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  • Title: Energy dissipation capacities of CAD-CAM restorative materials: A comparative evaluation of resilience and toughness.
    Author: Niem T, Youssef N, Wöstmann B.
    Journal: J Prosthet Dent; 2019 Jan; 121(1):101-109. PubMed ID: 30017162.
    Abstract:
    STATEMENT OF PROBLEM: Well-balanced physical properties of computer-aided design and computer-aided manufacturing (CAD-CAM) materials are important to ensure the clinical success and longevity of restorations. Therefore, the capacity of a material to dissipate destructive fracture energy by means of elastic and plastic material deformation is of interest. However, little information is available on how to quantify the resilience and toughness of CAD-CAM materials. PURPOSE: The purpose of this in vitro study was to investigate and compare the resilience and toughness of CAD-CAM restorative materials and assess their capability to dissipate destructive fracture energy in comparison with a high-gold-content alloy. MATERIAL AND METHODS: Restorative materials for 3-unit fixed partial dentures (Alphador No. 1, IPS e.max CAD, Lava Plus, PEEK Optima), crowns and onlays (CERASMART, CEREC Blocs, Lava Ultimate, VITA ENAMIC), and interim prostheses (M-PM Disc, Telio CAD) were investigated. The strain energy density was determined with a 3-point bend test to calculate the modulus of toughness, the modulus of resilience, and the elastic recovery and thus characterize the material properties of resilience and toughness. Data were statistically analyzed with a generalized linear mixed model by using the Huber-White sandwich estimator (α=.05). RESULTS: Significant differences were found among the materials concerning the modulus of toughness, the modulus of resilience, the elastic recovery, and the difference between the elastic recovery and the modulus of resilience (P<.001). Alphador produced the highest mean regarding the modulus of toughness followed by Telio CAD, Lava Plus, M-PM Disc, CERASMART, and Lava Ultimate; all showed significantly higher capacities to dissipate energy by elastic and plastic deformation when compared with the ceramic materials (IPS e.max CAD, VITA ENAMIC, CEREC Blocs). For the modulus of resilience and elastic recovery, Lava Plus and Alphador showed the highest mean values and therefore better able to only elastically absorb destructive fracture energy; the least able materials were VITA ENAMIC and CEREC Blocs. As PEEK Optima, M-PM Disc, and Lava Ultimate showed higher mean values for the modulus of resilience than IPS e.max CAD, they were better able to elastically dissipate energy. CONCLUSIONS: Alphador had the highest values for the modulus of toughness, the elastic recovery, and the difference between the elastic recovery and the modulus of resilience; this was equivalent to pronounced energy dissipation capacities. In comparison, Lava Plus showed the highest modulus of resilience but significantly lower results for all other parameters and therefore fewer energy-consuming capabilities. The new polymer-based CAD-CAM restorative materials in general had a higher modulus of toughness and elastic recovery than ceramics and thereby partially resemble Lava Plus, all with similar capacities to dissipate destructive energy.
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