UNIVERSIDADE ESTADUAL PAULISTA

“JÚLIO DE MESQUITA FILHO”

Instituto de Ciência e Tecnologia

Campus de São José dos Campos

ORIGINAL ARTICLE DOI: https://doi.org/10.4322/bds.2023.e3923

Braz Dent Sci 2023 Oct/Dec;26 (4): e3923

Inﬂuence of substrate, cement and aging on the biaxial ﬂexural

strength of lithium disilicate

Inﬂuência do substrato, cimento e envelhecimento na resistência a ﬂexão biaxial do dissilicato de lítio

Leonardo Custódio de LIMA

, Jean Soares MIRANDA

, Ronaldo Luis Almeida de CARVALHO

,

Aline Serrado de Pinho BARCELLOS

, Marina AMARAL

, Estevão Tomomitsu KIMPARA



1 - Departamento de Odontologia Restauradora, Faculdade de Odontologia, Universidade de São Paulo, SP, Brazil.

2 - Departamento de Odontologia, Universidade Federal de Juiz de Fora, Governador Valadares, MG, Brazil.

3 - Departamento de Odontologia, Universidade Braz Cubas, Mogi das Cruzes, SP, Brazil.

4 - Departamento de Materiais e Dentários e Prótese, Instituto de Ciência e Tecnologia, Unesp, São José dos Campos, SP, Brazil.

5 - Departamento de Odontologia, Universidade de Taubaté, Taubaté, SP, Brazil.

How to cite: Lima LC, Miranda JS, Carvalho RLA, Barcellos ASP, Amaral M, Kimpara ET. Inuence of substrate, cement and aging on the

biaxial exural strength of lithium disilicate. Braz Dent Sci. 2023;26(4):e3923. https://doi.org/10.4322/bds.2023.e3923

ABSTRACT

Objective: To evaluate the biaxial exural strength (BFS) of lithium disilicate (L), cemented on different substrates

(epoxy resin - E and metal - M) with dual-cure resin cement (Rc) and zinc phosphate cement (Zc), not aged,

thermally aged (TC) or thermo-mechanical aged (TC/MC). Material and Methods: Disks of L, E, and M were

fabricated, and the cementation was performed according to the following groups: ERc (L+E+Rc); MRc (L+M+Rc);

MZc (L+M+Zc); EZc (L+E+Zc). Ten samples from each described group were tested in BFS, ten more samples

were subjected to TC (1×10

cycles between 5 ºC and 55 ºC water), and the last 10 samples were subjected

to TC/MC (MC: 1.2×10

cycles, 50 N, 3.8 Hz). The BFS test was performed and scanning electron microscopy

(SEM) was performed to evaluate the failure mode. The effect of the cementation strategy (cement/substrate)

was compared in each aging method and the effect of the aging method was evaluated for each cementation

strategy by one-way ANOVA and Tukey post-hoc test (α=0.05). Results: The strength values were highest to

M (237.8 ~ 463.9 MPa), in comparison to the E (41.03 ~ 66.76 MPa), despite aging and luting agent. Flexural

strength data decreased after TC and TC/MC in groups cemented with Zc, but was stable when cemented with

Rc. SEM analysis indicated that failure origins were located at the tensile surface of the L. Conclusion: Lithium

disilicate discs cemented to the metallic substrate presented the highest biaxial exural strength. The cementation

with dual-cure resin cement did not decrease BFS after aging.

KEYWORDS

Aging; Cementation; Ceramics; Flexural strength; Lithium disilicate.

RESUMO

Objetivo: Avaliar a resistência à exão biaxial (BFS) do dissilicato de lítio (L), cimentado sobre diferentes

substratos (resina epóxi - E e metal - M) com cimento resinoso dual (Rc) e cimento de fosfato de zinco (Zc), não

envelhecido, submetido ao envelhecido térmico (TC) ou ao envelhecido térmico-mecânico (TC/MC). Material

e Métodos: Foram confeccionados discos de L, E e M, e a cimentação foi realizada de acordo com os seguintes

grupos: ERc (L+E+Rc); MRc (L+M+Rc); MZc (L+M+Zc); EZc (L+E+Zc). Dez amostras de cada grupo descrito

foram testadas em BFS, mais dez amostras foram submetidas à TC (1×10

ciclos de imersão em água entre

5 ºC e 55 ºC), e as últimas 10 amostras foram submetidas à TC/MC (MC: 1.2 ×10

ciclos, 50 N, 3.8 Hz). Foram

realizados os testes de BFS e a microscopia eletrônica de varredura (MEV) para avaliar o modo de falha. O efeito

da estratégia de cimentação (cimento/substrato) foi comparado em cada método de envelhecimento e o efeito

do método de envelhecimento foi avaliado para cada estratégia de cimentação por ANOVA a um fator e teste

Braz Dent Sci 2023 Oct/Dec;26 (4): e3923

Lima LC et al.

Influence of substrate, cement, and aging on the biaxial flexural streng th of lithium disilicate

Lima LC et al.

Inﬂuence of substrate, cement, and aging on the biaxial

ﬂexural strength of lithium disilicate

INTRODUCTION

As an aesthetic smile has an important role in

life quality and personal relationships, metal-free

restorations, such as those made with ceramic

materials, are increasingly used. Even with the

improvement in ceramic’s physical properties,

some of these materials are still subject to splints

and cracks [1]. For these reasons, the vitreous

lithium disilicate ceramic (L) is now widely used,

since it can resist stressing conditions, such as

masticatory forces, mimics the natural tooth

color, and has a wide indication [2].

Currently, the L restorations are adhesively

luted on the tooth structure (enamel or dentin)

presenting satisfactory bond strength to the

tooth structure [3]. Adhesive luting agents are

usually compared to conventional cement, such

as zinc phosphate [4], since it is considered a

standard luting agent [5] due to the lengthy

clinical history [6]. In addition, L can be a

suitable material for restorations over metal

substrates, such as cast metal post/cores, or metal

components of implant prostheses [2], but the

behavior of the L when luted with different agents

on metallic substrate needs to be more explored.

The luting agent used is an important

component for restoration longevity, since it can

create a link between the dental substrate and

the ceramic, reducing the stress, protecting the

substrate from saliva absorption, and reinforcing

the ceramic strength [7]. As the L is a vitreous

material, an adhesive cementation with resin

cement is recommended, mainly because this

material has silica and can be etched by the

hydrofluoric acid, thus obtaining satisfactory

adhesion due to the micromechanical and

chemical bonds [8]. However, their use for the

metallic substrate has some limitations, given the

minimal chemical afnity between luting agents

and metallic alloys [9], which stimulated the

establishment of different protocols for metal to

create micromechanical and chemical retention

between those substrates. As an example, acid

etching, air abrasion with aluminum oxide and

the use of chemical components, such as metal

primer [10].

To investigate the performance of ceramic

restorations, studies were made evaluating their

optical [11] and mechanical behavior [12], the

luting process and how the cracks propagate in

this material. However, information about the

longevity of the L restorations luted with different

type of luting agents when submitted to aging or

fatigue is rare in the literature.

Within this context, the aim of this study

was to evaluate the biaxial exural strength of

lithium disilicate ceramic discs, luted on different

substrates (epoxy resin and metal) with dual-cure

resin cement or conventional zinc phosphate

cement, thermally or thermo-mechanically aged

or not-aged. The null hypotheses tested were that

the different luting agents, the type of substrate

and the aging protocol would not inuence the

biaxial exural strength of lithium disilicate.

MATERIALS AND METHODS

Specimens preparation

Prefabricated lithium disilicate blocks

(IPS e.max CAD, Ivoclar Vivadent, Schaan,

Liechtenstein) were cut with a Diamond trephine

drill into 12 mm diameter cylinders. Cylinders

were sectioned (Extec High Concentration,

Extec) into discs of 1.2 ±0.2 mm thickness,

according to ISO 6872 [13], with a precision

saw machine (Isomet 1000, Buehler, Plymouth,

MN, EUA). All discs were polished (Politriz,

Buehler) with increasing grit silicon carbide paper

(400 to 1200 grit, Norton), obtaining 120 lithium

post-hoc de Tukey (α=0,05). Resultados: Os valores de resistência foram maiores para M (237.8 ~ 463.9 MPa),

em comparação com E (41.03 ~ 66.76 MPa), independentemente do envelhecimento e do agente cimentante

utilizado. Os dados de resistência à exão diminuíram após TC e TC/MC nos grupos cimentados com Zc, mas

se mantiveram estáveis quando cimentados com Rc. A análise MEV indicou que a origem das falhas estava

localizada na superfície de tração do L. Conclusão: Os discos de dissilicato de lítio cimentados ao substrato

metálico apresentaram maior resistência à exão biaxial. A cimentação com cimento resinoso dual não diminuiu

o BFS após o envelhecimento.

PALAVRAS-CHAVE

Cerâmica; Cimentação; Dissilicato de lítio; Envelhecimento; Resistência à exão.

Braz Dent Sci 2023 Oct/Dec;26 (4): e3923

Lima LC et al.

Influence of substrate, cement, and aging on the biaxial flexural streng th of lithium disilicate

Lima LC et al.

Inﬂuence of substrate, cement and aging on the biaxial ﬂexural

strength of lithium disilicate

disilicate discs that were randomly distributed

into twelve groups (n = 10).

The crystallization process was made in

specific furnace (Programat EP 3000, Ivoclar

Vivadent) with a maximum temperature of 850ºC

for 10 min as recommended by the manufacturer.

The epoxy resin (Nema Grade G10, International

Paper, Hampton, USA), a material with the elastic

modulus analogue to dentin [14], which had a

cylindrical shape (12 mm), was also cut (Isomet

1000) and polished (Politriz) with increasing grit

silicon carbide paper (400 to 1200 grit), obtaining

60 epoxy resin discs (1.2 ±0.2 mm thick) randomly

distributed into six groups (n = 10). In previous

study [15], the epoxy resin has been already used as

a substrate to evaluate the biaxial exural strength

of a ceramic material.

The 60 metal discs were initially waxed

(GEO Crowax, Renfert) and fused with a

Co-Cr (cobalt-chrome) alloy (DeguDent Ind.

And Com. Ltda.). After polishing with sandpaper

#120 #400 and #600, the final thickness of

the discs was 1.2 ±0.2 mm. All metal discs

were sandblasted with aluminum oxide (50µm,

BioArt) on the cementation surface. Then they

were randomly distributed into six groups

(n = 10). All materials used in the present study,

respective commercial information, and elastic

modulus [14,16-18] are described in Table I.

The groups were dened according to the

type of luting agent (dual-cure resin cement - Rc

or conventional zinc phosphate – Zc), substrate

(epoxy resin - E or metal - M), initial testing,

thermal cycling (TC) and thermal cycling

followed by mechanical cycling (TC/MC). Twelve

groups were formed: ERc; ERc-TC; ERc-TC/MC;

EZc; EZc-TC; EZc-TC/MC; MRc; MRc-TC; MRc-T/

MC; MZc; MZc-TC; and MZc-TC/MC.

Cementation process

Before any surface treatment, all discs

(ceramic, metallic and epoxy dentin) were

cleaned for five minutes in ultrasonic bath

(Cristófoli Ultrasonic Washer) with isopropyl

alcohol. The surface treatments performed on

each material surface according to luting agent

are described in Table II.

For cementation, the dual-cure resin cement

was mixed, placed on the center of the lithium

disilicate treated surface, and immediately

bonded to the treated surface of the substrate

material disc (E or M). A 750-g load was applied

for 60 s to the top of lithium disilicate disc to

allow cement excess removal and to obtain

Table I - Description of materials used

Type of material

Trade mark/ Manufacturer Composition

Elastic modulus

Lithium disilicate 95 GPa

IPS e-max CAD / Ivoclar Vivadent, Schaan,

Liechtenstein

SIO

, LI

O, K

O, P

, ZRO

, ZNO, AL

, MGO

Dual Cure Resin Cement 8.3 GPa

Panavia F/ Kuraray,Tokyo, Japan

Paste A:

MDP; Aromatic dimethacrylate; Silanized

silica; Catalysts and Initiators.

Paste B:

124/5000

Aromatic dimethacrylate; Particles of silanized

barium glass; Sodium ﬂuoride; Catalysts;

Accelerators and Pigments

Conventional zinc phosphate

cement 22.4 GPa

Cement LS / SS White, Rio de Janeiro, Brazil

Powder: zinc oxide (90%) and magnesium oxide

(10%);

Liquid: orthophosphoric acid, water, aluminum

and zinc.

Metal substrate 203 GPa

Fit Flex / Degudent Dentsply, São Paulo, Brazil cobalt – chrome alloy

Epoxi Resin substrate 18 GPa

NEMA Grade G10 / St. Louis, Missouri, EUA Epoxi resin

Hydroﬂuoric etching acid Condac Porcelain 5% / FGM, Joinville, Brazil 5% hydroﬂuoric acid

Phosphoric etching acid Condac 37% / FGM, Joinville, Brazil 37% ﬂuoridric acid

Aluminum oxide particles Kota Knebel / KOTA, Cotia, Brazil 320µm aluminum oxide particles

Silane bonding agent

Monobond S / Ivoclar Vivadent, Schaan,

Liechtenstein

Silane methacrylate alcohol solution

Metal Primer Alloy Primer / Kuraray, Tokyo, Japan VBATDT, 10-MDP and acetone

Braz Dent Sci 2023 Oct/Dec;26 (4): e3923

Lima LC et al.

Influence of substrate, cement, and aging on the biaxial flexural streng th of lithium disilicate

Lima LC et al.

Inﬂuence of substrate, cement and aging on the biaxial ﬂexural

strength of lithium disilicate

uniform distribution of cement throughout the

interface. The excess of cement material was

removed, and each side of the discs was light

cured for 40 s with 1200 mW/cm

LED (Radii

Cal, SDI). The light intensity was measured on a

radiometer (Kondortech-Kondentech). After the

bonding, all specimens were immersed in distilled

water and stored at 37°C for 24 hours.

The cementation with the zinc phosphate

cement was performed with carefully staged

additions of powder to the liquid, on a glass slide,

as recommended by manufacturer. At reaching

the recommended consistency, after 1 min

manipulation, the cement was placed on the

lithium disilicate disc, and the cementation was

performed as described before. In this case,

samples (substrate, conventional cement, and

ceramic) remained under the 750-g load for

10 minutes to respect this material chemical

cure time.

Ten samples from each cementation

strategy (n=10) were tested by biaxial exural

strength test, other ten samples from each

cementation strategy (n=10) were subjected

to 1×10

thermocycles (Nova Ética), between

two water baths of 5

C and 55

C, with a

time of 30s each. And the last ten samples

from each cementation strategy (n=10) were

subjected to TC as described before, followed

by 1.2 × 10

mechanical cycles (ERIOS, Model:

ER-11000), under 50N load, at 3.8 Hz. Samples

were immersed in 37°C water during MC.

Biaxial exural strength test – BFS

The biaxial exural strength test (n = 10)

was performed in a universal testing machine

(EMIC DL-1000, EMIC) according to ISO

6872 [13]. The dimensions of each sample were

measured with digital caliper (model 500-195-

20B, Mitutoyo America) before the test. Lithium

disilicate disc was positioned on the top, for

simulation of occlusal load on a flat occlusal

restoration, and an increasing load (1 mm/min)

was applied to the center of the disc with a piston

(3-mm radius) until fracture of lithium disilicate –

catastrophic failure. Biaxial exural strength was

calculated according to the equation described for

computations for multilayers [13,19], as follows:

( )

P X Y

S 0.2387

−

= −

(1)

In this formula, S (expressed in Pascals) means

the maximum tensile stress; P (expressed in

Newtons) means the amount of load needed to

fracture the material and d means the specimen

thickness (expressed in mm). X and Y were

calculated based on the ceramic’s Poisson’s ratio

(v), the radius of support circle (r1), of loaded

area (r2) and of the specimen (r3) as follows:

( )

r2 r2

X 1 v In

r3 2 r3



−

 

=++



 

 





(2)

( ) ( )

r 2 r1

Y 1v1In 1v

r3 r3



 



=+ + +−

 



 



(3)

The Poisson ratio considered were: 0.25 to

L [18], 0.3 to epoxy resin [20] and 0.3 to metal [21].

Figure 1 is a schematic illustration of the sample

dimensions and test setup.

Statistics

Data were subjected to descriptive statistical

analysis (mean and standard deviation). The effect

of cementation strategy (cement/substrate) were

compared in each aging method (no aging,

thermocycling and thermocycling + mechanical

Table II - Surface treatments applied to each material according to the cement used

Cement Material Surface treatment

Dual cure resin

cement (Rc)

Lithium disilicate (L)

5% hydroﬂuoric acid etching (20s) + washed by air-water spray (40s) + air dried (30s) +

silane (30s) + air dried (30s)

Epoxi resin (E)

37% phosphoric acid etching (15s) + washed by air-water spray (30s) + air dried (30s) +

mixture of adhesive primers (A and B) from resin cement

Metal (M)

Sandblasting with aluminum oxide particles (10mm, 45º, 2.8 bar, 15s) + application of the

metal primer

Conventional

Zinc Phosphate

Cement (Zc)

Lithium disilicate (L) No treatment

Epoxi resin (E) No treatment

Metal (M) Sandblasting with aluminum oxide particles (10mm, 45º, 2.8 bar, 15s)

Braz Dent Sci 2023 Oct/Dec;26 (4): e3923

Lima LC et al.

Influence of substrate, cement, and aging on the biaxial flexural streng th of lithium disilicate

Lima LC et al.

Inﬂuence of substrate, cement and aging on the biaxial ﬂexural

strength of lithium disilicate

cycling), and the effect of aging method was

evaluated for each cementation strategy by one-

way ANOVA followed by Tukey post hoc test

(α=0.05).

Scanning Electron Microscopy (SEM)

Fractured surfaces were examined under

an optical microscope (Discovery V20, Carl

Zeiss Microscopy) with 100× magnification,

for origin and failure propagation pattern

identication. Representative specimens were

sputter coated with gold and evaluated under

scanning electron microscopy (SEM; Inspect S50,

FEI) for illustrative images.

RESULTS

Four samples from MZc-TC and three from

EZc-TC groups failed during thermocycling, and

were not considered for statistical analysis, because

they were considered outliers (unrepresentative).

Seven samples from MZc-TC/MC and nine

samples from EZc-TC/MC failed after thermal and

mechanical cycling; these groups were excluded

from statistical analysis. Flexural strength data

with statistical analysis and number of tested

samples per group are showed in Table III.

The highest strength values were found

in groups cemented to the metallic substrate,

despite aging and luting agent. Flexural strength

data decreased after TC and TC/MC in groups

cemented with conventional zinc phosphate

cement but was stable for lithium disilicate

cemented with dual-cure resin cement.

No substrate disc presented fracture after

test. Thus, the values presented were regarding

the strength of lithium disilicate. The fractographic

analysis showed that all lithium disilicate discs

fractured from the cementation surface toward

the piston contact point (Figure 2A – 1F).

DISCUSSION

In the present study, the biaxial flexural

strength of lithium disilicate ceramic was

evaluated when cemented on different substrates

with different protocols. Additionally, aging was

performed to simulate stress conditions that

occur in the oral cavity. The highest strength

values were found in groups cemented to metallic

Table III - Means and respective standard deviations of biaxial ﬂexural strength data (values in MPa) obtained for the specimens, according

to the experimental group

Substrate mate-

rial

Cement Without aging With aging (TC)

With aging (TC +

MC)

ANOVA 1-way

(aging method)

63.84 (17.09)

64.73 (13.55)

66.76 (15,80)

p=0.920

(n=10) (n=10) (n=10)

53.15 (6.25)

41.03 (10.09)

65,25 (----)

p=0.013

(n=10) (n=6) (n=1)*

321.9 (116.04)

290.9 (81.20)

330,05 (65,5)

p=0.598

(n=10) (n=10) (n=10)

463.9 (161.70)

237.8 (126.6)

296,32 (151,50)

p=0.095

(n=10) (n=7) (n=3)*

ANOVA 1-way (cementation strategy –

cement/substrate)

p<0.001 p<0.001 p<0.000

*Groups not included in statistical analysis. Diﬀerent uppercase superscript letters indicate statistical diﬀerence in the same column.

Figure 1 - Schematic illustration of the sample dimensions and test

setup.

Braz Dent Sci 2023 Oct/Dec;26 (4): e3923

Lima LC et al.

Influence of substrate, cement, and aging on the biaxial flexural streng th of lithium disilicate

Lima LC et al.

Inﬂuence of substrate, cement and aging on the biaxial ﬂexural

strength of lithium disilicate

substrate, despite aging and luting agent. Flexural

strength data decreased after TC and TC/MC

in groups cemented with conventional zinc

phosphate cement but was stable for lithium

disilicate cemented with dual-cure resin cement.

Previous literature suggested that the

thermocycling reduced the adhesion between

metal and ceramics [22]. In the present study,

the samples format favored the contact of cement

with water during the thermal aging which

allows a potential degradation. But, in the groups

conventionally cemented with zinc phosphate,

lower strength values were presented because

this material has higher solubility, no adhesion

proprieties and lower mechanical property when

compared with resin cements [23].

Despite the cement variable did not present

statistically signicant differences in the non-aged

samples, which make us partially accept the rst

null hypothesis, when an adhesive cementation

was made, regardless of the type of substrate, the

mechanical strength of the ceramic was stable

after aging compared to the ceramic that was

conventionally cemented with zinc phosphate

material. This was expected because it is known

that an adhesive cementation can help to cure

some aws and microcracks of the restoration,

promoting better mechanical proprieties to the

ceramic material and being an important part of

a multilayered restoration [24]. Different surface

treatments were used for lithium disilicate,

to better simulate the clinical practice, which

requests different protocols according to the type

of substrate and/or cement.

Although the chemical adhesion of resin

cements to metallic substrates is not established,

the use of cement with 10-MDP functional

monomers in its composition could be the

responsible to promote better bonding on the

metal substrate and consequently a greater

mechanical behavior of the samples [25]. This

type of performance has already been noticed

when, in a previous study [26], zirconia ceramics,

which have an elastic modulus closer to the

metals, were cemented with an adhesive system

that contained MDP.

Finally, the null hypothesis that the type of

substrate would not inuence the mechanical

behavior of the samples was rejected. This is

due to the superior results obtained by groups

Figure 2 - A-F: Representative images of the fractographic analyzes (100× magniﬁcation) performed on samples indicating that the fracture

originated on the tensile surface (white arrows). Figure2A - ERc-TC; Figure2B – EZc; Figure2C - EZc-TC; Figure2D – MRc; Figure2E - MZc-TC

and Figure2F – MZc-TC.

Braz Dent Sci 2023 Oct/Dec;26 (4): e3923

Lima LC et al.

Influence of substrate, cement, and aging on the biaxial flexural streng th of lithium disilicate

Lima LC et al.

Inﬂuence of substrate, cement and aging on the biaxial ﬂexural

strength of lithium disilicate

cemented on metal, regardless of the aging

process. The possible explanation for this

is that the metallic substrate (Co-Cr) has a

satisfactory hardness value, with a tensile

strength of 1389 MPa and an elastic modulus of

203 GPa [17], while the epoxy resin present lower

values, with a tensile strength of 450 MPa and

an elastic modulus of 18 GPa [27]. The substrate

has influence on the mechanical behavior of

the restorative material: substrates with elastic

modulus higher than the restorative material led

to a more resistant assembly [28].

Failure analysis indicated that fracture

always started on the tensile (cementation)

surface of the ceramic, as previously reported

in literature [11,12,29]. This fact explains the

higher amount of failures occurred during TC/

MC ageing, where the cementation surface was

affected, resulting in loss of retention of L discs.

The load application on the restorative material

generates compression near the contact point

and tensile stresses at the cementation surface.

Brittle materials, in general, present higher

strength to compression, and they are more prone

to fracture under tensile stress. In addition, the

crystallization process was performed with a

maximum temperature of 850ºC, and this sintering

parameter can decrease the mechanical properties,

as a higher amount of porosity can be observed,

when compared with 900ºC and 950ºC [30].

It should be emphasized that the data found

in the present study are the result of an in vitro

experiment, which has certain limitations, such

as the use of lithium disilicate discs instead

of complete restorations, which require prior

prosthetic preparation of the substrate, followed

by molding steps, and thus more accurately

simulate the clinical reality. But even with these

limitations, the study proved useful because it

was able to suggest that the adhesive resin cement

is an adequate option for luting the lithium

disilicate both on dentin and on a metal substrate.

CONCLUSIONS

Based on ndings of this study, it can be

concluded that: (1) The biaxial exural strength

of the lithium disilicate ceramic was the highest

when cemented under a high elastic modulus

substrate, despite the cement used; (2) Zinc

phosphate cement presented the highest initial

results but after aging, high decrease in strength

and debonding were recorded, while adhesive

cementation presented stable strength results;

(3) Aging methods promoted decrease in exural

strength of lithium disilicate discs.

Author’s Contributions

LCL, JSM, RLAC, ETK: Conceptualization.

LCL, JSM, RLAC, ASPB, ETK: Methodology. LCL,

JSM, RLAC, ETK: Software. LCL, JSM, RLAC,

ETK: Validation. LCL, JSM, RLAC, MA, ETK:

Formal Analysis. LCL, JSM, RLAC, ASPB, ETK:

Investigation. LCL, JSM, RLAC, ETK: Resources.

LCL, JSM, ETK: Data Curation. LCL, JSM, MA,

ETK: Writing – Original Draft Preparation. LCL,

JSM, MA, ETK: Writing – Review & Editing. JSM,

RLAC, ASPB, ETK: Supervision. LCL, JSM, RLAC,

ASPB, MA, ETK: Project Administration. LCL, ETK:

Funding Acquisition.

Conict of Interest

The authors have no proprietary, nancial,

or other personal interest of any nature or kind

in any product, service, and/or company that is

presented in this article.

Funding

The present manuscript was supported by

the Institutional Scientic Initiation Scholarship

Program – PIBIC (Process 35851) – Scholarship of

the rst author.

Regulatory Statement

Not applicable.

REFERENCES

1. Alessandretti R, Borba M, Della Bona A. Cyclic contact fatigue

resistance of ceramics for monolithic and multilayer dental

restorations. Dent Mater. 2020;36(4):535-41. http://dx.doi.

org/10.1016/j.dental.2020.02.006. PMid:32057488.

2. Pieger S, Salman A, Bidra AS. Clinical outcomes of lithium

disilicate single crowns and partial fixed dental prostheses: a

systematic review. J Prosthet Dent. 2014;112(1):22-30. http://

dx.doi.org/10.1016/j.prosdent.2014.01.005. PMid:24674802.

3. Schmitter M, Schurig A, Simon M, Höhne C. Influence of dental tissue

substructure and dimension on the fracture strength of lithium

disilicate and zirconia ceramics. Int J Prosthodont. 2022;35(4):434-

41. http://dx.doi.org/10.11607/ijp.7451. PMid:33662062.

4. Chiapinotto GF, da Rosa LS, Scotti N, Kleverlaan CJ, Valandro

LF, Pereira GKR. Does adhesive luting promote improved

fatigue performance of lithium disilicate simplified crowns? J

Mech Behav Biomed Mater. 2022;134:105373. http://dx.doi.

org/10.1016/j.jmbbm.2022.105373. PMid:35868064.

Braz Dent Sci 2023 Oct/Dec;26 (4): e3923

Lima LC et al.

Influence of substrate, cement, and aging on the biaxial flexural streng th of lithium disilicate

Lima LC et al.

Inﬂuence of substrate, cement and aging on the biaxial ﬂexural

strength of lithium disilicate

5. Hill EE, Lott J. A clinically focused discussion of luting materials.

Aust Dent J. 2011;56(Suppl 1):67-76. http://dx.doi.org/10.1111/

j.1834-7819.2010.01297.x. PMid:21564117.

6. Masaka N, Yoneda S, Masaka K. An up to 43-year longitudinal

study of fixed prosthetic restorations retained with 4-META/

MMA-TBB resin cement or zinc phosphate cement. J Prosthet

Dent. 2021. http://dx.doi.org/10.1016/j. PMid:34175113.

7. Krämer N, Lohbauer U, Frankenberger R. Adhesive luting of

indirect restorations. Am J Dent. 2000;13(Spec No):60D-76D.

PMid:11763920.

8. Rossi NR, Sato TP, Marinho CC, Macedo VC, Paes TJA Jr, Kimpara

ET. Influence of surface treatments in flexural strength and

superficial topography of a lithium disilicate ceramic. Braz Dent

Sci. 2019;22(3):305-12. http://dx.doi.org/10.14295/bds.2019.

v22i3.1678.

9. Jamel RS, Nayif MM, Abdulla MA. Influence of different surface

treatments of nickel chrome metal alloy and types of metal

primer monomers on the tensile bond strength of a resin cement.

Saudi Dent J. 2019;31(3):343-9. http://dx.doi.org/10.1016/j.

sdentj.2019.03.006. PMid:31337938.

10. Freitas AP, Francisconi PA. Effect of a metal primer on the

bond strength of the resin-metal interface. J Appl Oral

Sci. 2004;12(2):113-6. http://dx.doi.org/10.1590/S1678-

77572004000200006. PMid:21365132.

11. Miranda JS, Barcellos ASP, MartinelliLobo CM, Caneppele TMF,

Amaral M, Kimpara ET. Effect of staining and repeated firing

on the surface and optical properties of lithium disilicate. J

Esthet Restor Dent. 2020;32(1):113-8. http://dx.doi.org/10.1111/

jerd.12558. PMid:31854512.

12. Miranda JS, Barcellos ASP, Campos TMB, Cesar PF, Amaral

M, Kimpara ET. Effect of repeated firings and staining on the

mechanical behavior and composition of lithium disilicate.

Dent Mater. 2020;36(5):e149-57. http://dx.doi.org/10.1016/j.

dental.2020.02.003. PMid:32061444.

13. International Standards Organization. ISO 6872:2015: Dentistry

– Ceramic materials. Geneva, Switzerland: ISO; 2015.

14. Kelly JR, Rungruanganunt P, Hunter B, Vailati F. Development

of a clinically validated bulk failure test for ceramic crowns. J

Prosthet Dent. 2010;104(4):228-38. http://dx.doi.org/10.1016/

S0022-3913(10)60129-1. PMid:20875527.

15. Tribst JPM, Dal Piva AMO, Lopes GC, Borges ALS, Bottino

MA, Özcan M,et al. Biaxial flexural strength and Weilbull

characteristics of adhesively luted hybrid and reinforced CAD/

CAM materials to dentin: effect of self-etching ceramic primer

versus hydrofluoric acid etching. JAST. 2020;34(12):1253-68.

http://dx.doi.org/10.1080/01694243.2019.1710991.

16. Li ZC, White SN. Mechanical properties of dental luting cements.

J Prosthet Dent. 1999;81(5):597-609. http://dx.doi.org/10.1016/

S0022-3913(99)70216-7. PMid:10220666.

17. Mirković N. Mechanical properties of metal-ceramic systems from

nickel-chromium and cobalt-chromium alloys. Vojnosanit Pregl.

2007;64(4):241-5. http://dx.doi.org/10.2298/VSP0704241M.

PMid:17580533.

18. Belli R, Wendler M, de Ligny D, Cicconi MR, Petschelt A, Peterlik

H,etal. Chairside CAD/CAM materials. Part 1: measurement

of elastic constants and microstructural characterization.

Dent Mater. 2017;33(1):84-98. http://dx.doi.org/10.1016/j.

dental.2016.10.009. PMid:27890354.

19. Hsueh CH, Kelly JR. Simple solutions of multilayered

discs subjected to biaxial moment loading. Dent

Mater. 2009;25(4):506-13. http://dx.doi.org/10.1016/j.

dental.2008.10.002. PMid:19036422.

20. Monteiro JB, Riquieri H, Prochnow C, Guilardi LF, Pereira GKR,

Borges ALS,etal. Fatigue failure load of two resin-bonded

zirconia-reinforced lithium silicate glass-ceramics: effect of

ceramic thickness. Dent Mater. 2018;34(6):891-900. http://

dx.doi.org/10.1016/j.dental.2018.03.004. PMid:29588077.

21. Dowson D, Priest M, Dalmaz G, Lubrecht A, editors. Tribological

research and design for engineering systems. Lyon, France:

Elsevier Science; 2003.

22. Poljak-Guberina R, Catovic A, Jerolimov V, Franz M, Bergman V.

The fatigue strength of the interface between Ag-Pd alloy and

hydrothermal ceramic. Dent Mater. 1999;15(6):417-20. http://

dx.doi.org/10.1016/S0109-5641(99)00068-8. PMid:10863442.

23. Rosenstiel SF, Land MF, Crispin BJ. Dental luting agents: A

review of the current literature. J Prosthet Dent. 1998;80(3):280-

301. http://dx.doi.org/10.1016/S0022-3913(98)70128-3.

PMid:9760360.

24. Miranda JS, Monteiro JB, Silva PNF, Valera MC, Bresciani E, Melo

RM. Can different etching protocols change the properties of a

hybrid ceramic? Gen Dent. 2020;68(2):20-5. PMid:32105221.

25. Di Francescantonio M, de Oliveira MT, Garcia RN, Romanini

JC, da Silva NR, Giannini M. Bond strength of resin cements

to Co-Cr and Ni-Cr metal alloys using adhesive primers. J

Prosthodont. 2010;19(2):125-9. http://dx.doi.org/10.1111/j.1532-

849X.2009.00534.x. PMid:20002979.

26. Dias TM, Pacheco RR, De Sá RBC, Di Francescantonio M, Berger

SB, Giannini M. Evaluation of the effect of metal primers and

type of resin cement on the bond strength to zirconia. Rev Bras

Odontol. 2012;69:15-20.

27. Ravi-Chandar K, Satapathy S. Mechanical properties of G-10

glass-epoxy composite. Local: Institute for Advanced Technology

The University of Texas at Austin, Austin, TX. Defense Technical

Information Center; 2007.

28. Facenda JC, Borba M, Benetti P, Della Bona A, Corazza PH.

Effect of supporting substrate on the failure behavior of

a polymer-infiltrated ceramic network material. J Prosthet

Dent. 2019;121(6):929-34. http://dx.doi.org/10.1016/j.

prosdent.2018.08.008. PMid:30745103.

29. Archangelo KC, Penteado MM, Dal Piva AMO, Nogueira AS, Tribst

JPM, Borges ALS. Stress distribution and failure load of multilayer

and monolayer glass ceramic. Braz Dent Sci. 2019;22(1):17-22.

http://dx.doi.org/10.14295/bds.2019.v22i1.1611.

30. Morais DC, Santos MFT, Campos TMB, Trichês ES, Borges

ALS. Study of crystallization, microstructure and mechanical

properties of lithium disilicate glass-ceramics as a function of

the sintering temperature. Braz Dent Sci. 2021;24(2):1-9. http://

dx.doi.org/10.14295/bds.2021.v24i2.2378.

Jean Soares Miranda

(Corresponding address)

Departamento de Odontologia, Universidade Federal de Juiz de Fora, Governador

Valadares, MG, Brazil.

Email: jean.miranda@ufjf.br

Date submitted: 2023 June 10

Accept submission: 2023 Aug 25