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      Effect of cements on fracture resistance of monolithic zirconia crowns

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          Abstract

          Objectives The present study investigated the effect of cements on fracture resistance of monolithic zirconia crowns in relation to their compressive strength.

          Materials and methods Four different cements were tested: zinc phosphate cement (ZPC), glass-ionomer cement (GIC), self-adhesive resin-based cement (SRC) and resin-based cement (RC). RC was used in both dual cure mode (RC-D) and chemical cure mode (RC-C). First, the compressive strength of each cement was tested according to a standard (ISO 9917-1:2004). Second, load-to-failure test was performed to analyze the crown fracture resistance. CAD/CAM-produced monolithic zirconia crowns with a minimal thickness of 0.5 mm were prepared and cemented to dies with each cement. The crown–die samples were loaded until fracture.

          Results The compressive strength of SRC, RC-D and RC-C was significantly higher than those of ZPC and GIC ( p < 0.05). However, there was no significant difference in the fracture load of the crown between the groups.

          Conclusion The values achieved in the load-to-failure test suggest that monolithic zirconia crowns with a minimal thickness of 0.5 mm may have good resistance against fracture regardless of types of cements.

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          Most cited references33

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          Clinically relevant approach to failure testing of all-ceramic restorations.

          One common test of single-unit restorations involves applying loads to clinically realistic specimens through spherical indenters, or equivalently, loading curved incisal edges against flat compression platens. As knowledge has become available regarding clinical failure mechanisms and the behavior of in vitro tests, it is possible to constructively question the clinical validity of such failure testing and to move toward developing more relevant test methods. This article reviewed characteristics of the traditional load-to-failure test, contrasted these with characteristics of clinical failure for all-ceramic restorations, and sought to explain the discrepancies. Literature regarding intraoral conditions was reviewed to develop an understanding of how laboratory testing could be revised. Variables considered to be important in simulating clinical conditions were described, along with their recent laboratory evaluation. Traditional fracture tests of single unit all-ceramic prostheses are inappropriate, because they do not create failure mechanisms seen in retrieved clinical specimens. Validated tests are needed to elucidate the role(s) that cement systems, bonding, occlusion, and even metal copings play in the success of fixed prostheses and to make meaningful comparisons possible among novel ceramic and metal substructures. Research over the past 6 years has shown that crack systems mimicking clinical failure can be produced in all-ceramic restorations under appropriate conditions.
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            The mechanical properties of human dentin: a critical review and re-evaluation of the dental literature.

            The past 50 years of research on the mechanical properties of human dentin are reviewed. Since the body of work in this field is highly inconsistent, it was often necessary to re-analyze prior studies, when possible, and to re-assess them within the framework of composite mechanics and dentin structure. A critical re-evaluation of the literature indicates that the magnitudes of the elastic constants of dentin must be revised considerably upward. The Young's and shear moduli lie between 20-25 GPa and 7-10 GPa, respectively. Viscoelastic behavior (time-dependent stress relaxation) measurably reduces these values at strain rates of physiological relevance; the reduced modulus (infinite relaxation time) is about 12 GPa. Furthermore, it appears as if the elastic properties are anisotropic (not the same in all directions); sonic methods detect hexagonal anisotropy, although its magnitude appears to be small. Strength data are re-interpreted within the framework of the Weibull distribution function. The large coefficients of variation cited in all strength studies can then be understood in terms of a distribution of flaws within the dentin specimens. The apparent size-effect in the tensile and shear strength data has its origins in this flaw distribution, and can be quantified by the Weibull analysis. Finally, the relatively few fracture mechanics and fatigue studies are discussed. Dentin has a fatigue limit. For stresses smaller than the normal stresses of mastication, approximately 30 MPa, a flaw-free dentin specimen apparently will not fail. However, a more conservative approach based on fatigue crack growth rates indicates that if there is a pre-existing flaw of sufficient size (approximately 0.3-1.0 mm), it can grow to catastrophic proportion with cyclic loading at stresses below 30 MPa.
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              Bonding between oxide ceramics and adhesive cement systems: a systematic review.

              The following aims were set for this systematic literature review: (a) to make an inventory of existing methods to achieve bondable surfaces on oxide ceramics and (b) to evaluate which methods might provide sufficient bond strength. Current literature of in vitro studies regarding bond strength achieved using different surface treatments on oxide ceramics in combination with adhesive cement systems was selected from PubMed and systematically analyzed and completed with reference tracking. The total number of publications included for aim a was 127 studies, 23 of which were used for aim b. The surface treatments are divided into seven main groups: as-produced, grinding/polishing, airborne particle abrasion, surface coating, laser treatment, acid treatment, and primer treatment. There are large variations, making comparison of the studies difficult. An as-produced surface of oxide ceramic needs to be surface treated to achieve durable bond strength. Abrasive surface treatment and/or silica-coating treatment with the use of primer treatment can provide sufficient bond strength for bonding oxide ceramics. This conclusion, however, needs to be confirmed by clinical studies. There is no universal surface treatment. Consideration should be given to the specific materials to be cemented and to the adhesive cement system to be used. Copyright © 2013 Wiley Periodicals, Inc.
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                Author and article information

                Journal
                Acta Biomater Odontol Scand
                Acta Biomater Odontol Scand
                IABO
                iabo20
                Acta Biomaterialia Odontologica Scandinavica
                Taylor & Francis
                2333-7931
                1 January 2016
                26 January 2016
                : 2
                : 1
                : 12-19
                Affiliations
                [ a ]Department of Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, University of Gothenburg , Gothenburg, Sweden
                [ b ]Laboratory for Redox Regulation, Tohoku University Graduate School of Dentistry , Sendai, Japan
                [ c ]Research Group for Biomaterials Used in Dentistry and Medicine, Department for Clinical Dentistry, Faculty of Health Sciences, the Arctic University of Norway , Tromsø, Norway
                [ d ]Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry , Sendai, Japan
                Author notes
                CONTACT Ulf Örtengren ulf.ortengren@ 123456uit.no Department for Clinical Dentistry/Faculty of Health Sciences, The Arctic University of Norway , Tromsø 9037, Norway
                Article
                1129908
                10.3109/23337931.2015.1129908
                4894086
                27335900
                bb0ba4d3-077b-49f0-a6c4-a92be4ed957e
                © 2016 The Author(s). Published by Taylor & Francis.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 8 June 2015
                : 7 December 2015
                Page count
                Pages: 8
                Funding
                Funded by: Stiftelserna Wilhelm och Martina Lundgrens 10.13039/501100003745
                Categories
                Article
                Original Article

                monolithic zirconia crowns,fracture resistance,zinc phosphate cement,glass-ionomer cement,resin-based cement

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