Modern CAD/CAM silicate ceramics, their translucency level and impact of hydrothermal aging on translucency, Martens hardness, biaxial flexural strength and their reliability.

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OBJECTIVES: To investigate the impact of hydrothermal aging on Martens parameter (Martens hardness: HM/elastic indentation modulus: E IT ) and biaxial flexural strength (BFS) of recently available CAD/CAM silicate ceramics.

METHODS: 220 specimens (diameter: 12 mm, thickness: 0.95 mm) were fabricated from six CAD/CAM ceramics in two translucency levels (LT/HT): (a) two lithium disilicate (Amber Mill, ABM; IPS e.max CAD, IEM), (b) one lithium metasilicate (Cetra Duo, CEL), (c) one lithium alumina silicate (n!ce, NIC), and (d) two leucite ceramics (Initial LRF Block, LRF; IPS Empress CAD, IPR). HM/E IT and BFS were measured initially and after hydrothermal aging (134 °C/0.2 MPa/100 h) in an autoclave. The Kolmogorov-Smirnov-test, t-test, one-way ANOVA with post-hoc Scheffé test, Kruskal-Wallis-test, Mann-Whitney-U-test with Bonferroni correction and Weibull statistics were performed (α = 0.05).

RESULTS: CEL and IEM showed the highest and the leucite ceramics the lowest Martens parameter. Within HT, ABM and NIC were in same initial HM value range with CEL and IEM. ABM and NIC showed lower initial E IT values than CEL and IEM, however higher than IPR. The lowest aged values were analyzed for ABM. After aging, Martens parameter decreased for LRF, ABM, and CEL. IEM showed the initial highest BFS, followed by ABM. NIC and LRF showed the lowest BFS. IEM and ABM presented the highest aged BFS. Hydrothermal aging increased BFS values for LRF (HT), IPR, CEL (HT), and NIC (HT) compared to the initial values. CAD/CAM leucite ceramics showed higher Weibull modul values compared to lithium silicate ceramics.

SIGNIFICANCE: The well-considered selection of ceramics in relation to the areas of indication has the highest influence on the long-term stability of restorations: CAD/CAM lithium disilicate ceramics presented the highest and leucite ceramics the lowest mechanical properties, whereas the reliability was better for leucite than for lithium silicate ceramics.