Fixed Prosthodontics, Department of Conservative Dentistry, Alexandria University, Alexandria, Egypt.
Fixed prosthodontics, Department of Conservative Dentistry, Alexandria University, Alexandria, Egypt.
J Prosthet Dent. 2024 Nov;132(5):984.e1-984.e7. doi: 10.1016/j.prosdent.2024.07.012. Epub 2024 Aug 1.
Occlusal veneers are a conservative method of reestablishing vertical dimensions of occlusion (VDO) for worn teeth. A restorative material used for occlusal veneers should have a smooth surface, adequate wear resistance, and low abrasiveness to the antagonists, as total wear of occlusal veneers and their antagonists determines the stability of the reestablished VDO. Studies on roughness, wear, and abrasiveness of occlusal veneers are scarce.
The purpose of this in vitro study was to assess the surface roughness, wear, and abrasiveness of printed and milled occlusal veneers after thermomechanical aging against natural cusps and restorative materials.
Forty-eight extracted mandibular first molars were prepared for occlusal veneers and scanned with an intraoral scanner. The scans were exported to a computer-aided design program to design the occlusal veneers in 3 groups (n=16) according to the restorative material: group IP: milled lithium disilicate; group EN: milled hybrid ceramic (Vita Enamic), group VA: printed hybrid ceramic (Varseosmile Crown plus). The occlusal veneers in each group were bonded to their corresponding abutments and subjected to 250 000 mechanical cycles and a simultaneous 1000 thermal cycles in a mastication simulator. During thermomechanical aging, half of the specimens of each study group (n=8) were opposed by natural cusps (antagonist C) and the other half by antagonist cusps fabricated from the same restorative material as the occlusal veneers (antagonist R). The wear of the occlusal veneers and their antagonists was assessed with a 3-dimensional processing software program. The surface roughness of the veneers was assessed with a contact profilometer. The results were statistically analyzed with a 2-way ANOVA followed by the post hoc Tukey HSD test (α=.05).
The 2-way ANOVA indicated a significant effect for the material and the antagonist on surface roughness, wear, and abrasiveness (P<.05). When opposed by antagonist C, VA showed significantly higher surface roughness than IP and EN (P<.001). VA had significantly higher surface wear followed by EN and IP (P<.001). IP caused significantly higher wear to antagonist C than EN and VA (P<.001). In addition, IP had significantly higher total wear (combined wear of veneers and their antagonists) followed by VA and EN (P<.001). When opposed by antagonist R, no significant difference was found among the 3 materials for surface roughness (P=.08), material wear (P=.12), opposing wear (P=.11), or total wear (P=.11).
Both material and antagonist had a significant effect on surface roughness and occlusal stability when occlusal veneers were fabricated to restore VDO. VA had significantly more surface roughness and wear than EN and IP when opposed by natural cusps. IP abraded natural cusps significantly more than EN and VA. The 3 tested materials showed similar roughness, wear, and abrasiveness when opposed by the same material.
牙合面贴面是修复磨耗牙齿垂直距离(VDO)的一种保守方法。用于牙合面贴面的修复材料应具有光滑的表面、足够的耐磨性和对颌牙的低磨损性,因为牙合面贴面及其对颌牙的总磨损决定了重建的 VDO 的稳定性。关于牙合面贴面的粗糙度、磨损和耐磨性的研究很少。
本体外研究的目的是评估经过热机械老化后,与天然牙尖和修复材料相比,打印和铣削牙合面贴面的表面粗糙度、磨损和耐磨性。
48 颗下颌第一磨牙被制备成牙合面贴面,并使用口内扫描仪进行扫描。扫描结果被导出到计算机辅助设计程序中,根据修复材料将扫描结果设计成 3 组(每组 16 个):组 IP:铣削硅酸锂;组 EN:铣削混合陶瓷(Vita Enamic);组 VA:打印混合陶瓷(Varseosmile Crown plus)。每组的牙合面贴面都粘结到相应的基牙上,并在咀嚼模拟器中进行 250000 次机械循环和 1000 次热循环。在热机械老化过程中,每组的一半试件(每组 8 个)与天然牙尖(对颌牙 C)对抗,另一半试件与与牙合面贴面相同的修复材料制成的对颌牙尖(对颌牙 R)对抗。使用三维处理软件程序评估牙合面贴面及其对颌牙的磨损情况。使用接触式轮廓仪评估贴面的表面粗糙度。结果采用双因素方差分析,然后采用事后 Tukey HSD 检验(α=.05)进行统计学分析。
双因素方差分析表明,材料和对颌牙对抗颌稳定性、表面粗糙度、磨损和耐磨性有显著影响(P<.05)。当与对颌牙 C 对抗时,VA 的表面粗糙度显著高于 IP 和 EN(P<.001)。VA 的表面磨损量显著高于 EN 和 IP(P<.001)。IP 引起的对颌牙 C 的磨损量显著高于 EN 和 VA(P<.001)。此外,IP 的总磨损量(贴面及其对颌牙的总磨损量)显著高于 VA 和 EN(P<.001)。当与对颌牙 R 对抗时,3 种材料之间的表面粗糙度(P=.08)、材料磨损(P=.12)、对颌牙磨损(P=.11)或总磨损(P=.11)均无显著差异。
在修复 VDO 时,牙合面贴面的材料和对颌牙对抗颌稳定性和表面粗糙度均有显著影响。VA 与天然牙尖对抗时的表面粗糙度和磨损量显著高于 EN 和 IP。IP 对天然牙尖的磨损量显著高于 EN 和 VA。当与相同材料对抗时,3 种测试材料的粗糙度、磨损和耐磨性相似。