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OBJECTIVES: 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. METHODS: "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. RESULTS: 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. SIGNIFICANCE: 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.

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The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.

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Abstract The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.

Resumo O presente estudo é um estudo clínico prospectivo, controlado, randomizado e de longo curto prazo, com o objetivo de avaliar o desempenho clínico de restauraç ões adesivas cerâmica vítrea reforçada com dissilicato de lítio e cerâmica feldspática por um período de até 2 anos. Um total de 11 pacientes (7 mulheres, 4 homens; faixa etária: 18-60 anos, idade média: 39 anos) foram inseridas para este estudo. Cada paciente recebeu duas restaurações por grupo em um delineamento de boca dividida. LD: Onze onlays, realizados com cerâmica à base de dissilicato de lítio (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein); e FP: Onze onlays, realizados com cerâmica feldspática (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Os retornos foram realizados em 2 semanas (linha de base = R1), 1 ano (R2) e 2 anos (R3) após a cimentação, por três investigadores independentes, cegos e calibrados, usando espelhos, óculos de aumento, sondas e radiografias interproximais. Foram avaliadas a sensibilidade pós-operatória, cárie secundária, integridade marginal, descoloração marginal, correspondência de cores, rugosidade da superfície, integridade dentária e integridade da restauração. O teste de Friedman (95%) foi utilizado para determinar se havia uma diferença estatisticamente significante na comparação periódica dos parâmetros nas restaurações cerâmicas. Um total de 95,4% das restaurações estava clinicamente aceitável no retorno de 2 anos, sem diferença para qualquer parâmetro de avaliação para ambos os materiais cerâmicos. Com base nos dados de 2 anos, as restaurações CAD-CAM fabricados com cerâmica feldspática e à base de dissilicato de lítio apresentaram desempenho clínico semelhante.

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OBJECTIVE: Glaze application on monolithic zirconia (Y-TZP) can be a practical approach to improve the mechanical properties of this material. Our study evaluated the effect of glazing side and mechanical cycling on the biaxial flexure strength (BFS) of a Y-TZP. METHODOLOGY: Eighty sintered Y-TZP discs (Ø:12 mm; thickness: 1.2 mm - ISO 6872) were produced and randomly assigned into eight groups (n=10), according to the factors "glazing side" (control - no glazing; GT - glaze on tensile side; GC - glaze on compression side; GTC - glaze on both sides) and "mechanical aging" (non-aged and aged, A - mechanical cycling: 1.2×106, 84 N, 3 Hz, under water at 37°C). Specimens were subjected to BFS test (1 mm/min; 1,000 Kgf load cell) and fractured surfaces were analyzed by stereomicroscopy and SEM. Hsueh's rigorous solutions were used to estimate the stress at failure of glazed specimens. Two-way ANOVA, Tukey's test (5%), and Weibull analysis were performed. RESULTS: The "glazing side", "mechanical aging" and the interaction of the factors were significant (p<0.05). Groups GC (1157.9±146.9 MPa), GT (1156.1±195.3 MPa), GTC (986.0±187.4 MPa) and GTC-A (1131.9±128.9 MPa) presented higher BFS than control groups (Tukey, 5%). Hsueh's rigorous solutions showed that the maximum tensile stress was presented in the bottom of zirconia layer, at the zirconia/glaze interface. Weibull characteristic strength (σo) of the GC was higher than all groups (p<0.05), except to GT, GTC-A and GTC, which were similar among them. The fractography showed initiation of failures from zirconia the tensile side regardless of the side of glaze application and fatigue. CONCLUSION: Glazing zirconia applied on both tensile and compression sides improves the flexural strength of Y-TZP, regardless the mechanical aging.

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Abstract Glaze application on monolithic zirconia (Y-TZP) can be a practical approach to improve the mechanical properties of this material. Objective Our study evaluated the effect of glazing side and mechanical cycling on the biaxial flexure strength (BFS) of a Y-TZP. Methodology Eighty sintered Y-TZP discs (Ø:12 mm; thickness: 1.2 mm - ISO 6872) were produced and randomly assigned into eight groups (n=10), according to the factors "glazing side" (control - no glazing; GT - glaze on tensile side; GC - glaze on compression side; GTC - glaze on both sides) and "mechanical aging" (non-aged and aged, A - mechanical cycling: 1.2×106, 84 N, 3 Hz, under water at 37°C). Specimens were subjected to BFS test (1 mm/min; 1,000 Kgf load cell) and fractured surfaces were analyzed by stereomicroscopy and SEM. Hsueh's rigorous solutions were used to estimate the stress at failure of glazed specimens. Two-way ANOVA, Tukey's test (5%), and Weibull analysis were performed. Results The "glazing side", "mechanical aging" and the interaction of the factors were significant (p<0.05). Groups GC (1157.9±146.9 MPa), GT (1156.1±195.3 MPa), GTC (986.0±187.4 MPa) and GTC-A (1131.9±128.9 MPa) presented higher BFS than control groups (Tukey, 5%). Hsueh's rigorous solutions showed that the maximum tensile stress was presented in the bottom of zirconia layer, at the zirconia/glaze interface. Weibull characteristic strength (σo) of the GC was higher than all groups (p<0.05), except to GT, GTC-A and GTC, which were similar among them. The fractography showed initiation of failures from zirconia the tensile side regardless of the side of glaze application and fatigue. Conclusion Glazing zirconia applied on both tensile and compression sides improves the flexural strength of Y-TZP, regardless the mechanical aging.

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The aim of this study was to investigate the three-dimensional wear, volumetric loss and surface roughness after chewing simulation of two glass ceramics. Lithium disilicate (LD, Emax CAD, Ivoclar) and Zirconia reinforced lithium silicate (ZLS, Vita Suprinity, Vita Zhanfabrick) discs (n=20/g) were scanned to obtain stereolithography (STL) files for each sample. All discs were submitted to chewing simulation with sliding configuration (30 N, 300,000 cycles, 6 mm and 1.7 Hz) with steatite as antagonist. The samples were then scanned again and the volume loss and the deepest defect depth was measured using the superimposed file from the baseline using three-dimensional digital parametric inspection software (GOM Inspect, Braunschweig, Germany). Surface roughness (Ra and Rz) was analyzed with a contact profilometer. Data were analyzed by one-way ANOVA and Tukey test (α=0.5%). ANOVA showed significant differences among the groups. Considering the ceramic volume loss, wear depth defect length and Rz roughness, LD (-22.09±5.57%; 0.80±0.06 µm; 3.08±1.02 µm) showed higher mean values than ZLS (-15.67±4.51%; 0.56±0.09 µm; 1.51±0.90 µm). Ra mean values were similar for both materials (p=0.064). All discs exhibited slight surface scratches along with the sliding direction with pitted wear patterns, while large cracks were observed on wear traces. These same areas can be identified in blue, overlapping the STL files before and after chewing simulation in inspection software. The linear reduction generated by sliding contact shows a graph with a similar wear pattern shape. ZLS was more resistant to wear than LD, with less volume loss and shallower surface defects.

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This study evaluated the influence of zirconia surface finishes on the wear of an enamel analogue. 40 zirconia discs were divided into four groups: control (without finish); glazed; polished; polished and glazed. All samples were subjected to wear against steatite antagonists. The specimens underwent roughness, topographic, scanning electron microscopy (SEM) and wettability analyses. Quantitative wear measurements were performed on both steatites and discs. To measure wear of steatites the weight before and after the test and the diameter after the test were used. Profilometer measurements were performed to determine the wear on discs. Roughness, volumetric wear and mass loss were analyzed using the Kruskal-Wallis and Dunn tests (5%), while contact angle values were analyzed with One-way ANOVA and Tukey tests (5%). The polished group had the lowest roughness means, being statistically different from the other groups (p-value=0.0001). The glazed group presented the lowest steatite volumetric wear (p-value=0.0001), but not statistically different from the polished and glazed group, whereas these groups presented the highest zirconia volumetric wear, with statistically different (p-value=0.0002) compared to the others. SEM showed irregularities on the control groups surface, grooves on the polished group, and a homogeneous surface for the glazed group with a few pores. All groups presented contact angles lower than 90 degrees, characterizing hydrophilic surfaces. It can be concluded that just glazed zirconia caused less wear on the antagonist when compared to no finish and polished zirconia.

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Abstract The aim of this study was to investigate the three-dimensional wear, volumetric loss and surface roughness after chewing simulation of two glass ceramics. Lithium disilicate (LD, Emax CAD, Ivoclar) and Zirconia reinforced lithium silicate (ZLS, Vita Suprinity, Vita Zhanfabrick) discs (n=20/g) were scanned to obtain stereolithography (STL) files for each sample. All discs were submitted to chewing simulation with sliding configuration (30 N, 300,000 cycles, 6 mm and 1.7 Hz) with steatite as antagonist. The samples were then scanned again and the volume loss and the deepest defect depth was measured using the superimposed file from the baseline using three-dimensional digital parametric inspection software (GOM Inspect, Braunschweig, Germany). Surface roughness (Ra and Rz) was analyzed with a contact profilometer. Data were analyzed by one-way ANOVA and Tukey test (α=0.5%). ANOVA showed significant differences among the groups. Considering the ceramic volume loss, wear depth defect length and Rz roughness, LD (-22.09±5.57%; 0.80±0.06 µm; 3.08±1.02 µm) showed higher mean values than ZLS (-15.67±4.51%; 0.56±0.09 µm; 1.51±0.90 µm). Ra mean values were similar for both materials (p=0.064). All discs exhibited slight surface scratches along with the sliding direction with pitted wear patterns, while large cracks were observed on wear traces. These same areas can be identified in blue, overlapping the STL files before and after chewing simulation in inspection software. The linear reduction generated by sliding contact shows a graph with a similar wear pattern shape. ZLS was more resistant to wear than LD, with less volume loss and shallower surface defects.

Resumo O objetivo deste estudo foi investigar o desgaste tridimensional, perda volumétrica e rugosidade após a simulação de mastigação de dois materiais vitro-cerâmicos. Discos de dissilicato de lítio (LD, Emax CAD, Ivoclar) e silicato de lítio reforçado com zircônia (ZLS, Vita Suprinity, Vita Zhanfabrick) (n=20/g) foram confeccionados e digitalizados para obtenção de arquivos de estereolitografia (STL) de cada amostra. Todos os discos foram submetidos à simulação de mastigação com configuração deslizante (30 N, 300.000 ciclos, 6 mm e 1,7 Hz) com esteatita como antagonista. As amostras foram escaneadas novamente e a perda de volume e o defeito mais profundo foram medidos usando o arquivo sobreposto da linha de base através de um software de inspeção paramétrica digital e tridimensional (GOM Inspect, Braunschweig, Alemanha). A rugosidade superficial (Ra e Rz) foi avaliada através de rugosímetro de contato. Os resultados foram analisados por ANOVA 1-fator e teste Tukey (α=0,5%). ANOVA mostrou diferenças significantes entre os grupos. Considerando a perda de volume cerâmico, comprimento do defeito e rugosidade Rz, LD (-22,09±5,57%; 0,80±0,06 µm; 3,08±1.02 µm) apresentou valores médios superiores a ZLS (-15,67±4,51%; 0,56±0,09 µm; 1.51±0.90 µm). Todos os discos exibiram pequenos arranhões na superfície conforme a direção de deslizamento com padrões de desgaste, enquanto grandes ranhuras foram observadas nos traços de desgaste. Essas mesmas áreas podem ser identificadas em azul, sobrepondo os arquivos STL antes e depois da simulação de mastigação no software de inspeção. A redução linear gerada pelo contato deslizante mostra um gráfico com uma forma de padrão de desgaste semelhante. ZLS foi mais resistente ao desgaste do que LD, com menor perda de volume e menores defeitos superficiais.

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Abstract This study evaluated the influence of zirconia surface finishes on the wear of an enamel analogue. 40 zirconia discs were divided into four groups: control (without finish); glazed; polished; polished and glazed. All samples were subjected to wear against steatite antagonists. The specimens underwent roughness, topographic, scanning electron microscopy (SEM) and wettability analyses. Quantitative wear measurements were performed on both steatites and discs. To measure wear of steatites the weight before and after the test and the diameter after the test were used. Profilometer measurements were performed to determine the wear on discs. Roughness, volumetric wear and mass loss were analyzed using the Kruskal-Wallis and Dunn tests (5%), while contact angle values were analyzed with One-way ANOVA and Tukey tests (5%). The polished group had the lowest roughness means, being statistically different from the other groups (p-value=0.0001). The glazed group presented the lowest steatite volumetric wear (p-value=0.0001), but not statistically different from the polished and glazed group, whereas these groups presented the highest zirconia volumetric wear, with statistically different (p-value=0.0002) compared to the others. SEM showed irregularities on the control groups surface, grooves on the polished group, and a homogeneous surface for the glazed group with a few pores. All groups presented contact angles lower than 90 degrees, characterizing hydrophilic surfaces. It can be concluded that just glazed zirconia caused less wear on the antagonist when compared to no finish and polished zirconia.

Resumo Este estudo avaliou a influência dos acabamentos superficiais da zircônia no desgaste de um análogo de esmalte. 40 discos de zircônia foram divididos em quatro grupos: controle (sem acabamento); glazeado; polido; polido e glazeado. Todas as amostras foram submetidas ao desgaste contra antagonistas de esteatita. Os espécimes foram submetidos à análise de rugosidade, topografia, microscopia eletrônica de varredura (MEV) e análise de molhabilidade. Medidas quantitativas de desgaste foram realizadas nos antagonistas e nos discos de zircônia. Para medir o desgaste das esteatitas, foi mensurado o peso antes e depois do desgaste e o diâmetro após o teste. A análise de perfilometria mensurou o desgaste dos discos. Rugosidade, desgaste volumétrico e perda de massa foram analisados pelos testes de Kruskal-Wallis e Dunn (5%), enquanto os valores de ângulo de contato foram analisados com os testes One-way ANOVA e Tukey (5%). O grupo polido apresentou as menores médias de rugosidade, sendo estatisticamente diferente dos demais grupos (p-valor=0,0001). O grupo glazeado apresentou o menor desgaste volumétrico do antagonista (p-valor=0,0001), mas não foi estatisticamente diferente do grupo polido e glazeado, enquanto que esses grupos apresentaram o maior desgaste volumétrico da zircônia, com diferença estatisticamente diferente (p-valor=0,0002) em comparação com os outros. MEV mostrou irregularidades na superfície do grupo controle, sulcos no grupo polido e uma superfície homogênea para o grupo glazeado, com poucos poros. Todos os grupos apresentaram ângulos de contato menores que 90 graus, caracterizando superfícies hidrofílicas. Dentro das limitações deste estudo in vitro, é possível concluir que zircônia glazeada causou menos desgaste ao antagonista quando comparada a zircônia sem tratamento ou polida. Além disso, não foi encontrada diferença no desgaste do antagonista para os grupos de zirconia polida e controle.

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The aim of this study was to evaluate the failure probability of two types of abutment screws after compressive load and to analyze the stress distribution with finite element method. Sixty (60) single-tooth implant restorations were assembled on titanium implants (e-fix, A.S. Technology - Titanium Fix). The groups were divided into Conventional screw (Screw neck 1.5 ø mm) and Experimental screw (Screw neck constricted with 1.2 ø mm). Specimens were subjected to single load to failure with compressive test according ISO 14801. The fractured specimens were subjected to stereomicroscopy for measurement of remaining screws inside the implant and characterization of fracture origin. Representative specimens were analyzed by scanning electronic microscopy. For finite element method (FEM), an identical 3D model of the two in vitro test groups were used with similar conditions (30º, 100 N load). The stress in the abutment screw was analyzed by von-Mises criteria. The results of strength means were 4132.5 ± 76 MPa and 4528.2 ± 127.2 for conventional and experimental groups, respectively. During microscopy, the mean (mm) of the remaining screw piece inside the implants were 0.97 ± 0.23 and 1.32 ± 0.12 for conventional and experimental groups, respectively. In FEM, the conventional group showed stress concentered in an unfavorable region (peak of 39.23 MPa), while the experimental group showed more stress areas but less concentration than the conventional group (36.6 MPa). In using the tested experimental geometry, the abutment screw can have its strength improved, and the origin of failure can be more favorable to clinical resolution.

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PURPOSE: This study evaluated the effect of different loading pistons, made of various materials and with different elastic moduli acting as antagonist material, on stress distribution and fatigue behavior of a CAD/CAM silica-based ceramic. MATERIALS AND METHODS: Discs of CAD/CAM made silica-based ceramic (N = 60) (VITA MARK II) were divided into six groups (n = 10 per group), according to the test method (M: Monotonic; F: Fatigue) and the antagonist piston material (T: Tungsten; S: Steel; G: Epoxy resin). FT, FS and FG combinations were submitted to mechanical cycling (2 × 106 cycles, 4 Hz, 45 N). The bending stress after fatigue were also valuated using Weibull analysis and the parameters η (eta), ß (beta) and the mean time to failure (MTTF) were calculated. Fractographic analysis and Finite Element Analysis (FEA) were performed. Data were analyzed using ANOVA and Tukey's tests (alpha=0.05). RESULTS: MG presented significantly less bending strength (MPa) (75.6) compared to MT (87.8) and MS (84.4) (p < 0.05). Six specimens from FT (MMTF: 8.3 × 106; ß:0.60; η:5.6 × 106), four from FS (MMTF: 1.9 × 106; ß:1.2; η:2.0 × 106) and one from FG (MMTF: 1.3 × 106; ß:0.48; η:0.64 × 106) survived the fatigue test. The stress peak on the tensile surface of S was similar to that of T and both were less than that of G. The failure origins were on the tensile surface. CONCLUSION: The epoxy resin pistons were able to decrease the bending stress, and life expectancy (faster failure) of a silica-based ceramic compared to tungsten and steel.

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The aim of this study was to determine if multiple processing (heat-pressing) of a dental ceramic influences flexural strength, hardness, and microstructure. Ninety bar-shaped specimens (15 mm × 4 mm × 2 mm) of a pressed ceramic (Vita PM9) were fabricated and randomly divided into 6 groups (n = 15) according to the factors "number of pressings" (C1, C2, and C3, fired 1, 2, and 3 times, respectively) and "mechanical cycling" (M). Half of the specimens were mechanically cycled (106 cycles, 45 N, 3.4 Hz, in water) and all specimens were tested for 3-point bending (0.5 mm/min, load 1000 kgf) and Vickers hardness (19.6 N for 20 s). X-ray diffraction was used to characterize the phases and scanning electron microscopy to characterize the microstructure. The flexural strength data was statistically analyzed with Weibull analysis, ANOVA, and Tukey test. Hardness data was evaluated by 2-way ANOVA and Fisher test. All tests were performed with a significance level of 0.05. Two-way ANOVA revealed that neither "number of pressings" (p=0.085) or "mechanical cycling" (0.055) significantly affected flexural strength. But Weibull analysis showed significant difference for Weibull moduli and characteristic strength between groups. For hardness, a statistical difference was seen for the interaction "Number of pressings * Mechanical cycling", (p = 0.016). Hardness decreased in the following order: C1 (775±17.2), CM3 (751±101), CM2 (735±45), C3 (701±82), CM1 (671±82), and C2 (663±92). Fewer defects were observed with an increased number of firings. Therefore, the possibility of recycling PM9 ceramic does not interfere in the evaluated mechanical properties and improves microstructure.

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The effects of several ceramic surface treatments on bond strength of a polymer-infiltrated ceramic network and resin composite as repair material were evaluated. CAD-CAM blocks of a polymer-infiltrated ceramic network (Vita Enamic) were sliced and subjected to aging process, followed by embedding in acrylic resin. The bonding/repair area was treated as follows (n = 30): C- without treatment; UA- universal adhesive application; FM- 10% hydrofluoric acid and silane application; OM-airborne-particle abrasion with aluminum oxide and silane application; RP- tribochemical silica coating; and CA- surface grinding and application of universal adhesive. Composite resin cylinders were made on the treated surface. Specimens from each group were assigned randomly to two subgroups (n = 15) considering storage condition: Baseline (shear tests after 48 hours) or Storage (tests after 6 months under distilled water). The treated surfaces were analyzed by goniometry, roughness, and SEM. Two-way ANOVA and 1-way ANOVA were applied to analyze the bond data and roughness / contact angle data, respectively, followed by Tukey's test (α = 5%). Surface treatments and storage conditions affected bond strengths (p < 0.01). Surface grinding (CA) followed by universal adhesive promoted the highest value of bond strength (14.5 ± 4.8 MPa for baseline, 8.5 ± 3.4 MPa for storage) and the roughest ceramic surface. Grinding with silicon carbide paper (simulating diamond bur) followed by the application of a universal adhesive system is the best option for repairing fractures of the polymer-infiltrated ceramic network.

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Tratamentos reabilitadores estéticos têm se difundido nos dias atuais em função da evolução dos sistemas cerâmicos, aliados ao desenvolvimento tecnológico, possibilitando a realização de restaurações estéticas com mínima espessura e grande beleza, de uma forma mais rápida e precisa. Dessa forma, o objetivo deste trabalho foi a apresentação de um caso clínico, em que dois laminados cerâmicos foram confeccionados em dissilicato de lítio. Utilizou-se uma técnica de moldagem diferenciada (com escaneamento intraoral) e a confecção de um modelo digital (com impressora 3D). Atualmente, essas técnicas representam as novas possibilidades que a evolução digital tem disponibilizado para a Odontologia adesiva.

Aesthetic rehabilitation treatments have become widespread in the present day due to the evolution of the ceramic systems, combined with the technological development, enabling the accomplishment of aesthetic restorations with minimal thickness and beauty, in a faster and more precise way. In this way, the objective of this work was to present a clinical case, where two ceramic laminates were made in lithium disilicate. A diff erent dental impression technique (with intraoral scanning) and the creation of a digital model (with 3D printer) were used. Currently, these techniques represent the new possibilities that digital evolution has made available to adhesive dentistry.

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Abstract: The effects of several ceramic surface treatments on bond strength of a polymer-infiltrated ceramic network and resin composite as repair material were evaluated. CAD-CAM blocks of a polymer-infiltrated ceramic network (Vita Enamic) were sliced and subjected to aging process, followed by embedding in acrylic resin. The bonding/repair area was treated as follows (n = 30): C- without treatment; UA- universal adhesive application; FM- 10% hydrofluoric acid and silane application; OM-airborne-particle abrasion with aluminum oxide and silane application; RP- tribochemical silica coating; and CA- surface grinding and application of universal adhesive. Composite resin cylinders were made on the treated surface. Specimens from each group were assigned randomly to two subgroups (n = 15) considering storage condition: Baseline (shear tests after 48 hours) or Storage (tests after 6 months under distilled water). The treated surfaces were analyzed by goniometry, roughness, and SEM. Two-way ANOVA and 1-way ANOVA were applied to analyze the bond data and roughness / contact angle data, respectively, followed by Tukey's test (α = 5%). Surface treatments and storage conditions affected bond strengths (p < 0.01). Surface grinding (CA) followed by universal adhesive promoted the highest value of bond strength (14.5 ± 4.8 MPa for baseline, 8.5 ± 3.4 MPa for storage) and the roughest ceramic surface. Grinding with silicon carbide paper (simulating diamond bur) followed by the application of a universal adhesive system is the best option for repairing fractures of the polymer-infiltrated ceramic network.

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Objective: This study evaluated the effects of the incorporation of silver nanoparticles (AgNPs) obtained from Fusarium oxysporum on heat-activated acrylic resin (HAAR) and their influence on resin's surface roughness, hardness, color alteration and antimicrobial capacity against Candida albicans. Material and Methods: For this, 50 discs of HAAR (2x5 mm) were produced and divided into three groups, Control: HAAR; Ag1: HAAR plus 0.539 mg of AgNPs; and Ag2: HAAR plus 1.1 mg of AgNPs. Knopp hardness (HK), surface roughness (Ra and Rz) and color alteration according to the CIE Lab were measured. Specimens were then evaluated in vitro with regard to C. albicans biofilm formation through formed colony count (CFU/mL). Scanning Electron Microscopy (SEM) and Atomic force microscopy (AFM) analyses were performed. Results: The addition of AgNPs of both concentrations changed Ra, Rz and HK significantly. There was statistically significant difference for L (p=0.00); a*(p=0.00) and b*(p=0.00) parameters. There were no differences between Ag1 and Ag2 biofilm formation, but the comparison of both with the control group presented a significant reduction (p=0.0091) on biofilm formation. SEM and AFM images showed no signs of NPs clustering. Conclusion: It can be concluded tha AgNPs incorporation in HAAR was effective in reducing C. albicans activity, with a slight change in color and hardness of the material, being effective therefore, in regions such as the dental prostheses palate, which have lesser aesthetic appeal. (AU)

Objetivo: Este estudo avaliou os efeitos da incorporação de nanopartículas de prata (AgNPs) obtidas a partir de Fusarium oxysporum em resina acrílica ativada termicamente (RAAT) e sua influência na rugosidade, dureza, cor e capacidade antimicrobiana contra Candida albicans. Material e Métodos: Para isso, 50 discos de RAAT (2x5 mm) foram produzidos e divididos em três grupos, Controle: RAAT; Ag1: RAAT com 0,539 mg de AgNPs; e Ag2: RAAT com 1,1 mg de AgNPs. Foram medidas a dureza Knopp (DK), a rugosidade superficial (Ra e Rz) e a alteração da cor de acordo com o sistema CIE Lab. As amostras foram então avaliadas in vitro em relação à formação de biofilme de C. albicans através da contagem de unidades formadoras de colônia (UFC / mL). Foram realizadas análises de Microscopia Eletrônica de Varredura (MEV) e Microscopia de Força Atômica (AFM). Resultados: A adição de AgNPs de ambas as concentrações alterou significativamente Ra. Rz e DK. Houve diferença estatisticamente significativa para os parâmetros L (p = 0,00); a * (p = 0,00) e b * (p = 0,00). Não houve diferenças entre a formação de biofilme Ag1 e Ag2, mas a comparação entre ambos com o grupo controle apresentou redução significativa (p = 0,0091) na formação de biofilmes. As imagens de MEV e AFM não mostraram sinais de agrupamento de NPs. Conclusão: Pode-se concluir que a incorporação de AgNP no RAAT foi eficaz na redução da atividade de C. albicans, com uma discreta alteração na cor e dureza do material, sendo efetiva, portanto, em regiões linguais de próteses dentárias, que possuem menor apelo estético. (AU)

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Abstract The aim of this study was to determine if multiple processing (heat-pressing) of a dental ceramic influences flexural strength, hardness, and microstructure. Ninety bar-shaped specimens (15 mm × 4 mm × 2 mm) of a pressed ceramic (Vita PM9) were fabricated and randomly divided into 6 groups (n = 15) according to the factors "number of pressings" (C1, C2, and C3, fired 1, 2, and 3 times, respectively) and "mechanical cycling" (M). Half of the specimens were mechanically cycled (106 cycles, 45 N, 3.4 Hz, in water) and all specimens were tested for 3-point bending (0.5 mm/min, load 1000 kgf) and Vickers hardness (19.6 N for 20 s). X-ray diffraction was used to characterize the phases and scanning electron microscopy to characterize the microstructure. The flexural strength data was statistically analyzed with Weibull analysis, ANOVA, and Tukey test. Hardness data was evaluated by 2-way ANOVA and Fisher test. All tests were performed with a significance level of 0.05. Two-way ANOVA revealed that neither "number of pressings" (p=0.085) or "mechanical cycling" (0.055) significantly affected flexural strength. But Weibull analysis showed significant difference for Weibull moduli and characteristic strength between groups. For hardness, a statistical difference was seen for the interaction "Number of pressings * Mechanical cycling", (p = 0.016). Hardness decreased in the following order: C1 (775±17.2), CM3 (751±101), CM2 (735±45), C3 (701±82), CM1 (671±82), and C2 (663±92). Fewer defects were observed with an increased number of firings. Therefore, the possibility of recycling PM9 ceramic does not interfere in the evaluated mechanical properties and improves microstructure.

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Objective: To evaluate the bond strength of different repair treatments for composite resin to aged Y-TZP ceramics. Material and Methods: Zirconia blocks were cut into smaller specimens, sintered according to manufacturer's recommendations (final dimensions of 4×4×3 mm), and randomly allocated into nine groups (n=15) according to the surface treatment and presence/ absence of aging of the substrate (subjected to lowtemperature degradation - LTD), as follows: without LTD (Control: without treatment; TBS: tribochemical silica coating + silane + adhesive); with LTD (Control-LTD: without treatment; TBS-LTD: TBS with hydrothermal degradation; MoS-LTD: Monobond S + adhesive; MoPLTD: Monobond Plus + adhesive; MZP-LTD: Metal/ Zirconia Primer + adhesive; USB-LTD: Single Bond Universal; AP-LTD: Alloy primer + adhesive). LTD was simulated in an autoclave (134 °C, 2 bar, 5 h). The ceramic blocks were embedded in PVC cylinders with a self-curing acrylic resin; each surface treatment protocol was performed; a composite resin cylinder ( : 3.25 mm and height: 3 mm) was then build-up using split metallic matrices. All the specimens were aged (thermocycling + storage in water for 90 days) and subjected to the shear bond strength test using a universal testing machine (1 mm/min). The failure mode was classified into four types: adhesive, composite resin cohesive fracture, ceramic cohesive fracture, and mixed. The bond strength values were subjected to Mann­Whitney test. Results: Only air-abraded samples (TBS and TBS­LTD) survived thermocycling. More than 80% of the samples of the other groups presented pre-test failures. TBS groups presented higher values of bond strength (3.94) compared to TBSLTD (0.96). The predominant type of failure for the surviving samples were adhesive. Conclusion: Air particle abrasion is mandatory to improve the bond strength of the Y-TZP substrate; an aged substrate presents an even more unfavorable scenario for adhesion. (AU)

Objetivo: Avaliar a resistência de união ao cisalhamento gerada por diferentes técnicas de reparo em resina composta aderida em zircônia envelhecida (sujeita a degradação a baixa temperatura - LTD). Material e Métodos: blocos de zircônia foram seccionados em espécimes, sinterizados de acordo com o fabricante (dimensões finais de 4x4x3 mm), e aleatorizados em nove grupos (n=15) de acordo com o tratamento de superfície e presença/ausência de envelhecimento do substrato (LTD), conforme: sem LTD (Control: sem tratamento; TBS: tribosilicatização + silano + adesivo); com LTD (Control-LTD: Monobond S + adesivo; MoP-LTD: Monobond plus + adesivo; MZPLTD: Meta/Zirconia primer + adesivo). LTD foi simulada em autoclave (134 °C, 2 bar, 5 h). Os blocos de cerâmica foram embutidos em cilindros de PVC com resina acrílica autopolimerizável; cada tratamento de superfície foi realizado; um cilindro de resina composta ( : 3,25 mm 3 mm de altura) foi confeccionado usando matrizes metálicas bipartidas. Todos os espécimes foram envelhecidos (termociclagem + armazenagem em água por 90 dias) e sujeitos ao teste de cisalhamento usando um equipamento de teste universal (1 mm/ min). O modo de falha foi classificado em quatro grupos: adesivo, fratura coesiva em resina composta, fratura coesiva da cerâmica, e mista. Os valores de adesão foram sujeitos ao teste de Mann-Whitney. Resultados: somente as amostras jateadas (TBS e TBSLTD) sobreviveram a termociclagem. Mais que 80% dos espécimes dos outros grupos apresentaram falhas préteste. Os grupos TBS apresentaram os maiores valores de resistência ao cisalhamento (3,94) comparado com TBS-LTD (0,96). Os tipos predominantes de falha para os espécimes sobreviventes foi adesiva. Conclusão: o jateamento é recomendável para aumentar a resistência adesiva à zircônia; um substrato envelhecido apresenta um cenário mais desfavorável de adesão. (AU)

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Monolithic restorations of Y-TZP have been recommended as a restorative alternative on prosthetic dentistry as it allows a substantial reduction of ceramic thickness, which means a greater preservation of tooth structure. However, the influence of grinding and aging when using a thinner layer of the material is unclear. This investigation aimed to evaluate and compare the effects of ceramic thickness (0.5 mm and 1.0 mm), grinding and aging (low-temperature degradation) on the mechanical behavior and surface characteristics of a full-contour Y-TZP ceramic. Y-TZP disc-shaped specimens (15 mm diameter) were manufactured with both thicknesses and randomly assigned into 4 groups considering the factors 'grinding with diamond bur' and 'aging in autoclave'. Surface topography (roughness, 3D profilometry and SEM), phase transformation, flexural strength and structural reliability (Weibull) analyses were executed. Grinding affected the surface topography, while aging did not promote any effect. An increase in m-phase content was observed after grinding and aging, although different susceptibilities were observed. Regardless of zirconia's thickness, no deleterious effect of grinding or aging on the mechanical properties was observed. Thus, in our testing assembly, reducing the thickness of the Y-TZP ceramic did not alter its response to grinding and low temperature degradation and did not impair its mechanical performance.

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OBJECTIVE: This study evaluated the influence of porcelain (VM9, VITA Zahnfabrik, Germany) thickness on the flexural strength and crack propagation in bilayered zirconia systems (YZ, VITA Zahnfabrik, Germany). MATERIAL AND METHODS: Thirty zirconia bars (20.0x4.0x1.0 mm) and six zirconia blocks (12.0x7.5x1.2 mm) were prepared and veneered with porcelain with different thickness: 1 mm, 2 mm, or 3 mm. The bars of each experimental group (n=10) were subjected to four-point flexural strength testing. In each ceramic block, a Vickers indentation was created under a load of 10 kgf for 10 seconds, for the propagation of cracks. RESULTS: The results of flexural strength were evaluated by One-way ANOVA and Tukey's test, with a significance level of 5%. The factor "thickness of the porcelain" was statistically significant (p=0.001) and the l-mm group presented the highest values of flexural strength. The cracks were predominant among the bending specimens with 1 and 2 mm of porcelain, and catastrophic failures were found in 50% of 3-mm-thick porcelain. After the indentation of blocks, the most severe defects were observed in blocks with 3-mm-thick porcelain. CONCLUSION: The smallest (1 mm) thickness of porcelain on the zirconia infrastructure presented higher values of flexural strength. Better resistance to defect propagation was observed near the porcelain/ zirconia interface for all groups. Higher flexural strength was found for a thinner porcelain layer in a bilayered zirconia system. The damage caused by a Vickers indentation near and far the interface with the zirconia shows that the stress profiles are different.

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