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BACKGROUND: This study aims to evaluate the effect of surface treatment and resin cement on the shear bond strength (SBS) and mode of failure of polyetheretherketone (PEEK) to lithium disilicate ceramic (LDC). This is suggested to study alternative veneering of PEEK frameworks with a ceramic material. METHODS: eighty discs were prepared from PEEK blank and from lithium disilicate ceramic. Samples were divided into four groups according to surface treatment: Group (A) air abraded with 110 µm Al2O3, Group (AP) air abrasion and primer application, Group (S) 98% sulfuric acid etching for 60 s, Group (SP) Sulfuric acid and primer. Each group was subdivided into two subgroups based on resin cement type used for bonding LDC:1) subgroup (L) self- adhesive resin cement and 2) subgroup (B) conventional resin cement (n = 10). Thermocycling was done for all samples. The bond strength was assessed using the shear bond strength test (SBS). Failure mode analysis was done at 50X magnification with a stereomicroscope. Samples were chosen from each group for scanning electron microscope (SEM). The three-way nested ANOVA followed by Tukey's post hoc test were used for statistical analysis of results. Comparisons of effects were done utilizing one way ANOVA and (p < 0.05). RESULTS: The highest mean of shear bond strength values was demonstrated in Group of air abrasion with primer application using conventional resin cement (APB) (12.21 ± 2.14 MPa). Sulfuric acid groups showed lower shear bond strength values and the majority failed in thermocycling especially when no primer was applied. The failure mode analysis showed that the predominant failure type was adhesive failure between cement and PEEK, while the remaining was mixed failure between cement and PEEK. CONCLUSION: The air abrasion followed by primer application and conventional resin cement used for bonding Lithium Disilicate to PEEK achieved the best bond strength. Primer application did not have an effect when self-adhesive resin cement was used in air-abraded groups. Priming step is mandatory whenever sulfuric acid etching surface treatment is utilized for PEEK.

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Objective: This clinical study was conducted to evaluate the effect of loading protocol using hybrid ceramic resinous material on marginal bone loss. Material and Methods: This study was conducted in the fixed prosthodontics department, at Ain Shams University on 30 titanium endosseous tapered threaded implants which were placed in 30 patients in the upper premolar area. Patients were divided randomly according to the loading protocol into 3 groups (10 patients each): Group I (IFLV): patients received CAD/CAM polymer infiltrated ceramic (VITA-ENAMIC) crowns (immediate functional loading), Group II (IFLP): patients received CAD/CAM PMMA crowns (in occlusion for 3 months) followed by CAD/CAM polymer infiltrated ceramic (VITA-ENAMIC) crowns (functional loading), and Group III (INFLP): patients received CAD/CAM PMMA crowns (out of occlusion for 3 months) followed by CAD/CAM VITA-ENAMIC crowns (functional loading). Results: After three months; the highest value of marginal bone loss (mm) was found in IFLV, followed by IFLP, while the lowest value was found in INFLP. After six months, the highest value was found in IFLP, followed by IFLV, while the lowest value was found in INFLP. Also, after twelve months, the highest value was found in IFLV, followed by IFLP, while the lowest value was found in INFLP. Marginal bone loss values were within the accepted values for clinical success for all the tested groups. Conclusion: Immediate non-functional loading provided more acceptable outcomes than immediate functional loading. Also, immediately functional and non-functional implant loading using hybrid ceramic as permanent material has shown promising results with proper patient selection (AU)

Objetivo: Este estudo clínico foi realizado para avaliar o efeito do protocolo de carregamento utilizando material resinoso cerâmico híbrido na perda óssea marginal. Material e Métodos: Este estudo foi realizado no departamento de prótese fixa da Universidade Ain Shams em 30 implantes endósseos cônicos de titânio que foram instalados em 30 pacientes na região de pré-molares superiores. Os pacientes foram divididos aleatoriamente de acordo com o protocolo de carregamento em 3 grupos (10 pacientes cada): Grupo I (IFLV): os pacientes receberam coroas usinadas em CAD/CAM de cerâmica infiltrada com polímero (VITA-ENAMIC) (carga imediata), Grupo II (IFLP): os pacientes receberam coroas usinadas em CAD/CAM de PMMA (em oclusão por 3 meses) seguidas por coroas de cerâmica infiltrada com polímero (VITA-ENAMIC) (carga funcional), e Grupo III (INFLP): os pacientes receberam coroas usinadas em CAD/CAM de PMMA (infraoclusão por 3 meses) seguido de coroas de VITA-ENAMIC (carga funcional). Resultados: Após três meses; o maior valor de perda óssea marginal (mm) foi encontrado no IFLV, seguido pelo IFLP, enquanto o menor valor foi encontrado no INFLP. Após seis meses, o maior valor foi encontrado no IFLP, seguido do IFLV, enquanto o menor valor foi encontrado no INFLP. Além disso, após doze meses, o maior valor foi encontrado no IFLV, seguido pelo IFLP, enquanto o menor valor foi encontrado no INFLP. Os valores de perda óssea marginal estavam todos dentro de valores aceitáveis para sucesso clínico para todos os grupos testados. Conclusão: A carga funcional não imediata proporcionou resultados mais aceitáveis do que a carga imediata. Além disso, o carregamento funcional imediato e não imediato de implantes utilizando coroas finais de cerâmica híbrida mostrou resultados promissores com a seleção adequada dos pacientes.(AU)

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