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Objectives: To evaluate the effect of in-lab simulation of CAD/CAM grinding and intaglio surface treatments on the surface characteristics (topography and roughness) and fatigue behavior of adhesively luted 4YSZ simplified restorations. Methods: Ceramic discs (Ø = 10 mm, thickness = 1 mm) were randomly allocated into 6 groups considering: “In-lab simulation of CAD/CAM grinding” (ground or polished) and “intaglio surface treatments”: Ctrl (without surface treatment), AlOx (aluminum oxide air abrasion) or GLZ (glaze spray application). The surface roughness of all samples was measured, the treated discs received a ceramic primer, were luted with resin cement onto a dentin analogue material (woven glass-reinforced epoxy resin) and tested under a cyclic fatigue test (step-stress approach, n = 15; 1.4 Hz, 10,000 cycles/step, step-size of 100N starting at 200N until failure). A complementary analysis was performed to corroborate the findings in the fatigue test that the glaze fill defects increase the mechanical properties of the ceramic. To do so, bars (n= 10; 1.0 × 1.0 × 12 mm; considering the groups: N-ID: non-indented; ID: indented; ID-GLZ: indented plus glaze spray application) were indented in a vickers hardness tester to produce a crack pattern, treated with glaze or not, and then submitted to flexural strength tests (FS). Fractographic and topographic analysis were performed. Results: In-lab simulation of CAD/CAM grinding decreased the fatigue failure load of the 4YSZ ceramic when comparing polished and ground groups, regardless of surface treatment. GLZ induced better fatigue performance compared to the air abrasion, regardless of the grinding condition (ground or polished surface). The results of the flexural strength test corroborated the findings in the fatigue test, as the ID-GLZ group presented superior FS than the ID group, however both had inferior FS than N-ID. There is an inverse association between roughness and fatigue failure load, as the higher the surface roughness, the lower the fatigue failure load. Failures in the fatigue and flexural strength tests started from the face subjected to tensile stresses. Conclusion: In-lab simulation of CAD/CAM grinding had a detrimental effect on the fatigue behavior of 4YSZ and glaze spray induced better 4YSZ performance compared to the air abrasion. The intaglio surface treatments differently influenced the 4YSZ fatigue performance, however, only glaze spray can reverse the damage caused by the grinding.

This study aimed to evaluate the impact of mechanical fatigue cycling using the step-stress approach along with hydrothermaldegradation (134 ºC with a constant pressure of 2 bars for 20 h), and a novel intercalated hydrothermal/fatigue aging protocol on different aspects of the aging resistance of three generations of dental zirconias."Y"Z T (VITA), INCORIS "T"ZI (Dentsply Sirona) and "K"ATANA UTML (Noritake Kuraray) - 1st, 2nd and 3rd generation, respectively-, zirconia disks (N = 153), were divided into 6 groups (n = 3) for monotonic testing and 9 groups (n = 15) for mechanical fatigue testing, according to 3 proposed treatments for each zirconia: CF (control - only mechanical fatigue cycling); AF (aging in hydrothermal reactor at 134 °C for 20 h + mechanical fatigue cycling); AFA (Alternating protocol: 4 steps of 5 h of hydrothermal aging intercalated with mechanical fatigue cycling). Mechanical fatigue aging was performed according to the step-stress approach through biaxial flexural setup (piston-on-3-balls, initial strength: 100 MPa, step: 50 MPa/10,000, frequency: 20 Hz) until failure. Data were analyzed using Kaplan-Meier and Mantel-Cox test (α = 0.05), in addition to Weibull analysis. Fractured disks were analyzed in stereomicroscope, Scanning Electron Microscopy and X-Ray Diffraction.Continuous hydrothermal and mechanical fatigue cycling decreased the fatigue strength of YAF group (516 ± 38 MPa), while the alternating protocol increased it (730 ± 58 MPa). KATANA UTML showed no differences for both treatments and did not undergo t-m phase transformation. The TAF group showed the highest fatigue strength (810 ± 76 MPa) and cycles for failure (147,000.00 cycles). The fracture origin for all specimens was on the tensile side in pre-existing defects.INCORIS TZI zirconia had higher fatigue strength and survival rates after hydrothermal and mechanical fatigue aging. Although less resistant, KATANA UTML did not suffer chemical degradation.

To assess the effects of a resin cement in high and low viscosity and distinct conditioning of the intaglio surface of lithium disilicate glass-ceramic crowns on fatigue performance of the crowns.Prosthetic preparations (full-crown) in resin epoxy and crowns in lithium disilicate glass-ceramic were machined and allocated considering 2 factors (n = 10): "surface treatment" (HF - 5% hydrofluoric acid etching, followed by silane application; or EP-self-etching ceramic primer) and "resin cement" (high or low viscosity). The preparations were etched with 10% hydrofluoric acid and an adhesive was applied. The intaglio surfaces of the ceramic crowns were treated as aforementioned (HF or EP) and luted with high or low viscosity. The bonded sets were subjected to fatigue testing (step-stress approach: initial load of 200 N, step-size of 50 N, 10,000 cycles/step, 20 Hz) and complementary analyses (fractographic, topographic, and cross-sectional bonded interfacial zone analyses) were performed.Treatment with HF and silane with high viscosity resin cement (955 N/156,000 cycles) and EP with low viscosity resin cement (1090 N/183,000 cycles) showed the best fatigue performance (statistical similarity between them). The failures originated from defects of the cement-ceramic interface, and the HF treatment induced a more pronounced topographical alteration.Distinct topographical patterns from the HF and EP treatments induced better fatigue results for the specific viscosity of the resin cement. Therefore, the fatigue performance depended on the existing topography, type of intaglio surface's defects/irregularities after surface treatment, and how the luting agent filled the irregularities.

The aim of the study was to evaluate whether the region (internal or external) of the CAD/CAM block influences the mechanical performance of restorative materials. Blocks of different CAD/CAM materials (Composites: KAV – Katana Avencia; LULT – LULT Ultimate; Ceramics: ENAM – Vita Enamic; NICE - N!CE; EMP – IPS Empress CAD; VMII – Vita Mark II; EMAX – IPS e.max CAD) were selected, and direct resin composite blocks (APX - Clearfil AP-X; FSUP - Filtek Supreme) were built using the incremental technique on a mold from one of the CAD/CAM blocks. All blocks were sectioned into bar-shaped specimens (1 × 1 × 14 mm), which were separated into two groups according to the region of the block (inside or outside). 3-point bending tests were performed following ISO 6872:2015 and flexural strength data were analyzed using one-way ANOVA and Bonferroni post-hoc tests (p < 0.05). Weibull module and characteristic strength were also calculated. In general, the mean flexural strength values were not statistically different (p > 0.05) between the inside and outside regions of each material, except for LULT (inside > outside) and EMAX (outside > inside). Comparing the materials, a similar strength (only discrete variations) was observed for inside, outside or merged (inside and outside data assembled together) regions: EMAX > KAV = LULT > NICE = APX > EMP = ENAM = VMII ≥ FSUP (merged condition). Characteristic strength at 63.2% failure probability and at 5% failure probability generally corroborates such observations. There were no statistical differences for Weibull module data (inside, outside, or merged), except for KAV and NICE (outside > inside). Thus, the region from where the restoration is milled within the CAD/CAM block generally does not influence the mechanical performance hereof (flexural strength, failure probability, risk of premature failures, and mechanical reliability) of the material, except for LULT and EMAX.

This study compared the flexural strength under monotonic (static - sσ) and cyclic load application (fatigue - fσ), hardness (H) and fracture toughness (KIC) of different layers of a multi-layered zirconia (IPS e.max ZirCAD MT Multi, Ivoclar). Each layer was sectioned, classified into three groups according to yttria content (4-YSZ, 4/5-YSZ and 5-YSZ), and shaped on samples for flexural strength and fracture toughness tests (bars: 1.0 × 1.0 × 11 mm); and Vickers hardness test (plates: 1.5 × 4.0 × 5.0 mm). Flexural strength under monotonic load application (sσ; n = 10) was obtained through two different devices (three-point-bending and ball-in-hole device) and fatigue flexural strength (fσ; n = 15; initial load: 10 N; step-size: 5 N; 10,000 cycles/step) was assessed using a ball-in-hole device under cyclic load application. Vickers hardness test (n = 5), fracture toughness test (n = 10), and additional analyzes (Finite Element Analysis - FEA, Energy-dispersive X-ray spectroscopy - EDS and Scanning Electron Microscopy - SEM) were also performed. No differences were found between the different devices in the monotonic flexural strength test, and FEA showed similar tensile stress distribution for the two devices. 4-YSZ showed higher values of flexural strength under monotonic and cyclic load application modes (sσ = 1114.73 MPa; fσ = 798.84 MPa), and fracture toughness (KIC = 3.90 MPa√m). 4/5-YSZ had an intermediate sσ; however, fσ was similar to 5-YSZ (404.00–429.36 MPa) and KIC similar to 4-YSZ (KIC = 3.66 MPa√m). No statistical differences were found for hardness and Weibull modulus for fatigue flexural strength data. The amount of yttria in the layer compositions increased from 4-YSZ to 5-YSZ, and larger zirconia crystals were observed in the topographic images of 5-YSZ. Failures in the flexural strength and toughness tests started from the face subjected to tensile stress. Different layers of the multi-layered zirconia blank presented distinct mechanical properties. 4-YSZ (cervical layer) presented the highest flexural strength under monotonic and cyclic loads (fatigue), and higher fracture toughness even similar to the transition layer (4/5-YSZ). Hardness was similar between the layers. The ball-in-hole device performed similarly to the three-point bending device and can be used as an alternative to the traditional method.

This study aimed to evaluate the influence of ceramic surface treatments, resin cement viscosities, and storage regimens on the fatigue performance of bonded glass-ceramics (lithium disilicate, LD; feldspathic, FEL). Ceramic discs (Ø = 10 mm; thickness = 1.5 mm) were allocated into eight groups per ceramic (n = 15), considering three factors: “ceramic surface treatment” in two levels – 5% hydrofluoric acid etching and silane-based coupling agent application (HF), or self-etching ceramic primer (E&P); “resin cement viscosity” in two levels – in high or low viscosity; and “storage regimen” in two levels – baseline, 24 h to 5 days; or aging, 180 days + 25,000 thermal cycles. Adhesive luting was performed onto glass fiber-reinforced epoxy resin discs (Ø = 10 mm; thickness = 2 mm) and the bonded assemblies were subjected to cyclic fatigue tests: initial load = 200 N; step-size = 25 N (FEL) and 50 N (LD); 10,000 cycles/step; 20 Hz. Scanning electron microscopy (SEM) inspections were performed. Regarding the LD ceramic, the fatigue behavior was reduced after aging for HF_HIGH and E&P_LOW conditions, while stable performance was observed for HF_LOW and E&P_HIGH. Regarding the FEL results, aging negatively affected HF_HIGH, E&P_HIGH, and E&P_LOW, being that only the HF_LOW condition presented a stable behavior. The failure initiated from defects on the etched surface of the ceramics, where the cross-sectional analysis commonly revealed unfilled areas. Long-term aging might induce a decrease in mechanical behavior. The ‘ceramic microstructure/surface conditioning/resin cement viscosity relationships’ modulate the fatigue performance of lithium disilicate and feldspathic glass-ceramics.

The characteristics of dental ceramics have been extensively studied over the years to provide highly qualified materials for use in prosthetic restorations. The ability to adhere to dental substrates, outstanding aesthetics (translucency, color, and substrate masking ability) and improved mechanical properties provide these materials with optical features and high strength to withstand masticatory stimuli. Different classifications are adopted, and it is generally considered that glass-ceramics have better optical characteristics due to the high glass content, and polycrystalline ceramics have superior strength favored by their densified and organized crystals, hampering crack growth. This knowledge was largely built-up during years of scientific research through different testing methodologies, but mainly employing static loads. It is important to not only take into account the intensity of loads that these materials will be exposed to, but also the effect of the intermittence of cyclic load application leading to mechanical fatigue and the influence of factors related to the crack origin and their propagation under this condition. Furthermore, the bonding surface of ceramic restorations requires surface treatments that improve the bond strength to luting agents; however, these treatments require caution because of their potential to produce defects and affect the structural behavior. Moreover, ceramic restorations often require internal adjustments for proper seating or external adjustments for fitting the occlusal contact with the antagonist. In this sense, finishing/polishing protocols may alter the defect population, as luting agents may also interact by filling in the superficial defects on the restoration intaglio surface. Thus, the balance among all these factors will define the performance of a restorative setup, as well as the posterior exposure to the humid environment and the masticatory stimuli (cyclical loading), which may favor developing slow and subcritical growth of cracks in ceramic materials and the degradation of the bond interface. Therefore, it is essential that the concepts which explain the fatigue mechanism are understood, as well as the crack propagation and failure patterns of restorative ceramic materials.

Purpose The aim of this study was to inspect the mechanical fatigue behavior of an implant-supported restorative system using polyether ether ketone (PEEK) and yttria partially stabilized zirconia polycrystals (YZ) as materials for customized definitive implant-supported hybrid abutments, supporting two types of all-ceramic restorations: translucent zirconia (TZ) and lithium disilicate (LD) monolithic crowns. Materials and methods Forty Morse taper implants were included in epoxy resin. Titanium intermediary abutments were placed, and the specimens were randomly allocated into four groups (n = 10) according to the customized hybrid abutment material (PEEK or YZ) and the monolithic crowns (TZ or LD) representing a maxillary central incisor crown. The specimens were subjected to a mechanical fatigue test (step-stress analysis) by means of an initial 200-N load for 5,000 cycles and subsequent increase of 50 N (step-size) at each 10,000 cycles, until failure occurred. The load at failure and number of cycles until failure were recorded; survival probabilities and specimen displacement were calculated for each step. The failure pattern was evaluated, and the Weibull modulus was obtained for each condition. Results Fatigue of both types of crowns was not influenced by the abutment material (LD-PEEK = LD-YZ; TZ-PEEK = TZ-YZ). In the PEEK abutment, the values obtained in the LD and TZ crowns showed no statistical difference; however, in the YZ abutment, the TZ crown presented a load at failure value that was statistically higher than that for LD. Failure pattern analysis revealed a higher prevalence of crown fracture for LD groups, while screw/implant platform fractures were shown for TZ groups. Conclusion YZ and PEEK hybrid abutments promoted similar fatigue levels regardless of the crown materials, TZ crowns promoted a higher fatigue level than LD ones when associated with YZ abutments, and LD crowns promoted a similar fatigue level to TZ ones when associated with PEEK custom abutments. Higher prevalence of crown fractures was shown for LD and screw/implant platform fractures for TZ groups.

This systematic review aims to explore and compile the effect of adhesive luting on the mechanical properties of dental ceramics used as restorative materials.The PubMed/MEDLINE, Web of Science and Scopus databases were searched on January 31st, 2021 to select laboratory studies written in English, without publishing-date restrictions, which compared the mechanical properties of commercially available dental ceramics as restorative materials luted using adhesive vs non-adhesive strategies. A total of 20 (out of 2039) studies were eligible and included in the analysis. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences (RevMan5.1, random effects model, α = 0.05) were obtained by comparing resistance values of adhesive and non-adhesive conditions (global analysis). Subgroup analyses were performed considering ceramic composition and aging.In the global analysis, adhesive luting induced higher mechanical resistance values compared to non-adhesive luting (p ≤ 0.01). The same effect was observed for glass and alumina ceramics (p ≤ 0.01), but not for zirconia polycrystals (p = 0.83). Adhesive luting was favorable in both the aged and non-aged subgroup analysis (p ≤ 0.01). High heterogeneity was found in all meta-analyses. All analyzed studies in the systematic review scored negatively for risk of bias in most of the factors considered.Adhesive luting reinforces the mechanical properties of dental ceramics used as restorative materials, with the exception of zirconia polycrystals.

This study evaluated the influence of ceramic surface conditioning and storage regimen (baseline vs. aging) on the fatigue performance of simplified lithium disilicate glass-ceramic restorations. A total of 90 ceramic discs (O= 10 mm; thickness= 1.0 mm) were allocated into 6 groups (n= 15), considering 2 factors: “ceramic surface treatment” – CA (only silane-based coupling agent, Monobond N), HF (5% hydrofluoric acid etching), or HF+CA (5% HF acid etching plus silane-based coupling agent); and “storage regimen” – baseline (24 hours – 5 days of distilled water at 37 °C), or long-term aging (180 days of distilled water at 37 °C + 25,000 thermal cycles). After intaglio ceramic conditioning, adhesive bonding (Multilink N) was performed onto epoxy resin discs (O= 10 mm; thickness= 2.5 mm) and the bonded sets were subjected to step-stress fatigue tests (initial load: 200 N; step-size: 50 N; 10,000 cycles per step; 20 Hz). Fatigue data were analyzed using Kaplan-Meier and Weibull statistical analyses. Fractography and topography analyses were also conducted. The fatigue findings demonstrated that the performance among groups for both baseline and aging conditions maintained a tendency: the CA groups had the worst behavior (baseline: 893 N/143,667 cycles; aging: 639 N/84,179 cycles), while the surface etching with HF (baseline: 1247 N/214,333 cycles; aging: 816.67 N/128,333 cycles) and HF+CA groups (baseline: 1290 N/222,333 cycles; aging: 900 N/145,000 cycles) had no statistically significant difference between them. The aging protocol reduced the performance of all groups. The groups with better fatigue performance (HF and HF+CA) did not have statistical differences regarding structural reliability (Weibull modulus). Most failures were radial cracks from the cementation interface, except for CA aging specimens, with 27% failing from debonding. The HF etching led to noteworthy surface topographical alterations. Micromechanical interlocking resulting from HF acid etching remained prevalent in the fatigue behavior. Thus, the silane-based coupling agent (Monobond N) does not need to be applied after HF etching in terms of fatigue behavior outcomes.

Made available in DSpace on 2022-05-01T12:56:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 PURPOSE. To characterize the microstructure of three yttria partially stabilized zirconia ceramics and to compare their hardness, indentation fracture resistance (IFR), biaxial flexural strength (BFS), and fatigue flexural strength. MATERIALS AND METHODS. Disc-shaped specimens were obtained from 3Y-TZP (Vita YZ HT), 4Y-PSZ (Vita YZ ST) and 5Y-PSZ (Vita YZ XT), following the ISO 6872/2015 guidelines for BFS testing (final dimensions of 12 mm in diameter, 0.7 and 1.2 ± 0.1 mm in thicknesses). Energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD) and scanning electron microscopy (SEM) analyses were performed, and mechanical properties were assessed by Vickers hardness, IFR, quasi-static BFS and fatigue tests. RESULTS. All ceramics showed similar chemical compositions, but mainly differed in the amount of yttria, which was higher as the amount of cubic phase in the diffractogram (5Y-PSZ > 4Y-PSZ > 3Y-TZP). The 4Y- and 5Y-PSZ specimens showed surface defects under SEM, while 3Y-TZP exhibited greater grain uniformity on the surface. 5Y-PSZ and 3Y-TZP presented the highest hardness values, while 3Y-TZP was higher than 4Y- and 5Y-PSZ with regard to the IFR. The 5Y-PSZ specimen (0.7 and 1.2 mm) showed the worst mechanical performance (fatigue BFS and cycles until failure), while 3Y-TZP and 4Y-PSZ presented statistically similar values, higher than 5Y-PSZ for both thicknesses (0.7 and 1.2 mm). Moreover, 3Y-TZP showed the highest (1.2 mm group) and the lowest (0.7 mm group) degradation percentage, and 5Y-PSZ had higher strength degradation than 4Y-PSZ group. CONCLUSION. Despite the microstructural differences, 4Y-PSZ and 3Y-TZP had similar fatigue behavior regardless of thickness. 5Y-PSZ had the lowest mechanical performance. [J Adv Prosthodont 2021;13:385–95] Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) Institute of Science and Technology College of Dentistry University of Taubaté (Unitau) Technological Institute of Aeronautics Physics department College of Dentistry Federal University of Santa Maria (UFSM) Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) Institute of Science and Technology

To evaluate the fatigue failure load (FFL), cycles for fatigue failure (CFF) and survival rates of different occlusal thicknesses of resin composite simplified crowns with internal adjustments (IA) or without as control (C).30 monolithic simplified crowns of CAD/CAM resin composite (Tetric CAD, Ivoclar) were milled in three different occlusal thicknesses (0.5 mm, 1.0 mm, and 1.5 mm). Half of the crowns were submitted to restricted adjustment with diamond burs on the crown's inner surface and half remained milled without internal adjustment. The samples were treated and adhesively luted onto a prosthetic preparation made of epoxy resin reinforced by glass-fiber substrate. The sets were subjected to a fatigue test (cyclic fatigue: initial load of 200 N; step-size of 50 N; 10,000 cycles/step; 20 Hz; maximum load: 2800 N).Microscopic analysis of tested representative samples was performed. The fatigue data were statistically analyzed (α= 0.05) and the micrograpic images were qualitatively evaluated.All specimens from groups 1.0C and 1.5C survived the cyclic loads, while all 0.5C samples failed during the test. The 1.0IA and 1.5IA crowns showed no statistical difference for FFL (2530 N= 2670 N) and CFF (471,000 cycles= 499,000 cycles) between them, and they were both statistically superior to the 0.5IA (FFL= 1812.50 N; CFF= 327,500 cycles). The 1.0 mm and 1.5 mm crowns presented superior fatigue behavior (2530 N-2800 N) compared to the 0.5 mm crowns (1812 N-2140 N), whether internal adjustment was performed or not. A statistically significant difference was found for FFL and CFF of 0.5 mm crowns with and without internal adjustment, with a deleterious impact of the adjustment for both parameters (FFL and CFF: 0.5C 0.5IA).Resin composite milled crowns can bear high cyclic fatigue loads despite thickness, although thicker crowns had better mechanical behavior; however, the internal adjustment in the composite resin crown leads to a detrimental effect on its fatigue behavior, which presents a risk of mechanical failure due to premature fatigue.

This study evaluated the influence of the piston material (glass fiber-reinforced epoxy resin or stainless steel) and the piston tip diameter (6 or 40 mm) on the fatigue mechanical behavior, failure mode, and stress distribution of feldspathic ceramic simplified restorations. Pistons were machined in glass fiber-reinforced epoxy resin (ER) and in stainless steel (SS), with active tips simulating the curvature radius of 6- or 40-mm diameter spheres. A total of sixty (N= 60) feldspathic ceramic discs (Ø= 10 mm; thickness= 1.0 mm) were adhesively luted onto supporting substrate discs (Ø= 10 mm; thickness= 2.5 mm) and allocated into 4 groups (n= 15) according to the piston used for fatigue testing: ER_6, ER_40, SS_6, SS_40. Afterwards, the specimens were submitted to the cyclic fatigue test (20 Hz frequency; initial load= 100 N; step= 50 N; 10,000 cycles/step, upon specimen failure detection). The collected data were analyzed by two-way ANOVA (α= 0.05) to verify differences by considering 'piston material' and 'piston diameter' as factors, and their association. In addition, a survival analysis (Kaplan Meier with Mantel-Cox log-rank post-hoc tests) was conducted (α= 0.05). Fractographic and finite element (FEA) analyzes were also performed. 'Piston material' (p= 0.040, F= 4.43) and 'piston diameter' (p 0.000, F= 563.21) had a significant influence on the fatigue failure load (FFL) and the number of cycles for failure (CFF) values. Feldspathic restorations showed higher FFL and CFF (p 0.05) when tested with a 40 mm diameter piston compared to a 6 mm diameter piston (ER_40 and SS_40 ER_6 SS_6). In relation to the piston material, ER and SS pistons with 40 mm diameter promoted similar fatigue performance (ER_40: 946.67 N/179,333 cycles = SS_40: 936.67 N/177,333 cycles), while 6 mm diameter groups presented different fatigue performance (ER_6: 440 N; 78,000 cycles SS_6: 353.3 N; 60,667 cycles). Hertzian cone crack failures were only observed in the groups tested with 6 mm pistons, regardless of piston material. Higher stress concentration on the ceramic surface was observed when using 6 mm diameter pistons, whereas the SS_6 group showed a slight increase in stress concentration in comparison to the ER_6 group. The piston diameter showed an influence on the fatigue behavior, failure mode, and stress distribution of feldspathic ceramic simplified restorations. However, the influence of piston material is only observed when 6 mm diameter pistons are used. The 40 mm diameter pistons led to radial crack, being more appropriate for fatigue test of simplified feldspathic ceramic restorations with a thickness ≤ 1 mm. Whilst the 6 mm diameter pistons should be avoided, once tend to induce Hertzian cone crack failures and to underestimate fatigue performance.

The aim of this study was to evaluate the topography and the fatigue performance of lithium disilicate glass-ceramic after surface grinding through different laboratory protocols used to simulate the Computer-aided design/Computer-aided manufacturing (CAD/CAM) milling. Ceramic discs (IPS e.max CAD, Ø = 13.5 mm × 1.2 mm of thickness) were produced through different methodologies: milling in CAD/CAM system (CAD/CAM group); produced in-lab with a polished surface (POL group); or produced through in-lab methods and randomly distributed into five groups according to different grinding protocols to simulate the CAD/CAM milling [grinding with a CAD/CAM bur coupled to a mandrel (CAD/CAM Bur group); fine diamond bur using oscillatory movements (DBO group); fine diamond bur in x and y axes of the disc (DBXY group); #60-grit silicon carbide sandpaper (SiC group); and #60-grit wood sandpaper (WS group)]. The specimens were fatigue tested (n = 15) according to the step-stress method (initial load: 60 N; step-size: 20 N; 10,000 cycles/step; 20 Hz frequency). A roughness analysis was performed on all specimens, while fractal dimension (FD) and fractography were performed on representative samples. The Kaplan-Meier analysis showed that the POL (293.3 N) group presented better fatigue performance (higher load and number of cycles for failure) (p 0.05) than the other groups (CAD/CAM = 222.7 N; CAD/CAM Bur = 181.3 N; DBO = 184.0 N; DBXY = 192.0 N; SiC = 182.6 N; WS = 182.6 N). For roughness, only the SiC (Ra = 1.616; Rz = 10.465) and WS (Ra = 1.673; Rz = 10.655) groups produced statistically similar Ra (μm) and Rz (μm) values to the CAD/CAM (Ra = 1.628; Rz = 9.571) group (p 0.05). The surface created by CAD/CAM milling and POL group exhibited more complexity (FD) higher values than the experimental groups. For the ceramic surface topography images, the CAD/CAM milling visibly produced a uniform surface compared to the other groups; however, the POL group was the smoothest. The DBO, DBXY, SiC, and WS groups resulted in similar characteristics of surface topography. Therefore, although the SiC and WS groups showed similar roughness to the control group (CAD/CAM), no in-lab simulation method was fully capable to mimic the mechanical performance of the CAD/CAM-milled lithium disilicate glass-ceramic.

This study aimed to evaluate the effects of various polishing systems associated or not to finishing with diamond burs of lower-grit size on the topography, roughness, and fatigue behavior of a ground yttrium-stabilized tetragonal polycrystalline zirconia (Y-TZP). Disc specimens of Y-TZP (Zenostar T, Ivoclar-Vivadent) were produced (diameter = 15 mm, thickness = 1.2 ± 0.2 mm; ISO 6872-2015) and randomly allocated into 8 groups: [Ctrl] as-sintered; [Gr] ground with coarse diamond bur; [Gr+Eve] grinding + polishing with EveDiacera (2-step polishing system); [Gr+Fin+Eve] grinding + finishing + polishing with EveDiacera; [Gr+Kg] grinding + polishing with Kg Viking (2-step polishing system); [Gr+Fin+Kg] grinding + finishing + polishing with Kg Viking; [Gr+Op] grinding + polishing with Optrafine (3-step polishing system); and [Gr+Fin+Op] grinding + finishing + polishing with Optrafine. Next, surface topography, roughness, phase transformation, fatigue strength (staircase method), and fractography analyses were performed. Grinding changed the surface topography and generated higher roughness (Ra in μm) (1.214); the subsequent finishing/polishing procedures were able to reduce the roughness (0.326–0.839); however, it remained higher than the control [ctrl] group (0.221). All samples subjected to surface treatment presented an increase in m-phase content (8.04–17.46%). In terms of fatigue strength (in MPa), the grinding group (677.36) and polishing/finishing groups (641.66–707.20) presented higher fatigue strength than the control [ctrl] group (592.48). Finishing before polishing had no effect on fatigue strength (645.37–707.20). Grinding altered the Y-TZP surface features and increased their fatigue strength by phase transformation mechanism, while the finishing/polishing procedures promoted surface smoothening, while maintaining high fatigue strengths. Finishing as an additional step before polishing had no effect on roughness reduction and fatigue strength improvements; thus, the finishing procedure might be unnecessary.

To evaluate the effect of different etching times of a self-etching ceramic primer on the microshear bond strength (µSBS) and topographic surface pattern of a lithium-disilicate glass-ceramic.Ceramic slices were subjected to an in-lab simulation of CAD/CAM milling and randomly allocated to 10 groups (n = 35) considering two factors: "surface treatment" in 5 levels - one control group (5% hydrofluoric acid + silane application [HF5+SIL]), and 4 experimental groups using ceramic etching/primer (Monobond EtchPrime, EP) with different passive application times (40 s, 2 min, 5 min, or 10 min); and "aging" factor in 2 levels - short-term (after 24 h), or long-term (storage for 180 days + 12,000 thermal cycles). Composite cement cylinders were built and µSBS tests were run in a universal testing machine. The failure patterns were categorized, and complementary analyses with SEM and Atomic Force Microscopy (AFM) were performed.The groups showed statistically similar bond strengths in the short term (range 22.4 to 25. 1 MPa). However, only the EP 20s+40s (19. 3 MPa) and EP 20s+5min (21.5 MPa) groups maintained stable bond strength in the long term, and HF5+SIL (17. 1 MPa) presented statistically significantly lower values than did EP 20s+5min. The failure pattern was predominantly adhesive. The increased application time of the ceramic primer promoted greater dissolution of the glass matrix; thus, the EP 20s+10min group presented the most complex surface characteristics in the fractal dimension analysis.The self-etching ceramic primer can be used as an alternative to classical conditioning with HF plus silane, promoting stable bond strength for etching times of 40 s or 5 min of passive application.

The aim of this study was to characterize the flexural strength and elastic modulus of CAD/CAM resin composite material and to evaluate the influence of different surface treatments and storage conditions on the fatigue behavior of bonded composite crowns. Bars (flexural strength, n= 30; elastic modulus, n= 5) (1.2 × 4 × 12 mm) were produced for three-point bending test and CAD/CAM milled crowns (n= 5) (thickness= 1 mm) adhesively cemented to an epoxy resin substrate for fatigue tests. Bars and crowns were randomly allocated into two “surface treatments”: no surface treatment (CTRL) and air-abrasion with 110 μm Al2O3 particles (AlOx); while the crowns were also subdivided into “aging condition” (baseline - storage for 24 h to 7 days, and aging – storage for 150 days + 25,000 thermal cycles). The three-point bending test was performed according to ISO 6872 and the luted crowns were subjected to step-stress fatigue test (initial load of 200 N; step-size of 50 N; 10,000 cycles per step; 20 Hz). Complementary analysis by Stereomicroscopy and Field Emission Scanning Electron Microscopy (FE-SEM) were performed. The flexural strength and fatigue data were submitted to statistical tests (α= 0.05). The results showed that air-abrasion reduces the flexural strength and the characteristic strength of the resin composite, without modifying its elastic modulus or its structural reliability (Weibull Modulus). Air-abrasion did not influence the fatigue behavior of the cemented crowns. Notwithstanding, a decrease in the survival rate was observed after 445,000 cycles (2,400 N) when subjected to aging at both the CTRL or AlOx conditions. FE-SEM micrographs of the crowns showed that alumina particle air-abrasion treatment can modify the topography of its treated inner surface. Therefore, air-abrasion with alumina powder introduces defects onto the surface of the CAD/CAM resin composite material, decreasing the flexural strength, but without changing its elastic modulus and reliability. Adhesive cementation onto an epoxy resin substrate prevented an influence of the introduced defects on the fatigue performance of the resin composite restoration. Nevertheless, the fatigue behavior may be damaged by aging regimen.

Made available in DSpace on 2022-04-28T19:47:51Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-03-01 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) The aim of this study was to assess the resin microshear bond strength (μSBS) and the surface topography of lithium disilicate ceramic milled by CAD/CAM and to compare it with in-lab methods that simulate the topography of milled surfaces; thus, assessing the feasibility of those in-lab methods for in vitro microshear studies. The study was composed of 2 control groups (CAD/CAM group – discs were milled by a CAD/CAM system; POL – polished ceramics surface) and 4 testing groups (SiC – manual grinding simulation with #60 silicon carbide paper; WS – manual grinding with #60 wood-sandpaper; DB – grinding with a fine cylindrical diamond bur; MANDREL – grinding with a CAD/CAM bur coupled to a mandrel). After production, the ceramic samples were crystallized. Surface treatment with hydrofluoric acid (HF) and silane was performed on the bonding surface, then the starch matrices were filled by the resin cement and light-activated. The specimens (n= 45) were submitted to μSBS after 24 h of storage in water (37° C) and the failure pattern was analyzed. Topographic analysis, surface roughness, contact angle, and fractal dimension were performed. One-way ANOVA and Tukey's post-hoc tests were run for roughness, while Bonferroni’ post hoc was used for μSBS data. Fractal dimension data was qualitatively assessed. No difference was found in the μSBS between in-lab simulation methods and the milled group, while the polished group presented the lowest μSBS values. The CAD/CAM milled specimens presented the highest roughness values, while the POL the lowest ones. In regards to surface complexity, no difference was found among all simulated groups and the CAD/CAM group, with an exception for the POL group. All conditions presented an increase in surface complexity after HF etching. Therefore, the resin bond strength to lithium disilicate glass-ceramic is not influenced by the in-lab simulation method, meaning they are predictable approaches when evaluating the resin bonding to the tested ceramic; the surface polishing underestimates the bond results in ∼40%. MSciD and PhD Graduate Programs in Oral Science – Prosthodontic Units Faculty of Odontology Federal University of Santa Maria Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) – Institute of Science and Technology MSciD and PhD Graduate Programs in Physics Department of Physics Federal University of Santa Maria (UFSM) Department of Dental Materials and Prosthodontics São Paulo State University (UNESP) – Institute of Science and Technology

The aim of the present scoping review was to identify and discuss the methods, testing parameters, and characteristics used to induce cyclic fatigue on non-anatomic dental ceramic specimens. In vitro studies written in English which evaluated commercially-available non-anatomic dental ceramic specimens subjected to mechanical cyclic fatigue were selected. The search was performed in the PubMed, Scopus and Web of Science databases. The initial search yielded 1,636 articles, of which 81 were included. Based on the collected data, most of the included studies evaluated dental ceramic specimens cemented to supporting substrate (n = 42; 51.9%); used step-stress (n = 35; 42.2%) accelerated fatigue test, loading frequencies above 10 Hz (n = 31, 35.6%), stainless steel (n = 28, 32.6%) load applicator with spherical shaped tip 40 mm diameter (n = 25, 30.9%); applied only axial loads (n = 77, 95.1%); and considered a wet testing environment (n = 65, 78.3%). The definition of test geometry, method, and testing parameters must be cautiously considered according to the study objective and the scenario that is simulated. Accelerated fatigue tests, load frequencies up to 20 Hz, a 40 mm stainless steel spherical load applicator and a wet testing environment are the major common defined parameters presented in the existing literature. More studies exploring the influence of such factors on fatigue mechanism are necessary.

The aim of the study was to evaluate the effect of a ceramic primer and its increased passive application on the fatigue performance of adhesively cemented lithium disilicate simplified restorations. Ceramic discs (Ø = 10 mm; thickness = 1.0 mm) were submitted to an in-lab simulation of CAD/CAM milling and allocated into 8 groups (n = 15), considering 2 factors: “surface treatment”– PRIMER, only coupling agent application (Monobond N); HF5+PRIMER, 5% hydrofluoric acid and coupling agent; E&P 20s + 40s and E&P 20s+5min, ceramic etching/priming (Monobond Etch & Prime, E&P) for 20 s of active application followed by 40 s or 5 min of passive application, respectively; and “aging condition”– baseline, storage for 24 h to 5 days; aged, storage for 90 days +12,000 thermal cycles. Adhesive cementation (Multilink N) was performed onto epoxy discs (Ø = 10 mm; thickness = 2 mm) and the cemented assemblies were subjected to step-stress fatigue tests (initial load of 200 N; step-size of 50 N; 10,000 cycles per step; 20 Hz). The results showed that the groups had similar fatigue performance in the baseline condition (except for E&P 20s+5min: 940.0 N; 123,000 cycles > PRIMER: 786.7 N; 92,333 cycles). When aged, the PRIMER group presented the worst fatigue performance (480.8 N; 31,154 cycles) compared to the other groups (810.0–840.0 N; 97,000–103,000 cycles). In addition, only the PRIMER treatment showed unstable fatigue performance (baseline > aged). Therefore, ceramic surface treatment promoting micromechanical interlocking and chemical bonds is mandatory for stable fatigue performance of adhesively cemented lithium disilicate restorations. The one-step ceramic primer/conditioner promoted similar fatigue performance to the 5% hydrofluoric acid + coupling agent, but increased E&P etching time did not improve the fatigue behavior.

This study evaluated and compared the effects of two glaze application methods (brush and spray) on the fatigue strength and surface characteristics (topography and roughness) of a translucent yttrium stabilized partially tetragonal zirconia polycrystal ceramic (Y-TZP) prior to and after grinding. Disc-shaped specimens of translucent Y-TZP (Vita YZ-HT; Vita-Zahnfabrik) were processed (ISO 6872–2015) and randomly allocated into 6 groups, according to the surface treatments performed on the tensile surface: Ctrl – as-sintered (no treatment); Gr – grinding with a diamond bur (181 μm-grit; #3101G); Br – glaze obtained from a powder–liquid mix and applied by brush (Vita Akzent; Vita Zahnfabrik); Sp – glaze application via spray (Vita Akzent Plus; Vita Zahnfabrik); Gr + Br and Gr + Sp – association of grinding + respective glaze method. Analyses of surface roughness (Ra and Rz), fatigue strength (staircase method), surface topography and fractography were carried out. The as-sintered condition had the smoothest surface, while grinding led to the rougher and more heterogeneous topography. Both glaze application methods showed a potential for topography evenness (smoothening effect), while the glaze spray method led to thinner layers of material, showing a limitation in reducing the roughness compared to the brush method. No deleterious effect on fatigue strength of the Y-TZP could be observed, as the glaze-spray application on the as-sintered surface showed the highest values. Fractography depicted two distinct fracture origin regions: from defects in the surface/sub-surface region for the Ctrl and Gr groups; and at the zirconia-glaze layer interface for Br, Sp, Gr + Br and Gr + Sp. The clinical relevance of this work is that the tested glaze application methods did not damage the fatigue strength of the tested Y-TZP.

Purpose To characterize the effect of two processing techniques (pressing and CAD/CAM — Computer Aided Design/Computer Aided Machining) of lithium-disilicate (LD) based crowns on the microstructure, topography, roughness, fractal dimension, internal and marginal adaptation. Methods One-hundred identical preparations for monolithic crowns were made with dentin analogue material (G10 epoxy resin). One of the preparations was scanned and a monolithic crown in lithium-disilicate was planned in the CAD system. Fifty crowns were milled in a wax pattern and subjected to pressing (IPS e.max Press), while 50 crowns were machined at CAD/CAM (IPS e.max CAD) and posteriorly crystallized. Internal and marginal adaptation were assessed via replica technique at four manufacturing moments (Milled wax pattern; LDPRESS; Milled LDCAD; Crystallized LDCAD) and considering 5 regions (margin, cervico-axial angle, axial wall, axial-occlusal angle and occlusal wall). Complementary analysis considering microstructure and topography, roughness and fractal dimension were performed in Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). Results The processing technique resulted in different ceramic microstructure, topography, roughness and fractal dimension, whereas CAD/CAM lead to smoother, more homogeneous but more complex topography features (higher fractal dimension) in comparison to the pressing technique (P Conclusions CAD/CAM and the pressing techniques for manufacturing LD crowns lead to completely different ceramic surface characteristics and affect crown adaptation at the margin and at occluso-axial angle.

This study aimed to evaluate the influence of loading frequency on the fatigue mechanical behavior of adhesively cemented polymer-infiltrated ceramic-network (PICN) and lithium disilicate (LD) simplified monolithic restorations. Thirty (30) disc-shaped specimens (O = 10 mm; thickness = 1.0 mm) of each ceramic material (PICN – Enamic, Vita Zahnfabrik or LD – IPS e.max CAD, Ivoclar Vivadent) were produced and adhesively cemented onto dentin analogue discs made of fiber and epoxy resin material (O = 10 mm; thickness = 2.0 mm). PICN and LD cemented assemblies were randomly allocated into 2 groups (n = 15) according to the loading frequency used for the fatigue testing (20 Hz or 2 Hz), composing the PICN_20, PICN_2, LD_20 and LD_2 testing groups. Fatigue tests were run using the step-stress approach (initial load = 200 N; step-size = 100 N; 10,000 cycles per step) and the collected data (fatigue failure load – FFL and number of cycles for failure – CFF) were analyzed by survival tests (Kaplan Meier and Mantel-Cox) and Weibull analysis. Fractographic analysis of failed specimens were also performed. No statistically significant differences were detected in relation to FFL and CFF between the groups within the same ceramic material (PICN_20: 1127 N/102,667 cycles = PICN_2: 1120 N/102,000 cycles; LD_20: 980 N/88,000 cycles = LD_2: 900 N/80,000 cycles). All failures were radial cracks in the cementation surface. Therefore, the use of a 20 Hz loading frequency shows to be a viable alternative to accelerate cyclic fatigue tests without affecting the fatigue mechanical behavior and the failure pattern of simplified restorations made of lithium disilicate glass ceramic or polymer infiltrated ceramic network bonded to the dentin analogue.

This study aimed to evaluate the effect of shading procedures on the fatigue performance and optical properties of an yttria-stabilized tetragonal zirconia polycrystal ceramic (4Y-TZP – stabilized by 4 mol% Y2O3). Disc-shaped specimens were produced at pre-sintered stage and randomly allocated into 5 groups (n=15) considering the shading technique: Ctrl (no pigmentation); Brush 1× and Brush 3× (brushing on 1 or 3 applications, respectively); Immer 2min and Immer 4min (immersion for 2 or 4 min, respectively). Following each pigment application, the specimens were dried in accordance with the manufacturers’ guidelines (15 min in a stove at 70 °C) and sintered in a specific furnace. Biaxial flexural fatigue test followed a step-stress approach (initial strength: 200 MPa; step-size: 25 MPa; 10.000 cycles/step; frequency: 20 Hz). Optical measurements were conducted in a spectrophotometer following the CIEDE2000 parameters. Roughness, topography, crystalline grain size, crystalline phase content and fractography analysis were also performed. The flexural fatigue strength (FFS) and the number of cycles to fracture (CFF) were statistically affected by pigmentation techniques (mean FFS in MPa/mean CFF): Ctrl (446.7/105,619) > Brush 1 × (436.7/102,854) ≥ Brush 3 × (405.0/89,962) ≥ Immer 2 min (395.0/85,103) ≥ Immer 4 min (383.3/81,382), although the exposure intensity (increase in number of applications or in application time) to the pigment had no effect (Brush 1 × = Brush 3 × ; Immer 2 min = Immer 4 min). Regarding optical properties, shading techniques similarly affected translucency and opalescence parameters, regardless of the exposure intensity to the pigment (Brush 1 × = Brush 3 × = Immer 2 min = Immer 4 min > Ctrl), whereas the exposure intensity to the pigment only promoted relevant alterations in the color change parameter (ΔE00) for the brushing technique (Brush 3 × > Brush 1 × ). No difference was observed in crystalline phase content, topographic pattern or roughness, although an increase in the zirconia grain size could be detected. Thus, the shading technique might affect the fatigue behavior and promote optical changes in a 4Y-TZP ceramic.

This study characterized the mechanical properties (static and under fatigue), the crystalline microstructure (monoclinic - m, tetragonal - t and cubic - c phase contents) and the surface topography of three yttrium-stabilized zirconia (YSZ) materials with different translucent properties, before and after aging in an autoclave (low temperature degradation). Disc-shaped specimens were produced from second generation (Katana ML/HT – high-translucent) and third generations (Katana STML – super-translucent and UTML – ultra-translucent) YSZ ceramics (Kuraray Noritake Dental Inc.), following ISO 6872–2015 guidelines for biaxial flexural strength testing (final dimensions: 15 mm in diameter and 1.2 ± 0.2 mm in thickness), and then subjected to the respective tests and analyses. ML was mainly composed of tetragonal crystals, while STML and UTML presented cubic content. Aging increased the monoclinic content for ML and did not affect STML and UTML. Topographical analysis highlights different grain sizes on the ceramic surface (UTML > STML > ML) and aging had no effect on this outcome. Weibull analysis showed the highest characteristic strength for ML both before and after aging, and statistically similar Weibull moduli for all groups. ML material also obtained the highest survival rates (ML > STML > UTML) for both fatigue strength and number of cycles to failure. All fractures originated from surface defects on the tensile side. Third generation zirconia (Katana STML and UTML) are fully stabilized materials (with tetragonal and cubic crystals), being totally inert to the autoclave aging, and presented lower mechanical properties than the second-generation zirconia (Katana ML - metastable zirconia).

This study aims to evaluate the flexural fatigue strength and survival estimates of an Y-TZP monolithic ceramic after grinding and aging. Ceramic discs (1.2 mm thickness × 15.0 mm diameter - ISO, 6872, 2015 ) of zirconia (Zirlux FC2 – Ardent; Ivoclar Vivadent) were made and randomly allocated into 6 groups (n = 10), according to grinding and aging factors: Ctrl – as-sintered; Ctrl Sto – as-sintered and dry stored at room temperature for 2 years; Ctrl Aut Sto – as-sintered, submitted to autoclaved aging (134 °C, 2 bar, 20 h) and then dry stored for 2 years; and similar conditions for ground samples (Ground; Ground Sto; Ground Aut Sto). Grinding was performed with diamond burs (#3101G, KG Sorensen) coupled to a contra-angle torque multiplier attached to a low speed motor under constant irrigation. Fatigue testing followed a step-stress approach. Data from strength and number of cycles until fracture were recorded and analyzed through Kaplan-Meier and Mantel-Cox tests. Both grinding and aging increase monoclinic phase content. The topography was altered by grinding but not by aging procedures. Grinding did not alter the fatigue strength (Ctrl = Ground), while aging increase it only for ground groups (Ground Sto, Ground Aut Sto). Aged conditions (Ctrl Sto; Ground Sto; Ctrl Aut Sto; Ground Aut Sto) showed increased survival probabilities for both flexural fatigue strength and cycles for failure. Therefore, despite promoting monoclinic phase increase, aging and grinding did not deleteriously affect the fatigue behavior of Y-TZP ceramics.