Tribst João Paulo Mendes, Etoeharnowo Lilis, Tadros Maril, Feilzer Albert J, Werner Arie, Kleverlaan Cornelis J, Dal Piva Amanda Maria de Oliveira
Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
Biomater Investig Dent. 2023 Nov 16;10(1):2279066. doi: 10.1080/26415275.2023.2279066. eCollection 2023.
This study investigated the impact of luting procedure and restoration thicknesses on the flexural strength of CAD/CAM restorations. Traditional luting agents have been questioned in favor of pre-heated resin composites or flowable composites.
400 disc-shaped restorations (lithium disilicate [IPS e.max CAD] or resin composite [Tetric CAD, Ivoclar]) were cemented onto dentin analog discs using different procedures (n = 20): dual-curing resin cement (Panavia V5), light-curing resin cement (Panavia Veneer LC), pre-heated resin composite (Clearfil™ AP-X) with or without pre-heated restoration, and high-filled flowable composite (Clearfil Majesty™ Flow). The biaxial flexural strength was calculated.
There were significant effects of material, thickness, and luting procedure on flexural strength (p < 0.001). Resin composite specimens exhibited lower flexural strength (90 MPa) compared to lithium disilicate specimens (571 MPa), with thicker restorations (338 MPa) being stronger than thinner ones (323 MPa). Light-curing cement showed the highest strength (408.8 MPa), followed by dual-curing cement (362 MPa), pre-heated cement with pre-heated composite (318 MPa), pre-heated composite (304 MPa), and flowable resin composite (259 MPa). The light-curing cement yielded similar results to the pre-heated resin composite associated or not with the pre-heated crown for the thicker lithium disilicate specimens, whereas for the thinner lithium disilicate specimens all luting procedures performed similarly. Thin resin composite discs showed higher flexural strength when luted with light-curing cement, whereas the luting procedure had less influence for the thicker restorations.
Luting procedures impact the flexural strength of CAD/CAM lithium disilicate and resin composite restorations. Pre-heated resin composite, with or without pre-heated restoration, can replace dual-curing cement. Nevertheless, light-curing cement is superior for resin composite and 1.5 mm lithium disilicate restorations.
本研究调查了粘结程序和修复体厚度对CAD/CAM修复体弯曲强度的影响。传统粘结剂受到质疑，有人支持使用预热树脂复合材料或可流动复合材料。
使用不同程序（n = 20）将400个圆盘形修复体（二硅酸锂[IPS e.max CAD]或树脂复合材料[Tetric CAD，义获嘉]）粘结到牙本质模拟圆盘上：双固化树脂粘结剂（Panavia V5）、光固化树脂粘结剂（Panavia Veneer LC）、有或没有预热修复体的预热树脂复合材料（Clearfil™ AP-X）以及高填充可流动复合材料（Clearfil Majesty™ Flow）。计算双轴弯曲强度。
材料、厚度和粘结程序对弯曲强度有显著影响（p < 0.001）。与二硅酸锂标本（571 MPa）相比，树脂复合材料标本的弯曲强度较低（90 MPa），较厚的修复体（338 MPa）比薄的修复体（323 MPa）更强。光固化粘结剂显示出最高强度（408.8 MPa），其次是双固化粘结剂（362 MPa）、与预热复合材料一起使用的预热粘结剂（318 MPa）、预热复合材料（304 MPa）和可流动树脂复合材料（259 MPa）。对于较厚的二硅酸锂标本，光固化粘结剂产生的结果与有或没有预热牙冠的预热树脂复合材料相似，而对于较薄的二硅酸锂标本，所有粘结程序的表现相似。当用轻固化水泥粘结时，薄树脂复合材料圆盘显示出更高的弯曲强度，而对于较厚的修复体，粘结程序的影响较小。
粘结程序会影响CAD/CAM二硅酸锂和树脂复合材料修复体的弯曲强度。有或没有预热修复体的预热树脂复合材料可以替代双固化粘结剂。然而，光固化粘结剂对于树脂复合材料和1.5毫米二硅酸锂修复体更优越。
