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      “Digitally Oriented Materials”: Focus on Lithium Disilicate Ceramics

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          Abstract

          The present paper was aimed at reporting the state of the art about lithium disilicate ceramics. The physical, mechanical, and optical properties of this material were reviewed as well as the manufacturing processes, the results of in vitro and in vivo investigations related to survival and success rates over time, and hints for the clinical indications in the light of the latest literature data. Due to excellent optical properties, high mechanical resistance, restorative versatility, and different manufacturing techniques, lithium disilicate can be considered to date one of the most promising dental materials in Digital Dentistry.

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          Most cited references86

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          Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs).

          The objective of this systematic review was to assess and compare the 5- and 10-year survival of different types of tooth-supported and implant-supported fixed dental prosthesis (FDPs) and single crowns (SCs) and to describe the incidence of biological and technical complications. Three electronic searches complemented by manual searching were conducted to identify prospective and retrospective cohort studies on FDPs and SCs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using random-effects Poisson's regression models to obtain summary estimates of 5- and 10-year survival proportions. Meta-analysis of the included studies indicated an estimated 5-year survival of conventional tooth-supported FDPs of 93.8%, cantilever FDPs of 91.4%, solely implant-supported FDPs of 95.2%, combined tooth-implant-supported FDPs of 95.5% and implant-supported SCs of 94.5%. Moreover, after 10 years of function the estimated survival decreased to 89.2% for conventional FDPs, to 80.3% for cantilever FDPs, to 86.7% for implant-supported FDPs, to 77.8% for combined tooth-implant-supported FDPs and to 89.4% for implant-supported SCs. Despite high survival rates, 38.7% the patients with implant-supported FDPs had some complications after the 5-year observation period. This is compared with 15.7% for conventional FDPs and 20.6% for cantilever FDPs, respectively. For conventional tooth-supported FDPs, the most frequent complications were biological complications like caries and loss of pulp vitality. Compared with tooth-supported FDPs, the incidence of technical complications was significantly higher for the implant-supported reconstructions. The most frequent technical complications were fractures of the veneer material (ceramic fractures or chipping), abutment or screw loosening and loss of retention. On the basis of the results of the present systematic review, planning of prosthetic rehabilitations should preferentially include conventional end abutment tooth-supported FDPs, solely implant-supported FDPs or implant-supported SCs. Only for reasons of anatomical structures or patient-centered preferences and as a second option should cantilever tooth-supported FDPs or FDPs supported by combination of implants and teeth be chosen.
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            Ceramic dental biomaterials and CAD/CAM technology: state of the art.

            Ceramics are widely used as indirect restorative materials in dentistry because of their high biocompatibility and pleasing aesthetics. The objective is to review the state of the arts of CAD/CAM all-ceramic biomaterials.
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              Wear characteristics of current aesthetic dental restorative CAD/CAM materials: two-body wear, gloss retention, roughness and Martens hardness.

              This study determined the two-body wear and toothbrushing wear parameters, including gloss and roughness measurements and additionally Martens hardness, of nine aesthetic CAD/CAM materials, one direct resin-based nanocomposite plus that of human enamel as a control group. Two-body wear was investigated in a computer-controlled chewing simulator (1.2 million loadings, 49N at 1.7Hz; 3000 thermocycles 5/50°C). Each of the 11 groups consisted of 12 specimens and 12 enamel antagonists. Quantitative analysis of wear was carried out with a 3D-surface analyser. Gloss and roughness measurements were evaluated using a glossmeter and an inductive surface profilometer before and after abrasive toothbrushing of machine-polished specimens. Additionally Martens hardness was measured. Statistically significant differences were calculated with one-way ANOVA (analysis of variance). Statistically significant differences were found for two-body wear, gloss, surface roughness and hardness. Zirconium dioxide ceramics showed no material wear and low wear of the enamel antagonist. Two-body wear of CAD/CAM-silicate and -lithium disilicate ceramics, -hybrid ceramics and -nanocomposite as well as direct nanocomposite did not differ significantly from that of human enamel. Temporary polymers showed significantly higher material wear than permanent materials. Abrasive toothbrushing significantly reduced gloss and increased roughness of all materials except zirconium dioxide ceramics. Gloss retention was highest with zirconium dioxide ceramics, silicate ceramics, hybrid ceramics and nanocomposites. Temporary polymers showed least gloss retention. Martens hardness differed significantly among ceramics, between ceramics and composites, and between resin composites and acrylic block materials as well. All permanent aesthetic CAD/CAM block materials tested behave similarly or better with respect to two-body wear and toothbrushing wear than human enamel, which is not true for temporary polymer CAD/CAM block materials. Ceramics show the best gloss retention compared to hybrid ceramics, composites and acrylic polymers. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Int J Dent
                Int J Dent
                IJD
                International Journal of Dentistry
                Hindawi Publishing Corporation
                1687-8728
                1687-8736
                2016
                18 August 2016
                : 2016
                : 9840594
                Affiliations
                1Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Fixed Prosthodontics, “Federico II” University of Naples, 80100 Naples, Italy
                2Department of Medical Biotechnologies, Division of Fixed Prosthodontics, University of Siena, 53100 Siena, Italy
                3Department of Surgical and Morphological Sciences, Dental School, University of Varese, 21100 Varese, Italy
                Author notes
                *Fernando Zarone: zarone@ 123456unina.it

                Academic Editor: Patricia Pereira

                Author information
                http://orcid.org/0000-0003-4919-1381
                http://orcid.org/0000-0002-5560-7817
                Article
                10.1155/2016/9840594
                5007340
                27635140
                caa6c8c9-225a-4f73-81c6-2dac376130b2
                Copyright © 2016 Fernando Zarone et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 February 2016
                : 25 July 2016
                Categories
                Review Article

                Dentistry
                Dentistry

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