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Adaptation of zirconia crowns created by conventional versus optical impression: in vitro study.

Sibel CETIK ; Babak BAHRAMI ; InÈs FOSSOYEUX ; Ramin ATASH

The Journal of Advanced Prosthodontics.2017;9(3):208-216. doi:10.4047/jap.2017.9.3.208

PURPOSE: The aim of this study was to compare the precision of optical impression (Trios, 3Shape) versus that of conventional impression (Imprint IV, 3M-ESPE) with three different margins (shoulder, chamfer, and knife-edge) on Frasaco teeth. MATERIALS AND METHODS: The sample comprised of 60 zirconia half-crowns, divided into six groups according to the type of impression and margin. Scanning electron microscopy enabled us to analyze the gap between the zirconia crowns and the Frasaco teeth, using ImageJ software, based on eight reproducible and standardized measuring points. RESULTS: No statistically significant difference was found between conventional impressions and optical impressions, except for two of the eight points. A statistically significant difference was observed between the three margin types; the chamfer and knife-edge finishing lines appeared to offer better adaptation results than the shoulder margin. CONCLUSION: Zirconia crowns created from optical impression and those created from conventional impression present similar adaptation. While offering identical results, the former have many advantages. In view of our findings, we believe the chamfer margin should be favored.
Crowns* ; In Vitro Techniques* ; Microscopy, Electron, Scanning ; Shoulder ; Tooth

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Investigations on the effects of mouthrinses on the colour stability and surface roughness of different dental bioceramics.

Koray SOYGUN ; Osman VAROL ; Ali OZER ; Giray BOLAYIR

The Journal of Advanced Prosthodontics.2017;9(3):200-207. doi:10.4047/jap.2017.9.3.200

PURPOSE: In this study, three bioceramic materials, [IPS Empress CAD (Ivoclar), IPS e.max CAD (Ivoclar), and Lava Ultimate CAD (3M ESPE)] were treated with three commercial mouthrinses [Listerine, Tantum Verde, and Klorhex]; and changes in colour reflectance and surface roughness values were then quantitatively assessed. MATERIALS AND METHODS: One hundred and twenty ceramic samples, with dimensions of 2 × 12 × 14 mm, were prepared and divided into nine sample groups, except three control samples. The samples were immersed in the mouthrinse solutions for 120 hrs, and changes in colour reflectance and surface roughness values were measured by UV light spectrophotometry (Vita Easyshade; VITA Zahnfabrik) and by profilometer device (MitutoyoSurftest SJ-301), respectively. The change of surface roughness was inspected by Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). RESULTS: There was a positive correlation between the ΔE and increase in the surface roughness. Two of the ceramic materials, IPS Empress and Lava Ultimate, were affected significantly by the treatment of the mouthrinse solutions (P<.05). The most affecting solution was Tantum Verde and the most affected material was Lava Ultimate. As expected, the most resistant material to ΔE and chemical corrosion was IPS e max CAD among the materials used. CONCLUSION: This work implied that mouthrinse with lower alcohol content had less deteriorating effect on colour and on the surface morphology of the bioceramic materials.
Benzydamine ; Ceramics ; Corrosion ; Microscopy, Atomic Force ; Microscopy, Electron, Scanning ; Refractometry ; Spectrophotometry ; Ultraviolet Rays

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Cumulative survival rate and associated risk factors of Implantium implants: A 10-year retrospective clinical study.

Jin Hong PARK ; Young Soo KIM ; Jae Jun RYU ; Sang Wan SHIN ; Jeong Yol LEE

The Journal of Advanced Prosthodontics.2017;9(3):195-199. doi:10.4047/jap.2017.9.3.195

PURPOSE: The objective of this study was to determine the cumulative survival rate (CSR) and associated risk factors of Implantium implants by retrospective clinical study. MATERIALS AND METHODS: Patients who received Implantium implants (Dentium Co., Seoul, Korea) at Korea University Guro Hospital from 2004 to 2011 were included. The period between the first surgery and the last hospital visit until December 2015 was set as the observation period for this study. Clinical and radiographic data were collected from patient records, including all complications observed during the follow-up period. Kaplan-Meier analysis was performed to examine CSR. Multiple Cox proportional hazard model was employed to assess the associations between potential risk factors and CSR. RESULTS: A total of 370 implants were placed in 121 patients (mean age, 56.1 years; range, 19 to 75 years). Of the 370 implants, 13 failed, including 7 implants that were lost before loading. The 10-year cumulative survival rate of implants was 94.8%. The multiple Cox proportional hazard model revealed that significant risk factor of implant failure were smoking and maxillary implant (P<.05). CONCLUSION: The 10-year CSR of Implantium implants was 94.8%. Risk factors of implant failure were smoking and maxillary implant.
Clinical Study* ; Dental Implants ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Korea ; Proportional Hazards Models ; Retrospective Studies* ; Risk Factors* ; Seoul ; Smoke ; Smoking ; Survival Rate*

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Surface changes of metal alloys and high-strength ceramics after ultrasonic scaling and intraoral polishing.

Hyung In YOON ; Hyo Mi NOH ; Eun Jin PARK

The Journal of Advanced Prosthodontics.2017;9(3):188-194. doi:10.4047/jap.2017.9.3.188

PURPOSE: This study was to evaluate the effect of repeated ultrasonic scaling and surface polishing with intraoral polishing kits on the surface roughness of three different restorative materials. MATERIALS AND METHODS: A total of 15 identical discs were fabricated with three different materials. The ultrasonic scaling was conducted for 20 seconds on the test surfaces. Subsequently, a multi-step polishing with recommended intraoral polishing kit was performed for 30 seconds. The 3D profiler and scanning electron microscopy were used to investigate surface integrity before scaling (pristine), after scaling, and after surface polishing for each material. Non-parametric Friedman and Wilcoxon signed rank sum tests were employed to statistically evaluate surface roughness changes of the pristine, scaled, and polished specimens. The level of significance was set at 0.05. RESULTS: Surface roughness values before scaling (pristine), after scaling, and polishing of the metal alloys were 3.02±0.34 µm, 2.44±0.72 µm, and 3.49±0.72 µm, respectively. Surface roughness of lithium disilicate increased from 2.35±1.05 µm (pristine) to 28.54±9.64 µm (scaling), and further increased after polishing (56.66±9.12 µm, P<.05). The zirconia showed the most increase in roughness after scaling (from 1.65±0.42 µm to 101.37±18.75 µm), while its surface roughness decreased after polishing (29.57±18.86 µm, P<.05). CONCLUSION: Ultrasonic scaling significantly changed the surface integrities of lithium disilicate and zirconia. Surface polishing with multi-step intraoral kit after repeated scaling was only effective for the zirconia, while it was not for lithium disilicate.
Alloys* ; Ceramics* ; Lithium ; Microscopy, Electron, Scanning ; Ultrasonics*

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The effect of prolonged storage and disinfection on the dimensional stability of 5 vinyl polyether silicone impression materials.

Usama NASSAR ; Carlos FLORES-MIR ; Giseon HEO ; Ysidora TORREALBA

The Journal of Advanced Prosthodontics.2017;9(3):182-187. doi:10.4047/jap.2017.9.3.182

PURPOSE: Vinyl polyether silicone (VPES) has a different composition from other elastomeric impression materials as it combines vinyl polysiloxane (VPS) and polyether (PE). Therefore, it is important to study its properties and behavior under different test conditions. This study investigated the dimensional stability of 5 VPES consistencies when stored for up to 2 weeks, with and without using a standard disinfection procedure. MATERIALS AND METHODS: 40 discs of each VPES consistency (total 200) were made using a stainless steel die and ring as described by ANSI /ADA specification No. 19. 20 discs of each material were immersed in a 2.5% buffered glutaraldehyde solution for 30 minutes. Dimensional stability measurements were calculated immediately after fabrication and repeated on the same discs after 7 and 14 days of storage. The data was analyzed using two-way ANOVA with a significance level set at α = 0.05. RESULTS: The discs mean contraction was below 0.5% at all test times ranging from 0.200 ± 0.014 to 0.325 ± 0.007. Repeated measures ANOVA showed a statistically significant difference after 2-week storage between the disinfected and non-disinfected groups (P < .001). Although there was no statistically significant difference between the materials at the time of fabrication, the contraction of the materials increased with storage for 1 and 2 weeks. CONCLUSION: The dimensional changes of VPES impression discs after disinfection and prolonged storage complied with ANSI/ADA standard. The tested VPES impression materials were dimensionally stable for clinical use after disinfection for 30 minutes in glutaraldehyde and storage for up to 2 weeks.
Disinfection* ; Elastomers ; Glutaral ; Silicon* ; Silicones* ; Siloxanes ; Stainless Steel

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Evaluation of marginal and internal gaps of Ni-Cr and Co-Cr alloy copings manufactured by microstereolithography.

Dong Yeon KIM ; Chong Myeong KIM ; Ji Hwan KIM ; Hae Young KIM ; Woong Chul KIM

The Journal of Advanced Prosthodontics.2017;9(3):176-181. doi:10.4047/jap.2017.9.3.176

PURPOSE: The purpose of this study was to evaluate the marginal and internal gaps of Ni-Cr and Co-Cr copings, fabricated using the dental µ-SLA system. MATERIALS AND METHODS: Ten study dies were made using a two-step silicone impression with a dental stone (type IV) from the master die of a tooth. Ni-Cr (NC group) and Co-Cr (CC group) alloy copings were designed using a dental scanner, CAD software, resin coping, and casting process. In addition, 10 Ni-Cr alloy copings were manufactured using the lost-wax technique (LW group). The marginal and internal gaps in the 3 groups were measured using a digital microscope (160 ×) with the silicone replica technique, and the obtained data were analyzed using the non-parametric Kruskal-Wallis H test. Post-hoc comparisons were performed using Bonferroni-corrected Mann-Whitney U tests (α=.05). RESULTS: The mean (±standard deviation) values of the marginal, chamfer, axial wall, and occlusal gaps in the 3 groups were as follows: 81.5±73.8, 98.1±76.1, 87.1±44.8, and 146.8±78.7 µm in the LW group; 76.8±48.0, 141.7±57.1, 80.7±47.5, and 194.69±63.8 µm in the NC group; and 124.2±52.0, 199.5±71.0, 67.1±37.6, and 244.5±58.9 µm in the CC group. CONCLUSION: The marginal gap in the LW and NC groups were clinically acceptable. Further improvement is needed for CC group to be used clinical practice.
Alloys* ; Replica Techniques ; Silicon ; Silicones ; Tooth

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Fracture resistances of zirconia, cast Ni-Cr, and fiber-glass composite posts under all-ceramic crowns in endodontically treated premolars.

Sareh HABIBZADEH ; Hamid Reza RAJATI ; Habib HAJMIRAGHA ; Shima ESMAILZADEH ; Mohamadjavad KHARAZIFARD

The Journal of Advanced Prosthodontics.2017;9(3):170-175. doi:10.4047/jap.2017.9.3.170

PURPOSE: The aim of the present study was to evaluate the fracture resistances of zirconia, cast nickel-chromium alloy (Ni-Cr), and fiber-composite post systems under all-ceramic crowns in endodontically treated mandibular first premolars. MATERIALS AND METHODS: A total of 36 extracted human mandibular premolars were selected, subjected to standard endodontic treatment, and divided into three groups (n=12) as follows: cast Ni-Cr post-and-core, one-piece custom-milled zirconia post-and-core, and prefabricated fiber-glass post with composite resin core. Each specimen had an all-ceramic crown with zirconia coping and was then loaded to failure using a universal testing machine at a cross-head speed of 0.5 mm/min, at an angle of 45 degrees to the long axis of the roots. Fracture resistance and modes of failure were analyzed. The significance of the results was assessed using analysis of variance (ANOVA) and Tukey honest significance difference (HSD) tests (α=.05). RESULTS: Fiber-glass posts with composite cores showed the highest fracture resistance values (915.70±323 N), and the zirconia post system showed the lowest resistance (435.34±220 N). The corresponding mean value for the Ni-Cr casting post and cores was reported as 780.59±270 N. The differences among the groups were statistically significant (P<.05) for the zirconia group, as tested by ANOVA and Tukey HSD tests. CONCLUSION: The fracture resistance of zirconia post-and-core systems was found to be significantly lower than those of fiberglass and cast Ni-Cr post systems. Moreover, catastrophic and non-restorable fractures were more prevalent in teeth restored by zirconia posts.
Alloys ; Bicuspid* ; Crowns* ; Humans ; Tooth

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Evaluation of the marginal and internal gaps of three different dental prostheses: comparison of the silicone replica technique and three-dimensional superimposition analysis.

Jin Young PARK ; So Yeon BAE ; Jae Jun LEE ; Ji Hwan KIM ; Hae Young KIM ; Woong Chul KIM

The Journal of Advanced Prosthodontics.2017;9(3):159-169. doi:10.4047/jap.2017.9.3.159

PURPOSE: The purposes of this study were to evaluate the marginal and internal gaps, and the potential clinical applications of three different methods of dental prostheses fabrication, and to compare the prostheses prepared using the silicone replica technique (SRT) and those prepared using the three-dimensional superimposition analysis (3DSA). MATERIALS AND METHODS: Five Pekkton, lithium disilicate, and zirconia crowns were each manufactured and tested using both the SRT and the two-dimensional section of the 3DSA. The data were analyzed with the nonparametric version of a two-way analysis of variance using rank-transformed values and the Tukey's post-hoc test (α = .05). RESULTS: Significant differences were observed between the fabrication methods in the marginal gap (P < .010), deep chamfer (P < .001), axial wall (P < .001), and occlusal area (P < .001). A significant difference in the occlusal area was found between the two measurement methods (P < .030), whereas no significant differences were found in the marginal gap (P > .350), deep chamfer (P > .719), and axial wall (P > .150). As the 3DSA method is three-dimensional, it allows for the measurement of arbitrary points. CONCLUSION: All of the three fabrication methods are valid for measuring clinical objectives because they produced prostheses within the clinically acceptable range. Furthermore, a three-dimensional superimposition analysis verification method such as the silicone replica technique is also applicable in clinical settings.
Crowns ; Dental Prosthesis* ; Lithium ; Methods ; Prostheses and Implants ; Replica Techniques* ; Silicon* ; Silicones*

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The effect of different cooling rates and coping thicknesses on the failure load of zirconia-ceramic crowns after fatigue loading.

Yu Lung TANG ; Jee Hwan KIM ; June Sung SHIM ; Sunjai KIM

The Journal of Advanced Prosthodontics.2017;9(3):152-158. doi:10.4047/jap.2017.9.3.152

PURPOSE: The purpose of this study was to evaluate the influence of different coping thicknesses and veneer ceramic cooling rates on the failure load of zirconia-ceramic crowns. MATERIALS AND METHODS: Zirconia copings of two different thicknesses (0.5 mm or 1.5 mm; n=20 each) were fabricated from scanning 40 identical abutment models using a dental computer-aided design and computer-aided manufacturing system. Zirconia-ceramic crowns were completed by veneering feldspathic ceramics under different cooling rates (conventional or slow, n=20 each), resulting in 4 different groups (CONV05, SLOW05, CONV15, SLOW15; n=10 per group). Each crown was cemented on the abutment. 300,000 cycles of a 50-N load and thermocycling were applied on the crown, and then, a monotonic load was applied on each crown until failure. The mean failure loads were evaluated with two-way analysis of variance (P=.05). RESULTS: No cohesive or adhesive failure was observed after fatigue loading with thermocycling. Among the 4 groups, SLOW15 group (slow cooling and 1.5 mm chipping thickness) resulted in a significantly greater mean failure load than the other groups (P<.001). Coping fractures were only observed in SLOW15 group. CONCLUSION: The failure load of zirconia-ceramic crowns was significantly influenced by cooling rate as well as coping thickness. Under conventional cooling conditions, the mean failure load was not influenced by the coping thickness; however, under slow cooling conditions, the mean failure load was significantly influenced by the coping thickness.
Adhesives ; Ceramics ; Computer-Aided Design ; Crowns* ; Fatigue*

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Stress analysis of mandibular implant overdenture with locator and bar/clip attachment: Comparative study with differences in the denture base length.

Jin Suk YOO ; Kung Rock KWON ; Kwantae NOH ; Hyeonjong LEE ; Janghyun PAEK

The Journal of Advanced Prosthodontics.2017;9(3):143-151. doi:10.4047/jap.2017.9.3.143

PURPOSE: The design of the attachment must provide an optimum stress distribution around the implant. In this study, for implant overdentures with a bar/clip attachment or a locator attachment, the stress transmitted to the implant in accordance with the change in the denture base length and the vertical pressure was measured and analyzed. MATERIALS AND METHODS: Test model was created with epoxy resin. The strain gauges made a tight contact with implant surfaces. A universal testing machine was used to exert a vertical pressure on the mandibular implant overdenture and the strain rate of the implants was measured. RESULTS: Means and standard deviations of the maximum micro-deformation rates were determined. 1) Locator attachment: The implants on the working side generally showed higher strain than those on the non-working side. Tensile force was observed on the mesial surface of the implant on the working side, and the compressive force was applied to the buccal surface and on the surfaces of the implant on the non-working side. 2) Bar/clip attachment: The implants on the both non-working and working sides showed high strain; all surfaces except the mesial surface of the implant on the non-working side showed a compressive force. CONCLUSION: To minimize the strain on implants in mandibular implant overdentures, the attachment of the implant should be carefully selected and the denture base should be extended as much as possible.
Denture Bases* ; Denture, Overlay* ; Dentures*

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