Ryoichi Inagaki

Fracture resistance of monolithic zirconia molar crowns with reduced thickness

Abstract Objectives. The purpose of the present study was to analyze the relationship between fracture load of monolithic zirconia crowns and axial/occlusal thickness and to evaluate the fracture resistance of monolithic zirconia crowns with reduced thickness in comparison with that of monolithic lithium disilicate crowns with regular thickness. Materials and methods. Monolithic zirconia crowns (Lava Plus Zirconia, 3M/ESPE) with specified axial/occlusal thicknesses and lithium disilicate crowns (IPS e.max press, Ivoclar/Vivadent) with regular thickness were fabricated using a dental CAD/CAM system and a press technique, respectively. The crowns cemented onto dies were loaded until fracture. Based on measurements of the crown thickness made by micro-CT and the fracture load, multiple regression analysis was performed. Results. It was revealed that the occlusal thickness significantly affected the fracture load (p < 0.01), but the axial thickness did not (p = 0.2828). Although the reduction of the occlusal thickness decreased the fracture resistance of the monolithic zirconia crowns, the fracture load of the zirconia crowns with the occlusal thickness of 0.5 mm (5558 ± 522 N) was significantly higher than that of lithium disilicate crowns with an occlusal thickness of 1.5 mm (3147 ± 409 N). Conclusion. Within the limitations of the present study, it is suggested that monolithic zirconia crown with chamfer width of 0.5 mm and occlusal thickness of 0.5 mm can be used in the molar region in terms of fracture resistance.

The influence of low-temperature degradation and cyclic loading on the fracture resistance of monolithic zirconia molar crowns

The present study analyzed the kinetics of low-temperature degradation (LTD) in zirconia, and evaluated the influence of LTD and cyclic loading on the fracture resistance of monolithic zirconia molar crowns. Bar-shaped zirconia specimens were divided into nine groups and autoclaved at 134°C for 0-200h to induce LTD. The surface fraction and penetration depth of the monoclinic phase were examined using X-ray diffraction and scanning electron microscopy. Monolithic zirconia molar crowns were prepared for crown fracture testing. The crowns were autoclaved for 0-100h (n=6) and cemented to dies. Six crown-die samples that were not autoclaved and six samples that were autoclaved for 100h were subjected to cyclic loading with a load of 300N for 240,000 cycles. All samples were tested in a load-to-failure test. The monoclinic fraction on the surface increased with autoclaving time and reached a plateau after 50h. The depth of the monoclinic phase increased without reaching a plateau. The fracture load of the crowns significantly decreased from 5683N (SD: 342) to 3975N (SD: 194) after 100h of autoclaving. Cyclic loading did not significantly affect the fracture resistance of the crowns in all cases. Kinetic analysis showed no linear correlation between the surface fraction and depth of the monoclinic phase after 50h of autoclaving. Even though LTD increased the monoclinic phase, resulting in lower strength, the fracture resistance of the monolithic zirconia crowns was still sufficient to withstand the loading conditions in the molar regions.

Fracture resistance of computer-aided design/computer-aided manufacturing-generated composite resin-based molar crowns.

The aim of this study was to investigate whether different fabrication processes, such as the computer-aided design/computer-aided manufacturing (CAD/CAM) system or the manual build-up technique, affect the fracture resistance of composite resin-based crowns. Lava Ultimate (LU), Estenia C&B (EC&B), and lithium disilicate glass-ceramic IPS e.max press (EMP) were used. Four types of molar crowns were fabricated: CAD/CAM-generated composite resin-based crowns (LU crowns); manually built-up monolayer composite resin-based crowns (EC&B-monolayer crowns); manually built-up layered composite resin-based crowns (EC&B-layered crowns); and EMP crowns. Each type of crown was cemented to dies and the fracture resistance was tested. EC&B-layered crowns showed significantly lower fracture resistance compared with LU and EMP crowns, although there was no significant difference in flexural strength or fracture toughness between LU and EC&B materials. Micro-computed tomography and fractographic analysis showed that decreased strength probably resulted from internal voids in the EC&B-layered crowns introduced by the layering process. There was no significant difference in fracture resistance among LU, EC&B-monolayer, and EMP crowns. Both types of composite resin-based crowns showed fracture loads of >2000 N, which is higher than the molar bite force. Therefore, CAD/CAM-generated crowns, without internal defects, may be applied to molar regions with sufficient fracture resistance.

Machinability of an experimental Ti-Ag alloy in terms of tool life in a dental CAD/CAM system.

Titanium is difficult to machine because of its intrinsic properties. In a previous study, the machinability of titanium was improved by alloying with silver. This study aimed to evaluate the durability of tungsten carbide burs after the fabrication of frameworks using a Ti-20%Ag alloy and titanium with a computer-aided design and computer-aided manufacturing system. There was a significant difference in attrition area ratio between the two metals. Compared with titanium, the ratio of the area of attrition of machining burs was significantly lower for the experimental Ti-20%Ag alloy. The difference in the area of attrition for titanium and Ti-20%Ag became remarkable with increasing number of machining operations. The results show that the same burs can be used for a longer time with Ti-20%Ag than with pure titanium. Therefore, in terms of tool life, the machinability of the Ti-20%Ag alloy is superior to that of titanium.

Influence of microscale expansion and contraction caused by thermal and mechanical fatigue on retentive strength of CAD/CAM-generated resin-based composite crowns

CAD/CAM-generated resin-based composite crowns have been proposed as an inexpensive alternative to conventional crowns. However, concerns have been raised about crown loosening in clinical use. Therefore, the present in vitro study aimed to evaluate the influence of thermal and mechanical cycling (TC and MC) on retentive strength of CAD/CAM resin-based crowns in relation to microscale expansion and contraction caused by fatigue. Eighty standardized dies were produced using a resin-based composite material. Crowns were milled from resin-based composite (n = 40) and glass-ceramic blocks (n = 40; control) using a dental CAD/CAM system. The crowns bonded to the dies were subjected to TC (temperature: 5 and 55 °C, cycles: 50,000) and MC (load: 200 N, cycles: 1.2 million). After fatigue treatment, retentive strength of the crowns was evaluated by a crown pull-off test at a crosshead speed of 1 mm/min. Coefficient of thermal expansion (CTE) and modulus of elasticity (E-modulus) of each material were also analyzed to estimate the microscale expansion and contraction during TC and MC. TC and MC significantly reduced the retentive strength of the CAD/CAM resin-based crowns whereas that of the CAD/CAM ceramic crowns was only affected by TC. In addition, the resin-based crowns showed a higher number of crown loosening during TC than the ceramic crowns. Analyses of CTE and E-modulus indicated that the resin-based crowns would be more deformed during TC and MC than the ceramic crowns. The present study demonstrated that the resistance of crowns to microscale expansion and contraction caused by thermal and mechanical fatigue would play an important role in maintaining retentive strength.

Strength of porcelain fused to Ti-20% Ag alloy made by CAD/CAM

Titanium and titanium alloys are difficult to machine. This problem arises when milling, using dental CAD/CAM systems. In a previous study, an experimental binary titanium alloy with 20 mass% Ag showed good grindability. In this study, the fracture strength of porcelain fused to a Ti-20 mass% Ag alloy crown made using a CAD/CAM (GN-1, GC, Japan) system is investigated. As controls, similar pure titanium (JIS grade II) samples made using cast and using the CAD/CAM system were also examined. The crowns were made assuming a maxillary left central tooth. The fracture strengths were statistically analyzed using one-way ANOVA followed by Tukey pairwise tests. There was no significant difference in the fracture strength of porcelain fused to metal crowns between the Ti-20 mass% Ag alloy frame crowns and the pure titanium frame crowns.

Strength of porcelain fused to pure titanium made by CAD/CAM

This study is an investigation of the bond strength of porcelain to pure titanium, cast and machined by CAD/CAM processes, and a determination of the fracture strength of porcelain fused to pure titanium crown by both methods. The bond strength was evaluated according to the surface treatment conditions. The mean bond strengths were ranged from 36.1 to 49.4 MPa. The surface treatment conditions had a significant effect on the bond strength. The mean fracture strength for the cast frame crowns was 1667 N, and that for the machined frame crowns was 1554 N. There was no significant difference between the two methods. Acceptable bond strength and fracture strength were achieved by both methods.

Surface properties of dental zirconia ceramics affected by ultrasonic scaling and low-temperature degradation

Zirconia (3Y-TZP) dental prostheses are widely used in clinical dentistry. However, the effect of ultrasonic scaling performed as a part of professional tooth cleaning on 3Y-TZP dental prostheses, especially in conjunction with low-temperature degradation (LTD), has not been fully investigated. The present study aimed to evaluate the influence of ultrasonic scaling and LTD on the surface properties of 3Y-TZP in relation to bacterial adhesion on the treated surface. 3Y-TZP specimens (4 × 4 × 2 mm) were polished and then subjected to autoclaving at 134°C for 100 h to induce LTD, followed by 10 rounds of ultrasonic scaling using a steel scaler tip for 1 min each. Surface roughness, crystalline structure, wettability, and hardness were analyzed by optical interferometry, X-ray diffraction analysis, contact angle measurement, and nano-indentation technique, respectively. Subsequently, bacterial adhesion onto the treated 3Y-TZP surface was evaluated using Streptococcus mitis and S. oralis. The results demonstrated that the combination of ultrasonic scaling and LTD significantly increased the Sa value (surface roughness parameter) of the polished 3Y-TZP surface from 1.6 nm to 117 nm. LTD affected the crystalline structure, causing phase transformation from the tetragonal to the monoclinic phase, and decreased both the contact angle and surface hardness. However, bacterial adhesion was not influenced by these changes in surface properties. The present study suggests that ultrasonic scaling may be acceptable for debridement of 3Y-TZP dental prostheses because it did not facilitate bacterial adhesion even in the combination with LTD, although it did cause slight roughening of the surface.

Effect of Zirconia Frame Thickness on Fracture Toughness of Veneer Porcelain

This review article focused on the influence of the zirconia thickness on the strength of the veneer porcelain, which was evaluated with a fracture toughness test according to JIS R 1607. The veneer porcelains for the zirconia all-ceramic crown were fired on two different thicknesses (0.4 mm and 0.8 mm) of zirconia frames (ZAC). As the controls, veneer porcelains fired on metal frames for porcelain fused to metal crown (PFM) were used. The fracture toughness value evaluated by measuring the extent of cracking associated with a Vickers indentation on the veneer porcelain part was significantly larger at the points of 1.5 mm in 0.4 mm thickness frame of ZAC samples compared with in the 0.8 mm frame.

Corrosion Resistance of Dental Metals to Hydroxyl Radical Generated by Photolysis of H2O2

Corrosion resistance of dental metals to hydroxyl radical generated by photolysis of H2O2 is discussed in comparison with that to H2O2 alone in this review article.