Kessler Andreas, Reichert Thilo, Lindner Stefanie, Liebermann Anja, El Gezawi Moataz, Kaisarly Dalia
Assistant Professor, Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, University of Freiburg, Freiburg, Germany; Assistant Professor, Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany.
Postdoctorate, Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian-University of Munich, Munich, Germany.
J Prosthet Dent. 2024 Sep;132(3):623.e1-623.e7. doi: 10.1016/j.prosdent.2024.04.002. Epub 2024 Jun 8.
Although bonding is important for long-term clinical success, studies on the bonding of additively manufactured ceramics are sparse.
The purpose of this in vitro study was to determine the influence of manufacturing methods, additive (LCM) versus subtractive (CAM). and ceramic materials, zirconia (ZrO) and lithium disilicate (LiSi), on the tensile bond strength (TBS), failure mode, and surface roughness of ceramics.
A total of 240 ceramic specimens (n=60/group; 2×2×10 mm) were prepared. Two additively manufactured (LCM-printed) ceramics, LiSi and ZrO (Lithoz), subtractively manufactured LiSi (IPS e.max CAD), and subtractively manufactured ZrO (KATANA Zirconia HTML PLUS) were evaluated. From each material, 40 specimens were bonded together (n=20 ceramic-ceramic specimens/group), and 20 specimens were bonded to equally sized human dentin specimens (n=20 ceramic-dentin specimens/group). The ZrO specimens were airborne-particle abraded (AlO, 50 µm, 0.1 MPa), and the LiSi specimens were etched with hydrofluoric acid. Then, a universal primer (Monobond Plus) was applied. After the dentin was coated with an etch-and-rinse adhesive (Syntac Classic), the specimens were bonded with luting composite resin (Variolink Esthetic DC), light polymerized for 40 seconds, thermally aged (10 000 cycles between 5 °C and 55 °C), tested for TBS, and statistically analyzed (1- and 3-way ANOVA and Weibull analysis). The ceramic surface was examined with scanning electron microscopy, and surface roughness was measured with digital microscopy before and after surface pretreatment.
TBS varied between 5.88 ±2.22 MPa and 6.34 ±2.26 MPa in the ceramic-dentin groups and 12.40 ±1.56 MPa and 18.82 ±5.92 MPa in the ceramic-ceramic groups. No significant difference was observed regarding the manufacturing method and material for different bonding conditions (P>.05). Additive and subtractive LiSi showed the highest reliability with m=18.27. The ceramic-ceramic specimens failed cohesively in the luting composite resin, whereas the ceramic-dentin specimens failed adhesively.
The manufacturing method and material used had little effect on bond strength values or surface properties. The recently introduced printed materials performed similarly to conventionally milled materials.
尽管粘结对于长期临床成功很重要，但关于增材制造陶瓷粘结的研究却很少。
本体外研究的目的是确定制造方法（增材制造（LCM）与减材制造（CAM））以及陶瓷材料（氧化锆（ZrO）和二硅酸锂（LiSi））对陶瓷拉伸粘结强度（TBS）、失效模式和表面粗糙度的影响。
共制备240个陶瓷试件（每组n = 60；2×2×10毫米）。评估了两种增材制造（LCM打印）陶瓷LiSi和ZrO（Lithoz）、减材制造的LiSi（IPS e.max CAD）以及减材制造的ZrO（KATANA Zirconia HTML PLUS）。从每种材料中，将40个试件粘结在一起（每组n = 20个陶瓷 - 陶瓷试件），20个试件粘结到尺寸相同的人牙本质试件上（每组n = 20个陶瓷 - 牙本质试件）。ZrO试件进行空气颗粒喷砂处理（AlO，50微米，0.1兆帕），LiSi试件用氢氟酸蚀刻。然后，应用通用底漆（Monobond Plus）。在牙本质用酸蚀冲洗粘结剂（Syntac Classic）涂布后，试件用粘结复合树脂（Variolink Esthetic DC）粘结，光固化40秒，进行热老化（在5°C和55°C之间循环10000次），测试TBS并进行统计分析（单因素和三因素方差分析以及威布尔分析）。用扫描电子显微镜检查陶瓷表面，在表面预处理前后用数字显微镜测量表面粗糙度。
在陶瓷 - 牙本质组中，TBS在5.88±2.22兆帕和6.34±2.26兆帕之间变化，在陶瓷 - 陶瓷组中在12.40±1.56兆帕和18.82±5.92兆帕之间变化。对于不同粘结条件下的制造方法和材料，未观察到显著差异（P>0.05）。增材和减材制造的LiSi表现出最高的可靠性，m = 18.27。陶瓷 - 陶瓷试件在粘结复合树脂中发生内聚破坏，而陶瓷 - 牙本质试件发生粘结破坏。
所使用的制造方法和材料对粘结强度值或表面性能影响很小。最近引入的打印材料与传统铣削材料表现相似。
