Intraoral repair of chipped or fractured veneered zirconia crowns and fixed dental prosthesis: clinical guidelines based on literature review

Agingu, Check; Zhang, Changyuan; Jiang, Neng-wu; Cheng, Hui; Özcan, Mutlu; Yu, Hao

doi:10.1080/01694243.2018.1443639

“…To avoid the chipping of layered restorations, monolithic restorations have been promoted [ 1 ]. Monolithic restorations made of translucent Y-TZP ceramics, such as 3Y-TZP and 5Y-TZP, have become popular in recent decades.…”

Section: Discussionmentioning

confidence: 99%

“…The popularity of dental zirconia has increased in recent decades because of its excellent mechanical characteristics, biocompatibility, and acceptable esthetic properties [ 1 , 2 ]. A questionnaire-based survey regarding the selection of dental ceramic materials reported that dental zirconia was one of the top choices for both anterior (layered) and posterior (monolithic) restorations [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Aging on the Color and Translucency of Monolithic Translucent Y-TZP Ceramics: A Systematic Review and Meta-Analysis of In Vitro Studies

Zhang

¹

,

Agingu

²

,

Tsoi

³

et al. 2021

BioMed Research International

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Background. Monolithic restorations made of translucent yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) have become popular over the past few decades. However, whether aging affects the color and translucency of monolithic translucent Y-TZP is unclear. Objective. The aim of this systematic review and meta-analysis of in vitro studies was to evaluate the effects of aging on the color and translucency of monolithic translucent Y-TZP ceramics. Materials and Methods. This systematic review/meta-analysis was reported according to the PRISMA statement and registered in the OSF registries (https://osf.io/5qjmu). Four databases including Medline via the PubMed, Embase, and Web of Science databases and the Cochrane Library were searched using no publication year and language limits. The last search was executed on November 20, 2020. In vitro studies comparing the translucency and/or color of monolithic translucent Y-TZP ceramics before and after simulated aging were selected. Meta-analyses were performed using Review Manager software (version 5.3, Cochrane Collaboration, Oxford, UK) with random-effects models at a significance level of 0.05. A risk-of-bias assessment was also performed for the included studies. Results. Of the 188 potentially relevant studies, 13 were included in the systematic review. The hydrothermal aging duration ranged from 1 to 100 h at relatively similar temperatures (~134°C). In the general meta-analyses, the aged Y-TZP ceramics exhibited similar translucency parameter (TP), L ∗ , and b ∗ values compared with the nonaged controls ( P = .73 , P = .49 , and P = .62 , respectively). Moreover, there was a significant difference between the aged and nonaged Y-TZP ceramics in the a ∗ value ( P = .03 ; MD = − 0.26 ; 95% CI = − 0.51 to − 0.02 ), favoring the nonaged Y-TZP ceramics. The subgroup analyses showed that the duration of aging contributed to changes in the translucency and color of the Y-TZP ceramics. Conclusions. The optical properties of monolithic translucent Y-TZP ceramics were stable after hydrothermal aging at 134°C and 0.2 MPa for ≤20 h. Moreover, clinically unacceptable changes in the translucency and color of monolithic translucent Y-TZP ceramics were found after hydrothermal aging for >20 h.

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“…While minor chipping failures (score Bravo) are recommended to be polished, chippings into the framework (score Delta), needs to be replaced which is a costly option for the patients. On the other hand, failures rated with score Charlie where cohesive failure is observed solely in the feldspathic with and without zirconia framework exposure could be repaired [7].…”

Section: Introductionmentioning

confidence: 99%

Comparison of repair protocols for veneered zirconia as a function of surface conditioning parameters, ceramic primer types and defect sizes

Schellenberg

¹

,

Özcan

²

2021

Journal of Adhesion Science and Technology

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This study assessed the effect of surface conditioning methods and ceramic primers on the repair strength of resin-composite to zirconia-veneering ceramic with different defect sizes. Zirconia (IPS e.max ZirCAD) (n ¼ 30) and veneering ceramic (Creation) (n ¼ 30) alone acted as control groups. In the 1st part of the study, zirconia was silica-coated (SC) and treated with 3 different ceramic primers (Monobond Plus þ Helibond (MBP), Clearfil Ceramic Primer Plus (CCP), Z-Prime Plus (ZPP)). Feldspathic ceramic was etched with 9.6% hydrofluoric acid (HF) and primed. After repairing with resin-composite (Empress Esthetic) and testing for shear bond strength (SBS), the best performing adhesive system (MBP) for both substrates (N ¼ 60, n ¼ 10 per group) was tested for defect sizes of (a) 3.2, (b) 4, (c) 5 mm with zirconia (diameter: 1.7 mm) being in the center (N ¼ 60, n ¼ 10 per group). Half of the specimens were repaired employing HFSC and the other half with SCHF. The specimens were stored in distilled water (37 C, 24 h) and thermocycled (5-55 C, 5000 cycles). The resin-substrate interface was loaded under shear force (1 mm/ min). Data (MPa) were analyzed using two-way ANOVA and Tukey's tests (a ¼ 0.05). In the 1st study, MBP resulted in significantly higher SBS (MPa) for both zirconia and veneering ceramic (Zirconia: 14.2 ± 3.6; Veneer: 11.0 ± 3.7), compared to those of CCP (Zirconia: 9.4 ± 2.2; Veneer: 7.5 ± 3.4) and ZPP (Zirconia: 5.0 ± 0.9; Veneer: 5.9 ± 2.1) (p < 0.01). Neither the size of the defect (p > 0.05) nor repair sequence showed a significant effect (p > 0.05) on the repair bond strength with mainly mixed type with cohesive fracture in the veneering ceramic.

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“…Small and medium failures are resolved using direct repairs with composite resin, 15 while large chippings including interproximal and occlusal areas require indirect repair protocols in the dental laboratory or are even considered for refabrication. 15,18 The objective of the repair is based on achieving a strong and stable adhesion between the repair and the fractured areas. Its longevity depends on the quality of the interface created during the repair.…”

Section: Discussionmentioning

confidence: 99%

“…Small and medium failures are resolved using direct repairs with composite resin, 15 while large chippings including interproximal and occlusal areas require indirect repair protocols in the dental laboratory or are even considered for refabrication. 15 18 …”

Section: Discussionmentioning

confidence: 99%

An Intraoral Repair Method for Chipping Fracture of a Multi-unit Fixed Zirconia Reconstruction: A Direct Dental Technique

Mesquita

¹

,

Husain

²

,

Molinero‐Mourelle

³

et al. 2021

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Fracture or chipping of veneering ceramic is one of the most frequent clinical failures in dentistry in fixed dental and implant-borne prostheses. Due to the friable nature of the ceramic material, chippings may result in an aesthetic and functional problem for the patient requiring a rapid solution. Direct repairs have been indicated for the restoration of function, aesthetics and comfort, especially in cases where the fractured prosthesis presents good adaptation and satisfactory aesthetics. This case report aims to present and discuss the techniques of the direct reveneering method, their advantages and disadvantages, as well as the importance of adhesive procedures in the success of these restorative approaches. Success in repairing the fractured area, regardless of the technique used, is fundamental to establish a strong and stable adhesion between the repaired and the fractured areas, since the longevity of the repair will depend on the quality of the interface generated.

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Intraoral repair of chipped or fractured veneered zirconia crowns and fixed dental prosthesis: clinical guidelines based on literature review

Cited by 26 publications

References 74 publications

Effects of Aging on the Color and Translucency of Monolithic Translucent Y-TZP Ceramics: A Systematic Review and Meta-Analysis of In Vitro Studies

Effects of Aging on the Color and Translucency of Monolithic Translucent Y-TZP Ceramics: A Systematic Review and Meta-Analysis of In Vitro Studies

Comparison of repair protocols for veneered zirconia as a function of surface conditioning parameters, ceramic primer types and defect sizes

An Intraoral Repair Method for Chipping Fracture of a Multi-unit Fixed Zirconia Reconstruction: A Direct Dental Technique

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