In this article, we review the recent history of the development of dental CAD/CAM systems for the fabrication of crowns and fixed partial dentures (FPDs), based on our 20 years of experience in this field. The current status of commercial dental CAD/CAM systems developed around the world is evaluated, with particular focus on the field of ceramic crowns and FPDs. Finally, we discuss the future perspectives applicable to dental CAD/CAM. The use of dental CAD/CAM systems is promising not only in the field of crowns and FPDs but also in other fields of dentistry, even if the contribution is presently limited. CAD/CAM technology will contribute to patients' health and QOL in the aging society.

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A review of dental CAD/CAM: current status and future perspectives from 20 years of experience.

As in many other industries, production stages are increasingly becoming automated in dental technology. As the price of dental laboratory work has become a major factor in treatment planning and therapy, automation could enable more competitive production in high-wage areas like Western Europe and the USA. Advances in computer technology now enable cost-effective production of individual pieces. Dental restorations produced with computer assistance have become more common in recent years. Most dental companies have access to CAD/CAM procedures, either in the dental practice, the dental laboratory or in the form of production centres. The many benefits associated with CAD/CAM generated dental restorations include: the access to new, almost defect-free, industrially prefabricated and controlled materials; an increase in quality and reproducibility and also data storage commensurate with a standardised chain of production; an improvement in precision and planning, as well as an increase in efficiency. As a result of continual developments in computer hardware and software, new methods of production and new treatment concepts are to be expected, which will enable an additional reduction in costs. Dentists, who will be confronted with these techniques in the future, require certain basic knowledge if they are to benefit from these new procedures. This article gives an overview of CAD/CAM-technologies and systems available for dentistry today.

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Digital dentistry: an overview of recent developments for CAD/CAM generated restorations

https://hal.archives-ouvertes.fr/hal-02397593/document

Review of titanium surface modification techniques and coatings for antibacterial applications.

Zirconia is unique in its polymorphic crystalline makeup, reported to be sensitive to manufacturing and handling processes, and there is debate about which processing method is least harmful to the final product. Currently, zirconia restorations are manufactured by either soft or hard-milling processes, with the manufacturer of each claiming advantages over the other. Chipping of the veneering porcelain is reported as a common problem and has been labelled as its main clinical setback. The objective of this systematic review is to report on the clinical success of zirconia-based restorations fabricated by both milling processes, in regard to framework fractures and veneering porcelain chipping. A comprehensive review of the literature was completed for in vivo trials on zirconia restorations in MEDLINE and PubMed between 1950 and 2009. A manual hand search of relevant dental journals was also completed. Seventeen clinical trials involving zirconia-based restorations were found, 13 were conducted on fixed partial dentures, two on single crowns and two on zirconia implant abutments, of which 11 were based on soft-milled zirconia and six on hard-milled zirconia. Chipping of the veneering porcelain was a common occurrence, and framework fracture was only observed in soft-milled zirconia. Based on the limited number of short-term in vivo studies, zirconia appears to be suitable for the fabrication of single crowns, and fixed partial dentures and implant abutments providing strict protocols during the manufacturing and delivery process are adhered to. Further long-term prospective studies are necessary to establish the best manufacturing process for zirconia-based restorations.

Clinical trials in zirconia: a systematic review.

From porcelain-fused-to-metal to zirconia: clinical and experimental considerations.

The biaxial flexural strength and fatigue property of Lava Y-TZP dental ceramic.

Fatigue and fracture properties of yttria partially stabilized zirconia crown systems

Objectives: Yttria partially-stabilized zirconia polycrystalline (Y-TZP) has been the subject of extensive research because of its high strength and toughness. The aim of this study was to evaluate the biaxial flexural strength, fatigue life, and to investigate in more detail on single cycle specimens, the pressure-induced phase transformation of a Y-TZP dental ceramic using Raman microspectroscopy. Materials and Methods: Thirty standardized discs (15 x 1.2 mm(2)) were used to examine the biaxial flexural strength (ISO 6872 standard) using a Dartec HC10 Servohydraulic testing machine (Zwick Ltd., UK). The specimens were also submitted to Vickers hardness (on polished and as-received surfaces within the same specimen) and dynamic fatigue test. The initial bulk phases were examined via X-ray diffraction and the local phase transformations that occurred in the zirconia induced by the various Vickers indentation loads (20-50 kg) were examined via Raman microspectroscopy on single cycle specimens. The fracture surface after biaxial flexural testing was also examined via Raman spectroscopy. Results: The Cercon specimens tested had flexural strength and Weibull modulus (m) of similar to 823.3 (+/- 114.7) MPa and 8.3, respectively. As-received surfaces (1378.7 +/- 51.8 Hv) had slightly higher hardness value compared with polished surfaces (1354.33 +/- 50.9 Hv); however, two-way analysis of variance showed no significant difference in hardness values between polished and as-received surfaces (P > 0.05). Additionally, the specimens survived to 5 x 10(5) cycles when using a load of 70% of the mean biaxial flexural strength or lower. Raman microspectroscopy showed transformation of tetragonal to cubic and monoclinic phases within the indentation area. The fraction of monoclinic phase showed only limited variation with load or distance from the center to indentation edge. The level of cubic phase, however, was greatest at the indentation center. Transformation to cubic phase was observed on the lower surfaces (tension side) of fractured specimens. It was also observed near the specimen center exposed upon fracture. In the latter region an increase in monoclinic phase was additionally observed. Further work will be carried out using Raman microspectroscopy to assess the effect of fatigue on phase transformations. Conclusion: The zirconia based ceramic has mechanical properties that may allow it to withstand the loading found in posterior areas. Transformation toughening was found when high loads impacted on the surface of zirconia. However it should be born in mind that this work was not carried out on veneered specimens, which exhibit different failure modes. (c) 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 88B: 366-377, 2009

Flexural Strength, Fatigue Life, and Stress-Induced Phase Transformation Study of Y-TZP Dental Ceramic

Statement of problem. When designing and cutting a crown preparation, a balance must be achieved between the amount of tooth structure conserved and the space created for the restoration. All-ceramic crowns, which contain a core, are usually veneered with porcelain to produce the desired aesthetics and contour. The effect of veneer porcelain on the strength of the restoration has been a cause of debate. Purpose. The purpose of this study was to investigate the effect of different thickness of veneer porcelain on the compressive load at fracture of Procera AllCeram crowns. Material and Methods. Sixty brass dies were fabricated with a crown-like preparation and a chamfer margin. Sixty crowns were fabricated with a 0.6-mm-thick core: Procera crowns with either a 0.4-mm- or 0.9-mm-thick veneer of AllCeram (Groups 1 and 2 respectively) and In-Ceram crowns with a 0.9-mm-thick veneer of Vitadur Alpha porcelain (Group 3). Each group consisted of 20 crowns. In-Ceram crowns were used as the control group. All crowns were measured at 4 axial and 1 occlusal random locations before autoglazing. They were air abraded and adhesively bonded onto the appropriate brass die using Clearfil Newbond Bonding Agent, Clearfil Porcelain Bond Activator, and Panavia 21 TC Dental Adhesive as the luting agent. After storage in distilled water at 37°C for 24 hours, the specimens were placed in a compressive test rig within an Instron universal testing machine and loaded in the center of the occlusal surface with a 4-mm diameter stainless steel ball. An axial preload of 20 N was applied before compressive testing at a crosshead speed of 0.1 mm/minute until fracture occurred. An analysis of variance revealed no significant difference in the load at fracture between the 3 groups ( P =.3). Using a Bonferroni correction, independent t tests revealed no significant difference in load at fracture for any of the pair-wise comparisons between the 3 test groups ( P Results. The mean load at fracture for Group 1 was 2197.6 N (SD = 776.4); Group 2, 2401.4 N (SD = 699.1); and Group 3, 2581.0 N (SD = 715.6). Conclusion. Within the parameters of this study, the axial thickness of veneer porcelain did not have a significant effect on the compressive load at fracture of Procera AllCeram crowns. (J Prosthet Dent 2003;89:154-60.)

An in vitro study of the compressive load at fracture of Procera AllCeram crowns with varying thickness of veneer porcelain

Purpose: The aim of the study was to assess the influence of interimplant divergence on retention of two Locator attachments before and after in vitro simulation of 3 to 5 years of use. Materials and Methods: A hydraulic universal testing machine was used to measure the retention of two blue Locator attachments during 5500 seating and unseating cycles. Ten pairs of Locators were tested with interimplant divergences of 0°, 10°, and 20°. Scanning electron microscopy (SEM) was used to examine surface changes of the components. The results were tested with ANOVA and Bonferroni post hoc correction when normally distributed. Results that were not normally distributed were tested with Kruskal-Wallis one-way ANOVA by ranks. Results: At the start of the experiment the 10° group showed significantly more retention than the 0° group, but no significant difference was found between the 0° and 20° groups or the 10° and 20° groups. After 5500 cycles, there was no significant difference in retention between any of the groups. The SEM images showed an approximately equal amount of wear in the nylon patrix inserts from all the groups. Conclusions: The retention of Locator pairs was not impaired by interimplant divergence of up to 20°. Retention after 5500 removal cycles was less than the initial retention in all groups. The nylon Locator patrices showed wear defects of similar location, type, and magnitude in the SEM images, regardless of interimplant angulation. © 2014 by the American College of Prosthodontists.

Ailbhe McDonald

Papers

The biaxial flexural strength and fatigue property of Lava Y-TZP dental ceramic.

Fatigue and fracture properties of yttria partially stabilized zirconia crown systems

Flexural Strength, Fatigue Life, and Stress-Induced Phase Transformation Study of Y-TZP Dental Ceramic

An in vitro study of the compressive load at fracture of Procera AllCeram crowns with varying thickness of veneer porcelain

The influence of interimplant divergence on the retention characteristics of locator attachments, a laboratory study.