Objectives:The optimum zirconia bonding protocol have been always a mystery to be solved throughout the past years. The purpose of this review is to go through the innumerable surface treatment methods and protocols concerned with the both internal and external zirconia surface treatment.Study selection, Data and Sources: An electronic Pubmed, Medline and Google scholar search was done to attain In-vitro studies on zirconia surface treatments published in english, with time frame between 2013 and 2020.Results: Hundred thirty-two in vitro studies and systematic reviews were surveyed in this appraisal. Numerous techniques were used for zirconia surface modifications, these methodologies were categorized and grouped in this review according to the surface modified. Laboratory test studies discuss internal surface treatments including micro-mechanical bonding, chemical bonding and external surface treatment including different core surface treatment, glazing and polishing.
Conclusions:With respect to the heterogeneity of the included studies; the internal surface treatment, most of the included studies verified the air particle abrasion as the generally approved micro-mechanical topographic modification protocol. Other internal surface treatment protocols as chemical etching showed promising results in laboratory studies with inadequacy of clinical application.The external surface studies verified different methods over others. However, self-glazed zirconia studies are scarce.
Background: The flat occlusal preparation design (FOD) of posterior teeth offers promising results of fracture resistance and stress distribution, but its application in vital teeth is limited as there may be a danger of pulp injury. Although this danger is omitted in endodontically treated teeth, there is no research work assessing the impact of FOD on the fracture resistance and distribution of stresses among these teeth. The aim of this study was to assess the impact of FOD of endodontically treated molars on the fracture resistance and distribution of stresses among a ceramic crown-molar structure when compared to the two planes occlusal preparation design (TOD). Methods: 20 human mandibular molars were endodontically treated and distributed equally to two groups: Group I (TOD) and Group II (FOD). Ceramic CAD/CAM milled lithium disilicate (IPS e.max CAD) crowns were produced for all preparations and adhered using self-adhesive resin cement. Using a universal testing machine, the fracture resistance test was performed. The fractured samples were examined using a stereomicroscope and scanning electron microscope to determine modes of failure. Stress distribution was evaluated by 3D finite element analysis, which was performed on digital models of endodontically treated mandibular molars (one model for each design). Results: Group II recorded statistically non-significant higher fracture resistance mean values (3107.2± 604.9 N) than Group I mean values (2962.6 ±524.27 N) as indicated by Student’s t-test (t=0.55, p= 0.57). Also, Group II resulted in more favorable failure mode as compared to Group I. Both preparation designs yielded low von-Mises stresses within the factor of safety. However, the stress distribution among different layers of the model differed. Conclusions: FOD having comparable fracture strength to TOD and a more favorable fracture behavior can be used for the preparation of endodontically treated molars.
Long-term clinical studies is still required to give accurate outlook regarding the ceramic inlays, recent ceramic materials developments permitted the construction of more enhanced esthetic restorations as crowns and bridges, yet no conclusive studies yet regarding the effectiveness of ceramic inlays versus other posterior restorative materials. Methods: A protocol of electronic and hand research was performed for English based researches in the MEDLINE database from 2000, till May 2019. Studies used in the current study were identified from in-vivo studies, in-vitro studies, previous systematic reviews, case reports. Conclusion: Ceramic inlay retained restorations proved clinical significant success compared to the alternative other posterior restorative options available.
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