Ceramic fragments using CAD/CAM systems are a viable clinical alternative to composites for the reconstruction of fractured teeth. Function and esthetics can be restored with the use of this treatment quickly and efficiently.
The aim of this study was to evaluate whether the compressive strength of lithium dissilicate ceramic inlays is influenced by the substrate (dentin or composite resin build-up) and to compare it to nonrestored teeth. Thirty freshly extracted human maxillary third molars were selected and randomly ascribed to three groups (n=10). Standardized Class II MOD preparations were made (bucco-palatal width = 2/3 of the intercuspal width and 2/3 of the width at the tooth equator for the proximal boxes), varying the extension of the preparations (Group 2: preparation limited to tooth structure; Group 3: pulpal floor of the preparation rebuilt with composite resin, IPS Empress Direct, restored with lithium dissilicate CAD/CAM ceramic inlays (e.max CAD) and cemented with a resin cement (Variolink II)). All groups were subjected to compressive strength test (1mm/min crosshead speed). The results showed that the fracture strength of G1 (control group) was significantly higher than G2 and G3, while within these groups there were no statistically significant differences. Both groups restored with lithium dissilicate restorations did not reach the fracture strength of the sound teeth but were statistically equivalent and sufficient to withstand physiologic masticatory forces.
The polishing step of teeth preparations for crowns is a step often performed, so that there is an increased time during the clinical procedure. The aim of this study is to evaluate the marginal and internal adaptation of all-ceramic CAD/CAM lithium disilicate crowns in polished preparations for crown and nonpolished preparations for crowns. For this purpose, 20 first molars were selected, which were divided into two groups (n = 10) G1, teeth that received surface roughening similar to preparation without polishing, and G2 (control), polished preparations. After the preparations were completed the teeth were scanned (Cerec Bluecam, Sirona, Bensheim, Germany), and the crowns were designed and machined using CAD/CAM technology (Sirona, Bensheim, Germany). The adaptation of the pieces was evaluated using polyvinyl siloxane replicas and stereomicroscope photographs with 70x magnifications. The normality test indicated a nonnormal result, so a Man–Whitney nonparametric test was performed. One out of the 24 measured regions showed a statistically significant difference (p = 0.0494). With this study it can be concluded that crowns fabricated by CAD/CAM technology performed on unpolished preparations are not influenced by the internal marginal adaptation and the ceramic part and are different from polished preparations.
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