An In-Vitro Acidic Media Simulation of GERD and Its Effect on Machine-Milled Ceramics’ Optical Properties

Abstract

Background: Gastroesophageal reflux disease (GERD) exposes restorative materials to gastric acid, which may compromise their esthetic and optical properties. Limited evidence exists regarding the performance of different CAD/CAM ceramics under acidic challenges. Methods: Forty CAD/CAM ceramic discs were prepared (n = 10 per group): high-translucency zirconia (Z; Ceramill Zolid Gen-X), lithium disilicate (E; IPS e.max CAD), zirconia-reinforced lithium silicate (S; VITA Suprinity), and hybrid ceramic (C; Cerasmart 270). Specimens were immersed in simulated gastric acid (0.06 M HCl, pH 1.2) at 37 °C for 96 h. Color difference (ΔE) and translucency parameter (ΔTP) were recorded before and after immersion using a spectrophotometer. Data were analyzed using one-way ANOVA with Tukey’s post hoc test (α = 0.05). Results: All materials exhibited changes in color and translucency after acidic immersion. Group Z demonstrated the lowest ΔE values, indicating the best color stability, whereas group C showed the highest ΔE and a significant reduction in ΔTP. Groups E and S revealed moderate but clinically acceptable changes. Intergroup differences were statistically significant (p < 0.05). Conclusions: Exposure to simulated gastric acid as in (GERD) resulted in measurable alterations in the optical properties of CAD/CAM ceramic materials. The extent of color change and translucency loss differed among the materials tested. High-translucency zirconia (Z) exhibited the greatest stability, while hybrid ceramic (C) showed the most pronounced changes. Zirconia-reinforced lithium silicate (S) and lithium disilicate (E) demonstrated moderate alterations, falling between these two extremes.