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Polyetheretherketone (PEEK) is an emerging thermoplastic polymer with good mechanical properties and an elastic modulus similar to that of alveolar bone. PEEK dental prostheses for computer-aided design/computer-aided manufacturing (CAD/CAM) systems on the market often have additives of titanium dioxide (TiO2) to strengthen their mechanical properties. However, the effects of combining aging, simulating a long-term intraoral environment, and TiO2 content on the fracture characteristics of PEEK dental prostheses have rarely been investigated. In this study, two types of commercially available PEEK blocks, containing 20% and 30% TiO2, were used to fabricate dental crowns by CAD/CAM systems and were aged for 5 and 10 h based on the ISO 13356 specifications. The compressive fracture load values of PEEK dental crowns were measured using a universal test machine. The morphology and crystallinity of the fracture surface were analyzed by scanning electron microscopy and an X-ray diffractometer, respectively. Statistical analysis was performed using the paired t-test (α = 0.05). Results showed no significant difference in the fracture load value of the test PEEK crowns with 20% and 30% TiO2 after 5 or 10 h of aging treatment; all test PEEK crowns have satisfactory fracture properties for clinical applications. Fracture surface analysis revealed that all test crowns fractured from the lingual side of the occlusal surface, with the fracture extending along the lingual sulcus to the lingual edge, showing a feather shape at the middle part of the fracture extension path and a coral shape at the end of the fracture. Crystalline analysis showed that PEEK crowns, regardless of aging time and TiO2 content, remained predominantly PEEK matrix and rutile phase TiO2. We would conclude that adding 20% or 30% TiO2 to PEEK crowns may have been sufficient to improve the fracture properties of PEEK crowns after 5 or 10 h of aging. Aging times below 10 h may still be safe for reducing the fracture properties of TiO2-containing PEEK crowns.

This study analyzed the fracture load before and after a chewing simulation of zirconia crowns that were trepanned and repaired using composite resin. Overall, 3 groups with 15 5Y-PSZ crowns in each group were tested. For group A, the fracture load of the unmodified crowns was evaluated. For group B, the crowns were trepanned and repaired using composite resin, also followed by a fracture test. For group C, crowns were prepared like in group B but received thermomechanical cycling before the final fracture tests. Furthermore, scanning electron microscopy (SEM) and X-ray microscopy (XRM) analysis were performed for group C. The mean fracture loads and standard deviation were 2260 N ± 410 N (group A), 1720 N ± 380 N (group B), and 1540 N ± 280 N (group C). Tukey-Kramer multiple comparisons showed a significant difference between groups A and B (p < 0.01) and groups A and C (p < 0.01). After ageing, surface fissures were detected via SEM, but no cracks that reached from the occlusal to the inner side of the crown were detected via XRM. Within the limitations of this study, it can be stated that trepanned and composite-repaired 5Y-PSZ crowns show lower fracture loads than 5Y-PSZ crowns without trepanation.

Objective: The aim of this study was to evaluate the marginal adaptation and fracture resistance of endocrowns made from Lithium disilicate (Emax CAD) and CAD/CAM composite blocks (Brillient Crios) restoring mandibular premolars. Materials and Methods: Fourteen extracted human single rooted mandibular premolars were endodontically prepared in a standardized way to receive CAD/CAM fabricated endocrowns, the samples were divided into two groups (n=7); E. max CAD (EM) group and Brillient Crios (BC) group. Marginal gaps (µm) evaluated under stereomicroscope after cementation and repeated after thermocycling. Fracture load was recorded and Failure modes were determined by digital microscope and scanning electron microscope SEM. Results: EM group verified higher vertical marginal gap mean value than BC either before or after thermocycling, the difference was statistically significant as indicated by two-way ANOVA (p>0.05). EM group recorded significantly higher fracture resistance mean values (737.55±223.3N) than BC (434.33±100.8 N) group, (p < 0.05) as verified by unpaired t-test. The failure mode presented that (71.44%) of BC specimens exhibited favorable type and (28.57%) catastrophic failure. Whereas, EM group revealed (71.43%) catastrophic failure and (28.57%) favorable type. Chi square test (P < 0.05) displayed statistically significant difference between both groups. Conclusions: Brilliant Crios endocrowns showed better marginal adaptation and more favorable failure mode than those fabricated from E max CAD. E max endocrowns revealed higher fracture resistance than Brillient Crios.

(1) Background: Due to advantages such as avoidance of chipping, pulp-friendly tooth preparation and cost reduction, zirconia is increasingly being used monolithically without veneering. Nevertheless, to enable good aesthetics, various multilayer systems have been developed. The aim of this study was to investigate the impact of different zirconia multilayer strategies and yttria levels on fracture load, fracture pattern, stress distribution and surface roughness. (2) Methods: Monolithic three-unit anterior FDPs were made from three different color-gradient zirconia multilayer materials with different yttria levels corresponding to varying strength and degrees of translucency grades (Katana HTML, STML, UTML, Kuraray) and one strength-gradient zirconia multilayer material (Katana YML, Kuraray) and artificially aged in a chewing simulator (1.2 × 106 load cycles, 50 N, 2 × 3000 thermocycles, 5–55 °C). Analyses of fracture load, fracture pattern, fracture surfaces, stress distribution and roughness were performed after the fracture load test. Shapiro–Wilk, Kruskal–Wallis, Mann–Whitney U-tests and one-way ANOVA were used (p < 0.05). (3) Results: Fracture loads of the high strength color-gradient material HTML and the strength-gradient material YML were comparable after 5 years of aging (p = 0.645). Increasing yttria levels resulted in a decrease in fracture resistance of 42–57% (p < 0.05). Surface roughness of different zirconia generations is comparable after polishing and aging. (4) Conclusions: Color-gradient multilayer zirconia materials and new strength-gradient zirconia materials with similar yttria levels in the basal layers show comparable mechanical properties and are suitable for anterior FDPs.

Implant-supported cement–screw-retained crowns combine the advantages of screw-retained and cement-retained crowns. However, the occlusal screw access hole interrupts porcelain integrity, which may...

INTRODUCTION: On rare occasions, fractures of the tibial plateau may occur after uni-compartmental knee arthroplasty (UKA) and account for 2% of total UKA failures. The purpose of this narrative review is to identify and discuss potential risk factors that might lead to prevention of this invalidating complication. MATERIALS AND METHODS: Electronic database of Pubmed, Scopus, Cochrane and Google Scholar were searched. A total of 457 articles related to the topic were found. Of those, 86 references were included in this narrative review. RESULTS: UKA implantation acts as a stress riser in the medial compartment. To avoid fractures, surgeons need to balance load and bone stock. Post-operative lower limb alignment, implant positioning, level of resection and sizing of the tibial tray have a strong influence on load distribution of the tibial bone. Pain on weight-bearing signals bone-load imbalance and acts as an indicator of bone remodeling and should be a trigger for unloading. The first three months after surgery are critical because of transient post-operative osteoporosis and local biomechanical changes. Acquired osteoporosis is a growing concern in the arthroplasty population. Split fractures require internal fixation, while subsidence fractures differ in their management depending of the amount of bone impaction. Loose implants require revision knee arthroplasty. CONCLUSION: Peri-prosthetic fracture is a rare, but troublesome event, which can lead to implant failure and revision surgery. Better knowledge of the multifactorial risk factors in association with a thorough surgical technique is key for prevention.

PURPOSE To evaluate the effect of endodontic access hole preparation on fracture resistance of translucent zirconia (5Y) and conventional zirconia crowns (3Y) with varying occlusal thicknesses. MATERIALS AND METHODS Polymethylmethacrylate (PMMA) dies, representing a prepared tooth, were milled. Zirconia crowns with 1 mm thick axial walls and varying occlusal thicknesses were milled from 3Y (Cercon HT) or 5Y (Cercon XT) zirconia discs and sintered. 160 crowns were divided into 16 groups (n = 10 per group) based on the zirconia type (3Y, 5Y), occlusal thickness (0.5, 1.0, 1.5, 2.0 mm), and access hole preparation (with access hole, control). Crowns were cemented on the PMMA dies with resin-modified glass ionomer cement (Rely X Luting Plus) under constant weight (500 g) and thermocycled for 10,000 cycles. In half of the samples, following 5000 cycles of thermocycling, a uniform endodontic access hole was created using a diamond bur and restored immediately with resin composite (Filtek Supreme Ultra, 3M ESPE). The fracture resistance of the specimens was tested on an Instron 5566 universal testing machine with a stainless steel ball indenter (9.0 mm dia.) and the maximum load before failure was recorded as fracture load (N). Three-way ANOVA testing examined the effect of zirconia type, occlusal thickness, and access hole preparation on fracture loads of the crowns. Statistical tests were two-sided and significance level was set at 95% (α = 0.05). RESULTS Fracture load was significantly affected by the type of zirconia, occlusal thickness, and access hole preparation (p < 0.001). Pairwise comparisons revealed that access hole preparation significantly reduced the fracture load of 3Y crowns with 0.5 or 1.0 mm of occlusal thickness and 5Y zirconia crowns with 0.5, 1.0, or 1.5 mm of occlusal thickness (p < 0.05). Increasing occlusal thickness reduced the effect of access hole preparation on fracture load. CONCLUSION Type of zirconia, occlusal thickness, and access hole preparation had significant effects on the fracture load of zirconia crowns. The effect of endodontic access was significant on the 3Y and 5Y zirconia crowns with ≤1.0 and ≤1.5 mm occlusal thicknesses, respectively.

Purpose To evaluate the effect of three two-retainer designs of a resin-bonded fixed dental prosthesis (RBFDP) on fracture resistance. Materials and methods A total of 21 three-unit, all-ceramic RBFPDs were fabricated to replace a missing maxillary lateral incisor. The prostheses were divided into three groups of 7 each: Group L (labial RBFPD); Group ML (modified labial RBFPD, fabricated the same as in Group L with additional preparation that included a shallow proximal groove at the pontic side); and Group P, an all-ceramic palatal RBFPD that acted as control. Preparations were done on the maxillary left central incisor and canine of a typodont model, and 21 epoxy resin models were duplicated for the three groups. The RBFPDs were designed using CAD software and constructed using the heat-pressed technique, after which the prostheses were bonded to their corresponding epoxy resin model according to the manufacturer's instructions. A fracture resistance test was performed on all specimens following aging. Data were analyzed using one-way ANOVA. Results The highest fracture load values were recorded in Group P (547.5 N), followed by Group ML (462.6 N) and then Group L (418.3 N). The difference among the three designs was not statistically significant (F = 2.5, P = 0.1). Conclusion Both labial and modified labial RBFDPs could be a viable alternative treatment option for replacement of missing maxillary lateral incisors.

ZrO2 nanoparticles (ZNPs) have excellent physical properties. This study investigated the fracture load of implant-supported, fixed cantilevered prosthesis materials, reinforced with ZNPs and various polymerization techniques, compared with conventional and CAD/CAM materials. Sixty specimens were made from two CAD/CAM; milled (MIL) (Ceramill TEMP); and 3D-printed (NextDent Denture 3D+). Conventional heat-polymerized acrylic resin was used to fabricate the other specimens, which were grouped according to their polymerization technique: conventionally (HP) and autoclave-polymerized (AP); conventionally cured and reinforced with 5 wt% ZNPs (HPZNP); and autoclave reinforced with 5 wt% ZNPs (APZNP). The specimens were thermocycled (5000 cycles/30 s dwell time). Each specimen was subjected to static vertical loading (1 mm/min) using a universal Instron testing machine until fracture. Scanning electron microscopy was used for fracture surface analyses. The ANOVA showed significant fracture load differences between all the tested groups (p = 0.001). The Tukey post hoc tests indicated a significant difference in fracture load between all tested groups (p ˂ 0.001) except HP vs. HPZNP and AP vs. MIL. APZNP had the lowest mean fracture load value (380.7 ± 52.8 N), while MIL had the highest (926.6 ± 82.8 N). The CAD/CAM materials exhibited the highest fracture load values, indicating that they could be used in long-term interim prostheses. Autoclave polymerization improved fracture load performance, whereas ZrO2 nanoparticles decreased the fracture load performance of cantilevered prostheses.

Background: The objective was to determine the optimal connector size and position within zirconia disks for implant-supported cantilever fixed dental prostheses (ICFDP). Methods: Two-unit ICFDPs (n = 60) were designed for the premolar region with connector sizes of either 9 or 12 mm2 and positioned in the enamel or dentin layer of two different types of zirconia disks. The restorations were milled and cemented onto zirconia implants. After simulated chewing for 1.2 Mio cycles, the fracture load was measured and fractures were analyzed. Results: No fractures of ICFDPs or along the implants were detected after simulated aging. The mean fracture load values were significantly higher for a connector size of 9 mm2 (951 N) compared with 12 mm2 (638 N). For the zirconia material with a higher biaxial flexural strength, the fracture load values were increased from 751 to 838 N, but more implant fractures occurred. The position within the zirconia disk did not influence the fracture load. Conclusions: A connector size of 9 mm2 and a zirconia material with a lower strength should be considered when designing ICFDPS on zirconia implants to reduce the risk of fractures along the intraosseous implant portion.

The optimization of welding parameters of the welded joints of TC4 titanium alloys/304 stainless steel (TC4/304 SS) by friction stir lap welding (FSLW) based on orthogonal test was researched. The results show that under low heat input (low rotating speed and high traversing speed), there was a damaging defect in stir zone (SZ) and cracks started from the defect under the tension. Under high heat input (high rotating speed and low traversing speed), the intermetallic compounds were barely formed, and the cracks formed from 304 SS blocks existed in thermal mechanically affected zone of TC4 titanium alloys (TMAZTC4), eventually obtaining the highest fracturing load. However, under middle heat input (middle rotating speed and low traversing speed), the intermetallic compounds and the maximum hardness were found at the interface, and cracks started from these compounds under the tension, getting a middle fracture load. In conclusion, the joints with good properties can be obtained with high rotating speed and low traversing speed.

To investigate the impact of different cleaning methods on the fracture load and two-body wear of additively manufactured three-unit fixed dental prostheses (FDP) for long-term temporary use, compared to the respective outcomes of milled provisional PMMA FDPs. Shape congruent three-unit FDPs were 3D printed using three different resin-based materials [FPT, GCT, NMF] or milled [TEL] (N = 48, n = 16 per group). After printing, the FDPs were cleaned using: Isopropanol (ISO), Yellow Magic 7 (YEL), or centrifugal force (CEN). Chewing simulation was carried out with a vertical load of 50 N (480,000 × 5 °C/55 °C). Two-body wear and fracture load were measured. Data were analyzed using global univariate ANOVA with partial eta squared, Kruskal-Wallis H, Mann-Whitney U, and Spearman’s rho test (p < 0.05). TEL showed less wear resistance than FPT (p = 0.001) for all cleaning methods tested. Concerning vertical material loss, NMF and GCT were in the same range of value (p = 0.419–0.997), except within FDPs cleaned in ISO (p = 0.021). FPT showed no impact of cleaning method on wear resistance (p = 0.219–0.692). TEL (p < 0.001) showed the highest and FPT (p < 0.001) the lowest fracture load. Regarding the cleaning methods, specimens treated with ISO showed lower fracture load than specimens cleaned with CEN (p = 0.044) or YEL (p = 0.036). The material selection and the cleaning method can have an impact on two-body wear and fracture load results. Printed restorations showed superior two-body wear resistance compared to milled FDPs but lower fracture load values. Regarding cleaning methods, ISO showed a negative effect on fracture load compared to the other methods tested.

Background: Ceramic veneers is one of the conservative esthetic treatment modality in dentistry. Success of veneer is very much dependent on the design preparation. Materials and Methods: Thirty selected teeth were categorized within three groups of 10 each with varying design preparations. After mounting the specimens, the incisal reduction was done, and porcelain laminate veneers were fabricated. Then cementation of the veneers was done with resin-cement, and fracture load was applied and recorded. Results: Multiple comparisons were done using post-hoc Tukey's test and modality of failure of veneers among the different designs were done using Chi-square test with the level of significance fixed at 0.05. Conclusion: Ceramic veneers preparation design including1 mm incisal reduction along with 1 mm of palatal-chamfer height revealed greater fracture toughness in contrast to incisal-reduction 1 mm along with butt-joint preparation design.

Aim The aim of this study was to evaluate the effect of cement on the fracture load of monolithic zirconia crowns with different yttria content (3 and 5 mol%). Methods A total of 62 monolithic zirconia crowns, 40 3Y-zirconia crowns (Prettau® Zirconia, Zirkonzahn) and 22 5Y-zirconia crowns (Prettau® 4 Anterior®, Zirkonzahn) were produced to a shallow chamfer molar preparation. The 3Y-crowns were divided into four groups and attached to composite abutment duplicates (SDR® flow+, Dentsply DeTrey GmbH) using the following four cementation techniques; (1) Self-adhesive resin-based cement, (2) Pre-treatment with air-abrasion and self-adhesive resin-based cement, (3) Zinc phosphate cement, (4) Glass-ionomer cement. The 5Y-crowns were divided into two groups and attached to the duplicates with; (1) Self-adhesive resin-based cement, or (2) Air-abrasion pre-treatment and self-adhesive resin-based cement. All crowns were loaded axially (0.5 mm/min) on the occlusal surface until fracture occurred. Results Among the 3Y-zirconia groups, the zinc phosphate cement group fractured at lower loads compared to the resin-based cement groups, with and without air-abrasion, (p

Utar, Merve/0000-0002-5876-3743 WOS:000562984900001 PubMed: 32845029 This study intended to analyze microcracks and fractographic markings on the surface of all ceramic crowns after milling and compare the fracture loads. 90 crowns were manufactured from two feldspathic (Priticrown-Pr and Vita Mark II-Vi) and a lithium disilicate (EmaxCAD-Em) blocks (n= 30). Two groups (n= 15) were prepared for each ceramic. In the first group, crowns were analyzed twice via the fluorescent penetrant method for microcrack detection, after the manufacturing process and thermal cycles. The load to fracture test was applied at a crosshead speed of 0.5 mm/min until catastrophic failure. Second group crowns were directly cemented onto the Co-Cr dies following the manufacturing process and loaded to fracture. Fractographic markings were analyzed through scanning electron microscope. Spearman correlation analysis, Kruskal-WallisHtest, Mann-WhitneyUtest, and Wilcoxon Signed Rank test were applied (alpha= .05). Fracture loads of Em crowns were higher than other groups (p .05). Thermal cycling did not affect microcrack numbers and fracture loads (p > .05). Tooth-shaped multilayered Pr blocks did not provide an advantage in terms of microcrack and fracture loads. Kirikkale University Scientific Projects Coordination UnitKirikkale University [2015-86] Kirikkale University Scientific Projects Coordination Unit, Grant/Award Number: 2015-86

PURPOSE To analyze the impact of different veneering techniques on the fracture load of telescopic secondary crowns made of a high-performance polymer (Ultaire aryl ketone polymer [UAKP]). MATERIALS AND METHODS Zirconia primary crown models (taper of 0 degrees) were prepared (N = 48), polished, scanned, and divided into four veneering groups (n = 12 each): premanufactured, digital, full anatomical, and vestibular. For all groups except vestibular, a standardized telescopic secondary crown (thickness: 0.6 mm, circular margin: 1 mm) was constructed, adapted to the corresponding primary crown, milled from UAKP, and veneered. The veneered master crown was developed based on the premanufactured group. After surface polishing, all specimens were artificially aged in a chewing simulator (1.2 million cycles, 50 N, 1.1 Hz, between 5°C and 55°C). Fracture load was tested in a universal testing machine with a piston (O = 6 mm, 1 mm/minute). Fracture patterns were analyzed. For statistical analysis, Kolmogorov-Smirnov test and descriptive statistics followed by one-way ANOVA with post hoc Scheffe test were conducted (P < .05). RESULTS Significant differences in fracture load were found between different veneering techniques (P < .001), with the highest values for the vestibular and digital groups, followed by the premanufactured group. Full anatomical veneering showed the significantly lowest fracture load (1,885 ± 397 N). For all specimens, cohesive brittle fractures with similar fracture patterns occurred, irrespective of the veneering technique. CONCLUSION The veneering technique of telescopic secondary crowns made of high-performance polymer affects overall stability. All veneering techniques provided sufficient fracture load values for telescopic secondary crowns made of UAKP. Digital veneers seem the most recommendable.

Objective This study investigates the influence of the most commonly used indenter materials on fatigue survival and fracture resistance of zirconia crowns. Materials and Methods A total of 40 zirconia crowns were prepared using computer-aided design (CAD)/computer-aided manufacturing (CAM) technology: 30 crowns were divided into three experimental groups of 10 specimens and the last 10 specimens acted as the control group. The experimental groups were subjected to chewing simulation with simultaneous thermocycling. Three indenter materials (steatite ceramic, stainless steel, and tungsten carbide) with identical diameter were used to load the specimens. All crowns were then subjected to single load to fracture test in universal testing machine. Load was applied vertically with a crosshead speed of 1 mm/min until failure, and fracture load was recorded. Statistical Analysis Normal distribution of data was confirmed using the Shapiro–Wilk test. Descriptive statistics including means and standard deviations were determined for all groups. Differences between groups were tested using Dunnett’s test and paired sample t-test. Results Chewing simulation for 1.2 million cycles resulted in 100% survival. The highest mean fracture load was recorded for the control group and the lowest one was for the group fatigued with stainless steel indenter. Chewing simulation statistically significantly (p < 0.05) reduced the mean fracture load of the crowns fatigued with stainless steel and steatite ceramic indenter. However, the mean fracture load for the crowns fatigued with tungsten carbide was not significantly different from that of the control group. Conclusion Steatite ceramic and stainless steel indenters produced close results and significantly reduced fracture load of zirconia crowns. However, tungsten carbide indenter caused nonsignificant reduction in the fracture load of zirconia crowns.

A direct relationship has been reported between yttria concentration and translucency in zirconia restorations. However, increased yttria concentration also increases the cubic phase of the zirconia, which reduces its strength. The effect of increased yttria content on the fracture resistance of zirconia as a function of material thickness after fatigue testing requires evaluation.The purpose of this in vitro study was to use the biaxial flexural test to evaluate the effect of yttria concentration on the mean fracture load (N) before and after fatiguing and thermocycling as a function of zirconia thickness.Disk-shaped specimens of 5 mol% yttria partially stabilized zirconia (5Y-PSZ, BruxZir Anterior Solid Zirconia) and 3 mol% yttria partially stabilized zirconia (3Y-PSZ, BruxZir Shaded Zirconia) were prepared to thicknesses of 1.2 and 0.7 mm. For each thickness, the biaxial flexural test was used to measure the fracture load (N) before and after fatigue testing, with 1.2 million cycles at a 110-N load and simultaneous thermocycling at 5 °C to 55 °C (n=20). The data were analyzed by repeated-measures ANOVA (α=.05).Yttria concentration, thickness, and exposure to fatiguing had a statistically significant effect on the mean biaxial flexural load (yttria concentration: P.001; thickness: P.001; fatiguing: P=.004 for the 3Y-PSZ). One of the major findings in this study was that 30% of the 1.2-mm-thick 5Y-PSZ specimens and 80% of the 0.7-mm-thick 5Y-PSZ specimens fractured during fatiguing. All specimens of the 3Y-PSZ groups survived the fatiguing protocol. The 3Y-PSZ groups had statistically significant higher flexural loads than the 5Y-PSZ groups. The 1.2-mm thickness groups had statistically significant higher flexural loads than the 0.7-mm thickness groups.Yttria concentration had a significant effect on the strength of zirconia. 5Y-PSZ was considerably less resistant to fracture before and after fatigue testing than 3Y-PSZ. Decreasing the thickness of zirconia reduces its fracture resistance, regardless of the zirconia type.

ObjectiveThe objective of this in vitro study was to investigate fracture load, fracture types, and impact of chewing simulation of human molars restored with 3D printed indirect polyetheretherketone (PEEK) inlays and compare these with milled indirect PEEK inlays, direct resin composite fillings, and sound teeth.Materials and methodsA total of 112 molars with form congruent class I cavities were restored with (n = 16/group) 3D printed indirect PEEK inlays via fused layer manufacturing (FLM): (1) Essentium PEEK (ESS), (2) KetaSpire PEEK MS-NT1 (KET), (3) VESTAKEEP i4 G (VES), (4) VICTREX PEEK 450G (VIC), (5) milled indirect PEEK inlays JUVORA Dental Disc 2 (JUV), and (6) direct resin composite fillings out of Tetric EvoCeram (TET). Sound teeth (7) acted as positive control group. Half of the specimens of each group (n = 8) were treated in a chewing simulator combined with thermal cycling (1.2 million × 50 N; 12,000 × 5 °C/55 °C). Fracture load and fracture types of all molars were determined. Statistical analyses using Kolmogorov-Smirnov test and two-way ANOVA with partial eta squared (ηp2) followed by Scheffé post hoc test, chi square test and Weibull modulusmwith 95% confidence interval were computed (p ResultsESS and TET demonstrated the lowest fracture load with a minimum of 956 N, whereas sound molars showed the highest values of up to 2981 N. Chewing simulation indicated no impact (p = 0.132). With regard to Weibull modulus, KET presented a lower value after chewing simulation than JUV, whereas TET had the highest value without chewing simulation. All indirect restorations revealed a tooth fracture (75–100%), direct resin composite fillings showed a restoration fracture (87.5%), and 50% of the sound teeth fractured completely or had cusp fractures.ConclusionsAll 3D printed and milled indirect PEEK inlays as well as the direct resin composite fillings presented a higher fracture load than the expected physiological and maximum chewing forces.Clinical relevance3D printing of inlays out of PEEK via FLM provided promising results in mechanics, but improvements in terms of precision and esthetics will be required to be practicable in vivo to represent an alternative dental material.

Various protocols are available to preclinically assess the fracture resistance of zirconia oral im plants. The objective of the present review was to determine the impact of different treatments (dynamic load ing, hydrothermal aging) and implant features (e.g., material, design or manufacturing) on the fracture re sistance of zirconia implants. An electronic screening of two databases (MEDLINE/Pubmed, Embase) was per formed. Investigations including > 5 screw‐shaped implants providing information to calculate the bending moment at the time point of static loading to fracture were considered. Data was extracted and meta‐analyses were conducted using multilevel mixed‐effects generalized linear models (GLMs). The Šidák method was used to correct for multiple testing. The initial search resulted in 1864 articles, and finally 19 investigations loading 731 zirconia implants to fracture were analyzed. In general, fracture resistance was affected by the implant de sign (1‐piece > 2‐piece, p = 0.004), material (alumina‐toughened zirconia/ATZ > yttria‐stabilized tetragonal zir conia polycrystal/Y‐TZP, p = 0.002) and abutment preparation (untouched > modified/grinded, p < 0.001). In case of 2‐piece implants, the amount of dynamic loading cycles prior to static loading (p < 0.001) or anatomical crown supply (p < 0.001) negatively affected the outcome. No impact was found for hydrothermal aging. Het erogeneous findings of the present review highlight the importance of thoroughly and individually evaluating the fracture resistance of every zirconia implant system prior to market release., Ziel dieser Übersichtsarbeit und Meta-Analyse ist es, auf Basis existierender Untersuchun-gen, die Bruchresistenz von dentalen Zirkonoxidimplantaten zu beurteilen. Zudem soll ermit-telt werden, welche Faktoren die Bruchresistenz beeinflussen. Betrachtete Einflussfaktoren sind unterschiedliche Merkmale der Versuchsprotokolle einbezogener Studien (Variation von Einbettwinkel und Hebelarm, verschiedene künstliche Belastungsverfahren, anatomische und nicht-anatomische Suprakonstruktionen der Implantate oder ein Beschleifen des Abutments) und individuelle Eigenschaften des Implantatkörpers (Durchmesser, Ausgangsmaterial, Design, Herstellungsverfahren, Verbindungsart von 2-teiligen Implantaten). Um passende Studien zu identifizieren, wurde eine Suchstrategie für die Datenbanken Pub-Med (Medline) und Embase entwickelt. Die Suche ergab 1864 Treffer, von denen diejenigen in die Meta-Analyse integriert wurden, die mindestens 5 schraubenförmige Zirkonoxidimplantate untersuchten und ausreichend Informationen zur Berechnung des Biegemoments zum Zeitpunkt des Bruchs beinhalten. Es wurden 17 Untersuchungen in die Meta-Analyse aufgenommen. Zudem konnten zwei weitere zum Zeitpunkt der Recherche noch unveröf-fentlichte Arbeiten durch Koautoren in der Übersichtsarbeit berücksichtigt werden. Insgesamt 731 Zirkonoxidimplantaten wurden durch ein multilevel generalisiertes gemischt-lineares Modell (GLMs) analysiert. Die Šidák-Methode wurde zur Korrektur von Mehrfachprüfungen verwendet. Die Meta-Analyse ergab, dass das Biegemoment zum Zeitpunkt des Bruchs durch das Im-plantatdesign (1-teilig > 2-teilig; p = 0,004), Ausgangsmaterial (engl.: alumina‐toughened zirconia / ATZ > yttria‐stabilized tetragonal zirconia polycrystal / Y-TZP; p = 0,002) und Modi-fikation des Abutments (unberührt > beschliffen; p < 0,001) signifikant beeinflusst wird. Auf die Bruchresistenz von 2-teiligen Implantaten wirkte sich außerdem eine hohe Anzahl von dynamischen Belastungszyklen (p < 0,001) und eine anatomische Kronenversorgung (p < 0,001) negativ aus. Der Erarbeitungsprozess und die Ergebnisse dieser systematischen Übersichtsarbeit und Me-ta-Analyse verdeutlichen, dass existierende präklinische Testprotokolle einer Überarbeitung und bei Anwendung einer exakten Einhaltung bedürfen. Dentale Zirkonoxidimplantate erfül-len die Anforderungen einer physiologischen Kaubelastung, eine Ausnahme bilden Implanta-te mit einem Durchmesser von ≤ 3,3mm. Die Heterogenität der Ergebnisse unterstreicht zu-dem die Wichtigkeit der Prüfung eines jeden einzelnen Zirkonoxidimplantatsystems vor sei-ner Markteinführung.

Nada Heidari,1 Rasha Amawi,1 Przemek Seweryniak,2 Fahad Bakitian,3 Per Vult von Steyern1 1Department of Materials Science and Technology, Malmö University, Malmö, Sweden; 2Commercial Dental Laboratory, Malmö, Sweden; 3Department of Restorative Dentistry, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Fahad Bakitian, Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, 21511, Saudi Arabia, Tel +966500507661, Email fabakitian@uqu.edu.saPurpose: To evaluate the effect of different placing strategies performed in the connector area on fracture resistance and fracture behaviour of monolithic multi-layered translucent zirconia fixed dental prostheses (FDPs).Materials and Methods: Thirty 3-unit monolithic FDPs were produced and divided into three groups (n = 10) based on the different strategies for placing the connector area of FDPs in multi-layered zirconia blank with varying contents of yttria ranging from 4 to 5 mol%. The groups were as follows: FDPs with connectors placed in dentin layer with 4 mol% yttria content, FDPs with connectors placed in gradient layer, and FDPs with connectors placed in translucent layer with 5 mol% yttria content. A final group (n = 10) of conventional monolithic zirconia with a monolayer of yttria content (4 mol%) has been used as a control group. The specimens were artificially aged using thermocycling and pre-loading procedures and subsequently loaded to fracture using a universal testing machine. Fracture loads and fracture behaviour were analyzed using one-way ANOVA and Fisher’s exact tests and statistically evaluated (p ≤ 0.05).Results: There were no significant differences in fracture loads among the groups based on the placing strategies of the connector area of the FDPs in the multi-layered translucent zirconia blank (p > 0.05). There was no significant difference in fracture loads between monolithic multi-layered translucent zirconia and conventional monolithic translucent zirconia materials (p > 0.05). Fracture behaviour of FDPs with connector area placed in translucent layer differed significantly compared to FDPs with connector area placed in dentin layer and FDPs in control group (p = 0.004).Conclusion: The placing strategies of the connector used in the computer aided design and manufacturing procedures do not considerably affect fracture resistance of monolithic FDPs made of multi-layered translucent zirconia. Monolithic FDPs made of multi-layered translucent zirconia show comparable strength to FDPs made of conventional translucent zirconia, but with different fracture behaviour.Keywords: all-ceramic restorations, computer-aided designmanufacturing, fracture load, multi-layered zirconia, Y-TZP

This investigation focuses on modelling the fracture zone of four materials at different test speeds. The influence of these test speeds on the fracture zone formula was investigated as well. The fracture behaviour of materials is an important parameter which greatly affects the performance of these materials. In this paper, an empirical formula was generated to predict the fracture zone. This formula was produced from experimental characterisation of the fracture process at different loading rates for some engineering materials. Statistical analysis was done for the results being obtained from the experimental work to verify the accuracy of this formula, and it was found that it can introduce an accurate base for fracture zone prediction and determination. It was noted that at fracture process initiation, there are no significant effects of varying loading rate; this effect is increased with increasing the fracture process propagation.

The article describes the results of the investigation focused on the properties of the Zr,Hf-(Zr,Hf)N-(Zr,Hf,Me,Al)N coatings, where Me means chromium (Cr), titanium (Ti), or molybdenum (Mo). These coatings have three-layer architecture, including adhesion, transition, and wear-resistant layers, while the latter, in turn, has a nanolayer structure. Despite the fact that the coatings under study have close values of hardness and critical fracture load LC2, there are noticeable differences in wear resistance during the turning of steel. The tools with the coatings under study demonstrated better wear resistance compared to an uncoated tool and the tool with the commercial ZrN coating. The best wear resistance was detected for a tool with the Zr,Hf-(Zr,Hf)N-(Zr,Hf,Ti,Al)N coating. The study of the pattern of cracking in the structure of the coatings has found that, during the cutting process, active cracking occurs in the coating with Cr, which leads to the fracture of the coating, while the process of cracking is noticeably less active in the coatings with Ti or Mo.

Fit accuracy and fracture strength of milled monolithic zirconia (Zi) and zirconia-reinforced lithium silicate (ZLS) crowns are important parameters determining the success of these restorations. This study aimed to evaluate and compare the marginal and internal fit of monolithic Zi and ZLS crowns, along with the fracture load, with and without mechanical aging. Thirty-two stone dies acquired from a customized master metal molar die were scanned, and ceramic crowns (16 Zi Ceramill Zolid HT+ and 16 ZLS Vita Suprinity) were designed and milled. Absolute marginal discrepancies (AMD), marginal gaps (MG), and internal gaps (IG) of the crowns, in relation to the master metal die, were evaluated using x-ray nanotomography (n = 16). Next, thirty-two metal dies were fabricated based on the master metal die, and crowns (16 Zi, 16 ZLS) cemented and divided into four groups of eight each, eight Zi with mechanical aging (MA), eight Zi without mechanical aging (WMA), eight ZLS (MA), and eight ZLS (WMA). Two groups of crowns (Zi-MA, ZLS-MA) were subjected to 500,000 mechanical cycles (200 ± 50 N, 10 Hz) followed by axial compressive strength testing of all crowns, until failure, and the values were recorded. Independent sample t tests (α = 0.05) revealed no significant differences between Zi and ZLS crowns (p &gt, 0.05), for both internal and marginal gaps, however, there were significant differences in AMD (p &lt, 0.005). Independent samples Mann–Whitney U and Kruskal–Wallis tests revealed significant differences between the two materials, Zi and ZLS, regardless of fatigue loading, and for the individual material groups based on aging (α = 0.05). Multiple comparisons using Bonferroni post-hoc analysis showed significant differences between Zi and ZLS material groups, with or without aging. Within the limitations of this study, the ZLS crown fit was found to be on par with Zi, except for the AMD parameter. As regards fracture resistance, both materials survived the normal range of masticatory forces, but the Zi crowns demonstrated greater resistance to fracture. The monolithic Zi and ZLS crowns seem suitable for clinical application, based on the fit and fracture strength values obtained.

Background The aim of this study was to develop a mathematically valid method of assessing fracture resistance of roots. The model developed used mesial roots of lower molars instrumented using stainless steel hand files (SS) and two rotary nickel-titanium (NiTi) systems. Methods Eighty human lower molars were selected and randomly divided into four groups (n = 20). After instrumentation, the root canals were obturated using thermoplasticized gutta percha. The roots were covered with a simulated periodontal ligament and mounted vertically in autopolymerizing acrylic in PVC tubes. Using a universal testing machine, the force to fracture (N) was applied and the maximum load (FL) was recorded. Remaining dentine volume was calculated and the fracture resistance (FR) was recorded. The data were analyzed using SPSS version 22 with P Results There were no significant differences among the instrumentation methods for FL but in FR the roots instrumented using rotary NiTi showed significantly lower values than control groups and SS files (P Conclusions Considering the effect of root length, volume of the root, and volume of the instrumented canal as well as the maximum failure load may be a more objective method of reporting fracture resistance of roots.

Recently, translucent zirconia has become the most prevalent material used as a restorative material. This study aimed to compare the crown fracture load of the four most common different translucent zirconia brands available in the market at 1.5 mm thickness. Standardized tooth preparations for a full ceramic crown were designed digitally with software (AutoCAD) by placing a 1.0 mm chamfer margin and 1.5 mm occluso-cervical curvature for the crown sample manufacturing. Stylized crowns were chosen to control the thickness of the crown. The axial and occlusal thickness were standardized to 1.5 mm thickness except at the central pit, which was 1.3 mm thick. The STL file for the tooth dies was prepared using software (3Shape TRIOS® Patient Monitoring, Copenhagen, Denmark). The tooth dies were printed with a resin material (NextDent Model 2.0, Vertex-Dental B.V., Soesterberg, The Netherlands) using a 3D printing software (3D Sprint® Client Version 3.0.0.2494) from a 3D printer (NextDent™ 5100, Vertex-Dental B.V., Soesterberg, The Netherlands). The printing layer thickness was 50 µm. Then, a total of twenty-eight (N = 28) stylized crowns were milled out of AmannGirrbach (Amann Girrbach GmbH, Pforzheim, Germany) (n = 7), Cercon HT (Dentsply Sirona, Bensheim, Germany) (n = 7), Cercon XT (Dentsply Sirona, Bensheim, Germany) (n = 7), and Vita YZ XT (Zahnfabrik, Bäd Sackingen, Germany) (n = 7). Following sintering the crowns, sandblasting was performed and they were bonded to the tooth dies with the resin cement (RelyX U-200, 3M ESPE, Seefeld, Germany) and permitted to self-cure under finger pressure for 6 min. The crowns were loaded on the occlusal surface in a universal testing machine (MTS Centurion) with a stainless-steel ball indenter (7 mm radius) with a loading rate of 1 mm/min to contact the stylized crowns on each of the four cusps until failure. A rubber sheet (1.5 mm thickness) was positioned between the crown and indenter, which helped with the load distribution. Statistical analysis was done using SPSS version 20 (IBM Company, Chicago, USA). The fracture loads were analyzed using Dunnett’s T3 test, and the number of cracks was analyzed using the Mann–Whitney U test among the groups. The significant level was set at p value = 0.05. The mean fracture loads were 3086.54 ± 441.74 N, 4804.94 ± 70.12 N, 3317.76 ± 199.80 N, and 2921.87 ± 349.67 N for AmannGirrbac, Cercon HT, Cercon XT, and Vita YZ XT, respectively. The mean fracture loads for the surfaces with the greatest number of cracks (excluding the occlusal surfaces) were on the lingual surface for AmannGirrbach and Cercon HT, on the distal and mesial for Cercon XT, and on the buccal for Vita YZ XT. We found that the AmannGirrbach had the most overall cracks. Cercon XT had the greatest number of occlusal cracks and appeared to be the most shattered. Cercon HT had the least number of cracks. In conclusion, Cercon HT presented the best strength properties, the highest fracture load, and no visible cracks. AmannGirrbach presented the lowest strength properties.

The prevention of root fractures of pulpless teeth is an important clinical issue to maintain healthy teeth through lifetime. The aim of this study was to examine a clinically effective treatment method for strengthening vulnerable pulpless teeth using CAD/CAM (computer-aided design/computer-aided manufacturing) fiber-reinforced post-core by conducting a fracture resistance test. A post-core made with a fiber-reinforced resin disk TRINIA (TR, SHOFU, Kyoto, Japan) was fabricated using a CAD/CAM system. The fiber-layer orientation of the CAD/CAM post-core was parallel to the axis of the restored tooth. A post-core using a conventional composite and a fiber post (CF) was also prepared. A fracture resistance test of teeth restored with the post-cores and zirconia crowns was conducted using a universal testing machine, and fracture patterns were identified by micro-CT observation. The fracture load of the roots restored with TR was 1555.9 ± 231.8 N, whereas that of CF was 1082.1 ± 226.7 N. The fracture load of TR was 43.8% that was significantly higher than that of CF (Student’s t-test, p &lt, 0.05). The restored teeth with CAD/CAM resin post-core were found to be repairable even after fracture. These results suggest that the CAD/CAM indirect fiber post-core has the potential to strengthen the vulnerable pulpless teeth.

OBJECTIVES To assess the mechanical stability of implants after implantoplasty and thermocyclic loading, the residual thickness of the instrumented areas and neighbouring tooth injury due to implantoplasty. MATERIALS AND METHODS Using a phantom head simulator and maxillary model implants were subjected to an implantoplasty procedure. Thirty implants were randomly assigned to receive one of three instrumentation sequences. After instrumentation, injury on neighbouring teeth was assessed. Instrumented implants and non-instrumented controls were subjected to 1.2 million cycles of thermo-mechanical loading in a chewing machine. Afterwards, maximum fracture load for all implants and an additional five pristine control implants was tested. RESULTS Generally, damage of neighbour teeth was a frequent finding (33 ± 56% of all cases) with considerable inter-group differences. No considerable inter-group difference for the residual implant thickness was found for different areas assessed. No implant fractured during cyclic loading. Fracture load was reduced after cyclic loading of uninstrumented implants from 2,724 ± 70 N to 2,299 ± 127 N, and after implantoplasty to 1,737 ± 165 N, while no effect by the instrumentation sequence could be observed. CONCLUSIONS Both implantoplasty and cyclic loading were shown to reduce the implants' maximum bending strength. Cyclic loading in a laboratory masticator, simulating a five-year equivalent of chewing, did not result in fractured implants. Since neighbouring tooth injury was assessed often, care should be taken with the selection of suitable instruments.

International audience; Due to growing demand for metal-free dental restorations, dental ceramics, especially dental zirconia, represent an increasing share of the dental implants market. They may offer mechanical performances of the same range as titanium ones. However, their use is still restricted by a lack of confidence in their durability and, in particular, in their ability to resist hydrothermal ageing. In the present study, the ageing kinetics of commercial zirconia dental implants are characterized by X-ray diffraction after accelerated ageing in an autoclave at different temperatures, enabling their extrapolation to body temperature. Measurements of the fracture loads show no effect of hydrothermal ageing even after ageing treatments simulated a 90-year implantation.

BACKGROUND: The aesthetics and strength of anterior porcelain layered zirconia (PLZ) crowns are mainly affected by the zirconia (Zr) coping design. There is a need for a modified design to enhance aesthetics with strength. OBJECTIVES: The purpose of this study was to compare the fracture resistance of anterior PLZ crowns having modified CAD-CAM Zr coping designs (in terms of thickness and marginal collar designs) with standard Zr copings. METHODS: Fifty PLZ crowns were fabricated and divided into two groups: Gr 1: Standard Zr Coping (SZC) (control gr) with 0.5 mm thickness (Facial-F, Mesial-M, Distal-D, incisal-I, and Palatal-P) without a collar; Gr 2: Collar Zr Coping (CZC) (test gr) with 2.5 mm collar height on M, D, P and 0.2 mm F and variable facial wall thickness. Subgroups: Gr 2a: (CZC-0.5 mm) facial wall thickness 0.5 mm; Gr 2b: (CZC-0.4 mm) facial wall thickness 0.4 mm; Gr 2c: (CZC-0.3 mm) facial wall thickness 0.3 mm; Gr 2d: (CZC-0.2 mm) facial wall thickness 0.2 mm. The fracture load was determined and analysed using One-way ANOVA and Dunnet test. RESULTS: The minimum fracture load was 927.36 ± 127.80 N observed for Gr 2c (CZC at 0.3 mm) while the maximum fracture load was 1373.61 ± 146.54 N observed for Gr 2a (CZC at 0.5 mm). A highly significant difference in mean fracture load among various Zr coping groups (p< 0.001) was determined. CONCLUSIONS: Novel Zr coping design for anterior PLZ crowns can provide better aesthetics with strength. Reducing the thickness of Zr coping in the aesthetic zone to 0.2 mm and providing a modified collar design (2.5 mm collar height on M, D, P, and 0.2 mm F) would provide strength without jeopardizing aesthetics.

Made available in DSpace on 2022-05-01T04:26:40Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-05-11 Objectives: This study compared the influence of occlusal anatomy on acrylic CAD/CAM crowns fracture load and stress distribution. The null hypothesis was that there would be no difference between the provisional crowns fracture load and stress according to different occlusal anatomy. Methods: A full-crown preparation was simulated using dentin analogue (G10, Protec, São Paulo, Brazil) totaling 20 identical preparations. Next, twenty acrylic crowns were milled using different occlusal design parameter (Young or Adult) available in the software database. The crowns were cemented (Temp-bond, NE Kerr Dental, Brea, CA, USA) and fractured using a compressive load (0.5 mm/min of cross-head speed). Data were analyzed by using one-way ANOVA and Tukey tests (p< 0.05). A similar geometry was modeled and exported to the analysis software to perform a static structural analysis. The maximum principal stress was calculated using the finite element method with 300 N chewing load simulation. Results: The occlusal anatomy significantly influenced the load-to-fracture (p

Objectives Functional loading and low-temperature degradation may give rise to impaired clinical long-term service of zirconia implant abutments. The aim of this study was to compare the fracture strength (primary outcome measure) and the volume percentage of monoclinic surface zirconia (m-ZrO2) of stock and CAD/CAM-customized zirconia implant abutments that functioned clinically for 1 year with geometrically identical pristine controls in an ex vivo experiment. Material and methods Twenty-three stock (ZirDesign (TM)) and 23 CAD/CAM-customized (Atlantis (TM)) zirconia implant abutments were retrieved after 1 year of clinical service. They were compared with pristine copies with respect to the volume fraction of the monoclinic phase using Raman spectroscopy and their fracture load by means of a single load-to-fracture test. Failure analysis was performed using optical and SEM microscopy. After verification of normal distribution, paired t tests were used for comparison of fracture loads between pristine and clinically aged specimen. All statistical tests employed a level of significance of alpha = 0.05. Results The fracture loads of the stock zirconia abutments were significantly (p

Objectives The aim was to explore the fracture behavior and marginal gap within the root canal of endodontically treated (ET) premolars restored with different fiber-reinforced post-core composites (FRCs). Further aim was to evaluate the composite curing at different depths in the canal. Materials and methods Eighty-seven intact upper premolars were collected and randomly divided into six groups. After endodontic procedure, standard MOD cavities were prepared and restored with their respective fiber-reinforced post-core materials: group 1: prefabricated unidirectional FRC-post + conventional composite core; group 2: prefabricated unidirectional FRC-post + short fiber composite (SFRC) core; group 3: individually formed unidirectional FRC-post + conventional composite core; group 4: randomly oriented SFRC directly layered as post and core; group 5: individually formed unidirectional FRC + randomly oriented SFRC as post and core. After restorations were completed, teeth (n = 3/group) were sectioned and then stained. Specimens were viewed under a stereo microscope and the percentage of microgaps within the root canal was calculated. Fracture load was measured using universal testing machine. Results SFRC application in the root canal (groups 4 and 5) showed significantly higher fracture load (876.7 N) compared to the other tested groups (512–613 N) (p Conclusions The restoration of ET premolars with the use of SFRC as post-core material displayed promising performance in matter of microgap and load-bearing capacity. Clinical significance Fracture resistance of ET premolar restored by bilayered composite restoration that includes both SFRC as post-core material and surface conventional resin seems to be beneficial.

Purpose: This study investigated influence of two conditioning methods and two luting cements on the fracture load of all-ceramic crowns. Materials and methods: A total of thirty-two CAD-CAM all-ceramic crowns, (Vita Mark II) were constructed on human upper premolars indicated for extraction and collected from department of oral surgery, faculty of dentistry, Mansoura University. The intaglio surfaces of 16 crowns were treated using acid (4.9% HF) with silane application. The other 16 crowns were conditioned using Monobond Etch & prime in one step. Each group divided into 2 subgroups (n=8) according to used type of luting cements. Self adhesive resin cement (Rely X U200) or multistep adhesive resin cement (Mutilinik Automix) were used for crowns cementation to appropriate teeth. Crowns were kept in water for 3 months but after cementations by one hour. Universal testing machine was used to record the fracture load for crowns (N). Results: Means fracture load of groups luted with multistep adhesive resin cement were significantly higher than means fracture load of test groups luted using self adhesive resin cement regardless of conditioning techniques used (P 0.05). Conclusions: Two techniques used for conditioning of Vita Mark II crowns did not affect significantly fracture load of these crowns. Multilink adhesive resin cement improved fracture loads of Vita Mark II crowns compared to RelyX U200.

The permeability of a new investment casting mold system prepared by adding needle cokes has been investigated in this work. The permeability tests of the molds were carried out at the temperature of 25–1200 °C. The results showed that the addition of needle cork could significally increase the permeability of the molds by a factor of about 4 because the burning of needle cokes increased the porosities of the molds. Meanwhile, the needle coke modified molds exhibited higher green strength and greater thickness both on flat section and at sharp edges compared with the full fused silica mold. Taking account of the mold thickness, the needle coke modified molds had increased adjusted fracture load (AFL) by a factor of about 2 at the test temperature of 25–1200 °C. The addition of needle coke significally improved the permeability of the molds during both autoclaving and casting, and optimized the correlation between the permeability and green strength of the molds.

Zirconia‐based restorations are showing an increase as the clinicians’ preferred choice at posterior sites because of the strength and esthetic properties of such restorations. However, all‐ceramic restorations fracture at higher rates than do metal‐based restorations. Margin design is one of several factors that can affect the fracture strength of all‐ceramic restorations. The aim of this study was to assess the effect of preparation and crown margin design on fracture resistance. Four groups of bilayer zirconia crowns (with 10 crowns in each group) were produced by hard‐ or soft‐machining technique, with the following four different margin designs: chamfer preparation (control); slice preparation; slice preparation with an additional cervical collar of 0.7 mm thickness; and reduced occlusal thickness (to 0.4 mm) on slice preparation with an additional cervical collar of 0.7 mm thickness. Additionally, 10 hard‐machined crowns with slice preparation were veneered and glazed with feldspathic porcelain. In total, 90 crowns were loaded centrally in the occlusal fossa until fracture. The load at fracture was higher than clinically relevant mastication loads for all preparation and margin designs. The crowns on a chamfer preparation fractured at higher loads compared with crowns on a slice preparation. An additional cervical collar increased load at fracture for hard‐machined crowns. publishedVersion

Background: This study investigated the influence of erbium‑doped: yttrium aluminum garnet (Er:YAG) laser on the pull‑out fracture load of fiber‑reinforced composite (FRC) posts luted to dentin with different resin cements. Materials and Methods: In this in vitro experimental study, 90 premolars were endodontically treated. The post spaces were prepared, and the teeth were divided into three groups dependent on the cement applied for luting FRC posts: Group 1: An etch‑and‑rinse system, Group 2: A self‑etch cement, and Group 3: A self‑adhesive cement. After 6 months’ storage and thermocycling, each group was divided into three subgroups (n = 10) according to the treatment applied for removing the posts; subgroup 1: Control, subgroup 2: Treatment with Er:YAG laser at 250 mJ, 20 Hz, and subgroup 3: Treatment by Er:YAG laser at 300 mJ, 10 Hz. The pull‑out load was recorded in Newton. The data were analyzed by two‑way ANOVA at P < 0.05. Results: The fracture load was significantly affected by the cementation group (P = 0.005) and treatment subgroup (P = 0.008). The pull‑out load of self‑etch cement was significantly greater than that of the self‑adhesive and etch‑and‑rinse systems (P < 0.05). Treatment with Er:YAG laser caused a significant reduction in pull‑out load of FRC posts (P < 0.05). Conclusion: The fracture load of fiber posts is influenced by the type of cement and treatment applied. Post removal would be less challenging when using a self‑adhesive or conventional etch‑and‑rinse cement or using Er:YAG laser at the FRC‑resin interface. Key Words: Lasers, post technique, resin cements, erbium

The purpose of this in vitro study was to evaluate the load-to-fracture values of cement-, screw-, and multiscrew-retained abutments for implant-supported fixed partial dentures (FPDs).Thirty-six implants with a diameter and length of 4.5 and 13 mm, respectively, were used to prepare 18 samples of FPDs. Based upon the variations on abutment design, the FPDs were divided into three categories as follows: cement-retained, screw-retained, and multiunit screw-retained abutments. Using a chewing simulator, cyclic loads of 1,250,000 load cycles with a load of 70 N were applied on all samples to simulate 5 years of human functional chewing. The samples were loaded until failure using an electromechanical test machine. Sample-size estimation was done, and fracture-load values were recorded as means and corresponding standard deviations; group comparisons were done using one-way analysis of variance and Tukey post hoc tests. A P value.01 was considered as an indicator of statistical significance.The fracture-load values for cement-, screw-, and multiunit screw-retained abutments were 2,109.2 ± 139.6 N, 3,888.8 ± 70 N, and 3,319.4 ± 218.9 N, respectively. The load-to-fracture values were significantly higher in screw-retained abutments (3,888.8 ± 70 N; P.001) than in cement-retained (2,109.2 ± 139.6 N) and multiunit screw-retained abutments (3,319.4 ± 218.9 N).Screw-retained implant-supported FPDs withstand higher occlusal forces compared with cement- and multiunit screw-based retention techniques. However, the results should be cautiously interpreted, as they were based on a relatively small sample size.

This study aimed to evaluate the effect of different chamfer preparations on the load capacity of reattached fractured incisors under lingual loading.Eighty #8 typodonts were randomly assigned to four groups (n = 20 each). They were sectioned to simulate crown fracture, and reattached with a self-etch adhesive and a resin composite. The preparation for each group was: (1) no chamfer; (2) buccal chamfer; (3) lingual chamfer; and (4) circumferential chamfer. Forty-eight human lower incisors were grouped and prepared similarly (n = 12 each). These teeth were tested for their load capacity under a lingual load on a universal testing machine. Finite element models were used to examine the stresses on the reattached surfaces to help interpret the experimental results.The buccal chamfer did not increase the load capacity when compared with the no-chamfer group. Lingual and circumferential chamfers respectively increased the fracture load by 36.9% and 32.3% in typodonts, and 78.5% and 33.3% in human incisors. The increase was statistically significant (p0.05). A higher fracture load tended to be accompanied by a larger area of deflected cohesive fracture. Finite element analysis showed that lingual and circumferential chamfers reduced the fracture-causing tensile stress at the lingual margin of the reattachment interface by approximately 70% and 60%, respectively, in human upper incisors.It was the joint design, and not the size of the bond area, that affected the load capacity of reattached incisors. Among the preparations considered, only those with a lingual chamfer could increase the load capacity of reattached incisors under a lingual load.

The aim of this study was to investigate the load to fracture and fracture pattern of prosthetic frameworks for tooth-supported fixed partial dentures (FPDs) fabricated with different subtractive computer-aided design and computer-aided manufacturing (CAD-CAM) materials. Materials and Methods: Thirty standardized specimens with two abutments were fabricated to receive three-unit posterior FDP frameworks with an intermediate pontic. Specimens were randomly divided into three groups (n = 10 each) according to the material: group 1 (MM)—milled metal, group 2 (L)—zirconia, and group 3 (P)—Polyetheretherketone (PEEK). The specimens were thermo-cycled and subjected to a three-point bending test until fracture using a universal testing machine (cross-head speed: 1 mm/min). Axial compressive loads were applied at the central fossa of the pontics. Data analysis was made using one-way analysis of variance, Tamhane post hoc test, and Weibull statistics (α = 0.05). Results: Significant differences were observed among the groups for the fracture load (p &lt, 0.0001). MM frameworks showed the highest fracture load values. The PEEK group registered higher fracture load values than zirconia samples. The Weibull statistics corroborated these results. The fracture pattern was different among the groups. Conclusions: Milled metal provided the highest fracture load values, followed by PEEK, and zirconia. However, all tested groups demonstrated clinically acceptable fracture load values higher than 1000 N. PEEK might be considered a promising alternative for posterior FPDs.

Purpose To investigate the impact of high-speed sintering and artificial aging on the fracture load of three-unit zirconia fixed dental prostheses (FDPs). Materials and methods Three-unit FDPs manufactured from 3Y-TZP (Ceramill Zolid, Amann Girrbach) and 4Y-TZP (Ceramill Zolid HT+, Amann Girrbach; N = 128, n = 64/group) were sintered at 1,580°C (high-speed sintering) or at 1,450°C (control group; n = 32/subgroup). Specimens were bonded to steel abutment models using Multilink Automix (Ivoclar Vivadent), and fracture load was examined without (n = 16/subgroup) and with artificial aging (6,000 thermocycles [5°C/55°C] and 1,200,000 chewing cycles [50 N]; n = 16/subgroup). Univariate analysis of variance, unpaired t test, and Weibull modulus were computed (P Results Sintering protocol (P = .944), artificial aging (P = .630), and zirconia material (P = .445) did not show an influence on the fracture load of three-unit FDPs. High-speed sintering led to superior Weibull modulus results for artificially aged 4Y-TZP specimens, while all other groups showed values in the same range. Conclusion The present study shows promising results for the novel high-speed sintering protocol, as it led to comparable fracture load and similar, or even superior, Weibull modulus results compared to the control group. The 4Y-TZP material presented fracture load results similar to the tried-and-tested 3Y-TZP. Artificial aging did not influence zirconia's resistance to fracture for either 3Y-TZP or 4Y-TZP.

CAD/CAM technologies and materials have the potential to improve the treatment of Robin Sequence with orthodontic appliances (Tübingen palatal plate, TPP). However, studies on the provided suitability and safety are lacking. The present study evaluates CAD/CAM technologies and materials for implementation into the workflow for producing these orthodontic appliances (TPPs), manufactured by different techniques and materials: additive manufacturing (AM) and subtractive manufacturing (SM) technologies vs. conventional manufacturing. The fracture load was obtained in a universal testing machine, and the breaking behavior of each bunch, as well as the necessity of adding a safety wire, was evaluated. The minimum fracture load was used to calculate the safety factor (SF) provided by each material. Secondary factors included manufacturing time, material cost and reproducibility. Dental LT clear showed the highest fracture load and best breaking behavior among AM materials. The highest fracture load and safety factor were obtained with Smile polyether ether ketone (PEEK). For the prototyping stage, the use of a Freeprint tray (SF = 114.145) is recommended. For final manufacturing, either the cost-effective approach, Dental LT clear (SF = 232.13%), or the safest but most expensive approach, Smile PEEK (SF = 491.48%), can be recommended.

To evaluate the effects of post length, post material, and substance loss on the fracture resistance of endodontically treated mandibular premolars.A total of 96 extracted human mandibular first premolars were endodontically treated and divided into 12 test groups (n = 8 each) based on the number of residual walls (one/two), post material (glass-fiber/titanium), and post length (5 mm, 7.5 mm, and 10 mm). After luting the posts, specimens received a composite resin core and a crown preparation with a 1.5-mm ferrule. Cast cobalt-chromium crowns were cemented using glass-ionomer cement. After 1,200,000 chewing cycles with a load of 49 N and simultaneous thermocycling (5°C to 55°C), specimens were quasi-statically loaded at 30 degrees to the longitudinal axis of the tooth until fracture. Fracture loads were analyzed using three-way, two-way, and one-way analysis of variance (α = .05). Fracture modes were examined under a stereomicroscope (×25) and recorded.Fracture loads ranged from 642 ± 190 N (one wall, glass fiber, 5 mm) to 1,170 ± 130 (two walls, titanium, 7.5 mm). The mean fracture load of titanium posts was significantly higher than that of glass-fiber posts (P.001), and the 7.5-mm post length exhibited significantly higher fracture loads than groups with 5-mm and 10-mm post length (P = .008).Teeth restored with titanium posts revealed considerably higher fracture resistance than teeth restored with glass-fiber posts, especially if 7.5-mm-length posts were used.

PURPOSE To investigate the fracture load of different veneers for monolithic single-unit fixed dental prostheses (FDPs) made of a novel potential framework material, polyphenylene sulfone (PPSU). MATERIALS AND METHODS The fracture loads of four PPSU frameworks with different veneers (manual polymer veneer with Ceramage Body A3B; prefabricated polymer veneer with Novo.lign; digital polymer veneer with Telio CAD; digital ceramic veneer with IPS Empress CAD) and a monolithic control group (PPSU, Gehr) were examined initially and after 1,200,000 masticatory (50 N, 1.3 Hz) and 6,000 thermal cycles (5°C/55°C). Fracture analysis was performed using light microscope imaging. Fracture types were classified, and relative frequencies were determined. Univariate analysis of variance, post hoc Scheffe, partial eta squared, Kruskal-Wallis test, and Weibull moduli using the maximum likelihood estimation method were calculated. The defined level of significance was adjusted by Bonferroni correction (P < .005). RESULTS Aging did not affect the fracture load values. Single-unit FDPs with a digital ceramic veneer showed lower values than monolithic and manual polymer-veneer specimens. Single-unit FDPs with a prefabricated and digital polymer veneer were in the same value range as specimens with a manual polymer and digital ceramic veneer. No differences were observed between manual polymer veneer and monolithic single-unit FDPs. All veneered specimens showed a fracture of the veneer. For monolithic single-unit FDPs, a plastic deformation was observed. CONCLUSION Veneered and monolithic PPSU showed sufficient fracture load values to indicate successful clinical use in single-unit FDPs. The choice of veneering method and material may play a minor role.

Purpose To determine the influence of thermal and mechanical cycling on fracture load and fracture pattern of resin nanoceramic crowns and polymer-infiltrated ceramic-network (PICN) crowns, both fabricated with CAD/CAM technology. Materials and methods A total of 90 premolar crowns bonded to titanium abutments were divided into three groups of 30 crowns each: 30 resin nanoceramic crowns (LU); 30 PICN crowns (VE); and 30 metal-ceramic crowns (MC). The 30 specimens of each group were further divided into three subgroups of 10 each that underwent (1) no treatment, (2) thermocycling (2,000 cycles, 5°C to 55°C), and (3) thermocycling with subsequent mechanical cycling (120,000 cycles, 80 N, 2 Hz). The specimens were loaded to failure, and two-way ANOVA and chi-square test were used to determine differences in fracture resistance and pattern. Results Mechanical and thermal cycling significantly influenced the critical load to failure of the three materials; however, no significant differences were observed between the thermocycled materials and the materials that were thermocycled with subsequent mechanical cycling. The MC specimens experienced significantly higher fracture loads than those of the LU and VE specimens, which showed no differences from each other in fracture resistance. The fracture patterns showed chipping in MC crowns and partial or complete fracture in LU and VE crowns. The fracture pattern depended on the material and was unrelated to the type of treatment it underwent. Conclusion All crowns showed adequate resistance to normal masticatory forces in the premolar area. The cyclic fatigue load negatively influenced all three materials.

Made available in DSpace on 2021-06-25T10:46:25Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-11-01 Background: To evaluate, in vitro, the effects of the cooling protocol, application technique, and veneering ceramic thickness on the fracture resistance of ceramic crowns with Y-TZP frameworks. Material and Methods: 80 frameworks were made from zirconia by the CAD/CAM technique and divided into 8 groups (n = 10) according to the factors: “application technique” (stratified-L and pressed -P), “thickness” (1 mm and 2 mm), and “cooling protocol” (slow-S and fast-F) of the feldspathic veneering ceramic. After, all crowns were cemented over G10 preparations with resin cement (Panavia F, Kuraray), mechanically cycled (2×106 cycles, 200 N, 3Hz), and subjected to the axial compression resistance test (0.5 mm/min, 10 kN). The data (N) underwent descriptive statistical analysis by 3-way ANOVA and Tukey's test (5%). Fracture analysis was performed to determine the possible origin of failure. Results: The factors “cooling protocol” (P=0.0058) and “application” technique (P=0.0001) influenced the fracture resistance of the crowns. For pressed veneer technique, the P2S (4608.9±464.5). A presented significantly higher results than that P2F(3621.1±523.0)BCD (Tukey's test). For the stratified technique, this difference was not observed (P>0.05). The thickness of the veneering ceramic was not significant regardless of the cooling protocol and technique (P>0.05). The predominant failure mode was chipping of the ceramic veneer originating in the subsurface. Conclusions: The pressed technique, used with a slow-cooling protocol, leads to the best outcome for the veneering of all-ceramic crowns. University Hospital Lauro Wanderley Federal University of Paraíba (UFPB) Department of Dental Materials and Prosthodontics São Paulo State University (Unesp) Institute of Science and Technology, São José dos Campos Department of Dentistry Santo Amaro University Department of Dentistry Division of Prosthodontics Federal University of Rio Grande do Norte (UFRN) Department of Dental Materials and Prosthodontics São Paulo State University (Unesp) Institute of Science and Technology, São José dos Campos

Objective: The purpose of this in-vitro study is to evaluate fracture resistance of two monolithic and one veneered zirconia crowns on human molar teeth fabricated after thermomechanical fatigue. Methods: Seventy-two human molar teeth were prepared to receive zirconia crowns. The specimens were divided into three experimental groups (n=24) according to restoration design, monolithic or veneered. The crowns were fabricated from GC initial zirconia, Dentsply Sirona TZI and Dentsply Sirona ZI. The prepared teeth were scanned with Sirona inEos X5 and the restorations were milled using Cerec inLab MC X5. The crowns were cemented by resin cement. Twelve crowns of each experimental group underwent thermomechanical fatigue using chewing Simulator for 240 000 chewing cycles with load of (100 N) and thermocycling (5 degrees C/55 degrees C), the remaining 12 crowns in each group did not undergo any thermomechanical fatigue and were considered as control group. All specimens were loaded until fracture using universal testing machine. Forces were applied to occlusal surface with 90 degrees angle. Loads of fracture were recorded. Collected data of fracture loads of all specimens were analyzed using SPSS 23.00 program. Results: Although thermomechanical fatigue significantly decreased fracture loads of only monolithic groups, monolithic zirconia crowns had higher fracture loads than veneered one. Among all specimens, the highest fracture load was found in GC group (5001,81 N) and the lowest was found in ZI group (2117.37 N). Two fracture patterns were observed among monolithic zirconia groups; total and crack, while three fracture patterns were observed in veneered group; porcelain fracture, porcelain and core, porcelain and core with tooth fracture. Conclusion: Thermomechanical fatigue has significant influence on monolithic zirconia, however, it showed higher fracture loads and can be alternative to veneered design.

PURPOSE To assess the effect of yttria mol% concentration and material thickness on the biaxial fracture load (N) of zirconia with and without mastication simulation. MATERIALS AND METHODS Disk-shaped specimens (N = 120) of 3 mol% yttria-partially stabilized zirconia, 3Y-PSZ (Katana High Translucent, Kuraray Noritake), 4 mol% yttria-partially stabilized zirconia, 4Y-PSZ (Katana Super Translucent Multi Layered) and 5 mol% Yttria-partially stabilized zirconia, 5Y-PSZ (Katana Ultra Translucent Multi Layered) were prepared to thicknesses of 0.7 and 1.2 mm. For each thickness, the biaxial fracture load (N) was measured with and without mastication simulation with 1.2 million cycles at a 110-N load and simultaneous thermal cycling at 5°C to 55°C. The data were analyzed by three-way Analysis of Variance (α = 0.05) and Tukey-Kramer adjusted multiple comparison test. RESULTS Yttria mol% concentration and material thickness had a statistically significant effect on the mean biaxial fracture load (F = 388.16, p < 0.001 and F = 714.33, p < 0.001 respectively). The mean biaxial fracture load ranged from the highest to the lowest; 3Y-PSZ, 4Y-PSZ, and 5Y-PSZ (p = 0.012). The mean biaxial fracture load of the 1.2 mm thickness groups was significantly higher than 0.7 mm thickness at any given condition (p = 0.002). Not all specimens survived the mastication simulation protocol. Fifty percent of the 0.7-mm-thick 4Y-PSZ specimens, 70% of the 0.7-mm-thick 5Y-PSZ specimens and 20% of 1.2-mm-thick 5Y-PSZ specimens fractured during mastication simulation. Mastication simulation had no statistically significant effect on the biaxial fracture load (F = 1.24, p = 0.239) of the survived specimens. CONCLUSIONS Lowering yttria mol% concentration and increasing material thickness significantly increases the fracture load of zirconia. At 0.7 mm thickness, only 3Y-PSZ survived masticatory simulation. A minimum material thickness of 1.2 mm is required for 4Y-PSZ or 5Y-PSZ.