastic moduli compared do sonic velocities and Poissons ratio. The results were analyzed in the light of stress concentration and loading bearing area models proposed in the literature.

Effect of Temperature on the Degree of Conversion and Working Time of Dual-Cured Resin Cements Exposed to Different Curing Conditions

OBJECTIVES This study evaluated the degree of conversion (DC) and working time (WT) of two commercial, dual-cured resin cements polymerized at varying temperatures and under different curing-light accessible conditions, using Fourier transformed infrared analysis (FTIR). MATERIALS AND METHODS Calibra (Cal; Dentsply Caulk) and Variolink II (Ivoclar Vivadent) were tested at 25°C or preheated to 37°C or 50°C and applied to a similar-temperature surface of a horizontal attenuated-total-reflectance unit (ATR) attached to an infrared spectrometer. The products were polymerized using one of four conditions: direct light exposure only (600 mW/cm(2)) through a glass slide or through a 1.5- or 3.0-mm-thick ceramic disc (A2 shade, IPS e.max, Ivoclar Vivadent) or allowed to self-cure in the absence of light curing. FTIR spectra were recorded for 20 min (1 spectrum/s, 16 scans/spectrum, resolution 4 cm(-1)) immediately after application to the ATR. DC was calculated using standard techniques of observing changes in aliphatic-to-aromatic peak ratios precuring and 20-min postcuring as well as during each 1-second interval. Time-based monomer conversion analysis was used to determine WT at each temperature. DC and WT data (n=6) were analyzed by two-way analysis of variance and Tukey post hoc test (p=0.05). RESULTS Higher temperatures increased DC regardless of curing mode and product. For Calibra, only the 3-mm-thick ceramic group showed lower DC than the other groups at 25°C (p=0.01830), while no significant difference was observed among groups at 37°C and 50°C. For Variolink, the 3-mm-thick ceramic group showed lower DC than the 1-mm-thick group only at 25°C, while the self-cure group showed lower DC than the others at all temperatures (p=0.00001). WT decreased with increasing temperature: at 37°C near 70% reduction and at 50°C near 90% for both products, with WT reduction reaching clinically inappropriate times in some cases (p=0.00001). CONCLUSION Elevated temperature during polymerization of dual-cured cements increased DC. WT was reduced with elevated temperature, but the extent of reduction might not be clinically acceptable.

Microstructure characterization and SCG of newly engineered dental ceramics.

OBJECTIVES The aim of this study was to characterize the microstructure of four dental CAD-CAM ceramics and evaluate their susceptibility to stress corrosion. METHODS SEM and EDS were performed for microstructural characterization. For evaluation of the pattern of crystallization of the ceramics and the molecular composition, XRD and FTIR, respectively, were used. Elastic modulus, Poissons ratio, density and fracture toughness were also measured. The specimens were subjected to biaxial flexure under five stress rates (0.006, 0.06, 0.6, 6 and 60MPa/s) to determine the subcritical crack growth parameters (n and D). Twenty-five specimens were further tested in mineral oil for determination of Weibull parameters. Two hundred forty ceramic discs (12mm diameter and 1.2mm thick) were made from four ceramics: feldspathic ceramic - FEL (Vita Mark II, Vita Zahnfabrik), ceramic-infiltrated polymer - PIC (Vita Enamic, Vita Zahnfabrik), lithium disilicate - LD (IPS e.max CAD, Ivoclar Vivadent) and zirconia-reinforced lithium silicate - LS (Vita Suprinity, Vita Zahnfabrik). RESULTS PIC discs presented organic and inorganic phases (n=29.1±7.7) and Weibull modulus (m) of 8.96. The FEL discs showed n=36.6±6.8 and m=8.02. The LD discs showed a structure with needle-like disilicate grains in a glassy matrix and had the lowest value of n (8.4±0.8) and m=6.19. The ZLS discs showed similar rod-like grains, n=11.2±1.4 and m=9.98. SIGNIFICANCE The FEL and PIC discs showed the lowest susceptibility to slow crack growth (SCG), whereas the LD and ZLS discs presented the highest. PIC presented the lowest elastic modulus and no crystals in its composition, while ZLS presented tetragonal zirconia. The overall strength and SCG of the new materials did not benefit from the additional phase or microconstituents present in them.

Effect of grinding with diamond-disc and -bur on the mechanical behavior of a Y-TZP ceramic

This study compared the effects of grinding on the surface micromorphology, phase transformation (t→m), biaxial flexural strength and structural reliability (Weibull analysis) of a Y-TZP (Lava) ceramic using diamond-discs and -burs. 170 discs (15×1.2mm) were produced and divided into 5 groups: without treatment (Ctrl, as-sintered), and ground with 4 different systems: extra-fine (25µm, Xfine) and coarse diamond-bur (181µm, Coarse), 600-grit (25µm, D600) and 120-grit diamond-disc (160µm, D120). Grinding with burs was performed using a contra-angle handpiece (T2-Revo R170, Sirona), while for discs (Allied) a Polishing Machine (Ecomet, Buehler) was employed, both under water-cooling. Micromorphological analysis showed distinct patterns generated by grinding with discs and burs, independent of grit size. There was no statistical difference for characteristic strength values (MPa) between smaller grit sizes (D600 - 1050.08 and Xfine - 1171.33), although they presented higher values compared to Ctrl (917.58). For bigger grit sizes, a significant difference was observed (Coarse - 1136.32>D120 - 727.47). Weibull Modules were statistically similar between the tested groups. Within the limits of this study, from a micromorphological point-of-view, the treatments performed did not generate similar effects, so from a methodological point-of-view, diamond-discs should not be employed to simulate clinical abrasion performed with diamond-burs on Y-TZP ceramics.

Effect of processing induced particle alignment on the fracture toughness and fracture behavior of multiphase dental ceramics

OBJECTIVE To investigate the processing induced particle alignment on fracture behavior of four multiphase dental ceramics (one porcelain, two glass-ceramics and a glass-infiltrated-alumina composite). METHODS Disks (Ø12 mm x 1.1mm-thick) and bars (3 mm x 4 mm x 20 mm) of each material were processed according to manufacturer instructions, machined and polished. Fracture toughness (K(Ic)) was determined by the indentation strength method using 3-point bending and biaxial flexure fixtures for the fracture of bars and disks, respectively. Microstructural and fractographic analyses were performed with scanning electron microscopy, energy dispersive spectroscopy and X-ray diffraction. RESULTS The isotropic microstructure of the porcelain and the leucite-based glass-ceramic resulted in similar fracture toughness values regardless of the specimen geometry. On the other hand, materials containing second-phase particles with high aspect ratio (lithium disilicate glass-ceramic and glass-infiltrated-alumina composite) showed lower fracture toughness for disk specimens compared to bars. For the lithium disilicate glass-ceramic disks, it was demonstrated that the occurrence of particle alignment during the heat-pressing procedure resulted in an unfavorable pattern that created weak microstructural paths during the biaxial test. For the glass-infiltrated-alumina composite, the microstructural analysis showed that the large alumina platelets tended to align their large surfaces perpendicularly to the direction of particle deposition during slip casting of green preforms. SIGNIFICANCE The fracture toughness of dental ceramics with anisotropic microstructure should be determined by means of biaxial testing, since it results in lower values.