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    Adhesion of veneering composite to metal-free CAD/CAM materials: effect of surface conditioning and adhesive resin type
    (Taylor & Francis Ltd, 2023) Onugoren, Nazik Irem; Demirci, Fatih; Tatar, Numan; Eyuboglu, Tan Firat; Ozcan, Mutlu
    ObjectivesThis study aimed to investigate the adhesion of veneering composite to metal-free computer-aided design/computer-aided manufacturing (CAD/CAM) materials with different compositions after surface conditioning and application of adhesive resins.Materials and MethodsA total of one hundred and sixty specimens were divided into four groups (n = 40) manufactured either from polyetheretherketone (PEEK; KERAstar PEEK), polyetherketoneketone (PEKK; Pekkton), fiber-reinforced composite (FRC; Trinia), or high-impact polymer composite (COMP; Bredent HIPC) CAD/CAM discs. Each group was then randomly subdivided into four different subgroups of adhesive systems (n = 10) as Visiolink (Bredent), Single Bond Universal (3M), G-Premio BOND (GC), and OptiBond Universal (Kerr). The shear bond strength (SBS) of each specimen with veneering composite material was tested with a universal testing machine following thermocycle aging (5000 times). The modes of failure resulting from the tests were determined with scanning electron microscope (SEM), dispersive spectroscopy (EDS), and analytical imaging. The data were statistically analyzed with two-way ANOVA and Bonferroni post hoc tests (alpha = 0.05).ResultsThe highest SBS values among all groups were found for the COMP material (20.28 +/- 2.08 MPa) with OptiBond Universal adhesive, while the lowest for the PEEK material (10.33 +/- 2.47 MPa) with G-Premio BOND. The most common failure mode for the PEEK and PEKK specimens was adhesive failure, for the FRC and COMP groups mixed failures were common.ConclusionsBond strength values of at least 10 MPa were achieved for all tested between metal-free CAD/CAM materials and adhesive resin application.
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    CAD/CAM single-retainer monolithic zirconia ceramic resin-bonded fixed partial dentures bonded with two different resin cements: Up to 40 months clinical results of a randomized-controlled pilot study
    (Wiley, 2022) Bilir, Halenur; Yuzbasioglu, Emir; Sayar, Gulsilay; Kilinc, Delal Dara; Bag, Harika Gozde Gozukara; Ozcan, Mutlu
    Purpose This pilot study was part of a larger study planned for the future which aimed to compare the clinical success of two different resin cements used in the cementation of CAD/CAM single-retainer monolithic zirconia ceramic resin-bonded fixed dentures (RBFPDs). Methods Twenty-four RBFPDs were fabricated with monolithic zirconia (Katana (TM) Zirconia HT, Kuraray Noritake Dental Inc, Tokyo, Japan). Panavia F2.0 (PF2.0; n = 12) and Panavia V5 (PV5; n = 12) were used for cementation. The survival period was defined as the time when the restoration was placed in the mouth and lasted until an irreparable damage occurred. The repairable failures were identified as relative and irreparable failures were identified as absolute failure. The survival rate of the RBFPDs was determined by the Kaplan-Meier estimator. Statistical significance was set at p < 0.05. Results The mean observation times of the PF2.0 group and the PV5 group were 40.45 +/- 6.15 months and 40.18 +/- 6.41 months, respectively. Four failures occurred in the PF2.0 group. No failure was observed in the PV5 group. The curves of survival rate (PF2.0 = 80%, PV5 = 100%) showed no statistically significant difference (p = 0.031), although success rate (PF2.0 = 66.7%, PV5 = 100%) showed statistically significant difference (p = 0.317). Conclusion Up to 40 months mean follow-up period, performance of RBFPDs bonded with PV5 was better than with PF2.0. Clinical Significance For clinicians, it is a matter of hesitation to apply single-retainer RBFPDs. This study contains results of 40 months (minimum 32, maximum 50.47 months) clinical follow-ups of single-retainer RBFPDs. These results will enlighten clinicians about the clinical success of the resin cement type for single-retainer monolithic zirconia ceramic RBFPDs.
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    Cement Thickness of Inlay Restorations Made of Lithium Disilicate, Polymer-Infiltrated Ceramic and Nano-Ceramic CAD/CAM Materials Evaluated Using 3D X-Ray Micro-Computed Tomography
    (Wiley, 2018) Uzgur, Recep; Ercan, Ertugrul; Uzgur, Zeynep; Colak, Hakan; Yalcin, Muhammet; Ozcan, Mutlu
    PurposeTo evaluate the marginal and internal cement thicknesses of inlay restorations made of various CAD/CAM materials using 3D X-ray micro-computed tomography (micro-CT) technique. Materials and MethodsCaries-free extracted mandibular molars (N = 30) with similar size were randomly assigned to three groups (N = 10 per group). Mesio-occlusal-distal (MOD) cavities were prepared, and inlay restorations were obtained by milling out CAD/CAM materials namely, (a) IPS: monolithic lithium disilicate (control), (b) VE: polymer-infiltrated ceramic, and (c) CS: nano-ceramic using a CAM unit. Marginal and internal cement thicknesses were measured using 3D micro-CT. Data were analyzed using 1-way ANOVA and Tukey's tests (alpha = 0.05). ResultsThe mean marginal and internal cement thickness were not significant in all inlay materials (p > 0.05). Mean marginal cement thickness (m) was the lowest for the IPS group (67.54 10.16) followed by VE (84.09 3.94) and CS (95.18 +/- 10.58) (p > 0.05). The internal cement thickness (m) was the lowest in the CS group (54.85 +/- 6.94) followed by IPS (60.58 +/- 9.22) and VE (77.53 +/- 12.13) (p > 0.05). ConclusionMarginal and internal cement thicknesses of MOD inlays made of monolithic lithium disilicate, polymer-infiltrated ceramic, and nano-ceramic CAD/CAM materials were similar and all less than 100 m, which could be considered clinically acceptable. Clinical significanceMOD inlays made of different CAD/CAM materials presented similar cement thickness, less than 100 m.
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    Clinical Performance of Nanofilled and Microhybrid Direct Composite Restorations on Endodontically Treated Teeth
    (Dennis Barber Ltd, 2019) Akalin, Tugba Toz; Bozkurt, Funda Ozturk; Tuncer, Aysun Kara; Bag, Harika Gozukara; Ozcan, Mutlu
    This study evaluated the clinical performance of direct restorations made of nanofilled and microhybrid resin composites in endodontically treated teeth. Twenty patients (11 males, 9 females; mean age: 34.2 +/- 10) that met the inclusion criteria received a total of 48 restorations. After employing etch-and-rinse adhesive system, one dentist placed all restorations using either a nanofilled (Filtek Ultimate) or microhybrid (Filtek Z250) resin composite. The restorations were clinically reviewed at baseline, 6 months, and up to 2 years using the modified United States Public Health Service (USPHS) criteria. The changes were analyzed using the McNemar test and marginal homogeneity tests (p< 0.05). The mean observation period was 17.4 months. With respect to color match, marginal adaptation, secondary caries, and surface texture, no significant differences were found between the two restorative materials (p> 0.05). Most restorations yielded alpha or bravo scores with respect to the evaluation criteria. Five restorations failed due to chipping up to 2 years (1 microhybrid at 6 m, and 3 at 2 years; 1 nanofilled at 2 y) and were repaired. One complete replacement and one extraction due to endodontic complications were needed for 2 microhybrid resin group at 2 years.
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    Evaluation of tensile strength of different esthetic coping materials to Ti-base and monolithic zirconia crowns
    (Taylor & Francis Ltd, 2022) Salginci, Irem; Yildirim Avcu, Guler; Ozcan, Mutlu
    This study evaluated the tensile strength of three aesthetic abutment materials at two different angulations (0 and 15 degrees) to Ti-base and monolithic zirconia crowns. Prefabricated polyvinylidene difluoride (Medentika Implant) abutments were obtained and zirconia (Kingch) and polyetheretherketone (Ceramill) copings were manufactured using a computer-aided design/computer-aided manufacturing system (n = 12). Bonding surfaces of the copings and Ti-bases were air-abraded with alumina and then metal primer was applied. Self-adhesive resin cement (Multilink Hybrid Abutment) was used for cementation of copings to Ti-base. The bonding surfaces of the monolithic zirconia crowns (Upcera ST ML) were air-abraded and crowns were cemented using self-adhesive cement (seT PP). Data were analyzed using Kruskal-Wallis and Mann-Whitney U tests. No significant difference was found in the tensile strength of abutment to the crown interface for 0 degrees tapered abutments (p > 0.05). Regarding 15 degrees tapered abutments, the highest tensile strength values were obtained with zirconia abutments (p < 0.05). The tensile strength of monolithic zirconia crowns was lower than the restorations used in routine clinical practice.
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    Load-bearing capacity and failure types of premolars restored with sonic activated bulk-fill-, nano-hybrid and silorane-based resin restorative materials
    (Taylor & Francis Ltd, 2016) Oztuerk-Bozkurt, Funda; Toz-Akalin, Tugba; Gozetici, Burcu; Kusdemir, Mahmut; Ozsoy, Alev; Gozukara-Bag, Harika; Ozcan, Mutlu
    This study evaluated the load-bearing capacity of premolars restored with three types of resin composite materials in mesio-occluso-distal (MOD) cavities. Extracted human premolars (N=30, n=10 per group) were randomly divided into three groups; MOD cavities were prepared and restored with one of the following resin materials: Group BFC: Bulk-fill composite (SonicFill, Kerr Corporation), Group NC: Nanohybrid resin composite (Filtek Z550, 3M ESPE), Group SC: Silorane-based composite (Filtek Silorane, 3M ESPE). For NC Clearfil SE Bond (Kuraray, Japan) and for SC, Silorane adhesive resin (Filtek Silorane System Adhesive, 3M ESPE) were used. The cavities in NC and SC groups were restored incrementally, while those in BFC groups were restored in bulk. After water storage (24h, 37 degrees C), each tooth was subjected to compressive loading with a stainless steel ball (diameter: 4mm) perpendicular to the occlusal surface (1mm/min). Failure types were categorized according to being repairable or irrepairable. Data were statistically analysed using Kruskal-Wallis test (=0.05). Two-parameter Weibull distribution values including the Weibull modulus, scale (m) and shape (0) values were calculated. Fracture resistance of premolars restored with BFC (829.84), NC (701.35) and SC (807.73) did not show significant difference (p=0.72). Weibull distribution presented lower shape (0) for SC (m=2.77) and NC (m=3.09) compared to BFC (m=5.01). The incidence of repairable failures was more common in BFC (80%) compared to NC (60%) and SC (50%). Adhesive failures were more often observed in NC (80%) and SC (70%) groups.