Search Results (32)

This in vitro investigation evaluated the marginal fit of three pressable glass-ceramic onlay materials: a conventional monolithic lithium disilicate (IPS e.max Press, EM, ivoclar vivadent AG, Schaan, Liechtenstein) and two zirconia-reinforced glass-ceramics (Vita Ambria, VA, VITA Zahnfabrik, Bad Säckingen, Germany; Celtra Press, CP, Sirona Dentsply, Milford, CT, USA). A typodont maxillary first premolar was prepared for an intensive onlay design by a single operator using a milling surveyor. The master die was duplicated with silicone impressions to create 72 identical epoxy resin dies. Seventy-two onlays (n = 24 per material) were fabricated and adhesively cemented to their respective dies. Vertical marginal gaps were recorded under a stereo-electron microscope before and after thermomechanical loading (TML) in a chewing simulator. Data were analyzed with one-way ANOVA and Tukey’s post hoc tests for intergroup comparisons and paired t-tests for pre- versus post-TML values. All groups showed a significant increase in marginal gap following TML. VA exhibited mean gaps of 46.41 µm before and 57.28 µm after loading (p = 0.001). EM demonstrated 41.16 µm before and 46.63 µm after TML (p = 0.002). CP showed 45.70 µm before and 55.99 µm after TML (p = 0.003). Among the three materials, EM maintained the most accurate marginal adaptation both before and after simulated chewing. Despite the increases, all post-loading values remained within the clinically acceptable threshold for marginal discrepancy. These findings indicated that thermomechanical fatigue adversely affected the marginal integrity of pressable glass-ceramic onlays, including zirconia-reinforced formulations. Nevertheless, zirconia-reinforced ceramics (VA and CP) achieved marginal gaps comparable to conventional lithium disilicate and remained within acceptable clinical limits. IPS e.max Press provided the best overall fit, suggesting it may offer superior long-term marginal stability for onlay restorations. Full article

Background: The multifactorial nature of CrossFit performance remains incompletely understood, particularly regarding sex- and experience-related physiological and biomechanical factors. Methods: Fifteen trained athletes (8 males, 7 females) completed assessments of anthropometry, estimated one-repetition maximums (bench press, back squat, deadlift), squat jump (SJ), maximal oxygen uptake (VO₂max), ventilatory responses ($\dot{\mathrm{V}}$E), and heart rate (HR). Spearman, Pearson, and partial correlations were calculated with Holm and false discovery rate (FDR) corrections. Results: Males displayed greater body mass, lean and muscle mass, maximal strength, and aerobic capacity than females (all Holm-adjusted p < 0.01). Experienced athletes completed Fran faster than beginners despite broadly similar anthropometric and aerobic profiles. In the pooled sample, WOD time showed moderate negative relationships with estimated 1RM back squat (ρ = −0.54), deadlift (ρ = −0.56), and bench press (ρ = −0.65) before correction; none remained significant after Holm/FDR adjustment, and partial correlations controlling for training years were further attenuated. Conclusions: This exploratory study provides preliminary evidence suggesting that maximal strength may contribute to Fran performance, whereas conventional aerobic measures were less influential. However, given the very small sample (n = 15, 8 males and 7 females) and the fact that no relationships remained statistically significant after correction for multiple testing, the results must be regarded as preliminary, hypothesis-generating evidence only, requiring confirmation in larger and adequately powered studies. Full article

An in vitro study evaluated the fracture resistance of four CAD/CAM restorative materials: lithium disilicate ceramic (IPS e.max CAD, EM), hybrid ceramic (Vita Enamic, VE), a polymer-based composite (Cerasmart, CS), and a novel 3D-printed resin (Ceramic Crown, CC) fabricated using digital press stereolithography (DPS) technology. Standardized full-coverage crowns were designed and manufactured for each material. All specimens underwent thermocycling and fracture testing using a universal testing machine. EM exhibited the highest fracture resistance (mean: 440.49 N), while VE showed the lowest (173.82 N). CS (265.49 N) and CC (306.76 N) presented intermediate values without statistically significant differences between them. Stereomicroscopic analysis revealed differences in fracture patterns, with IPS e.max CAD showing smooth, brittle fractures, while hybrid and polymer-based materials exhibited tortuous fracture surfaces. These results suggest that DPS technology achieves mechanical performance for Ceramic Crown comparable to that of milled polymer-based composites, while offering production advantages in terms of time efficiency. As one of the first studies to evaluate Ceramic Crown and DPS technology, these findings provide initial insights into their mechanical behavior. However, further studies are required to validate their clinical performance before widespread use can be recommended. Full article

Objective: Understanding unique ways that strength and power contribute to on-field performance in collegiate-based American football might aid coaches in recruiting and determining starters. Using retrospective analysis of existing data, including starting status (STR) and number of defensive tackles or contributing plays (CP), we sought a viable strategy to observe on-field play. Our purpose was to determine what role baseline and in-season strength, and power metrics contributed to on-field football performance (e.g., using STR and CP) from one Football Championship Subdivision (FCS) university. We hypothesized greater pre-season (baseline) and in-season (repeated variables) strength and power outcomes would lead to an increased number of STR among players (n = 53) as well as CP among defensive players (n = 30). Method: Power, determined through countermovement jump (CMJ) was observed weekly using a VALD Performance force deck (i.e., jump height) over a 9-week, in-season period (excluding weeks 6 and 8, a bye week, and erroneous data, respectively). Baseline measures of strength and power were also collected at the beginning of the season for each player using four specific measurements, namely the following: (a) peak vertical jump; (b) pull-ups to failure; (c) a one rep max for bench press; (d) power clean. Pearson’s correlation was used to correlate baseline measures and weekly power, along with baseline measures and the total number of STR and CP each week. Additionally, linear regressions were used to examine the effects of baseline measures (vertical jump, bench press) on STR and CP. Results: Moderate correlations (r > 0.5) were observed between baseline variables and weekly CMJ measures. Baseline measures of power clean were correlated with CP only in week 4. All other analyses were not significant. Conclusions: Since our on-field performance variables were not significant, future research should focus on more potent variables, as reported in the literature, such as football IQ, initial recruiting status, and psychological resilience, in addition to accounting for strength and power metrics. Full article

Background/Objectives: Fabrication of ceramic restorations with higher performance, biocompatibility, and mechanical durability, as well as excellent optical properties, is challenging. Therefore, this study was designed to investigate the mechanical properties and surface roughness of different glass ceramics manufactured with CAD/CAM and pressed techniques before and after exposure to simulated gastric acidic challenge. Methods: Lithium disilicate-based (LDS) ceramic, advanced lithium disilicate (ALDS), and zirconia-reinforced lithium silicate (ZLSC), were manufactured with two techniques. Disc-shaped (N = 336) specimens were used to test the biaxial flexural strength (BFS), while surface microhardness and surface roughness were evaluated before and after exposure to hydrochloric acid (34–37% concentration and 1.2 pH for 24 h). The results were statistically evaluated using two- and one-way ANOVA, Tukey’s post-hoc and Student’s t-test. Results: Both CAD and pressed types of LDS ceramic IPS e.max, showed significantly highest BFS and microhardness before and after acidic challenge (p = 0.01 and <0.01, respectively). ALDS and ZLSC showed significantly lower roughness before acidic aging, while all groups showed no significant difference after aging. Conclusion: Pressed groups showed better mechanical performance than CAD groups. LSD (IPS e.max types) continuously showed a better mechanical performance than modified LDS. ALDS and ZLSC showed the best performance in terms of surface smoothness, but after acidic exposure, no significant difference was observed compared to the other groups. Full article

(1) The aim of this in vitro study was to investigate the handling of proximal-cervical undermined enamel margins on the adhesive performance of differently fabricated and differently cemented ceramic inlays and partial crowns (2) Methods: 192 extracted third molars received MOD (n = 96) and partial crown (n = 96) preparations. A mesial 2 × 2 × 4 mm cervical groove was created in dentin to simulate a deeper (dentin) caries excavation. This dentin groove was either left (G/groove), filled with composite (F/filling), or completely removed (D/dentin). Distal proximal boxes did not receive a groove and served as controls within the same tooth. Labside (e.max Press) restorations additionally went through a temporary phase. Labside and chairside (e.max CAD) inlays and partial crowns were then adhesively luted with Syntac/Variolink Esthetic (SV) or Adhese Universal/Variolink Esthetic (AV). Initially, and again after thermomechanical loading (TML: 1 million cycles at 50 N, 25,000 thermocycles at 5 °C/55 °C), specimens were molded and the resulting 24 groups of epoxy replicas (n = 8) were gold-sputtered and examined for marginal gaps using scanning electron microscopy (200× magnification). Light microscopy (10× magnification) was used to measure proximal cervical crack propagation in adjacent enamel. (3) Results: Regardless of the adhesive system, D groups generally showed significantly lower marginal quality (79–88%; p < 0.05), with the universal adhesive performing better than the multi-step adhesive system (p < 0.05). Subgroups G and F were similar in marginal quality (94–98%; p > 0.05) and not worse than the controls (p > 0.05) regardless of the adhesive system, but showed less cracking in F than in G (p < 0.05). In general, fewer cracks were observed in chairside CAD/CAM restorations than in laboratory-fabricated restorations (p < 0.05). Partial crowns showed better marginal quality (96–98%) and less cracking than inlays (p < 0.05). (4) Conclusions: If the dentin level is lower than the enamel level in ceramic preparations after caries excavation in the proximal box, the resulting undermined enamel should not be removed. In terms of enamel integrity, partial crowns outperformed inlays. Full article

In contemporary dental practice, clinicians have a variety of materials and options for restoring single teeth compromised by carious or non-carious diseases. According to studies and new concepts in biomimetic restorative dentistry, indirect ceramic restorations will play an increasingly important role in daily practice. We follow up and evaluate clinically three times over a 10-year period on eighty-six indirect restorations (n = 86) of lithium disilicate e.Max Press (Ivoclar, Schaan, Liechtenstein) in 32 patients. Restorations are evaluated in the 2nd, 5th, and 10th years after the fixation. Four of the restorations studied (n = 86) had to be replaced at year 5 follow-up because of fracture (failure rate: 4.65%; Kaplan–Maier). There are no restorations with bulky, cohesive fractures. Lithium disilicate ceramic restorations provide a good treatment alternative for a 5- to 10-year period of observation, and they can be successfully applied in dental practice in 91.73% to 98.84% of cases. Advancements in digital dentistry, including the use of intraoral scanners and CAD/CAM technology, are set to further refine the precision and efficiency of indirect restorations for distal teeth, enabling quicker turnaround times and improved fit. Additionally, ongoing developments in biomaterials promise to enhance the durability and biocompatibility of these restorations, potentially leading to better long-term success rates and patient satisfaction. The goal of this clinical study was to look at how well biomimetic ceramic overlays and onlays made of lithium disilicate held onto teeth with a IV-generation adhesive system for 10 years. The study also looked at how well the edges of the teeth adjusted and how strong the teeth were overall. Full article

(1) Background: Dental glass–ceramics shrink during crystallization, complicating restoration manufacturing. Thermo-pressure molding was introduced to address this, with lithium disilicate crystals providing high strength. Residual tensile stresses can influence the chipping strength of single tooth crowns. (2) Methods: Insync dentine was layered onto three lithia-based disilicate core ceramics (Amber Press, IPS e.max Press) for microtensile bond strength tests. The Vickers test assessed the residual tensile stress and interfacial bonding. Porcelain-veneered posterior ceramic crowns were fabricated and subjected to axial loading, measuring fracture loads (three per group). (3) Results: A chemical bonding layer formed at the interface, which was thicker in the Insync-IPS e.max Press and increased with more firings. The ultimate tensile bond strength was 28.5 MPa for the four-times-fired Insync-Amber Press, similar to the twice-fired Insync-IPS e.max Press. No residual tensile stress was found in the Insync-Amber Press; the Insync-IPS e.max Press showed crack growth within 250 μm of the bonded interface. The average fracture resistance was twice as high for the Insync-Amber Press. (4) Conclusions: The Insync-Amber Press exhibited better thermal harmony with no crack growth, while the IPS e.max Press showed crack growth due to residual tensile stress. Insync-Amber Press posterior ceramic crowns had significantly greater fracture resistance than Insync-IPS e.max Press crowns. Full article

The aim of this study was to investigate the effects of a supplement rich in ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) and antioxidant vitamins on physical performance and body composition following a period of high-intensity functional training (HIFT). Nineteen healthy young adults (nine males, ten females) underwent an 8-week HIFT program (3 days·week⁻¹) where they were randomized 1:1 into either the supplement group (SG)—n = 10, receiving a 20 mL daily dose of a dietary cocktail formula (Neuroaspis™ PLP10) containing a mixture of ω-3 and ω-6 PUFAs (12,150 mg), vitamin A (0.6 mg), vitamin E (22 mg), and γ-tocopherol (760 mg)—or the placebo group (PG)—n = 9, receiving a 20 mL daily dose of virgin olive oil. Body composition, cardiorespiratory fitness, muscle strength, and muscle endurance were assessed before and after the training period. Body mass did not change, but muscle mass increased by 1.7 ± 1.9% or 0.40 ± 0.53 kg in the SG (p = 0.021) and decreased by 1.2 ± 1.6% or 0.28 ± 0.43 kg (p = 0.097) in the PG, compared with baseline. VO₂max, vertical jump, squat 1RM, bench press 1RM, and muscle endurance increased similarly in both groups. The effects of HIFT on physical performance parameters, muscle damage, and inflammation indices were not affected by the supplementation. In conclusion, HIFT combined with high doses of ω-3 and ω-6 PUFAs and antioxidant vitamins resulted in a small but significant increase in muscle mass and fat reduction compared with HIFT alone. Full article

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. Full article

Objective: To determine the effect of grit-blasting before and after sintering on the surface roughness of zirconia and the micro-tensile bond strength of a pressable veneering ceramic to zirconia. Methods: Pre-sintered zirconia blocks (IPS e.max ZirCAD, Ivoclar) were divided into four test groups of three specimens each and a control group (‘CTR’; no surface treatment). Pre-S-30, Pre-S-50, and Pre-S-110 were grit-blasted with 30-µm SiO₂-coated Al₂O₃, 50-µm Al₂O₃ and 110-µm Al₂O₃ particles, respectively, before sintering. Post-S-30 was grit-blasted with 30-µm SiO₂-coated Al₂O₃ after sintering. For each treatment, the surface roughness was measured (Ra, Perthometer M4P, Mahr Perthen). After sintering the zirconia blocks, a liner was applied and a pressable ceramic (IPS e.max ZirPress, Ivoclar) was heat-pressed. Sixteen microbars were obtained from each block and submitted to micro-tensile bond-strength (µTBS) testing. Data were analyzed with one-way ANOVA. Any correlation between Ra and µTBS was evaluated (Sperman test). Results: Grit-blasting before sintering with 110-µm Al₂O₃ (Ra_Pre-S-110 = 3.4 ± 0.4 µm), 50-µm Al₂O₃ (Ra_Pre-S-50 = 2.3 ± 0.5 µm), and 30-µm SiO₂-coated Al₂O₃ (Ra_Pre-S-30 = 1.2 ± 0.2 µm) resulted in significantly higher roughness than grit-blasting after sintering with 30-µm SiO₂-coated Al₂O₃ (Ra_Post-S-30 = 0.5 ± 0.1 µm). The highest µTBS was measured when the sintered zirconia was grit-blasted with 30-μm SiO₂-coated Al₂O₃ (µTBS_Post-S-30 = 28.5 ± 12.6 MPa), which was significantly different from that of specimens that were grit-blasted before sintering (µTBS_Pre-S-30 = 21.8 ± 10.4; µTBS_Pre-S-50 = 24.1 ± 12.6; µTBS_Pre-S-110 = 26.4 ± 14.1) or were not grit-blasted (µTBS_CTR = 20.2 ± 11.2). Conclusions: Grit-blasting zirconia before sintering enhanced the surface roughness proportionally to the particle size of the sand used. Grit-blasting with 30-µm SiO₂-coated Al₂O₃ after sintering improved bonding of the veneering ceramic to zirconia. Clinical Significance: As grit-blasting with 30-µm SiO₂-coated Al₂O₃ after sintering improved bonding of the veneering ceramic to zirconia, it may reduce veneering ceramic fractures/chipping. Full article

Dental crown marginal adaptation is a matter of the success of dental restoration treatment. Nowadays, there are many technological ways for crown manufacturing, such as tridimensional printing of an exactly desired shape through CAD-assisted systems and the appropriate shape milling of a predesigned bulk crown. Both methods are developed for patient benefits. The current research aims to investigate the marginal adaptation of E-Max crowns manufactured by printing-pressed and milling methods. The in vitro cementation procedures were effectuated on healthy teeth extracted for orthodontic purposes according to the standard procedures and the marginal adaptation was investigated with SEM microscopy. The restoration overview was inspected at a magnification of 100× and the microstructural details at 400×. The integrity of marginal adaptation was properly inspected in identical samples on segments of 2 mm from each buccal, palatal, distal and mesial side. The obtained results reveal a good marginal adaptation for all samples, with some particularities. The statistical analysis shows that the best values of the marginal adaptation were obtained for vestibular/buccal and palatal sides of the teeth being situated around 90–95%, while the values obtained for distal and mesial sides are slightly lower such as 80–90%. Furthermore, it was observed that the milled crowns presents better marginal adaptations than the printed-pressed ones, sustained by the statistical p < 0.05. This indicates that the milling process allows a better fit of the crown to the tooth surface and preserves the integrity of the bonding cement layer. Full article

It is unclear how zirconia dental crowns with different yttria compositions will perform clinically, and how they will compare with crowns made of glass-ceramics and polymers. The present objective was to determine failure loads of crowns and discs made of glass ceramics or polymers as compared to yttria-partially stabilized zirconia (Y-PSZ) crowns and discs with varying yttria concentrations. Crowns of zirconia (Cercon XT, Katana UTML, BruxZir Anterior), glass ceramic (Celtra press, IPS e.max press, Lisi press), and polymeric materials (Trilor, Juvora, Pekkton) were fabricated and cemented to epoxy abutments. The total number of specimens was 135 for crowns and 135 for discs (n = 15 specimens per material type and design). A universal testing machine was used to perform compressive loading of crowns/discs to failure with a steel piston along the longitudinal axis of the abutments. Energy dispersive spectroscopy (EDS) was used to identify the yttria concentration for each zirconia brand. The data were analyzed using generalized linear models and regression analyses. The results revealed significant differences (p < 0.05) in mean failure loads for different crown materials: Trilor (6811 ± 960 N) > Juvora (5215 ± 151 N) > Cercon (4260 ± 520 N) = BruxZir (4186 ± 269 N) = e.max (3981 ± 384 N) > Katana (3195 ± 350 N) = Lisi (3173 ± 234 N) = Pekkton (3105 ± 398 N) > Celtra (2696 ± 393 N). The general linear model revealed significant differences (p < 0.05) in mean failure loads when comparing the different materials for the discs, i.e., Trilor (5456 ± 1748 N) > Juvora (4274 ± 869 N) > Pekkton (3771 ± 294 N) > Katana (2859 ± 527 N) > Cercon (2319 ± 342 N) = BuxZir (2250 ± 515 N) = e.max (2303 ± 721 N) = Lisi (2333 ± 535 N) > Celtra (1965 ± 659 N). EDS showed that the zirconia materials contained yttria at different concentrations (BruxZir = 5Y-PSZ, Cercon = 4Y-PSZ, Katana = 3Y-PSZ). The yttria concentration had a significant effect on the failure load of the Katana (3Y-PSZ) crowns, which revealed lower failure loads than the Cercon (4Y-PSZ) and BruxZir (5Y-PSZ) crowns, whose failure loads were comparable or higher than e.max glass ceramic. The failure load of the trilayer disc specimens did not correlate with the failure load of the respective crown specimens for the zirconia, glass-ceramic and polymeric materials. Full article

The aim of this study was to investigate the effect of repeated pressing of lithium disilicate ceramic on the shear bond strength (SBS) of three types of resin cement. Methodology: A lithium disilicate ceramic (IPS e.max^® Press) was first heat-pressed to form rectangular disk specimens. Then, leftovers were used for the second and third presses. A total of 90 specimens were prepared and separated, according to the number of pressing cycles, into three groups: 1st, 2nd, and 3rd presses (n = 30). Each group was further subdivided into three groups (n = 10) according to the type of resin cement used, as follows: Multilink N (MN), Variolink Esthetic DC (VDC), and Variolink Esthetic LC (VLC). All the cement was bonded to the ceramic surface, which was etched with hydrofluoric acid and primed with Monobond Plus. All samples were light-cured and stored for 24 h. Shear bond strength was tested on a universal testing machine. Results: A two-way ANOVA was used to evaluate the influence of repeated pressing cycles and cement type as well as their interaction. The results indicated that cement type has a significant impact (p < 0.001) but not the number of pressing cycles (p = 0.970) or their interaction (p = 0.836). The Bonferroni post-hoc test showed that the SBS of MN was significantly higher than that of VDC and VLC in the first press and second press cycles, respectively. The SBS of MN was significantly higher than that of VDC and VLC cements in the third pressing cycle. There was no significant difference in the SBS between VLC and VDC in all three pressing cycles. Conclusion: The results of the current study did not report a detrimental effect of repeated pressing up to three cycles on the shear bond strength of the IPS e.max^® Press. Multilink resin cement showed the highest SBS to IPS e.max^® Press at the third pressing cycle. For all types of cement and heat pressing cycles, the majority of cement failures were adhesive. No cohesive failures occurred in any of the tested resin cements, regardless of the cement type or the number of heat pressing cycles tested. Full article

Pathological tooth wear is an escalating social problem. Occlusal veneers can be an alternative to traditional prosthetic restorations such as crowns, inlays, and onlays. Background: The aim of this study is to assess the fracture resistance of occlusal veneers made of various materials depending on their thickness. Methods: In total, 120 occlusal veneers were examined. The restorations were made of four ceramics: leucite LC (IPS Empress Esthetic), hybrid HC (Vita Enamic), lithium disilicate LDC (IPS e.max Press), and zirconium oxide ZOC (Ceramill Zolid HT). A total of 30 veneers were made of each material, 10 for each of the three thicknesses: 1 mm, 1.5 mm, 2 mm. The restorations were cemented on identical abutments duplicated from the developed phantom tooth 35 (KaVo) with composite cement (All Bond Universal). The samples prepared in this way were subjected to a compressive strength test in a universal testing machine. Statistical analysis of the results was performed. Results: The average fracture resistance of occlusal veneers made of zirconium oxide ceramic was 1086–1640 N, of lithium disilicate ceramics 456–1044 N, of hybrid ceramics 449–576 N, and of leucite ceramics 257–499 N. Conclusions: Occlusal veneers made of ceramics, zirconium oxide and lithium disilicate, had the highest resistance to fractures. Restorations made of leucite ceramics turned out to be the least resistant to forces. The greater the thickness of the ceramic occlusal veneers, the greater their fracture resistance. Full article