Skalskyi Valentyn, Makeev Valentyn, Stankevych Olena, Pavlychko Roman
Department of Acoustic Methods of Technical Diagnostics, Karpenko Physico-Mechanical Institute of National Academy of Sciences of Ukraine, 5 Naukova Str., Lviv 79060, Ukraine(1).
Department of Prosthetic Dentistry, Danylo Halytsky Lviv National Medical University, 69 Pekarska Str., Lviv 79010, Ukraine(2).
Dent Mater. 2018 Mar;34(3):e46-e55. doi: 10.1016/j.dental.2018.01.023.
The study aims at comparing the fracture resistance of different restorative materials used in dental endocrown restorations and respective endocrown restorations under a quasi-static compressive load using acoustic emission (AE) method.
Five restorative materials were used in this study. The restorative materials were manufactured into discs 13mm in diameter and 5mm thick, which were then divided into 5 groups and included into Type 1: Group B: zirconium dioxide (Prettau zirconia); Group C: ceramics (IPS e.max Press); Group D: metal ceramics (GC Initial MC+Nicrallium N2 BCS); Group E: composite resin (Nano Q); Group F: luting cement (RelyX™ U200). Twenty-five extracted human molars were divided into 5 groups and included into Type 2: Group A: control, no restoration; Group BE: restored by zirconium dioxide endocrowns; Group CE: restored by ceramic endocrowns; Group DE: restored by metal ceramic endocrowns; Group EE: restored by composite resin endocrowns. An increasing load was applied to the center of the samples with a hard steel ball until a fracture occurred. The loading rate was 0.12mm/min. An AE system was used to monitor the fracture of the samples. The load corresponding to the first AE event and the final fracture load were used to evaluate the fracture resistance of the restored teeth. The data were analyzed using ANOVA and Tukey's post hot test (α=0.05).
A lower threshold of 220μV was selected to exclude spurious background signals. For the initial fracture load of Type 1 samples, Group F (0.029kN)<Group E (0.039kN)<Group D (0.056kN)<Group C (0.253kN)<Group B (intact). The same trend was found for the final fracture load, i.e., Group F (1.289kN)<Group E (1.735kN)<Group D (3.362kN)<Group C (6.449kN)<Group B (intact). For the initial and final fracture load, statistically significant differences (p<0.05) were found between group C and the others groups. For the initial fracture load of Type 2 samples, Group EE (0.069kN)<Group DE (0.072kN)<Group CE (0.148kN)<Group BE (2.511kN). For the final fracture load, Group EE (1.533kN)<Group CE (2.726kN)<Group BE (3.082 kN)<Group DE (3.320kN). The initial fracture load of the ceramic samples is somewhat higher than that for the endocrown restorations with the endocrowns made of this material (0.253 and 0.148kN, respectively). At the same time, for the metal ceramic and composite resin samples, the initial fracture loads are somewhat lower than in case of compression of the endocrown restorations with the endocrowns made of these materials (0.056 and 0.072kN; 0.039 and 0.069kN, respectively). The final fracture load of all the samples of the dental materials exceeds the strength of the respective endocrown restorations. The final fracture loads of the endocrown restorations with zirconium dioxide and ceramic endocrowns (3.082 and 2.726kN, respectively) are significantly lower than the final fracture load of the respective endocrown materials (intact and 6.449kN, respectively).
Dental restorations should be made of high-strength materials. Zirconia displayed the highest fracture strength, while composite resin had the lowest fracture strength out of the materials used for the endocrowns. For teeth restored with endocrowns, the use of metal ceramics as endocrown material may lower the risk of failure during clinical use.
本研究旨在采用声发射(AE)方法,比较牙内冠修复中使用的不同修复材料及其各自的牙内冠修复体在准静态压缩载荷下的抗折强度。
本研究使用了五种修复材料。将修复材料制成直径13mm、厚5mm的圆盘,然后分为5组,包括:第1组:B组:二氧化锆(Prettau氧化锆);C组:陶瓷(IPS e.max Press);D组:金属陶瓷(GC Initial MC+Nicrallium N2 BCS);E组:复合树脂(Nano Q);F组:粘结剂(RelyX™ U200)。将25颗拔除的人磨牙分为5组,包括:第2组:A组:对照组,未修复;BE组:用二氧化锆牙内冠修复;CE组:用陶瓷牙内冠修复;DE组:用金属陶瓷牙内冠修复;EE组:用复合树脂牙内冠修复。用一个硬钢球向样品中心施加逐渐增加的载荷,直至发生断裂。加载速率为0.12mm/min。使用AE系统监测样品的断裂情况。将对应于第一个AE事件的载荷和最终断裂载荷用于评估修复后牙齿的抗折强度。数据采用方差分析和Tukey事后检验(α=0.05)进行分析。
选择较低的阈值220μV以排除虚假背景信号。对于第1组样品的初始断裂载荷,F组(0.029kN)<E组(0.039kN)<D组(0.056kN)<C组(0.253kN)<B组(完整)。最终断裂载荷也呈现相同趋势,即F组(1.289kN)<E组(1.735kN)<D组(3.362kN)<C组(6.449kN)<B组(完整)。对于初始和最终断裂载荷,C组与其他组之间存在统计学显著差异(p<0.05)。对于第2组样品的初始断裂载荷,EE组(0.069kN)<DE组(0.072kN)<CE组(0.148kN)<BE组(2.511kN)。对于最终断裂载荷,EE组(1.533kN)<CE组(2.726kN)<BE组(3.082kN)<DE组(3.320kN)。陶瓷样品的初始断裂载荷略高于用该材料制成的牙内冠修复体的初始断裂载荷(分别为0.253kN和0.148kN)。同时,对于金属陶瓷和复合树脂样品,其初始断裂载荷略低于用这些材料制成的牙内冠修复体压缩时的初始断裂载荷(分别为0.056kN和0.072kN;0.039kN和0.069kN)。所有牙科材料样品的最终断裂载荷均超过各自牙内冠修复体的强度。二氧化锆和陶瓷牙内冠修复体的最终断裂载荷(分别为3.082kN和2.726kN)显著低于各自牙内冠材料的最终断裂载荷(分别为完整和6.449kN)。
牙科修复体应采用高强度材料制作。在所用于牙内冠的材料中,氧化锆显示出最高的断裂强度,而复合树脂的断裂强度最低。对于用牙内冠修复的牙齿,使用金属陶瓷作为牙内冠材料可能会降低临床使用过程中失败的风险。