Current ceramic materials offer preferred optical properties for highly esthetic restorations. The inherent brittleness of some ceramic materials, specific treatment modalities, and certain clinical situations require resin bonding of the completed ceramic restoration to the supporting tooth structures for long-term clinical success. This article presents a literature review on the resin bond to dental ceramics. A PubMed database search was conducted for in vitro studies pertaining to the resin bond to ceramic materials. The search was limited to peer-reviewed articles published in English between 1966 and 2001. Although the resin bond to silica-based ceramics is well researched and documented, few in vitro studies on the resin bond to high-strength ceramic materials were identified. Available data suggest that resin bonding to these materials is less predictable and requires substantially different bonding methods than to silica-based ceramics. Further in vitro studies, as well as controlled clinical trials, are needed.

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Resin-ceramic bonding: a review of the literature.

Statement of problem Developments in ceramic core materials such as lithium disilicate, aluminum oxide, and zirconium oxide have allowed more widespread application of all-ceramic restorations over the past 10 years. With a plethora of ceramic materials and systems currently available for use, an overview of the scientific literature on the efficacy of this treatment therapy is indicated. Purpose This article reviews the current literature covering all-ceramic materials and systems, with respect to survival, material properties, marginal and internal fit, cementation and bonding, and color and esthetics, and provides clinical recommendations for their use. Material and methods A comprehensive review of the literature was completed seeking evidence for the treatment of teeth with all-ceramic restorations. A search of English language peer-reviewed literature was undertaken using MEDLINE and PubMed with a focus on evidence-based research articles published between 1996 and 2006. A hand search of relevant dental journals was also completed. Randomized controlled trials, nonrandomized controlled studies, longitudinal experimental clinical studies, longitudinal prospective studies, and longitudinal retrospective studies were reviewed. The last search was conducted on June 12, 2007. Data supporting the clinical application of all-ceramic materials and systems was sought. Results The literature demonstrates that multiple all-ceramic materials and systems are currently available for clinical use, and there is not a single universal material or system for all clinical situations. The successful application is dependent upon the clinician to match the materials, manufacturing techniques, and cementation or bonding procedures, with the individual clinical situation. Conclusions Within the scope of this systematic review, there is no evidence to support the universal application of a single ceramic material and system for all clinical situations. Additional longitudinal clinical studies are required to advance the development of ceramic materials and systems.

Current ceramic materials and systems with clinical recommendations: A systematic review

Statement of problem. The practice of fixed prosthodontic has changed dramatically with the introduction of innovative techniques and materials. Adhesive resin systems are examples of these changes that have led to the popularity of bonded ceramics and resin-retained fixed partial dentures. Today's dentist has the choice of a water-based luting agent (zinc phosphate, zinc polycarboxylate, glass ionomer, or reinforced zinc oxide-eugenol) or a resin system with or without an adhesive. Recent formulations of glass ionomer luting agents include resin components (resin-modified glass ionomers), which are increasingly popular in clinical practice. Purpose. This review summarizes the research on these systems with the goal of providing information that will help the reader choose the most suitable material. Material. The scientific studies have been evaluated in relation to the following categories: (1) biocompatibility, (2) caries or plaque inhibition, (3) microleakage, (4) strength and other mechanical properties, (5) solubility, (6) water sorption, (7) adhesion, (8) setting stresses, (9) wear resistance, (10) color stability, (11) radiopacity, (12) film thickness or viscosity, and (13) working and setting times. In addition, guidelines on luting-agent manipulation are related to available literature and include: (1) temporary cement removal, (2) smear layer removal, (3) powder/liquid ratio, (4) mixing temperature and speed, (5) seating force and vibration, and (6) moisture control. Tables of available products and their properties are also presented together with current recommendations by the authors with a rationale. (J Prosthet Dent 1998;80:280-301.)

Dental luting agents: A review of the current literature

Direct comparison of the bond strength results of the different test methods: A critical literature review

Background The authors conducted a comprehensive literature review to compile and compare clinical evidence for the treatment of teeth using all-ceramic restorations Types of Studies Reviewed The authors searched the English-language peer-reviewed literature using MEDLINE and PubMed with a focus on research published between 1993 and 2008 They also conducted a hand search of relevant dental journals They reviewed randomized controlled trials, nonrandomized controlled studies, longitudinal experimental clinical studies, longitudinal prospective studies and longitudinal retrospective studies Results Evidence suggests that for veneers, intracoronal restorations and complete-coverage restorations for single-rooted anterior teeth, clinicians may choose from any all-ceramic system on the basis of esthetic needs (many systems have had greater than 90 percent success at six years) Well-studied molar restorations include those made of alumina and, increasingly, zirconia and bonded lithium disilicate Reasonable evidence has shown the effectiveness of anterior three-unit fixed partial dentures made of lithium disilicate, alumina and zirconia For three-unit restorations involving a molar, expert consensus suggests that only zirconia-based systems are indicated Clinical Implications Available evidence indicates the effectiveness of many all-ceramic systems for numerous clinical applications Bonding has been shown to increase clinical success Studies of zirconia prostheses indicate problems with porcelain cracking

https://jada.ada.org/article/S0002-8177(14)63462-0/pdf

The clinical success of all-ceramic restorations.

Purpose: All-ceramic crowns are subject to fracture during function, especially in the posterior area. The use of yttrium-stabilized zirconium-oxide ceramic as a substructure for all-ceramic crowns to improve fracture resistance is unproven. The aim of this study was to compare fracture strength and fatigue resistance of new zirconium-oxide and feldspathic all-ceramic crowns made with computer-aided design/computer-aided manufacturing (CAD/CAM).

Materials and Methods: An ivorine molar was prepared to receive an all-ceramic crown. Using epoxy resin, 40 replication dies were made of the prepared tooth. Twenty feldspathic all-ceramic crowns (Vita Mark II) (VMII) and 20 zirconium-oxide crown copings (In-Ceram YZ) (YZ) were made using CAD/CAM technique (CEREC-3D). The YZ copings were sintered and veneered manually with a fine-particle ceramic (VM9). All crowns were cemented to their respective dies using resin cement (Panavia F 2.0). Ten crowns in each group were subjected to compressive fatigue loading in a universal testing machine (instron). The other ten crowns from each group were loaded to fracture at a crosshead speed of 1 mm/min. Data were statistically analyzed using independent t-test and Fisher's exact test at α= 0.05.

Results: There was a significant difference between the survival rates of the two materials during the fatigue test (p < 0.001). All VMII crowns survived without any crack formation, while all YZ crowns fractured (40%) or developed cracks (60%). All the YZ crown fractures occurred within the veneering layer during the fatigue test. There was no significant difference in mean fracture load between the two materials (p= 0.268). Mean fracture loads (standard deviation) in N were: 1459 (492) for YZ crowns and 1272 (109) for VMII crowns.

Conclusions: The performance of VMII crowns was superior to YZ crowns in the fatigue test. The premature fractures and cracks of the YZ crowns were attributed to weakness in the YZ veneer layer or in the core/veneer bond.

Fracture Strength and Fatigue Resistance of All‐Ceramic Molar Crowns Manufactured with CAD/CAM Technology

This study investigated the degree of hardening achieved through self-curing only and through dual-curing a group of eight new resin-based cements In addition, the effect of ceramic inlay thickness on cement hardness was determined Disk specimens measuring 6 mm in diameter and 25 mm thick were prepared from eight cements: Adherence, Choice, Duolink, Enforce, Lute-It, Nexus, Resinomer, and Variolink Eight specimens were prepared from each material; half were self-cured, while the remainder were dual-cured Knoop hardness measurements were then made at 1-hour, 1-day, and 1-week intervals In addition 12 specimens of the same dimensions were prepared from each cement and were dual-cured through ceramic spacers of varying thickness (1-6 mm) Hardness measurements were made as above ANOVA showed significant differences in hardness of self-cured versus dual-cured specimens for all cements (P < 00001) Significant differences were also found in the hardness of specimens dual-cured through ceramic spacers 2-3 mm in thickness or more compared with those that were dual-cured without spacer It is concluded that for some materials self-curing alone was not adequate to achieve sufficient hardening; cement hardness was significantly reduced when ceramic inlay thickness was 2-3 mm or more

Hardening of new resin cements cured through a ceramic inlay.

Dual-cure inlay resin cements polymerize both chemically and through light activation; however, clinically some aspects of the cement are not readily accessible to the light source. This study investigated the degree of cement hardening achieved through chemical curing only versus dual curing and the effect of inlay thickness on cement hardness. Disks 6×2.5 mm were prepared from seven commercially available cements. Eight specimens were prepared from each material; half of the specimens were cured chemically only, and the remainder were dual-cured. Knoop hardness measurements were then recorded at 1-hour, 1-day, and 1-week intervals. In addition, 24 specimens of the same dimensions were prepared from each cement. Twelve specimens were dual-cured through resin composite spacers of varying thicknesses (1 to 6 mm), and the others were cured through similar ceramic spacers, and hardness measurements were recorded. Multivariate analysis of variance revealed significant differences in hardness of chemically cured versus dual-cured specimens at the 5% level of significance for all examined cements. Significant differences were also found in the hardness of specimens dual cured through ceramic or resin composite spacers 2 to 3 mm in thickness or more versus those that were dual cured without spacer regardless of the spacer material. It is concluded that chemical curing alone was not sufficient to achieve maximum hardening of the examined cements. Cement hardness was significantly reduced when inlay thickness was 2 to 3 mm or more.

Chemical versus dual curing of resin inlay cements.

A literature review of longevity and clinical performance of IPS-Empress restorations is presented A MEDLINE search was conducted in fall 2000 Selection criteria were set so as to identify suitable clinical trials that were published in full and that had lasted more than 2 years A total of 6 clinical trials on the performance of IPS-Empress inlays and onlays and a total of 3 clinical trials on the performance of IPS-Empress crowns were identified Survival rates for IPS-Empress inlays and onlays ranged from 96% at 45 years to 91% at 7 years; most failures were due to bulk fracture IPS-Empress crowns had a survival rate ranging from 92% to 99% at 3 to 35 years; crown failure was also mainly due to fracture Dentists should inform their patients about these survival rates when offering such treatment The use of IPS-Empress crowns in the posterior of the mouth is not recommended until the results of more long-term clinical trials are available

Longevity and clinical performance of IPS-Empress ceramic restorations--a literature review.

Purpose This study investigated the effect of different cements on microleakage and marginal adaptation of porcelain crowns. Materials and Methods Eighty extracted molars were divided into two groups. Teeth in one group were prepared to receive Procera AllCeram crowns, whereas the other group was prepared to receive metal-ceramic crowns. Copings were made following standard techniques, and groups were divided for cementation with zinc phosphate, glass-ionomer, resin-modified glass-ionomer, or resin cement. Specimens were subjected to thermocycling prior to microleakage testing, then sectioned. Microleakage was scored using a five-point scale; marginal adaptation was assessed with a traveling microscope. Results A significant association was found between cement type and degree of microleakage. With zinc phosphate, 76% of Procera AllCeram and 90% of metal-ceramic copings exhibited extensive microleakage. With glass-ionomer, 49% of Procera AllCeram and 66% of metal-ceramic copings had 0 microleakage scores; with resin-modified glass-ionomer, 10% of Procera AllCeram and 84% of metal-ceramic copings had 0 microleakage scores. With resin cement, 34% of Procera AllCeram and 96% of metal-ceramic copings exhibited 0 microleakage. Procera AllCeram copings had a significantly larger mean marginal gap (54 μm) compared to metal ceramic (29 μm). Conclusion In both types of crowns, the use of resin cement resulted in the highest percentage of 0 microleakage scores, whereas the zinc phosphate cement resulted in the highest percentage of extensive microleakage.— Reprinted with permission of Quintessence Publishing.

Omar El-Mowafy

Papers

Fracture Strength and Fatigue Resistance of All‐Ceramic Molar Crowns Manufactured with CAD/CAM Technology

Hardening of new resin cements cured through a ceramic inlay.

Chemical versus dual curing of resin inlay cements.

Longevity and clinical performance of IPS-Empress ceramic restorations--a literature review.

Marginal adaptation and microleakage of Procera AllCeram crowns with four cements