Alexis Goujat1, Hazem Abouelleil2, Pierre Colon3, Christophe Jeannin4, Nelly Pradelle5, Dominique Seux6, Brigitte Grosgogeat7. 1. Associate Professor, Laboratory of Multimaterials and Interfaces, UMR CNRS 5615, Lyon 1 University; Faculty of Odontology, Department of Restorative Dentistry, Lyon Civil Hospices, Lyon, France. Electronic address: alexis.goujat@univ-lyon1.fr. 2. Associate Professor, Laboratory of Multimaterials and Interfaces, UMR CNRS 5615, Lyon 1 University; Faculty of Odontology, Department of Prosthodontics, Lyon Civil Hospices, Lyon, France. 3. Professor, Laboratory of Multimaterials and Interfaces, UMR CNRS 5615, Lyon 1 University, Faculty of Odontology, Department of Restorative Dentistry, Rothschild Hospital, Paris, France. 4. Associate Professor, Laboratory of Multimaterials and Interfaces, UMR CNRS 5615, Lyon 1 University, Faculty of Odontology, Department of Prosthodontics, Lyon Civil Hospices, Lyon, France. 5. Associate Professor, Laboratory of Multimaterials and Interfaces, UMR CNRS 5615, Lyon 1 University, Faculty of Odontology, Department of Restorative Dentistry, Rothschild Hospital, Paris, France. 6. Professor, Laboratory of Multimaterials and Interfaces, UMR CNRS 5615, Lyon 1 University, Faculty of Odontology, Department of Restorative Dentistry, Lyon Civil Hospices, Lyon, France. 7. Professor, Laboratory of Multimaterials and Interfaces, UMR CNRS 5615, Lyon 1 University, Faculty of Odontology, Department of Dental Biomaterials, Lyon Civil Hospices, Lyon, France.
Abstract
STATEMENT OF PROBLEM: Recent polymer-based computer-assisted design and computer-assisted manufacturing (CAD-CAM) materials have been commercialized for inlay restorations, a polymer-infiltrated ceramic-network (PICN) and composite resin nanoceramics. Little independent evidence regarding their mechanical properties exists. Internal adaptation is an important factor for the clinical success and longevity of a restoration, and data concerning this parameter for inlays made with these blocks are scarce. PURPOSE: The purpose of this in vitro study was to evaluate and compare the mechanical properties (flexural strength, flexural modulus, Vickers hardness, fracture toughness) and the internal adaptation of these recent polymer-based blocks with a lithium disilicate glass-ceramic block. MATERIAL AND METHODS: The materials tested in this study were a PICN material (Vita Enamic), 2 composite resin nanoceramics (Lava Ultimate; 3M ESPE and Cerasmart; GCDental Products), and a lithium disilicate glass-ceramic (IPS e.max CAD). Mechanical properties were evaluated according to ISO norm DIS 6872:2013. Bar-shaped specimens (18×3×3 mm) were prepared and submitted to a 3-point bend test using a universal testing machine at a cross-head speed of 0.5 mm/min. In addition, identical cavities were prepared in 60 human mandibular extracted molars (n=15) and optically scanned to receive mesioocclusodistal inlays milled with the 4 materials tested in a CEREC Inlab milling machine. The replica technique and a stereomicroscope (×20) were used to measure the internal fit of the inlays at 9 preselected locations. All data were statistically analyzed using 1-way ANOVA and the post hoc Tukey multiple comparison or Games-Howell test (α=.05). RESULTS: The mean flexural strength of the tested blocks ranged from 148.7 ±9.5 MPa (Vita Enamic) to 216.5 ±28.3 MPa (Cerasmart). The mean flexural modulus ranged from 23.3 ±6.4 GPa (Vita Enamic) to 52.8 ±10.5 GPa (IPS e.max CAD). The mean Vickers hardness ranged from 0.66 ±0.02 GPa (Cerasmart) to 5.98 ±0.69 GPa (IPS e.max CAD). The mean fracture toughness ranged from 1.2 ±0.17 MPa.m1/2 (Cerasmart) to 1.8 ±0.29 MPa.m1/2 (IPS e.max CAD). The values for internal discrepancy ranged from 119 ±55 μm to 234 ±51 μm. The mean internal discrepancy was significantly higher for Lava Ultimate (P<.05) than IPS e.max CAD and Cerasmart but not for Vita Enamic. The factor ''material'' was statistically significant in relation to the mechanical properties evaluated in this study (P<.05). The Pearson correlation was negative between the flexural strength results and the internal discrepancy of the materials tested (R2=0.941; P<.05). CONCLUSIONS: The mechanical properties of the CAD-CAM block materials tested were within the acceptable range for fabrication of single restorations according to the ISO standard for ceramics (ISO 6872:2008). IPS e.max CAD and Cerasmart were observed to have superior flexural strength and better internal fit.
STATEMENT OF PROBLEM: Recent polymer-based computer-assisted design and computer-assisted manufacturing (CAD-CAM) materials have been commercialized for inlay restorations, a polymer-infiltrated ceramic-network (PICN) and composite resin nanoceramics. Little independent evidence regarding their mechanical properties exists. Internal adaptation is an important factor for the clinical success and longevity of a restoration, and data concerning this parameter for inlays made with these blocks are scarce. PURPOSE: The purpose of this in vitro study was to evaluate and compare the mechanical properties (flexural strength, flexural modulus, Vickers hardness, fracture toughness) and the internal adaptation of these recent polymer-based blocks with a lithium disilicate glass-ceramic block. MATERIAL AND METHODS: The materials tested in this study were a PICN material (Vita Enamic), 2 composite resin nanoceramics (Lava Ultimate; 3M ESPE and Cerasmart; GCDental Products), and a lithium disilicate glass-ceramic (IPS e.max CAD). Mechanical properties were evaluated according to ISO norm DIS 6872:2013. Bar-shaped specimens (18×3×3 mm) were prepared and submitted to a 3-point bend test using a universal testing machine at a cross-head speed of 0.5 mm/min. In addition, identical cavities were prepared in 60 human mandibular extracted molars (n=15) and optically scanned to receive mesioocclusodistal inlays milled with the 4 materials tested in a CEREC Inlab milling machine. The replica technique and a stereomicroscope (×20) were used to measure the internal fit of the inlays at 9 preselected locations. All data were statistically analyzed using 1-way ANOVA and the post hoc Tukey multiple comparison or Games-Howell test (α=.05). RESULTS: The mean flexural strength of the tested blocks ranged from 148.7 ±9.5 MPa (Vita Enamic) to 216.5 ±28.3 MPa (Cerasmart). The mean flexural modulus ranged from 23.3 ±6.4 GPa (Vita Enamic) to 52.8 ±10.5 GPa (IPS e.max CAD). The mean Vickers hardness ranged from 0.66 ±0.02 GPa (Cerasmart) to 5.98 ±0.69 GPa (IPS e.max CAD). The mean fracture toughness ranged from 1.2 ±0.17 MPa.m1/2 (Cerasmart) to 1.8 ±0.29 MPa.m1/2 (IPS e.max CAD). The values for internal discrepancy ranged from 119 ±55 μm to 234 ±51 μm. The mean internal discrepancy was significantly higher for Lava Ultimate (P<.05) than IPS e.max CAD and Cerasmart but not for Vita Enamic. The factor ''material'' was statistically significant in relation to the mechanical properties evaluated in this study (P<.05). The Pearson correlation was negative between the flexural strength results and the internal discrepancy of the materials tested (R2=0.941; P<.05). CONCLUSIONS: The mechanical properties of the CAD-CAM block materials tested were within the acceptable range for fabrication of single restorations according to the ISO standard for ceramics (ISO 6872:2008). IPS e.max CAD and Cerasmart were observed to have superior flexural strength and better internal fit.
Authors: Anna Winter; Axel Schurig; Engelke Rasche; Franziska Rösner; Lisa Kanus; Marc Schmitter Journal: J Mater Sci Mater Med Date: 2019-12-23 Impact factor: 3.896
Authors: João P M Tribst; Amanda M O Dal Piva; Alexandre L S Borges; Lilian C Anami; Cornelis J Kleverlaan; Marco A Bottino Journal: Materials (Basel) Date: 2020-04-16 Impact factor: 3.623