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OBJECTIVES: To compare, in vitro, resin cement excess removal techniques at the veneer-tooth interface. MATERIALS AND METHODS: Anterior human teeth were restored with ceramic veneers and randomly divided according to the following techniques (n = 10): removal of excess resin cement with brush and dental floss, followed by light-curing with Valo (Group 1) or Elipar (Group 2) for 1 min and 40 s; tack-curing with Valo (Group 3) or Elipar (Group 4) for 1 s; and tack-curing with Valo (Group 5) or Elipar (Group 6) for 5 s. The tack-curing was followed by removal of excess with probe and dental floss and light-curing for 1 min and 40 s. The area of excess resin cement (mm2) was measured in micro-CT images using AutoCAD program. The failures at the cervical margin in the X, Y, and Z axes (µm) of greater value were measured using the DataViewer program. The specimens were submitted to microleakage with 2% basic fuchsin. RESULTS: According to the Kruskal-Wallis and multiple comparison test, the highest area of excess resin cement was found in Group 1 (5.06 mm2), which did not differ statistically from Groups 2 (3.70 mm2) and 5 (2.19 mm2). Groups 2, 3 (1.73 mm2), 4 (1.14 mm2), and 5 (2.18 mm2) did not differ statistically. Group 6 (0.77 mm2) obtained the lowest value, which did not differ statistically from Groups 3 and 4. According to the Kruskal-Wallis and Dunn test, there was no significant difference in failures in X (p = 0.981), Y (p = 0.860), and Z (p = 0.638) axes and no significant difference in microleakage (p = 0.203) among the groups. CONCLUSIONS: Tack-curing for 1 s or 5 s, followed by removal of excess resin cement using a probe and a dental floss, tended to result in a lower amount of excess material around the margin. CLINICAL RELEVANCE: The technique used for resin cement excess removal influences the amount of excess leaved at the veneer-tooth interface. Tack-curing for 1 s or 5 s is recommended to mitigate the excess resin cement.

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The longevity of ceramic laminate veneers can be influenced by several factors, which can result in the need for a removal process. Laser removal has emerged as a good alternative to facilitate the procedure, and its repercussions on tooth enamel have been investigated. We aimed to evaluate the efficacy of erbium lasers for debonding ceramic laminate veneers without damaging the tooth enamel. This systematic review based on the PICOS model adhered to the PRISMA statement. The PubMed/MEDLINE, Web of Science, Embase, and Scopus databases were systematically searched until December 1, 2022, and 2902 studies were retrieved. After screening, four in vitro studies that analyzed the dental morphology using scanning electron microscopy, optical analysis, stereomicroscopy, or x-ray dispersion spectroscopy were included. The risk of bias was assessed using the Cochrane Collaboration tool. Our findings suggest that erbium lasers are useful for ceramic laminate veneer removal without damaging the tooth enamel. However, the removal is influenced by the type and thickness of ceramic and type of cement used. It could be concluded that the application of Erbium laser did not promote superficial changes in the dental enamel. This effect was observed in all analysis performed.

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BACKGROUND/AIM: Little is known about the effect of dental trauma and mouthguards (MG) on teeth with ceramic laminate veneers (CLV). The aim was to evaluate the influence of CLV thickness and the presence of a MG with and without antagonist tooth contact on impact stresses during dental trauma. MATERIALS AND METHODS: Twelve 2D-finite element models of a head with maxillary structures and upper incisors, six with and six without antagonist tooth, were created in three CLV conditions: sound incisor (no CLV), 0.3 mm CLV, and 1.0 mm CLV. These were evaluated with and without a 4.0-mm ethylene-vinyl acetate MG, with and without an antagonist tooth. An impact analysis was performed in which the head frontally hits a rigid surface at a speed of 1 m/s (3.6 km/h). The results were analyzed using Critical modified von Mises (MPa). The mean of the 10% highest modified von Mises stresses in each structure was collected. RESULTS: MG presence substantially reduced impact stresses in the CLV and tooth structures. The contact of the antagonist tooth promoted better stress distribution and reduced the stress levels in the traumatized tooth. Critical stress areas were found in the palatal enamel, incisal enamel, labial cervical area, and enamel under the CLV for all models without MG. In the models with MG, the stresses reduced significantly. Critical modified von Mises stress showed that sound or prepared enamel experienced more critical impact stresses than 0.3 or 1.0-mm thick CLV. CONCLUSIONS: The use of 4.0 mm EVA mouthguard reduced the impact stress levels in models with 0.3-mm CLV and 1.0-mm CLV, similar to a sound tooth. The contact of an antagonist tooth and the MG better distributed the stresses and reduced the impact stress in the traumatized tooth.

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Objective: To evaluate fracture resistance and survival rate of IPS Empress CAD versus Polished Celtra Duo ceramic laminate veneers. Material and Methods:Thirty-six ceramic laminate veneers were fabricated for maxillary anterior teeth. The patients were divided into two groups according to the material Group 1(control group) fabricated from IPS Empress CAD laminate veneers and group 2 (intervention group) fabricated from Polished Celtra Duo laminate veneers. Standardized the same preparation with butt joint design and chamfer finish line located supra gingival were performed for all the teeth. The fabrication of the veneers was performed using Cad\Cam (Ceramill motion) machine, with software (Exocad). The veneers surfaces were treated and silanated according to the manufacture instruction of each ceramic and enamel surfaces were etched where total etch adhesive protocol was obeyed using BISCO. Follow up sessions were done every two months up to one year for each patient using dental probe and operator vision to evaluate the fracture, survival rate, marginal adaptation, sensitivity and caries. according to USPHS criteria (United States Public Health Service). This was performed by an experienced, blinded investigator. Results: Fracture resistance, marginal adaptation, retention, caries and sensitivity were evaluated according to the criteria of USPHS and we found there is no significant difference as both groups scaled zero score. Conclusion: Both IPS Empress Cad and Polished Celtra Duo laminate veneers revealed successful clinical performance in terms of fracture resistance, marginal adaptation, retention, and sensitivity after one year follow up period (AU)

Objetivo: Avaliar a resistência à fratura e a taxa de sobrevivência de laminados de cerâmica IPS Empress CAD versus Celtra Duo polidos. Material e Métodos: Trinta e seis facetas cerâmicas laminadas foram confeccionadas para dentes anteriores superiores. Os pacientes foram divididos em dois grupos de acordo com o material Grupo 1 (grupo controle) confeccionado com laminados IPS Empress CAD e grupo 2 (grupo intervenção) confeccionado com laminados Celtra Duo polidos. A mesma forma de preparo e acabamento de chanfro localizado supra-gengival padronizados foram realizados para todos os dentes. A confecção das facetas foi realizada em máquina Cad \ Cam (Ceramill motion), com software (Exocad). As superfícies laminadas foram tratadas e silanizadas de acordo com as instruções do fabricante de cada cerâmica e as superfícies de esmalte foram condicionadas seguindo o protocolo adesivo de condicionamento ácido total com BISCO. Sessões de acompanhamento foram realizadas a cada dois meses durante um ano para cada paciente usando sonda exploradora e visão do operador para avaliar a fratura, taxa de sobrevivência, adaptação marginal, sensibilidade e cárie; de acordo com os critérios USPHS (Serviço de Saúde Pública dos Estados Unidos). Isso foi realizado por um investigador experiente e cego. Resultados: a resistência à fratura, adaptação marginal, retenção, cárie e sensibilidade foram avaliadas de acordo com os critérios da USPHS e não encontramos diferença significativa, pois ambos os grupos escalonaram pontuação zero. Conclusão: As facetas laminadas IPS Empress Cad e Celtra Duo polido revelaram desempenho clínico bem-sucedido em termos de resistência à fratura, adaptação marginal, retenção e sensibilidade após um período de acompanhamento de um ano. (AU)

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Background: New applications in laser technology in aesthetic restorative dentistry merit further research. This study compares the debonding strength and failure mode of feldspathic ceramic veneers using either Er,Cr:YSGG (erbium,chromium:ytrrium-scandium-gallium-garnet) laser at two levels of fluency or no laser (control group). Methods: An in vitro comparative study was carried out using bovine teeth that were randomly distributed into 3 groups of 21 specimens each: (a) experimental group 1 (EG1): irradiated with Er,Cr:YSGG (Waterlase iPlus®; Biolase, Irvine) at an energy density per pulse of 4 J/cm2, using a handpiece (Turbo; Biolase) with a sapphire tip (MX7) and applying the beam perpendicular to the specimen at a distance of 4 mm for 60 sec; (b) experimental group 2 (EG2): irradiated as in EG1, but at 2.7 J/cm2; and (c) control group (CG): debonding without laser irradiation. Results: The stress required for veneer debonding was 8.19 MPa in CG, 0.91 MPa in EG1, and 0.48 MPa in EG2. The difference between the control and both experimental groups was statistically significant (p < 0.001). The percentages of adhesive failure were 40%, 61.9%, and 96%, respectively. Conclusions: Using the Er,Cr:YSGG laser at 4 or 2.7 J/cm2 requires significantly less force to debond ceramic veneers. The percentage of adhesive failures in the two experimental protocols was higher than in the control group. Application of the Er,Cr:YSGG laser using the parameters in this study may be useful in removing feldspathic ceramic veneers, avoiding damaging them and protecting the enamel.

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This technical report has been developed to repair the ceramic laminate veneer without removing after fracture. The bonding between the tooth and the laminate veneer is very strict, thus removing the restoration is difficult. The disadvantages such as the loss of tissue from the tooth, the cost and time loss are eliminated with this technique. In this technical report, the cementation of porcelain to porcelain in the presence of the fractured piece is explained step by step (AU)

Este relato técnico foi desenvolvido para reparar o laminado cerâmico sem remoção após fratura. A união entre o dente e o laminado é muito rígida, remover a restauração é difícil. As desvantagens como a perda de tecido do dente, o custo e a perda de tempo são eliminadas com esta técnica. Neste relato técnico, a cimentação de porcelana em porcelana na presença da peça fraturada é explicada passo a passo (AU)

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Objective: The purpose of this in vitro study was to evaluate the marginal fit of laminate veneers made of zirconia-reinforced lithium silicate with two thicknesses using different CAD/CAM systems. Material and methods: 42 Laminate veneers milled from zirconia-reinforced lithium silicate were divided into three main groups according to milling machine used into: group X5, laminate veneers fabricated by inLab MCX5 milling machine; group CM, laminate veneers fabricated by Ceramill motion 2 milling machine; and group XL, laminate veneers fabricated by inLab MCXL milling machine. Each group was divided into two subgroups according to veneer thickness into: subgroup I, 0.5 mm thickness laminate veneers and subgroup II, 0.3 mm thickness laminate veneers. The marginal fit was measured using stereomicroscope. The results were tabulated and statistically analyzed using two-way ANOVA test followed by Tukey's post hoc test. Comparisons of main and simple effects were done utilizing Bonferroni correction. The significance level was set at (p ≤0.05) for all tests. Results: The mean( ± SD) highest marginal discrepancy was recorded in subgroup CMII at 85.45 ± 1.82 µm while the least mean marginal discrepancy was recorded in subgroup X5I (71.24 ± 2.64 µm). Conclusion: Both thicknesses(0.5 mm thickness and 0.3 mm thickness) and all tested CAD/CAM systems produced zirconia-reinforced lithium silicate laminate veneers with clinically acceptable marginal gaps; however, the closed CAD/CAM systems produced veneers with superior marginal fit than open systems at 0.3 mm thickness. The CAD/CAM system with the 5-axis milling machine produced the best marginal fit with 0.5 mm thickness. (AU)

Objetivo: O objetivo deste estudo in vitro foi avaliar a adaptação marginal de facetas laminadas de silicato de lítio reforçado com zircônia com duas espessuras, utilizando diferentes sistemas CAD / CAM. Material e métodos: 42 facetas laminadas fresadas a partir desilicato de lítio reforçado com zircônia foram divididos em três grupos principais de acordo com a fresadora usada em: grupo X5, facetas laminadas fabricados pela fresadora inLab MCX5; grupo CM, facetas laminadas fabricados por Ceramill motion 2; e grupo XL, facetas laminadas fabricados pelo inLab MCXL. Cada grupo foi dividido em dois subgrupos, de acordo com a espessura do laminado, em: subgrupo I, facetas laminadas com 0,5 mm de espessura e subgrupo II, facetas laminadas com espessura de 0,3 mm. A adaptação marginal foi medida usando estereomicroscópio. Os resultados foram tabulados e analisados estatisticamente usando o teste ANOVA de dois fatores seguido pelo teste post hoc de Tukey. Comparações dos efeitos principais e simples foram realizadas utilizando a correção de Bonferroni (P ≤ 0,05). Resultados: A maior discrepância marginal média ( ± DP) foi registrada no subgrupo CMII em 85,45 ± 1,82 µm, enquanto a menor discrepância marginal média foi registrada no subgrupo X5I 71,24 ± 2,64 µm. Conclusão: Ambas as espessuras (0,5 mm e 0,3 mm)e todos os sistemas CAD / CAM testados produziram facetas de laminado de silicato de lítio reforçadas com zircônia com lacunas clinicamente aceitáveis. No entanto, os sistemas CAD / CAM fechados produziam facetas com adaptação marginal superior aos sistemas abertos com 0,3 mm de espessura. O sistema CAD / CAM com a fresadora de 5 eixos produziu a melhor adaptação marginal com 0,5 mm de espessura (AU)

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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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O sorriso está ligado diretamente à autoestima dos pacientes, e a busca por um tratamento dentário tem sido realizada cada vez mais por melhorias estéticas. Quando se percebe qualquer desvio da normalidade de um padrão estético, pode-se apresentar como consequências transtornos funcionais e sociais. O presente trabalho relatou um caso clínico de paciente com agenesia de incisivos laterais superiores e diastema interincisal. A proposta de tratamento, aceita de acordo com o anseio da paciente, foi a confecção de facetas indiretas em dissilicato de lítio, resultando em fechamento do diastema e reanatomização dos demais elementos dentários anteriores. O objetivo deste estudo foi apresentar as vantagens da utilização das facetas laminadas sem o preparo/desgaste da estrutura dental para o tratamento de agenesia de incisivos laterais superiores, através de um caso clínico.

The smile is directly connected with patient self-esteem and the demand for dental treatment as aesthetic improvement has been increased. When there is any deviation from normality of an aesthetic standard, it can be presented as consequences of functional and social disorders. In this paper, a clinical case of a patient with agenesis of upper lateral incisors and diastema between the central incisors is outlined. The proposed accepted treatment in accordance with the patient desire was the fabrication of indirect lithium disilicate veneers, resulting in diastema closure and reconfi guring of the remaining dental elements. The aim of this study is to present the advantages of laminate ceramics without preparation/abrasion of dental structure to treat the agenesis of upper lateral incisors.

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A dinâmica clínica em reabilitação oral requer um planejamento criterioso para conduzir o sucesso do tratamento, exemplificado pela atenção às características individuais de cada paciente, auxiliando na escolha de materiais restauradores que possibilitem a preservação da estrutura dental e que apresentem propriedades favoráveis para funções biomecânicas similares aos dentes naturais. Uma opção válida é propiciar o restabelecimento estético e funcional através de restaurações cerâmicas, primordialmente associadas ao correto diagnóstico e planejamento. O objetivo deste trabalho foi abordar os principais aspectos relacionados à reabilitação oral, utilizando cerâmicas odontológicas, por meio do relato de um caso. Para maior previsibilidade do mesmo e para otimização do tempo de trabalho, utilizou-se DSD, enceramento diagnóstico e matriz de silicone translúcida associada com resina composta flow. A harmonização e o equilíbrio do sistema pelo restabelecimento da oclusão através do trabalho baseado na DVO e nos desgastes oclusais também são de extrema importância para um resultado final efetivo. Assim, respaldando-se também pela literatura atual, nota-se que laminados oclusais ultrafinos, resinas compostas e cerâmicas são capazes de satisfazer os requisitos biomiméticos, salvando tecidos dentários e restaurando estética.

The clinical dynamics of oral rehabilitation requires careful planning to conduct the sucess of a clinical case, which is exemplified by the attention to the individual characteristics of each patient. Giving support for the choice of the restorative materials which enable dental structure preservation and show favorable properties for biomechanical functions similar to the natural tooth. A valid option is to provide the aesthetic and functional restoration through ceramic restorations, primarily associated to correct diagnosis and planning. The aim of this research is to approach the main aspects related to oral rehabilitation, using dental ceramics through this case report. For a greater predictability of the case and optimization of the working time, DSD, mock-up and translucent silicone matrix approached with flow composite resin were used. The standardization and balance of the system through the occlusal reestablishment according to the VOD and dental attrition are extremely important for an effective end result. Thus, based on the current literature, it is noticed that ultrathin occlusal laminate, composite resin and ceramics are able to meet the biomimetic requeriments, preserving dental tissues and restoring aesthetics.

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This clinical report describes how to achieve predictable outcomes for anterior teeth esthetic restorations with porcelain laminate veneers by associating the digital planning and design of the restoration with interim restorations. The previous digital smile design of the restoration eliminates the communication barrier with the patient and assists the clinician throughout patient treatment. Interim restorations (diagnostic mock-ups) further enhance communication with the patient and prevent unnecessary tooth reduction for conservative tooth preparation. Adequate communication between patient and clinician contributes to successful definitive restorations and patient satisfaction with the final esthetic outcome.

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This study evaluated the masking ability of different porcelain thicknesses and combination of enamel and/or dentin porcelain layers over simulated background dental substrates with higher (A2) and lower (C4) color values. Combination of the enamel (E) and dentin (D) monolayer porcelain disks with different thicknesses (0.5 mm, 0.8 mm, and 1 mm) resulted in the following bilayer groups (n=10): D1E1, D1E0.8; D1E0.5; D0.8E0.8; D0.8E0.5, and D0.5E0.5. CIELAB color coordinates were measured with a spectrophotometer. The translucency parameter of mono and bilayer specimens and the masking ability estimated by color variation (ΔE*ab) of bilayer specimens over simulated dental substrates were evaluated. Linear regression analysis was used to investigate the relationships translucency parameter × ΔE*, translucency parameter × porcelain thickness, and ΔE* × porcelain thickness. Data were analyzed statistically (α= 0.05). Thinner porcelain disks were associated with higher translucency. Porcelain monolayers were considerably more translucent than bilayers (enamel + dentin). Dentin porcelain was less translucent than enamel porcelain with same thickness. ΔE* was always lower when measured over A2 background. Higher ΔE* was observed for the C4 background, indicating poorer masking ability. Increased ΔE* was significantly associated with increased translucency for both backgrounds. Decreased translucency and ΔE* were associated with increased total porcelain thickness or increased dentin thickness for both backgrounds. In conclusion, increased porcelain thickness (particularly increased dentin layer) and increased porcelain opacity resulted in better masking ability of the dental backgrounds.

Resumo Este estudo avaliou a capacidade de mascaramento de diferentes espessuras de porcelana e a combinação de camadas de porcelana de esmalte e/ou de dentina sobre substratos dentais simulados de fundo com cores de maior (A2) e menor (C4) valor. Combinação de discos de porcelana em monocamadas de esmalte (E) e dentina (D) com diferentes espessuras (0,5 mm, 0,8 mm e 1 mm) resultou nos seguintes grupos bicamadas (n=10): D1E1, D1E0,8; D1E0,5; D0,8E0,8; D0,8E0,5 e D0,5E0,5. Coordenadas de cor CIELAB foram mensuradas com um espectrofotômetro. O parâmetro de translucidez de espécimes mono e bicamadas e a capacidade de mascaramento estimada pela variação de cor (ΔE*ab) dos espécimes bicamadas sobre os substratos dentais simulados foram avaliados. Análise de regressão linear foi utilizada para investigar as relações parâmetro de translucidez x ΔE*, parâmetro de translucidez x espessura da porcelana, e ΔE* x espessura da porcelana. Os dados foram analisados estatisticamente (α=0,05). Discos de porcelana mais finos foram associados a maior translucidez. Monocamadas de porcelana foram consideravelmente mais translúcidas que bicamadas (esmalte + dentina). Porcelana de dentina foi menos translúcida que porcelana de esmalte com mesma espessura. ΔE* foi sempre menor quando mensurado sobre fundo A2. Maior ΔE* foi observado para o fundo C4, indicando pior capacidade de mascaramento. Maior ΔE* foi significativamente associado à maior translucidez para ambos fundos. Menor translucidez e ΔE* foram associados ao aumento da espessura total da porcelana ou aumento da espessura de dentina para ambos fundos. Em conclusão, aumento da espessura da porcelana (particularmente aumento da camada de dentina) e aumento da opacidade da porcelana resultaram em melhor capacidade de mascaramento dos fundos dentários.

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Restaurações à base de resina composta direta têm mostrado boas taxas de longevidade, no entanto, apresentam comprometimento estético ao longo do tempo. Para suprir essa carência, as restaurações cerâmicas têm se tornado uma ótima opção de tratamento para dentes anteriores, sendo a cerâmica feldspática a que apresenta melhores propriedades estéticas e capacidade de reprodução de detalhes. Assim, este artigo procurou descrever a confecção de quatro laminados cerâmicos, à base de cerâmica feldspática, para restauração de incisivos superiores, inicialmente restaurados com restaurações insatisfatórias em resina composta. Após a conclusão da reabilitação, foi possível concluir que o tratamento restabeleceu satisfatoriamente a estética e a função da paciente.

Resin composite restorations show good survival rates; however, they present esthetic problems after longer clinical periods. For this, ceramic restorations are a good alternative and feldspathic ceramics present the best esthetic properties. This article describes the fabrication of four laminate veneers with feldspathic ceramics to restore the maxillary incisors with unsatisfactory composite restorations. Good levels of esthetic and function were achieved at case conclusion.

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Los continuos avances en la tecnología, materiales dentales y equipamientos han contribuido significativamente con el nivel que la Odontología estética está logrando hoy. Entre estas innovaciones, el desarrollo de restauraciones de cerámica pura ha evolucionado aportando diferentes alternativas. Las cerámicas han presentado una rápida evolución desde el punto de vista tecnológico con el objetivo de mejorar las propiedades mecánicas y ópticas. En la actualidad existen varios sistemas de cerámicas libres de metal con propiedades mecánicas y ópticas excelentes, para la confección de coronas unitarias y plurales. Estos sistemas modernos se presentan con variadas composiciones y diferentes técnicas de confección, haciendo de estos más versátiles. Dentro de esta perspectiva, el mercado odontológico ofrece una gama enorme de nuevos materiales indirectos y sistemas libres de metal para la confección de prótesis, lo que proporciona nuevas opciones, más también nuevas interrogantes para decidir entre las alternativas disponibles. En este contexto esta revisión de la literatura tiene como objetivo abordar los diferentes sistemas cerámicos del punto de vista de su composición y sus diferentes técnicas de obtención

The continuing advances in technology, dental materials and equipment have contributed significantly to improve the level of esthetic dentistry today. Among these innovations, development of pure ceramic restorations has evolved to give different alternatives. Dental ceramics have presented a rapidly technological changing to improve mechanical and optical properties. Currently there are several systems of metal free ceramics with excellent mechanical and optical properties, for making crowns and plurals. These modern systems are presented with various compositions and different preparation techniques, making these more versatile. Within this perspective, the dental market offers a huge range of new indirect and metal-free materials for prostheses, providing new options, plus also new questions to decide among the available alternatives. The aim of this review is take a view of the different ceramic systems in terms of its composition and different techniques of production

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