Lithium disilicate and zirconia reinforced lithium silicate glass-ceramics for CAD/CAM dental restorations: biocompatibility, mechanical and microstructural properties after crystallization
Journal of Dentistry, 2022
OBJECTIVES The objective of this study was to define the impact of heating rate on the crystal gr... more OBJECTIVES The objective of this study was to define the impact of heating rate on the crystal growth, the mechanical properties, and the biocompatibility of three different kinds of CAD/CAM glass-ceramics treated with a conventional furnace. METHODS Lithium disilicate (IPS EMax-CAD, Ivoclar Vivadent) (LS2) and two zirconia reinforced lithium silicate (ZLS) ceramics (Vita Suprinity PC, VITA Zahnfabrik; Celtra Duo, Dentsply Sirona) (ZLSS; ZLSC) were used. The mechanical properties and the crystal growth were evaluated on 42 specimens (n=14 per group). The thermal treatments recommended by the manufacturers were carried out. All groups were tested for fracture toughness (Ft) and Vickers hardness (Hv). Scanning electron microscope (SEM) images were taken after a slight surface etching with hydrofluoric acid solution (1% for 20 sec). Differential Thermal Analysis (DTA) was performed and cellular adhesion with human periodontal ligament stem cells (hPDLSCs) culture was qualitatively assayed. Data were analysed with Repeated Measurements ANOVA and ANOVA followed by Tukey post hoc test. RESULTS The crystals' mean size (±SD) after heat treatment was 1650.0 (±340.0) nm for LS2, 854.5 (±155.0) nm for ZLSS and 759.9 (±118.4) nm for ZLSC (p<0.05 among the groups). As consequence of crystallization, the Hv was 6.1±0.3 GPa for LS2, 7.6±0.7 GPa for ZLSS and 7.1±0.5 GPa for ZLSC (p<0.05 for LS2 vs ZLSS and ZLSC), while the Ft was 2.2±0.1 MPa m1/2 for LS2, 4.7±0.8 MPa m1/2 for ZLSS and 3.8±0.6 MPa m1/2 for ZLSC (p<0.05 among the groups). The DTA curves showed a crystallization process for LS2, ZLSS and ZLSC at a temperature range 810°C to 840°C. The amount of adherent hPDLSCs was superior on LS2 than on ZLS. CONCLUSIONS All the CAD/CAM materials can be properly crystallized if heat treated following the manufacturers' instructions. The crystallization process highly depends on temperature. ZLS glass ceramics show significantly inferior crystals dimensions and higher fracture toughness and Vickers hardness than LS2 ceramic. hPDLSCs cultured on LS2 have a superior adhesion than those cultured on ZLS. CLINICAL SIGNIFICANCE The clinical interest of this study relies on the demonstration that a proper heat-treatment of CAD/CAM lithium disilicate and ZLS glass ceramics generates products that are suitable for clinical service. The differences highlightable in mechanical properties and biocompatibility behaviour do not affect their successful clinical application.
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