David W Berzins’s research while affiliated with Marquette University and other places

The complex role of water in glass ionomer cement (polyalkenoate) dental restorative materials has been studied, but much of the present understanding concerning water balance within these materials is based on very early studies and short-term experiments. This study evaluated the nature of the water species of six conventional and four resin modified glass ionomer restorative materials over 3 years using thermogravimetric analysis techniques. Materials were prepared, placed in crucibles, and stored in physiologic phosphate buffered saline and evaluated at 24 h, 1 week, and then at 1, 3, 6, 9, 12, 18, 24, 30 and 36 months. All materials demonstrated a significant increase in unbound water percentage content but except for the resin modified materials, the enthalpy required to remove the unbound water species did not significantly change over 36 months. Also, bound water content percentage and removal enthalpy was established at 24 h, as no significant increase was noted in both bound water content and removal enthalpy over the course of this evaluation. This study suggests that unbound water species may increase with time and is loosely held except for the resin modified materials. Protective coatings placement and re-evaluation are prudent to prevent unbound water loss.

Statement of problem More translucent dental zirconias have been developed by incorporating the cubic phase and reducing the tetragonal phase content that undergoes transformation toughening, leading to reduced mechanical properties. Whether the clinically relevant mechanical property of the edge chipping toughness of the material is also reduced is unclear. Purpose The purpose of this in vitro study was to evaluate the edge chipping toughness and translucency of translucent zirconia, 3mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP), and lithium disilicate. Material and methods Two translucent zirconia products, Katana and Lava Esthetic; one 3Y-TZP, Lava Plus; and one lithium disilicate, IPS e.max Press were prepared and tested for phase composition via X-ray diffraction (XRD) (n=3), translucency via a spectrophotometer (n=20), and edge chipping via a universal testing machine with a custom-machined specimen holder and diamond indenter (n=20). The 3Y-TZP and lithium disilicate served as the optimal control materials for edge chipping and translucency, respectively. Translucency was compared with 1-way ANOVA and edge toughness with ANCOVA (α=.05). Results The XRD showed the 3Y-TZP to be almost completely tetragonal phase compared with the 2 translucent zirconia products that were predominantly cubic. Katana UTML and IPS e.max Press had a statistically similar (P>.05) translucency that was significantly (P<.05) greater than that of Lava Esthetic and Lava Plus. The edge toughness of Katana UTML was 304 N/mm, IPS e.max Press was 354 N/mm, Lava Esthetic was 394 N/mm, and Lava Plus was 717 N/mm, with significance rankings of Katana UTM<IPS e.max Press=Lava Esthetic<Lava Plus. Conclusions Some translucent zirconias had translucency similar to that of lithium disilicate; however, as translucency increased with increased cubic content, edge toughness decreased.

Statement of problem: Selective laser melting (SLM) technology has been introduced for printing metal dental restorations from Co-Cr base alloys or Au-Pt high noble alloys. However, information regarding the fit of restorations fabricated by using this technique is limited. Purpose: The purpose of this in vitro study was to determine the effect of 3 different finish line designs on the marginal and internal gaps of metal copings made from a base (Co-Cr), high noble (Au-Pd-Ag), and noble alloy (Co-Pd) by using the SLM technology. Material and methods: Three Ivorine right maxillary central incisors were prepared with a chamfer, deep chamfer, or shoulder finish line. The preparations were scanned by using a TRIOS scanner, and a total of 90 dies were printed using DPR 10 Resin (30×3 finish line designs). Ten SLM copings were fabricated for each margin design and metal alloy combination for a total of 90 copings (10×3 finish line designs×3 alloys). Copings were cemented onto dies using an autopolymerizing composite-resin luting material. All coping-die assemblies were sectioned buccolingually by using a low-speed diamond saw, and images were obtained by using an inverted bright field metallurgical microscope at ×100 magnification. Marginal and internal gaps were measured at 5 locations: buccal margin, midfacial, incisal, midlingual, and lingual margin. After gap measurements, representative specimens were embedded in autopolymerizing resin and prepared for metallographic examination. A 2-way multivariate analysis of variance (MANOVA) was conducted to determine the overall significance, followed by ANOVA for each dependent variable (α=.05). Results: The results indicated that alloy type and finish line had a significant influence on marginal gap of copings (P<.001). Relative to the internal gap, alloy type had a significant effect (P<.001), but the type of finish line had no statistically significant influence (P=.337). No statistically significant interactions occurred. Base alloys were printed with almost no observable porosity, whereas noble and high noble alloys exhibited hot tears and porosity. Conclusions: Thefinish line type did not influence the internal gap between copings and dies, whereas the alloy type influenced the marginal gap between copings and dies. SLM-fabricated Co-Cr copings on teeth prepared with a deep chamfer finish line demonstrated the lowest marginal gap.

Statement of problem: Research evaluating load-to-failure of pressed lithium disilicate glass-ceramic (LDGC) with a clinically validated test after adjustment and repair procedures is scarce. Purpose: The purpose of this in vitro study was to investigate the effect of the simulated chairside adjustment of the intaglio surface of monolithic pressed LDGC and procedures intended to repair damage. Material and methods: A total of 423 IPS e.max Press (Ivoclar Vivadent AG) disks (15 mm diameter, 1 mm height) were used in the study. The material was tested by using an equibiaxial loading arrangement (n≥30/group) and a contact pressure test (n≥20/group). Specimens were assigned to 1 of 14 groups. One-half was assigned to the equibiaxial load test and the other half underwent contact pressure testing. Testing was performed in 2 parts, before glazing and after glazing. Before-glazing specimens were devested and entered in the test protocol, while after-glazing specimens were devested and glazed before entering the test protocol. Equibiaxial flexure test specimens were placed on a ring-on-ring apparatus and loaded until failure. Contact pressure specimens were cemented to epoxy resin blocks with a resin cement and loaded with a 50-mm diameter hemisphere until failure. Tests were performed on a universal testing machine with a crosshead speed of 0.5 mm/min. Weibull statistics and likelihood ratio contour plots determined intergroup differences (95% confidence bounds). Results: Before glazing, the equibiaxial flexural strength test and the Weibull and likelihood ratio contour plots demonstrated a significantly higher failure strength for 1EC (188 MPa) than that of the damaged and/or repaired groups. Glazing following diamond-adjustment (1EGG) was the most beneficial post-damage procedure (176 MPa). Regarding the contact pressure test, the Weibull and likelihood ratio contour plots revealed no significant difference between the 1PC (98 MPa) and 1PGG (98 MPa) groups. Diamond-adjustment, without glazing (1EG and 1PG), resulted in the next-to-lowest equibiaxial flexure strength and the lowest contact pressure. After glazing, the strength of all the groups, when subjected to glazing following devesting, increased in comparison with corresponding groups in the before-glazing part of the study. Conclusions: A glazing treatment improved the mechanical properties of diamond-adjusted IPS e.max Press disks when evaluated by equibiaxial flexure and contact pressure tests.

Statement of problem: Two novel restorative materials, a polymer infiltrated ceramic network (PICN) and a resin nanoceramic (RNC), for computer-assisted design/computer-assisted manufacturing (CAD/CAM) applications have recently become commercially available. Little independent evidence regarding their mechanical properties exists to facilitate material selection. Purpose: The purpose of this in vitro study was to measure the edge chipping resistance and flexural strength of the PICN and RNC materials and compare them with 2 commonly used feldspathic ceramic (FC) and leucite reinforced glass-ceramic (LRGC) CAD/CAM materials that share the same clinical indications. Material and methods: PICN, RNC, FC, and LRGC material specimens were obtained by sectioning commercially available CAD/CAM blocks. Edge chipping test specimens (n=20/material) were adhesively attached to a resin substrate before testing. Edge chips were produced using a 120-degree, sharp, conical diamond indenter mounted on a universal testing machine and positioned 0.1 to 0.7 mm horizontally from the specimen's edge. The chipping force was plotted against distance to the edge, and the data were fitted to linear and quadratic equations. One-way ANOVA determined intergroup differences (α=.05) in edge chipping toughness. Beam specimens (n=22/material) were tested for determining flexural strength using a 3-point bend test. Weibull statistics determined intergroup differences (α=.05). Flexural modulus and work of fracture were also calculated, and 1-way ANOVA determined intergroup differences (α=.05) RESULTS: Significant (P<.05) differences were found among the 4 CAD/CAM materials for the 4 mechanical properties. Specifically, the material rankings were edge chipping toughness: RNC>LRGC=FC>PICN; flexural strength: RNC=LRGC>PICN>FC; flexural modulus: RNC<PICN<LRGC<FC; and work of fracture: RNC>LRGC=PICN>FC. Conclusions: The RNC material demonstrated superior performance for the mechanical properties tested compared with the other 3 materials.

Background/purpose: Although the effect of experimental surface modifications on various properties (e.g., fatigue, wear) on coated files have been tested in the past, there is no report for the coating quality of commercially available TiN coated files. The aim of this study was to characterize the surface and cross section of TiN coated endodontic files. Materials and methods: TiN coated nickel–titanium endodontic files (EasyShape) were surface and cross-sectionally analyzed via scanning electron microscopy backscattered electron imaging and energy-dispersive X-ray spectroscopy analysis in spot, area, and line scan modes. Results: Surface imaging revealed parallel oblong regions with higher mean atomic contrast, a finding attributed to increased Ni content. Cross-sectional analysis showed that the coating’s average total thickness was 0.31 μm and consisted of a thin layered film. Energy-dispersive X-ray spectroscopy analysis revealed the presence of Ti, Ni, N, and O in the coating, whereas only Ni and Ti were identified in the bulk of the file. Ti and O showed their peak compositions at the bulk/coating and coating/surface interfaces, respectively, whereas N displayed a rather constant content within the coated region. The N and O contents started increasing inner to the coating/bulk interface, denoting possible diffusion of both elements to the subcoating region. Conclusion: Surface and bulk characterization showed no uncoated areas of the files tested. Apart from Ti, Ni, and N, oxygen was also identified within the coating region.

Statement of problem: The effect of toothbrushing on extrinsically stained pressable ceramic materials is unknown. Purpose: The purpose of this in vitro study was to investigate the effects of toothbrushing on the shade and surface roughness of extrinsically stained, pressable ceramics. Material and methods: Two materials, leucite-based (IPS Empress Esthetic [EE]; Ivoclar Vivadent AG) and lithium disilicate-based ceramic (IPS e.max Press [EP]; Ivoclar Vivadent AG), were studied. For each material, 24 disk-shaped specimens, 10 mm (diameter)×3 mm (height) were fabricated. Three different methods (n=8) of applying extrinsic stains were performed on each material: glazed only (G, control group); stained then glazed (SG); and stained and glazed together (T). The specimens were brushed with a multistation brushing machine under a load of 1.96 N at a rate of 90 strokes per minute with a soft and straight toothbrush (Oral-B #35) and a 1:1 toothpaste and distilled water slurry. Shade and roughness were measured at baseline and at 72, 144, 216, and 288 hours, which is equivalent to 3, 6, 9, and 12 years of simulated toothbrushing for 2 minutes twice a day. A repeated measures ANOVA with staining technique as a fixed factor was used to evaluate shade and roughness (α=.05). Results: For EE groups, no significant change was found after 12 years of simulated toothbrushing regarding shade and surface roughness, irrespective of staining techniques (P>.05). However, EP groups demonstrated a significant shade change and an increase in surface roughness after 12 years of simulated toothbrushing. Shade change was found to depend on the method of applying stain. For the EP-SG technique, a significant shade change was observed only at the 9- to 12-year interval (P=.047). However, the EP-T technique demonstrated a significant difference in shade between baseline and 3 years (P=.005) and in the 6- to 9-year interval (P=.005). Surface roughness was only significantly affected at baseline and 3 years for the EP-T group (P=.005). Conclusions: For the shade and surface roughness of the EE groups, no statistically significant difference was found after 12 years of toothbrushing, irrespective of the staining technique. The shade and surface roughness of the EP groups were significantly statistically affected by toothbrushing time; only shade changes were found to depend on technique.

This study evaluated the effects of ceramic veneer thicknesses on the polymerization of two different resin cements. A total of 80 ceramic veneer disks were fabricated by using a pressable ceramic material (e.max Press; Ivoclar Vivadent) from a Low Translucency (LT) ingot (A1 shade). These disks were divided into light-cured (LC; NX3 Nexus LC; Kerr) and dual-cured (DC; NX3 Nexus DC; Kerr) and each group was further divided into four subgroups, based on ceramic disk thickness (0.3, 0.6, 0.9, and 1.2 mm). The values of Vickers microhardness (MH) and degree of conversion (DOC) were obtained for each specimen after a 24-hour storage period. Association between ceramic thickness, resin cement type, and light intensity readings (mW/cm(2)) with respect to microhardness and degree of conversion was statistically evaluated by using analysis of variance (ANOVA). For the DOC values, there was no significant difference observed among the LC resin cement subgroups, except in the 1.2 mm subgroup; only the DOC value (14.0 ± 7.4%) of 1.2 mm DC resin cement had significantly difference from that value (28.9 ± 7.5%) of 1.2 mm LC resin cement (p < 0.05). For the MH values between LC and DC resin cement groups, there was statistically significant difference (p < 0.05); overall, the MH values of LC resin cement groups demonstrated higher values than DC resin cement groups. On the other hands, among the DC resin cement subgroups, the MH values of 1.2 mm DC subgroup was significantly lower than the 0.3 mm and 0.6 mm subgroups (p < 0.05). However, among the LC subgroups, there was no statistically significant difference among them (p > 0.05). The degree of conversion and hardness of the resin cement was unaffected with veneering thicknesses between 0.3 and 0.9 mm. However, the DC resin cement group resulted in a significantly lower DOC and MH values for the 1.2 mm subgroup. While clinically adequate polymerization of LC resin cement can be achieved with a maximum 1.2 mm of porcelain veneer restoration, the increase of curing time or light intensity is clinically needed for DC resin cements at the thickness of more than 0.9 mm.

The inability to control die spacer thickness has been reported. However, little information is available on the congruency between the computer-aided design parameters for die spacer thickness and the actual printout. The purpose of this study was to evaluate the accuracy and precision of the die spacer thickness achieved by combining computer-aided design and 3-dimensional printing technology. An ivorine maxillary central incisor was prepared for a ceramic crown. The prepared tooth was duplicated by using polyvinyl siloxane duplicating silicone, and 80 die-stone models were produced from Type IV dental stone. The dies were randomly divided into 5 groups with assigned die spacer thicknesses of 25 μm, 45 μm, 65 μm, 85 μm, and 105 μm (n=16). The printed resin copings, obtained from a printer (ProJet DP 3000; 3D Systems), were cemented onto their respective die-stone models with self-adhesive resin cement and stored at room temperature until sectioning into halves in a buccolingual direction. The internal gap was measured at 5 defined locations per side of the sectioned die. Images of the printed resin coping/die-stone model internal gap dimensions were obtained with an inverted bright field metallurgical microscope at ×100 magnification. The acquired digital image was calibrated, and measurements were made using image analysis software. Mixed models (α=.05) were used to evaluate accuracy. A false discovery rate at 5% was used to adjust for multiple testing. Coefficient of variation was used to determine the precision for each group and was evaluated statistically with the Wald test (α=.05). The accuracy, expressed in terms of the mean differences between the prescribed die spacer thickness and the measured internal gap (standard deviation), was 50 μm (11) for the 25 μm group simulated die spacer thickness, 30 μm (10) for the 45 μm group, 15 μm (14) for the 65 μm group, 3 μm (23) for the 85 μm group, and -10 μm (32) for the 105 μm group. The precision mean of the measurements, expressed as a coefficient of variation, ranged between 14% and 33% for the 5 groups. For the accuracy evaluation, statistically significant differences were found for all the groups, except the group of 85 μm. For the precision assessment, the coefficient of variation was above 10% for all groups, showing the printer's inability to reproduce the uniform internal gap within the same group. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Purpose: To investigate polyalkenoate reaction rates in conventional glass-ionomer cement (GIC) and resin-modified glass ionomer (RMGI) restorative materials using infrared spectroscopy. Materials and methods: Nine conventional GIC and six RMGI restorative materials were prepared according to manufacturer's directions and placed on a FTIR (Fourier transform infrared spectroscopy) diamond ATR (attenuated total reflectance) surface. FTIR spectra (700 to 1800 cm-1) were obtained each minute for 3 h. VLC specimens were light polymerized after 1 min; at 5 min, all samples were covered with gauze saturated with deionized water. Polyalkenoate reaction was determined by measuring area growth (Å/cm-1) between 1375 and 1500 cm-1. Mean peak areas were determined at 5, 15, 30, 90, and 180 min and compared using ANOVA (p = 0.05) RESULTS: For all RMGI materials, VLC polymerization inhibited the polyalkenoate reaction rate. Compared to conventional GIC, RMGI materials demonstrated less polyalkenoate reaction. Compared to dark curing, RMGI light polymerization significantly inhibited the polyalkenoate reaction rate. Conclusions: The addition of resin components to glass-ionomer products significantly retards and impedes the polyalkenoate reaction. The polyalkenoate reaction rate of RMGI products was significantly lower than that of self-curing GIC restorative materials. Furthermore, light activation of RMGI products further retards the polyalkenoate rate. When clinicians require the therapeutic benefit of a polyalkenoate product, perhaps a conventional GIC restorative product should be the first material of choice.