This study evaluates the repair bond strength of resin-matrix and glass-matrix CAD/CAM ceramic materials based on two repair systems. Thirty specimens measuring 2.5 mm in thickness were prepared from Crystal Ultra (CU), Vita Enamic (EN), Lava Ultimate (LU), Cerasmart (CS), and Vitablocs Mark II (VM2) materials and aged for 5000 thermal cycles. Specimens were randomly allocated into three groups: control, Monobond-S (MS) primer, and Monobond Etch & Prime (MEP). Composite resin (Tetric N Ceram) (5 mm in diameter and 2 mm thick) was packed and light-cured onto treated specimen surfaces. Subsequently, the specimens’ shear bond strength (SBS) was evaluated, and failure modes was recorded. Statistical analysis was performed using factorial ANOVA and Tukey’s post hoc tests (a = 0.05). The factorial ANOVA revealed significant interactions between the material type and repair system, which was significant (p < 0.01). The highest and lowest SBS were obtained for CU (27.09 ± 1.11) and VM2 (4.30 ± 0.59) in MS and control groups, respectively. In all the groups, CU demonstrated higher SBS, whereas VM2 demonstrated lower SBS. There were no significant differences in SBS between EN and LU, and CS and CU in all the study groups (p > 0.05). The Monobond-S repair system provided non-significantly higher SBS compared to the MEP systems, except for VM2 and LU materials. The new resin-matrix CAD/CAM material demonstrated the highest SBS compared to the other materials for both conventional and MEP repair systems. Both repair systems showed clinically acceptable bond strength and allowed for successful repair of the resin-matrix ceramic materials.

In recent years, laminate veneer restorations should be considered as a minimally invasive treatment option for several aesthetic reasons. This study compared direct composite veneers’ and indirect ceramic laminate veneers’ longevity in multiple diastema closures. A total of 28 patients with a mean age of 26 years received 60 direct resin composite (Estelite Asteria; n = 14) and 60 indirect ceramic veneers (IPS e.max Press; n = 14) on the maxillary anterior teeth with diastema closure. Veneers were evaluated at baseline and thereafter every 6 months for up to 2 years using USPHS criteria. Data were analyzed with Fisher’s exact and chi-squared tests, while Kaplan–Meier curve was used to assess time to event. In total, three failures were observed in the form of debonding (n = 1) and fracture (n = 2) in the indirect ceramic veneers. No significant difference was observed between the survival rates of composite and ceramic veneers (Estelite Asteria: 93.4%, IPS e.max Press: 95%; p > 0.05). The overall survival rate was 94.2% (Kaplan–Meier). Staining (n = 11) and roughness (n = 14) were frequently observed for the resin composite veneers up to the final recall. Thereby, the preliminary results from this clinical trial comparing two veneer materials indicated that their survival rates were statistically similar. However, surface quality changes were more frequent in the composite veneer material.

This study assessed the shear bond strength (SBS) and failure modes of lithium disilicate ceramic veneering material to different high-performance polymers. Thirty-six square specimens measuring 7 × 7 × 2 ± 0.05 mm were prepared from pure polyetheretherketone (PEEK), Bio-high performance PEEK (BioHPP) and Trilor discs. Polymer specimens were air-borne abraded utilizing aluminum oxide particles, cleaned, and a bonding agent was applied (visio. link). The veneering LDC material (3 × 2 mm) was milled, hydrofluoric acid etched (9.5%) and primed (Clearfil ceramic). The LDC was bonded to the polymer specimens using dual-cured resin cement (Panavia V5) and light polymerized. The bonded specimens were subjected to 5000 cycles of physiological aging by thermocycling, and the SBS test was performed in a universal testing machine at 0.5 mm/min cross-head speed. The debonded specimens were analyzed to determine the primary bond failure sites (adhesive, mixed or cohesive). Data analysis was performed using one-way ANOVA and a post hoc Tukey test (α ≤ 0.05). The BioHPP material demonstrated the highest SBS values (23.94 ± 1.43 MPa), and the Trilor group recorded the lowest SBS values (17.09 ± 1.07 MPa). The PEEK group showed a mean SBS of 21.21 ± 1.51 MPa. The SBS comparison showed significant variations across all material groups (p < 0.001). Regarding failure modes, adhesive failure was observed in 40% of BioHPP and PEEK specimens and 90% of Trilor specimens. The cohesive failure occurred in 50% of PEEK and 30% of BioHPP specimens, while the Trilor specimens showed no cohesive failure. Mixed failures were reported in 30% of BioHPP and 10% of PEEK and Trilor specimens. The BioHPP material demonstrated high SBS followed by PEEK and Trilor. The SBS between the tested materials was statistically significant. However, the SBS of the tested implant framework materials was above the limit stipulated by the ISO 10477 standard (5 MPa) and the clinically acceptable range of 10–12 MPa.

Background and objectives: Even with the demand for high esthetics, the strength of the material for esthetic applications continues to be important. In this study, monolith zirconia (MZi) crowns fabricated using CAD/CAM were tested for fracture resistance (FR) in teeth with class II cavity designs with varying proximal depths, restored through a deep marginal elevation technique (DME). Materials and Methods: Forty premolars were randomly divided into four groups of ten teeth. In Group A, tooth preparation was conducted and MZi crowns were fabricated. In Group B, mesio-occluso-distal (MOD) cavities were prepared and restored with microhybrid composites before tooth preparation and the fabrication of MZi crowns. In Groups C and D, MOD cavities were prepared, differentiated by the depth of the gingival seat, 2 mm and 4 mm below the cemento-enamel junction (CEJ). Microhybrid composite resin was used for DME on the CEJ and for the restoration of the MOD cavities; beforehand, tooth preparations were conducted and MZi crowns were and cemented using resin cement. The maximum load to fracture (in newtons (N)) and FR (in megapascals (MPa)) were measured using the universal testing machine. Results: The average scores indicate a gradual decrease in the load required to fracture the samples from Groups A to D, with mean values of 3415.61 N, 2494.11 N, 2108.25 N and 1891.95 N, respectively. ANOVA revealed highly significant differences between the groups. Multiple group comparisons using the Tukey HSD post hoc test revealed that Group D had greater DME depths and showed significant differences compared with Group B. Conclusions: FR in teeth decreased when more tooth structure was involved, even with MZi crowns. However, DME up to 2 mm below the CEJ did not negatively influence the FR. Strengthening the DME-treated teeth with MZi crowns could be a reasonable clinical option, as the force required to fracture the samples far exceeded the maximum recorded biting force for posterior teeth.

This study evaluated the effect of acidic environment and tooth brushing on the color stability and translucency of stained 3D-printed ceramic-reinforced composite (CRC) resins for indirect restorations and hybrid prostheses. Twelve specimens were prepared from each 3D-printing resin material: Ceramic Crown (CC), OnX (ONX), and Tough 2 (T2), and one CAD/CAM milling resin, Lava Ultimate (LU). After preparation, all specimens were stained, then immersed in either water or citric acid. Subsequently, the specimens underwent simulated tooth brushing for 3650 cycles. Color stability (ΔE) and translucency parameter (TP) were measured using a spectrophotometer. Data were analyzed using ANOVA, post hoc Tukey tests, and independent Student t-tests (α = 0.05). Material type, immersion medium, and their interaction did not significantly influence the mean ΔE (p > 0.05). The lowest ΔE value was for LU in acid (ΔE = 1.11 ± 0.39), and the highest for T2 in water (ΔE = 2.09 ± 1.47). Except for ONX and LU in acid, all materials had ΔE values above the perceptibility threshold (ΔE = 1.2). The mean TP was significantly affected by material type, immersion medium, and their interaction (p < 0.05). The lowest TP value was for group CC in acid (0.91 ± 0.26); the highest was for group LU in acid (6.24 ± 0.56). After immersion and subsequent tooth brushing, TP values decreased for all materials. Exposure to an acidic environment and tooth brushing did not affect color stability but significantly reduced translucency. Both the 3D-printed CRCs and milled resin material displayed comparable color stability below clinically acceptable thresholds, though the translucency of 3D-printed materials remained lower compared to milled material.

In recent years, CAD/CAM technology has allowed indirect ceramic restorations to become a part of everyday chairside clinical practice. Therefore, the impact of different cavity-preparation designs on the fracture resistance of CAD/CAM fabricated ceramics was assessed in this study. Three designs of cuspal covering (none, palatal, and entire) and two widths of the occlusal isthmus (75% and 100% of the intercuspal distance) were used for the preparation of inlays and onlays to form six groups (n = 10/group). Moreover, thermomechanical cyclic loading was applied to every tooth under a chewing simulator. A universal testing machine was used to measure each group’s fracture resistance. The tested specimens were inspected for any signs of fractures and cracks to categorize failure patterns. Thereby, the values of fracture strength showed that there were statistically nonsignificant differences between the tested groups (p < 0.05). However, a significant difference (p = 0.01) was found between group 1 (inlays) (1950 ± 405) and group 6 (onlays) (3900 ± 770). Type III or type IV fracture modes were seen in the majority of the specimens. In conclusion, inlays and onlays made of zirconia using CAD/CAM technology were deemed reliable for restoring premolars, irrespective of the cavity-preparation design, except for inlays with a 75% intercuspal distance.