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SUMMARY Objectives To evaluate color changes in milled feldspathic porcelain laminate veneers following hydrofluoric acid etching (HFA), sandblasting (SB), or Er:YAG laser irradiation (LI). Methods and Materials Disc-shaped specimens (thickness=1 mm, diameter=8 mm) were milled from feldspathic porcelain blocks (n=40). Glazed specimens were randomly assigned to four subgroups (n=10 each) according to surface treatment: negative control, HFA, SB, and LI. A layer of translucent, light-cured resin cement (thickness=0.1 mm) was then applied following silanization. The color was characterized by the L*, a*, and b* uniform color space (CIE) using a reflection spectrophotometer. CIEDE2000 (ΔE00) was calculated to determine the color difference between each surface treatment and negative control groups. Data were statistically analyzed using analysis of variance (ANOVA), Kruskal-Wallis, and Dunn-Bonferroni post hoc tests. Results There were no significant differences in CIEL* and CIEb* coordinates between negative control and all surface treatment groups (p≥0.108). The SB group demonstrated significantly lower mean CIEa* (higher greenish hue) compared to other groups (p≤0.003). HFA exhibited significantly higher CIEa* (closer to red) when compared to LI (p=0.039). LI induced the smallest overall color change compared to negative control (ΔE00=1.43 [1.07]). However, the differences in ΔE00 values were not statistically significant (p=0.648). Conclusions The tested surface treatments did not affect the lightness or the yellowness of the 1-mm-thick milled feldspathic porcelain veneers. However, sandblasting resulted in a significant increase in the greenish hue. The Er:YAG laser resulted in the closest ΔE00 (1.43) to the 50:50% perceptibility threshold (ΔE00=1.2).

Objectives To evaluate and compare the perception of different dental professionals and laypersons toward altered gingival characteristics (microesthetics) and to identify those characteristics that are most negatively and positively rated. Materials and Methods A smiling photograph of a female dental student was selected and digitally manipulated to create changes in different microesthetic parameters. These altered images were rated by the following five groups: 120 orthodontists, 45 periodontists, 49 prosthodontists, 130 general dentists, and 172 laypersons. Smile esthetics scores were calculated, and comparisons between groups were performed using the univariate general linear model. Results The presence of black triangles between the upper incisors was the most negatively rated, and the ideal smile was the most positively rated. Significant differences were detected in the rating scores among the different study groups (P < .05). Orthodontists, prosthodontists, and general dentists scored the presence of a black triangle in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons. Conclusions The ideal smile and that with black triangles between the upper incisors were rated as the most and the least attractive smiles, respectively. Orthodontists, prosthodontists, and general dentists scored the presence of black triangles in the smile as the least attractive, whereas periodontists and laypersons perceived the inflamed gingiva and pigmented gingiva as the least attractive smiles, respectively. Dental specialists tended to give the altered smile images lower scores than the laypersons.

PURPOSE To evaluate surface roughness and topography of different zirconia-based restorations at various steps of finishing and polishing. MATERIALS AND METHODS Seventy-five zirconia discs were fabricated and divided into 3 layered and 2 monolithic groups: layered conventional (VM9; Vita), layered pressed (PM9; Vita), layered digital (TriLuxe Forte; Vita), opaque monolithic (Ceramill Zi; Amann Girrbach), and translucent monolithic (Zolid FX; Amann Girrbach). Surface roughness testing (Ra, Rz) and scanning electron microscopy were performed at the glazed, unglazed, finished, polished, super-polished, and super-polished with diamond paste steps. One-way ANOVA and Tukey tests were used for statistical analysis. RESULTS There were significant differences in all groups among the different steps (p < 0.001, F = 77.67 for layered conventional; p < 0.001, F = 133.90 for layered pressed; p < 0.001, F = 47.94 for layered digital; p < 0.001, F = 48.05 for zirconia opaque; p < 0.001, F = 43.91 for zirconia translucent). For the layered groups, glazed stage was significantly different from all other steps (p < 0.001). For the layered conventional and digital groups, polishing using diamond paste was not significantly different from the polished and super-polished steps (p = 0.448, p = 0.153), while for the layered pressed group, polishing using diamond paste was not significantly different from the super polished step (p = 0.815). For monolithic groups, there were no significant differences between the polished and super-polished steps (p = 0.957 for zirconia opaque, p = 1.00 for zirconia translucent). Both the diamond paste and super-polished steps showed no significant differences (p = 0.620, p = 0.550) from the glazed surface in the opaque zirconia group. CONCLUSIONS Surface roughness of monolithic and layered zirconia was improved by polishing; however, only opaque zirconia reached the level of surface roughness of the glazed stage. Type of buildup affected the surface roughness of adjusted ceramics, with monolithic zirconia showing lower surface roughness than layered zirconia. Polishing with diamond paste provided no significant improvement in the surface roughness of monolithic or layered zirconia.

Purpose: Occlusal bite force (OBF) is the most important parameter in assessing biting efficiency. The aim of this study was to record OBF changes after surgical correction of high angle maxillary/mandibular (Max/Mand) class III patients and to compare these with that recorded in class III patients with average Max/Mand angle. Materials and methods: Initially included were 42 patients with severe class III skeletal malocclusion who were scheduled for orthodontic surgery: group 1—22 patients with increased vertical relationship scheduled for bimaxillary surgery; group 2—20 patients with average vertical relationship scheduled for mandibular setback only. OBF measurements before surgery (T0), at debonding (T1) and at least 3 months after debonding (T2) were recorded using a portable occlusal force gauge. The following were also measured: maximum OBF (MOBF) achieved by the subject on each side, averaged OBF on each side (AOBF) and maximum OBF at the incisal region (MIOBF). At T2, only 33 patients (group 1: 17 and group 2: 16) were included in the analysis due to loss to follow-up. Results: MOBF increased significantly in group 1, while no significant changes were detected in group 2. MIOBF increased after surgical correction in both groups. Significant increase in MIOBF was observed at T1 (P < 0.001) followed by an insignificant decrease during the observation period (3–6 months after treatment; P > 0.05). The two groups differed significantly in MOBF at T1 and T2, while no statistically significant differences were detected between the groups for MIOBF changes at the various time intervals (P > 0.05). The number of posterior teeth with occlusal contacts increased in both groups. Relapse was detected in group 1 where the number of posterior teeth in contact decreased during the observation period (T1–T2). Conclusion: OBF greatly improved after surgical correction of the vertical morphology. Correction of high angle mandibular prognathism improves oral function in addition to esthetics. This study was supported by the Deanship of Research/Jordan University of Science and Technology (Grant number 44/2018).

PURPOSE To report a comprehensive description of dental implant system selection practices among dentists practicing implantology worldwide. MATERIALS AND METHODS An online questionnaire was designed and sent to members of 15 dental implant organizations. The survey questions addressed: dental implant system selection criteria, implant design variables, dentists' perspective to implant quality stamps, and dentists' satisfaction with their implant system(s). Responses were compiled and analyzed to determine correlation of responses using the chi-squared test (level of significance α ≤ 0.05). RESULTS Out of 4264 invitations sent, a total of 2001 (response rate = 46.9%) dentists participated in the survey. Approximately half of survey respondents (48.7%) were general dentists. More than two-thirds of the survey respondents (72.5%) were performing both the surgical and prosthetic implant phases. Implant-abutment connections were the most important dental implant system selection criterion (84.7%), followed by scientific evidence available on the implant system (82.8%), and simplicity of prosthetic steps (81.4%). Patient preferences (19.8%) were rated as the least important aspect. Sandblasted large gritted acid etched implant surfaces (SLA) were the most commonly used implant surfaces (75.8%); fluoride coated surfaces were the least commonly used (15.4%). CONCLUSION According to the results of this survey, most survey respondents practiced both surgical and prosthetic phases of dental implantology. The majority of survey respondents agreed on the importance of implant-abutment connections, scientific evidence available on implant systems, and simplicity of prosthetic steps when selecting implant systems.

Purpose To examine the effects of the veneering technique on the fracture resistance of zirconia-based crowns. Materials and Methods An artificial tooth was prepared with a 1.2 mm heavy chamfer finish line and 8° taper. The prepared tooth was scanned using CAD/CAM technology to fabricate 45 cobalt chromium (CoCr) testing dies. One CoCr die was scanned, and 45 zirconia copings were milled and divided according to the veneering technique into three groups of 15 specimens each: layering veneering (LV) using Vita Vm9, overpressing veneering (OV) using Vita Pm9, and digital veneering (DV) using Vita Triluxe forte. The crowns were cemented onto the testing dies using glass ionomer cement. The specimens were thermocycled (3000 cycles, 5° to 55°) then statically loaded (3.7 mm ball, 0.5 mm/min crosshead speed) until failure. Failed crowns were inspected using a magnifier, and failure patterns were identified. One-way ANOVA and multiple comparison Bonferroni tests were applied for statistical analysis of the results. Results Means and standard deviations of failure loads were 1200 ± 306 N for the LV group, 857 ± 188 N for the OV group, and 638 ± 194 N for the DV group. The differences in failure loads were statistically significant between all groups (p < 0.05). Failure mode was predominantly cohesive for LV and OV groups, whereas it was predominantly adhesive for the DV group. Conclusions The LV group was superior to other groups in terms of fracture resistance, while the DV group was inferior to the other groups in the same aspect.

Purpose To examine the effects of the veneering technique on the shade reproducibility of zirconia-based crowns. Materials and Methods An artificial tooth was prepared with a 1.2 mm heavy chamfer finish line and 8° taper. The prepared tooth was scanned using CAD/CAM technology to fabricate 45 cobalt chromium (CoCr) testing dies. One CoCr die was scanned, and 45 zirconia copings were milled and devided according to the veneering technique into 3 groups of 15 specimens each: layering veneering (LV) using Vita Vm9, overpressing veneering (OV) using Vita Pm9, and digital veneering (DV) using Vita Triluxe forte. All veneering layers had the same shade (A2). The specimens were cemented onto the testing dies using glass inomer cement. A spectrophotometer was used to measure the shade coordinates (L, C, h, a, b) for a Vita A2 shade tab and for each specimen. Both the CIE Lab (ΔEab) and the CIE DE2000 (ΔE00) color difference formulas were applied to compare the shade tab and the study groups. One-way ANOVA and multiple comparison Bonferroni tests were applied for statistical analysis of the results. Results Means and standard deviations (SDs) of ΔEab were 2.3 ± 1.3 for LV, 3.5 ± 0.8 for OV, and 4.0 ± 0.7 for DV. Means and SDs of ΔE00 were 1.4 ± 0.8 for LV, 2.1 ± 0.5 for OV, and 3.1 ± 0.4 for DV. ΔEab of LV group was significantly lower (p < 0.05) than both OV and DV groups, whereas the difference in ΔEab between OV and DV groups was not significant (p = 0.39). The differences in ΔE00 between all groups were significant (p < 0.05). Conclusions LV group was superior to other groups in terms of shade reproducibility. The ΔEab and the ΔE00 values of LV and OV groups were within clinically acceptable ranges; however, the ΔEab and the ΔE00 values of group DV were beyond the clinically acceptable ranges. The ΔE00 formula demonstrated a statistically significant difference between OV and the DV groups, while the ΔEab formula did not. The zirconia veneering technique had a significant influence on the shade reproducibility of zirconia-based crowns.

Purpose To determine the effect of type of base metal alloy, opaque thickness, and repeated firing on color of metal ceramic restorations. Materials and Methods Four nickel chromium and four cobalt chromium were selected with one noble alloy as a control. Ten discs (16 mm 0.5 mm) were prepared for each group. Color of specimens were measured using a spectrophotometer and were calculated using CIEDE2000 formula (ΔL′, ΔC′, ΔH′, ΔE′) between experimental groups and control at six stages of porcelain constructions: opaque 0.1 and 0.3 mm, dentine, enamel, glaze, and three times repeated firing. Shade A3 was used. One-way analysis of variance and Bonferroni multiple test were performed (α = 0.05). Results Alloy type and stage showed statistical significance on total color and color parameter differences from the control and there was significant interaction between them (p

To report a comprehensive description of dental implant system selection practices among dentists practicing implantology worldwide.An online questionnaire was designed and sent to members of 15 dental implant organizations. The survey questions addressed: dental implant system selection criteria, implant design variables, dentists' perspective to implant quality stamps, and dentists' satisfaction with their implant system(s). Responses were compiled and analyzed to determine correlation of responses using the chi-squared test (level of significance α ≤ 0.05).Out of 4264 invitations sent, a total of 2001 (response rate = 46.9%) dentists participated in the survey. Approximately half of survey respondents (48.7%) were general dentists. More than two-thirds of the survey respondents (72.5%) were performing both the surgical and prosthetic implant phases. Implant-abutment connections were the most important dental implant system selection criterion (84.7%), followed by scientific evidence available on the implant system (82.8%), and simplicity of prosthetic steps (81.4%). Patient preferences (19.8%) were rated as the least important aspect. Sandblasted large gritted acid etched implant surfaces (SLA) were the most commonly used implant surfaces (75.8%); fluoride coated surfaces were the least commonly used (15.4%).According to the results of this survey, most survey respondents practiced both surgical and prosthetic phases of dental implantology. The majority of survey respondents agreed on the importance of implant-abutment connections, scientific evidence available on implant systems, and simplicity of prosthetic steps when selecting implant systems.

Background Molar bonding procedures need continuous improvement to be widely accepted clinically and eventually replace molar bands. Material and methods The purpose of this study was to determine the effects of enamel micro-abrasion and silane coating of the base of molar tubes on shear and tensile bond strengths of orthodontic molar tubes. A total of 200 third molars were randomly allocated into five groups of 40 teeth as follows: group 1: molar tubes bonded to etched teeth (37% phosphoric acid gel; control group); group 2: molar tubes bonded to etched teeth (37% phosphoric acid) with the addition of silane to the base of molar tubes; group 3: molar tubes bonded to teeth pre-treated with 18% hydrochloric acid and pumice (micro-abrasion); group 4: molar tubes bonded to teeth pre-treated with microabrasion with the addition of silane to the base of molar tubes; group 5: molar tubes bonded to teeth pre-treated with microabrasion before conventional acid etching combined with the addition of silane to the base of molar tubes. The bond strength testing was performed using a computer control electromechanical universal testing machine. Results The highest mean shear and tensile bond strengths were recorded in group 5 (13.81±2.54MPa and 13.97±2.29 MPa, respectively). Micro-abrasion alone (group 3) and the combination of enamel micro-abrasion and the addition of silane (group 4) produced bond strength values comparable to the control. Conclusions Enamel surface pre-treatment (micro abrasion) before conventional acid etching combined with the addition of silane to the base of the molar tube produced the highest bond strengths among all tested groups. Key words:Molar, shear strength, tensile strength, orthodontic appliances.

Aim The aim of this study was to investigate the fracture resistance of two types of ceramic crowns cemented with two different cements. Methods and Materials Forty premolar crowns were fabricated using lithium-disilicate (IPS Empress-2) and glass-infiltrated aluminium-oxide (In-Ceram) ceramic systems. The crowns were divided into four groups (n=10) with Group 1 (IPS Empress-2) and Group 2 (In-Ceram) cemented with glass ionomer cement. Group 3 (IPS Empress-2) and Group 4 (In-Ceram) were cemented with resin cement. Crowns were tested in a universal testing machine at a compressive-load speed of 10 mm/min. Fracture modes were grouped into five categories. One way analysis of variance (ANOVA) and Bonferroni post-hoc tests were used to detect statistical significances (p Results The mean (SD) fracture resistance (Newtons) for Groups 1 to 4 were: 245.35 (82.69), 390.48 (67.03), 269.69 (10.33), and 418.36 (26.24). The cement type had no statistical significant effect (p>0.05) on fracture resistance within each ceramic system tested. In-Ceram crowns cemented with either glass ionomer or resin cements exhibited a statistically significantly higher fracture-resistance than IPS Empress-2 crowns (p Conclusion Fracture resistance of IPS Empress-2 and In-Ceram crowns was not affected by the type of cement used for luting. Clinical Significance Both In-Ceram and IPS Empress-2 crowns can be successfully luted with the cements tested with In-Ceram exhibiting higher fracture resistance than IPS Empress-2. Citation Al-Wahadni AM, Hussey DL, Grey N, Hatamleh MM. Fracture Resistance of Aluminium Oxide and Lithium Disilicate-based Crowns using Different Luting Cements: An in vitro Study. J Contemp Dent Pract 2009 March; (10)2:051-058.