EGYPTIAN Vol.

65, 3677:3685, October, 2019

DENTAL JOURNAL I.S.S.N 0070-9484

Fixed Prosthodontics, Dental materials, Conservative Dentistry and Endodontics

www.eda-egypt.org • Codex : 80/1910

THE EFFECT OF TYPE OF MATERIAL AND METHOD

OF CONSTRUCTION ON THE FRACTURE TOUGHNESS
OF DIFFERENT COMMERCIALLY AVAILABLE
PROVISIONAL RESTORATION RESINS

Mohamed Medhat El Sayed Shrif*

ABSTRACT
Purpose : to assess the most suitable resin restoration and methods of construction according to
the fracture toughness as a provisional restoration among Bis-acryl resin (self-cure), Rubberized-
Urethane resin (dual cure), CAD/CAM PMMA (VITA CAD-Temp), CAD/CAM PMMA (breCAM.
multiCOM).
Methods: A total of 40 specimens were constructed for this in vitro study. The specimens were
divided into 2 groups according to the method of construction; manually fabricated group (M) and
CAD/CAM group (C) (n=20 for each group). A split mold was specifically constructed for this in
vitro study. The mold was constructed from Teflon material. The speciments of each group were
prepared with dimensions (3 x 4 x 14) mm A notch was milled in the middle of each specimen by
microsaw machine. The 3-point bending test was carried out using universal testing machine (loud
cell 500 N). The fracture toughness data of each type of provisional material was tabulated and
analyzed. The fractured surface morphology was captured using Scanning Electron Microscope
(SEM).
Results: The 4 products were compared using ANOVA test. The greatest mean was recorded
in breCAM.multiCOM group (B) (1.074±0.195), whereas the lowest mean was recorded in Tuff-
Temp group (T) (0.6437±0.167). Tukey’s post hoc test revealed no significant difference between
Protemp 4 group (P), VITA CAD Temp group (V) and breCAM.multiCOM group (B). These 3
groups recorded significantly higher mean values in comparison to Tuff Temp group (T) CAD/CAM
group (C) (1.0134±0.157) recorded higher mean value the manual group (M) (0.8459±0.275). The
difference between the 2 construction methods was statistically significant (P=0.025)
Conclusion: the first part of the null hypothesis was rejected because not all products recorded
significantly different fracture toughness mean values. Also the second part of the null hypothesis
was rejected because not all CAD/CAM provisional crowns demonstrated superior fracture
toughness to that of conventional provisional materials.

KEYWORD: provisional restoration, Tuff-temp, Protemp

* Assistance Lecturer, Department of Fixed Prothodontics,Modern University For Technology and Information,
Cairo Egypt
(3678) E.D.J. Vol. 65, No. 4 Mohamed Medhat El Sayed Shrif

INTRODUCTION crowns, bridges, inlays/on lays and veneers,

including long-term provisional restorations.
Fixed prosthodontic treatment needs indirect
construction of the definitive prosthesis in the dental Shade (A2).
laboratory. While the definite prosthesis fabrication 2. Tuff Temp:-diurethane dimethacrylate resin ma-
has been finished, a provisional restoration is terial in which synthetic hydrogenated polybu-
necessary simulating the definite restoration in the tadine rubber molecules have been inserted.
shape and position. The requirements for satisfactory
3. VITA CAD Temp:-CAD /CAM block provi-
provisional restorations differ only slightly from the
sional resin material which consists of a fiber-
definitive treatment they precede.
free, high-molecular and cross-linked acrylate
Long-term provisional restoration is used in polymer MRP (Micro-filler Reinforced Poly-
long term Extensive prosthodontic treatment, acrylic)
such as Occlual vertical dimension raising,
4. breCAM.multiCOM:- CAD /CAM provisional
alveoloplasty, tissue augmentation, dental implant,
resin material disk which its manufacture based
and orthodontics.
on polymethyl methacrylate and has been offset
The importance of provisional restoration with >20% ceramic filers.
material requirements varies according to the
A split mold was specifically constructed for
Specific clinical treatments that the material is
this in vitro study. The mold was constructed from
used for. For instance, the esthetic requirement is
(Teflon) material. The mold had cuboid geometry
very important in anterior esthetic rehabilitation
with dimensions (40 x 30 x 25 mm) {fig 1}, which
than posterior rehabilitation. Also provisional
was split to two parts. The mold was milled by a
materials used in malocclusion correction and
lathe machine. The two Teflon parts were connected
vertical dimension raising case must have high
together by two metal bars with two screws on
mechanical properties.1,2 The cases that need long
their ends, used in separating and assembling the
term provisional restorations as implant cases, need
Teflon parts by winding and unwinding movement
durable provisional materials because of longer
to facilitate removal of the specimen from the
period of service.
mold after fabrication. The mold has a cuboid
MATERIAL AND METHODS: space (dimensions 3.0 x 4.0 x 14 mm) in which
A total of 40 specimens were constructed for this the manually fabricated provisional restoration
in vitro study. The specimens were divided into 2 materials (Protemp 4 and Tuff Temp) were poured
groups according to the method of construction; to construct specimens with these dimensions. After
manually fabricated group (M) and CAD/CAM pouring the specimen, the screws was unwind then
group (C) (n=20 for each group). Each group was the two parts were separated then the specimen
subdivided to 2 subgroups according to the type of removed easily from the mold space.3-5
the material; Protemp 4 group (P) , Tuff Temp group The Protemp 4 cartilage was loaded in a special
(T) , VITA CAD Temp group ( V) and breCAM. dispenser gun (3M ESPE, Garant™ Dispenser
multiCOM group (B) (n=10 for each subgroup). 4:1/10:1 ratio) The Tuff Temp specimens were
The temporary crown material had been used in this prepared in a similar manner as Protemp 4 specimens.
study: But the difference was that tuff temp was loaded in
1. Protemp 4:- bis-acrylic material with nanofillers another special dispenser gun ((AcumixAutomix
for the fabrication of single- and multiple-unit Cartridge Dispensing Gun, 1:1 / 2:1 ratio).
THE EFFECT OF TYPE OF MATERIAL AND METHOD OF CONSTRUCTION ON THE FRACTURE (3679)

VITA CAD Temp block with size (15.5 x 19 The 3-point bending test was carried out using
x 55 mm) code (CT-55) was milled by microsaw universal testing machine (loud cell 500 N). The
machine, using 0.5 mm thickness diamond disk, data were recorded using special software ( Bluehill
with rotation speed 2500 rpm and feeding rate Lite software version 3.3), to determine the peak
1mm/s, with cooling water spray. A cuboid sheet “force to fracture” for each specimen. 7,8
was cut from the complete block with dimensions
The peak “force to fracture” in Newton was
(4 x 14 x 50) mm.A breCAM. multiCOM disk with
derived from the stress-strain curve and recorded.
dimensions (98.5 mm diameter x 16 mm thickness),
This force was used to calculate the fracture
code (540 0301 0), was milled using the same
toughness (K1c) in MPa•m1/2. The fracture
microsaw machine with the same diamond disk type
toughness data of each type of provisional material
and milling speed(diamond disk Buehler USA).
was tabulated and analyzed. The fractured surface
The final CAD/CAM specimens’ preparation morphology was captured using Scanning Electron
the sectioned sheets were farther milled to obtain Microscope (Quanta™ FEG250 - Scanning Electron
10 specimens for each group with dimensions (3 x Microscope) at an accelerating voltage of 20 kV and
4 x 14) mm. A notch was milled in the middle of a magnification of 2000–20000x. The specimens
each specimen by microsaw machine (Isomet 4000 were sputtered with gold prior to scanning.
microsaw Buehler USA), using 0.35 mm thickness
diamond disk (diamond disk Buehler USA), with RESULTS:
rotation speed 2500 rpm and feeding rate 1mm/s,
The 4 products were compared using ANOVA
with cooling water spray.6
test. The greatest mean was recorded in breCAM.
multiCOM group (B) (1.074±0.195), whereas the
lowest mean was recorded in Tuff-Temp group (T)
(0.6437±0.167). The difference between the four
groups was statistically significant (P<0.0001). The
2 products within the same construction method were
compared using unpaired t test. Within the manual
group (M), the Protemp 4group (P) (1.048±0.203),
recorded higher mean value than TuffTemp group
(T) (0.6437±0.167). The difference between the 2
products was statistically significant (P<0.0001)
{fig 2}.
Fig (1): A split mold with cuboid geometry with dimensions (40 Within the CAD/ CAM group (C), breCAM.
x 30 x 25 mm) multiCOMgroup(B) (1.074±0.195), recorded
higher mean value than Vita CAD Temp group
The crack was imaged using stereomicroscope (V) (0.9528±0.077). The difference between the 2
products was not statistically significant (P=0.094).
(Omnimet image analysis software Buehler USA)
{Fig 3}.
at 50x magnification, and the accurate crack
To study the effect of method of construction
length value for each specimen was measured by
difference, the 2 methods were compared using
image analysis software (Instron Universal Testing unpaired t test. CAD/CAM group (C) (1.0134±0.157)
machine model 3345 England) and recorded. recorded higher mean value the manual group (M)
(3680) E.D.J. Vol. 65, No. 4 Mohamed Medhat El Sayed Shrif

Fig. (2): Column chart showing difference of mean fracture Fig. (3): Column chart showing difference of mean fracture
toughness test in different products within each toughness test in different products within each
construction method. construction method.

In Tuff Temp specimens (T), showed the fracture

surface with smooth fracture pattern without step
form brittle fracture configuration but with porous
surface and microcracks. The magnification of
the synthetic rubber molecule showed partial
disintegration of the molecules from the matrix. In
VITA CAD Temp specimens (V), showed step form
brittle fracture configuration with intimate contact
between polymer beads and the resin matrix without
surface porosity or any evidence of disintegration.
Fig (4): Cracks under scan electric microscope
DISCUSSION
In the present study, a comparison of the fracture
toughness of different provisional restoration
(0.8459±0.275). The difference between the 2 resins was done to study the effect of the type of
construction methods was statistically significant the material and method of construction on their
(P=0.025) mechanical behaviour. While this in vitro study may
not reflect the oral conditions, fracture toughness
SEM analysis values could be a useful predictor of clinical
It showed the pre-crack zone (arrow A) and the performance and helpful for comparing provisional
transition line between the pre-crack button and the materials tested in a controlled situation. Bis-acryl
beginning of fractured surface (arrows B). {Fig 4} composite resins have low exothermic reaction,
low polymerization shrinkage ,9-12 good wear
In Protemp 4 specimens (P), showed fracture resistance, and good strength; but, these materials
surface with step form configuration with river like are expensive, brittle, have less polished surface
structure which is a typical morphology of brittle 15
and their repair is difficult .16,17 The addition of
fracture through cleavage {Fig 4}. The surface nanofillers was claimed to provide a smooth surface
shows no porosities or filler matrix disintegration. after the polishing process and provide superior
THE EFFECT OF TYPE OF MATERIAL AND METHOD OF CONSTRUCTION ON THE FRACTURE (3681)

esthetic features to the material. The composite method of construction modifying on the fracture
resin materials which have this particle size have toughness of the provisional materials.
high strength, malleability and abrasion resistant
The last tested material was another
quality18. In this study, a bisacryle provisional
representative of PMMA which is in the form of
resin material was tested which was based on a
CAD/CAM disks in addition to 20% ceramic fillers
combination of nanofillers and polymers that work
to improve its mechanical properties specially the
together. The effect of bisacryle composition was
fracture toughness.28 So we tested this material to
tested and nanotechnology on the fracture toughness
evaluate the effect of CAD/CAM manufacturing
in comparison to the other materials.
technique and farther addition of 20% ceramics
Another type of provisional resin materials is fillers on its fracture toughness.
urethane dimethacrylates. Urethane dimethacrylates
There are variable methods were used in testing
have controllable working time, good wear
the fracture toughness of provisional resin materials.
resistance, low temperature changes, good color
These tests include three- point bending, four-point
stability and high fracture toughness.19,20 The
bending29 with single-edge notched beam30 chevron
synthetic rubber particles were claimed to improve
notch, compact tension 31 and the indentation
Urethane dimethacrylates mechanical properties,
hardness method31 specimens’ configuration. All
specially its fracture toughness to be used as a long
these methods gives a range of fracture toughness
term provisional resin restoration.21
(KIc) values, even for the same material.29 These
AnUrethane dimethacrylate provisional methods differ on its tested specimen geometry in
resin material was tested in this study which was the size and the shape, size of the crack, and loading
strengthened by adding synthetic rubber particles to configuration.
evaluate the effect of the Urethane dimethacrylate
The complexity of the subjected forces to the
composition and the addition of synthetic rubber
provisional restoration in the oral cavity makes
particles on the fracture toughness when compared
the suitable method selection for testing the frac-
with the other tested materials. PMMA material
ture toughness isn’t easy. So many studies have at-
provisionalresins is relatively inexpensive, with
tempted to establish some clinically reliable testing
good color stability, excellent polished surface, and
methods for measuring the fracture toughness of
good marginal adaptation.22 The major drawbacks
the provisional resin materials 32-34 The single edge
of this group of resins include, high polymerization
notched beam (SENB) is from the most reported
shrinkage15,21, low strength, wear resistance, and
reliable methods which have been used in fracture
exothermic polymerization which may cause pulpal
toughness testing standard, ISO 6872.35 The single-
irritation associated with excess free monomer.18-24
edge-notched beam (SENB) is suggested for dental
CAD/CAM technology was used to fabricate
materials, because this test requires a smaller speci-
temporary restorations as a trial to solve some of
men size to fulfil plane strain conditions as com-
these problems by the way of curing using resin
pared to configurations of specimens of other tests.
based blanks under optimal conditions to increase
So we used the single edge notched beam (SENB)
their mechanical strength and prevent porosities
as a fracture toughness testing method to compare
within the restorations.25 In addition, CAD/CAM
the fracture toughness of the 4 tested materials.
fabricated provisional materials reduce the chairside
time and produce superior results.27So we tested a The specimens were fabricated in the form of bars
poly methyl methaacrylate (PMMA) provisional with dimensions of (3.0 x 4.0 x 14 mm) according
resin material which was manufactured in the form to ISO 687236 modified to accommodate block sizes
of CAD/ CAM blocks to evaluate the effect of that the specimens were sectioned from 37.
(3682) E.D.J. Vol. 65, No. 4 Mohamed Medhat El Sayed Shrif

The improved processibility is another advantage the machine has the advantage of Linear feed
In addition to its hydrophobicity, and low adhesive mechanism with variable feed rate sections even the
forces. most delicate specimens so it suited the natural of
the study delicate resin materials.
The aim of mold constructing in the form of split
mold with metal screws is to easily seperate and In metal testing, an initial machined notched
assembles its two parts by unwending and rewending sample is fatigued to give some growth. In polymeric
the screws to help removing the spacimens from the materials, this method is often difficult to do because
mold space easily. of unstable fatigue crack growth and the necessity of
using low frequencies to avoid heating. In polymers
After pouring the specemens, a glass slab was
another method is applied by first machining a sharp
then seated over the mold to pack the mix and to
notch and then further sharpening it by using a razor
help removing the excess material. The specimens
blade. This is generally a much simpler technique
were allowed to polymerize for 7 min at room
than growing cracks in fatigue that suites the resin
temperature as recommended by the product using
material delicate nature. Polymers are viscoelastic
instructions. Tuff Temp specimens group (T) was
materials so it is recommended that feeding rate
light cured for 20 sec. Because it is a dual cured
must never be exceed 1 mm/s because of the danger
resin material. The using of glass slab had 2 aims.
of dynamic effects that may lead to errors.37 so the
The first was to avoid the air inhibited layer on
milling procedures were done under feeding rate1
the superficial surface of the specimen to allow
mm/s.
complete and equal curing. The second aim was
to standardize the distance between the light cure A notch on the central was introduced in each
unit tip and the specimen to standardize the light specimen by Isomet 4000 microsaw Buehler USA
curing measures between all the specimens. Surface machine. The specimens were milled with rotation
Finishing affect the mechanical properties of the speed 2500 rpm and feeding rate 1mm/s with cooling
provisional materials so after the specimens were water spray to avoid heating during the milling
removed, a razor was used to remove all of the flash of the speciemens to the planned dimensions, and
material and finished to the desired dimensions with then a sharp pre-crack was introduced at the end
400 grit and 600 grit abrasive papers. of the notch by a sharp razor to make fine sharp
cuts with average length 0.5 mm. Most of studies
In The CAD/CAM fabricated provesional recommended that the crack length (the notch + per-
material specimens (C), we used Isomet 4000 crack) (a) should be: 0.45 <a/W< 0.55.37, 38 So the
microsaw in milling the specimens to standardize crack was fabricated with an average leghth of 2mm
and control the sizes of the specimens. The process to apply this rule.
was done with rotation speed 2500 rpm and feeding
rate 1mm/s with cooling water spray. This machine The crack was imaged using MA 100 Nikon
is provided by cooling system (water) & cool steriomicroscope Japan At 50x magnification and
(anticorrosive agent) 30:1. The Integrated coolant the crack length values were measured by Omnimet
delivery system floods the specimen from both sides image analysis software Buehler USA to estimate
of the blade while tracking with blade movement. the actual crack length of each specimens to use it in
This feature was suitable for the resin material used the fracture toughness equation according to ASTM
to avoid heating and destruction of the specimens. E-399 to calculate the exact fracture toughness
The machine has SmartCut system which monitors value of each spacemen.
and adjusts feed rates to enhance surface quality The 3-point bending test was carried out. The
and prevent damage to specimen or machine. Also main advantage of this test is the ease of the specimen
THE EFFECT OF TYPE OF MATERIAL AND METHOD OF CONSTRUCTION ON THE FRACTURE (3683)

preparation and testing.39 Instron Universal Testing protemp 4.43 However other author 35compared the
machine was used with loud cell 500 N because the same products; Tuff temp with Protemp 4 and found
maximum biting forces is 100 N in anterior teeth superior mechanical properties were noted with the
and may reach to 500 N in the posterior teeth.40 urethane resin (Tuff-Temp) 1 hour after fabrication
and with a bis-acryl resin (Protemp 4) at 24 hours.
The fracture pattern and the fracture surface
Postgelation polymerization plays an important
morphology are important in studying the fracture
role in substantially increasing the flexural strength
toughness of the provisional resins. The fractured
and rigidity of the bis-acryl and, to a lesser extent,
surface was captured using Scanning Electron
urethane interim resins between 1 and 24 hours.
Microscope at an accelerating voltage of 20 kV
SEM photographs in this study showed a porous
and a magnification of 2000–20000 × to study
less dense structure of tuff temp as well as partially
the morphological characterization of the fracture
separated rubbers particles appeared on the fracture
sites. The Magnification of 2000–20000 × was
surface in comparison to the other products. This
used to clearly investigate the fracture surface and
may be another cause in its significant low fracture
material composition, matrix particles integration
toughness value.
and porosity. The specimens were sputtered with
gold prior to scanning. Sputter coating in scanning BreCAM.multicom and VITA CAD Temp are
electron microscopy is a sputter deposition process two examples of CAD/CAM fabricated provisional
to cover a specimen with a thin layer of conducting resin materials. Very little data exist in the literature
material, typically a metal, such as a  gold/ regarding the mechanical prosperities of these
palladium (Au/Pd) alloy. A conductive coating is modern provisional materials.BreCAM.multicom
needed to prevent charging of a specimen with an manufacture based on polymethyl methacrylate and
electron beam in conventional SEM mode (high has been offset with >20% ceramic filers in order to
vacuum, high voltage). While metal coatings are increase the strength. The inorganic filler (ceramic
also useful for increasing signal to noise ratio (heavy particle) has been integrated in the plastic matrix
metals are good secondary electron emitters.41 of the organic PMMA. In this study BreCAM.
multicom recorded higher fracture toughness mean
The null hypothesis of this study was that the value but without significant difference when
type of the material and technique of construction was compared with VITA CAD Temp, in despite
affect the fracture toughness of the provisional of adding 20% ceramic fillers to the PMMA in
restorations. BreCAM.multicom. In this study SEM photographs
Tuff temp recorded significantly the lowest showed a homogenous dense structure. However,
mean values in comparison to other products, micro voids were excited with the evidence of
showing that urethane dimethacrylate has lower ceramic fillers matrix separation during fracture. It
mechanical properties than other provisional resin may be a cause in the insignificant effect of adding
materials in this study. This was in agreement 20% ceramics. 43
with a previous study showed that light activated VITA CAD Temp consists of a fiber-free,
Urethane Dimethacrylate Resin had the least homogeneous, high-molecular and cross-linked
flexural strength in comparison to the other types acrylate polymer with micro-particle filler, or
of the provisional resin materials.42Tuff-Temp was MRP material. In the MRP material (Micro-filler
claimed by the manufacturer to exhibit very high Reinforced Polyacrylic) inorganic micro-fillers are
flexural strength without brittleness and Its far polymerized into the network and a completely
greater deflection at break; the key indicator of homogeneous, VITA CAD Temp was claimed that
toughness, was greater than bis-acrylics including its methyl methacrylate-free material is obtained
(3684) E.D.J. Vol. 65, No. 4 Mohamed Medhat El Sayed Shrif

by the unique repressing technique of VITA, which 6. Hamza, TA et al: The effect of fiber reinforcement on the
exhibits superior material quality and outstanding fracture toughness and flexural strength of provisional
abrasion resistance .Protemp 4 recorded the second restorative resins. The Journal of prosthetic dentistry,
2004. 91(3): p. 258-264.
highest fracture toughness mean value but without
significant difference when compared with BreCAM. 7. Meiers, JC and Freilich MA: Use of a prefabricated fiber-
multicom and VITA CAD Temp. However, another reinforced composite resin framework to provide a provi-
study showed significant higher flexural strength sional fixed partial denture over an integrating implant: a
clinical report. The Journal of prosthetic dentistry, 2006.
of protemp 4 when compared with VITA CAD
95(1): p. 14-18.
Temp1. the mechanical characteristics of Structure
Premium (Voco), Protemp 4 Temporization 8. Baldissara P, Katsinas G , and Scotti R : Use of carbon-
Material, Acrytemp, Kanitemp Royal, Integrity epoxy frameworks for reinforcing provisional fixed partial
Fluorescence and Luxatemp Fluorescence materials dentures. The Journal of prosthetic dentistry, 2004. 91(1):
p. 89-92.
had compared44. They found that the fracture
toughness of a Protemp 4 material was established 9. Grajower R, Shaharbani S, and Kaufman E: Temperature
to be the highest as compared to all others. rise in pulp chamber during fabrication of temporary self-
curing resin crowns. The Journal of prosthetic dentistry,
CONCLUSION 1979. 41(5): p. 535-540.

10. Manak E and Arora: A Comparative evaluation of

The first part of the null hypothesis was rejected
temperature changes in the pulpal chamber during direct
because not all products recorded significantly
fabrication of provisional restorations: an in vitro study.
different fracture toughness mean values. Also the The Journal of Indian Prosthodontic Society, 2011. 11(3):
second part of the null hypothesis was rejected p. 149-155.
because not all CAD/CAM provisional crowns
11. Kurtzman G : Crown and bridge temporization part 1:
demonstrated superior fracture toughness to that of
provisional materials. Inside Denistry, 2008. 4: p. 72-80.
conventional provisional material.
12. Lieu C, Nguyen TM and Payant L : In vitro comparison
REFRENCES of peak polymerization temperatures of 5 provisional res-
toration resins. Journal-canadian dental association, 2001.
1. Jain A R, Nallaswamy D, and Padma Ariga J: Full mouth 67(1): p. 36-39.
rehabilitation of a patient with reduced vertical dimension
using multiple metal ceramic restorations. Contemporary 13. Gegauff A and Holloway J: Interim fixed restorations.
clinical dentistry, 2013. 4(4): p. 531. Contemporary Fixed Prosthodontics. 4th ed. Mosby
Elsevier, 2006: p. 466-504.
2. Karakıs D, Kaymak D, and Dogan D: The evaluation of
maximum bite force in the occlusal rehabilitation of patient 14. Strassler H , Anolik C and Frey C: High-strength, aesthetic
with Angle Class III malocclusion: a case report. The provisional restorations using a bis-acryl composite.
journal of advanced prosthodontics, 2013. 5(3): p. 364-368. Dentistry today, 2007, 26(11): p. 128, 130.

3. Hammond B and Hodd J : Fiber-reinforced interim fixed 15. Guler AU et al: Effects of different drinks on stainability
dental prostheses: A clinical protocol. The Journal of of resin composite provisional restorative materials. The
Prosthetic Dentistry, 2016. 116(4): p. 496-500. Journal of prosthetic dentistry, 2005 . 94(2): p. 118-124.

4. Anderson TL: Fracture Mechanics: Fundamentals and 16. Bohnenkamp DM and Garcia LT: Repair of bis-acryl
Applications, USA, 2005. 3rd Ed. provisional restorations using flowable composite resin.
The Journal of prosthetic dentistry, 2004. 92(5):p.500-502.
5. Fahmy NZ and Sharawi A: Effect of two methods of
reinforcement on the fracture strength of interim fixed 17. Blalock JS and Cooper J: A technique for effective shade
partial dentures. Journal of Prosthodontics, 2009. 18(6): modification of a provisional restoration. The Journal of
p. 512-520. prosthetic dentistry, 2011. 105(5): p. 347-348.
THE EFFECT OF TYPE OF MATERIAL AND METHOD OF CONSTRUCTION ON THE FRACTURE (3685)

18. Kumar SR and Vijayalakshmi R: Nanotechnology in 30. Bagheri R et al: Effect of a home bleaching agent on the
dentistry. Indian J Dent Res, 2006. 17(2): p. 62-65. fracture toughness of resin composites, using short rod
19. Peutzfeldt A: Resin composites in dentistry: the monomer design. Journal of Dentistry, 2014. 15(2): p. 74.
systems. European journal of oral sciences, 1997. 105(2): 31. Fischer H and Marx R: Fracture toughness of dental
p. 97-116. ceramics: comparison of bending and indentation method.
20. Beatty M et al: Effect of cross linking agent content, Dental materials, 2002. 18(1): p. 12-19.
monomer functionality, and repeat unit chemistry on 32. Watanabe H et al: Fracture toughness comparison of six
properties of unfilled resins. Journal of biomedical resin composites. Dental materials , 2008. 24(3): p. 418-
materials research, 1993. 27(3): p. 403-413. 425.
21. Lee V, Cardenas HL and Rawls HR: Rubber-toughening 33. Fujishima A and Ferracane JL, Comparison of four modes
of dimethacrylate dental composite resin. Journal of fracture toughness testing for dental composites. Dental
of Biomedical Materials Research Part B: Applied Materials, 1996. 12(1): p. 38-43.
Biomaterials, 2010. 94(2): p. 447-454. 34. Triwatana, P, Srinuan P, and Suputtamongkol K,
22. Hammond BD, COOPER JR and Lazarchik DA : Comparison of two fracture toughness testing methods
Predictable repair of provisional restorations. Journal of using a glass-infiltrated and a zirconia dental ceramic. The
Esthetic and Restorative Dentistry, 2009. 21(1): p. 19-24. journal of advanced prosthodontics, 2013. 5(1): p. 36-43.
23. Burns DR, Beck D, and Nelson S K : A review of selected 35. ISO 6872: 2008. Dentistry — Ceramic materials, r.e., G.
dental literature on contemporary provisional fixed International Organization for Standardization, and 2008.
prosthodontic treatment: report of the Committee on 36. Norman C et al: Fracture toughness of a new resin
Research in Fixed Prosthodontics of the Academy of Fixed
nanoceramic CAD/CAM material. In Abstract# 639,
Prosthodontics. The Journal of prosthetic dentistry, 2003.
Annual Meeting of the AADR. 2012.
90(5): p. 474-497.
37. Williams J and Cawood M: European group on fracture:
24. Balkenhol M et al: Correlation between polymerization
Kc and Gc methods for polymers. Polymer testing, 1990.
shrinkage and marginal fit of temporary crowns. Dental
9(1): p. 15-26.
materials, 2008. 24(11): p. 1575-1584.
38. Garoushi S, Vallittu PK and Lassila LV : Fracture
25. Poticny DJ and Klim J: CAD/CAM in-office technology:
toughness, compressive strength and load-bearing capacity
innovations after 25 years for predictable, esthetic
of short glass fibre-reinforced composite resin. Chinese
outcomes. The Journal of the American Dental Association,
Journal of Dental Research, 2011. 14(1): p. 15.
2010. 141: p. 5S-9S.
39. Rao MA et al: Engineering properties of foods. 2014: CRC
26 Gougaloff R and Stalley FC: Immediate placement and
Press.
provisionalization of a dental implant utilizing the CEREC
40. Zhou Z et al : Dental biotribology. 2013: Springer.
3 CAD/CAM Protocol: a clinical case report. Journal of
the California Dental Association, 2010 . 38(3): p. 170-3, 41. Newbery D et al: Advanced Scanning Electron Microscopy
176-7. and X-Ray Microanalysis. Plenum Press. ISBN 0-306-
27. Alhareb A, Akil HM, and Ahmad Z A: Impact strength, 42140-2. (1986).
fracture toughness and hardness improvement of PMMA 42. Kadiyala K et al: Evaluation of Flexural Strength of
denture base through addition of nitrile rubber/ceramic Thermocycled Interim Resin Materials Used in Prosthetic
fillers. The Saudi Journal for Dental Research, 2017. 8(1): Rehabilitation-An In-vitro Study. Journal of clinical and
p. 26-34. diagnostic research: JCDR, 2016. 10(9): p. ZC91.
28. Ferooz M et al: The Role of home bleaching agent on the 43. Vita-zahnfabrik: Working instructions. cited 2015 Oct. .
fracture toughness of resin composites using four-point Available from: https: https://www.vita-zahnfabrik. com/
bending test. Journal of Dental Biomaterials, 2014. 1(1): pdb_cc3c49_en.html.
p. 9-15. 44. Abdullah AO, Tsitrou EA, and Pollington S: Comparative
29. Wang H et al: Fracture toughness comparison of three test in vitro evaluation of CAD/CAM vs conventional
methods with four dental porcelains. Dental materials, provisional crowns. Journal of Applied Oral Science,
2007. 23(7): p. 905-910. 2016. 24(3): p. 258-263.