Mante, Francis K.
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Publication Marginal Adaptation of CAD/CAM Hybrid Ceramic Crowns Made on Preparations With and Without Surface Finishing(2021-04-29) Al-Hussainy, Faisal; Conejo, Julian; Anadioti, Eva; Mante, Francis K.; Blatz, Markus B.Statement of problem: Studies on previous generations of chair-side Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems concluded that preparation quality has an impact on marginal fit of milled restorations. However, as chair-side CAD/CAM technology improves, and newer systems and materials are released, it remains unclear if preparation quality still impacts marginal adaptation of milled restoration. Purpose: This in vitro study evaluated the marginal adaptation of ceramic crowns fabricated with a chair-side CAD/CAM system on preparations completed with and without surface finishing to identify if finishing preparation protocols affect the marginal fit. The null hypothesis was that there was no difference in the mean marginal adaptation of ceramic restorations between the two finishing protocols. Materials and Methods: A total of 10 maxillary right central incisor acrylic teeth were screwed into precision restorative typodont with soft gum and attached to a portable bench mount. Teeth were divided into two groups (Control group CG, Finished group FG) and prepared for all ceramic crowns with medium only/and fine grit burs under dental loupes with 4.5x magnification. The CG was prepared using the medium grit bur only, while the FG was prepared using the medium grit bur and then refined with the fine grit bur for two minutes. Preparations were scanned with an intraoral scanner and hybrid ceramic crowns were designed, milled and hand polished following the manufacturer’s recommendations. The hybrid ceramic crowns were cemented on the prepared teeth using a dual cure resin cement system. Design, milling and cementation were made by the same operator. To measure the vertical marginal gap between the margin of the crown and the finish line of the acrylic tooth, scanning electron microscope (SEM) images were made (Singh Center for Nanotechnology, University of Pennsylvania) with magnification of ×100. A total of 50 measurements were made per tooth: 25 mid-facial margin area and 25 mid-palatal margin area. The data were analyzed with Mann-Whitney Rank Sum Test to determine differences between the groups. A statistical software program was used for the analysis. Results: The FG resulted in a significant decrease in the overall mean marginal gap of CAD/CAM all ceramic crowns compared to the CG (p<0.001). Conclusion: Crown preparation finishing with fine grit bur has a significant impact on the marginal gap of all ceramic restorations.Publication Bond Strength of Different Self-Adhesive Resin Cements to Zirconia(2021-06-30) Patel, Nupur; Anadioti, Eva; Conejo, Julial; Ozer, Fusun; Mante, Francis; Blatz, MarkusObjectives: The purpose of the study was to compare the shear bond strength of five self-adhesive resin cements used to bond zirconia. Methods: Seventy-two KATANA Zirconia STML (n=12) specimens were sectioned and sintered in an induction furnace (CEREC SpeedFire, Dentsply Sirona, Germany). Specimen surfaces were ground finished with 800 grit silicon carbide abrasive with cooling water and cleaned with ultrasonication in alcohol. Specimens were air-particle abraded with 50 μm aluminum oxide at 2.8 bar pressure. Cylindrical composite resin specimens (2.1 mm in diameter, 3 mm in height) were bonded to the zirconia samples with self-adhesive resin cements Panavia SA Universal (PSA), TheraCem (TCM), SpeedCem 2.0 (SCM), RelyX Unicem 2 (RCM), PermaCem 2.0 (PCM) and dual-cure multi-step composite resin cement Panavia V5 (control, PV5, after application of ceramic primer) following manufacturers’ instructions. A load of 1000 g was applied to the composite cylinders during bonding in an alignment apparatus, then light cured for 80 s. Samples were stored in distilled water at 37° C for 24 h, then subjected to 10,000 thermal cycles. Shear bond strength was determined using a universal testing machine at a crosshead speed of 0.5 mm/min expressed in MPa. The fractured surfaces of specimens were inspected with a stereo microscope and classified as 8 adhesive, cohesive, or mixed failures. One-way ANOVA test and Tukey test were applied for statistical analysis. Results: Shear bond strength values [MPa] were for PSA 8.64 (1.78 SD), TCM 9.05 (2.64 SD), SCM 8.54 (1.92 SD), RCM 7.60 (1.26 SD), PMC 7.59 (1.10 SD) and PV5 9.59 (1.55 SD). One-way ANOVA test revealed no statistically significant differences in shear bond strength between the resin cements tested (p>0.05). Pair wise comparison using Tukey test revealed that the shear bond strength using RCM was statistically lower than that using PV5 (p<0.05). Conclusions: According to the results of this in vitro study, self-adhesive resin cements can achieve shear bond strengths to zirconia that are comparable multi-step resin cements. In routine clinical application, self-adhesive resin cements can be a user- friendly, less technique sensitive alternative for bonding Zirconia restorations following the APC concept.Publication Investigating the maximum bite force and speech intelligence in patients requiring prosthetic rehabilitation(2025-06-13) Gupta, Aditi; Patel, Nupur; Lee, Jason D; Mante, Francis K.; Chang, Brian MObjective: Tooth loss leads to reduced occlusal contact area, altered jaw biomechanics, and diminished neuromuscular coordination, impairing both masticatory function and speech clarity. Edentulous patients often adapt by modifying food choices or swallowing behavior and may experience persistent phonetic disturbances. Maximum bite force is a validated measure of masticatory system performance, while speech intelligibility reflects the functional integration of a prosthesis within the oral cavity. This study aimed to objectively evaluate maximum bite force and speech intelligence among completely edentulous patients rehabilitated with different types of dental prostheses, compared to individuals with full natural dentition. Methods: A cross-sectional study was conducted with 60 participants divided into six groups: **(A)** Hybrid Prosthesis (at least one arch) **(B)** Implant-Retained Overdentures (IROD) in both arches **(C)** Maxillary Complete Removable Dental Prosthesis (CRDP) with Mandibular IROD **(D)** Implant Bar-Supported Prosthesis (at least one arch) **(E)** Maxillary and Mandibular CRDP **(F)** Full Natural Dentition (control group) IRB approval (Protocol #857207) and informed consent were obtained. Maximum bite force was recorded using a bilateral molar bite force transducer. Participants performed three maximal-effort bites per side; total and unilateral bite force data were analyzed. Speech intelligence was evaluated using a standardized dental articulation passage. A speech intelligibility scorer calculated the percentage of recognized words, averaged across three trials. Results: Group F (Full Natural Dentition) exhibited the highest mean bite force (752.03 N), followed by Groups A (522.97 N), B (294.12 N), C (174.23 N), D (162.17 N), and E (72.13 N). Fold increases over Group E (complete dentures) were 10.4× (F), 7.3× (A), 4× (B), 2.4× (C), and 2.25× (D). Repeated-measures ANOVA confirmed that total bite force was significantly higher than unilateral values (1.5–1.8× greater). Males had significantly higher bite force than females (p < 0.01). Speech intelligibility scores followed a similar gradient. Group F had the highest score (85.67%), followed by Groups A (70.13%), D (62.73%), C (58.17%), B (56.52%), and E (54.63%). Statistically significant differences were observed between Group E and Groups B, C, and D (p < 0.005). Fixed prostheses (Groups A and D) outperformed removable designs (Groups B, C, and E) in both bite force and speech performance. The superior speech outcomes associated with fixed prostheses are likely due to greater palatal stability and optimized tongue space. No gender-based differences were observed for speech scores. Correlation analysis revealed moderate positive relationships between bite force and speech intelligence across prosthetic groups. Stronger masticatory capacity was associated with improved phonetic clarity in fixed and implant-retained prosthesis users, whereas weaker bite forces in complete denture users correlated with reduced intelligibility. Conclusion: This study underscores the importance of assessing both masticatory and phonetic outcomes in prosthodontic rehabilitation. The findings establish a functional gradient of bite force across prosthetic designs: **Full Natural Dentition > Hybrid Prosthesis > IROD > Bar-Supported Prosthesis > CRDP + Mandibular IROD > CRDP.** Complete removable dental prosthesis exhibited only one-tenth the bite force of full natural dentition. Masticatory function improved 2.4× with a mandibular IROD, 4× with IROD in both arches, and 7.3× with a hybrid prosthesis. Fixed prostheses also yielded higher speech intelligibility, attributed to improved tongue space and palatal contours. While gender influenced bite force, it had no effect on speech. Bite force transducers and intelligibility scorers offer practical, objective tools to guide treatment planning, monitor rehabilitation success, and support evidence-based prosthodontic care.