Monolithic Zirconia Materials Research Articles

Translucency and Color Difference of Monolithic Zirconia Restorations: The Effect of Surface Finishing on Background Color

Aim: This study evaluates the effect of different surface finishing procedures on the color and translucency values of monolithic zirconia materials on three different colored composite backgrounds. Materials and Methods: Sixty monolithic zirconia blocks of three different translucency levels were prepared in vitro using computer-aided design/computer-aided manufacturing (CAD/CAM) systems. The correlation between repeat measurements was 0.5, resulting in a sample size of nine samples per group to detect a medium effect size, f = 0.25. Half of the zirconia blocks in each group were subjected to glazing, while the other half were polished ( n = 10). Composite blocks of three different colors were prepared to simulate dental substrates, and the zirconia specimens were placed on these composite backgrounds. The color parameters of the specimens were measured using a spectrophotometer on gray, black, and white backgrounds. Three-way repeated measure ANOVA was used to assess the interaction between the three independent variables (zirconia brand, surface finishing technique, and background color) and the effects of each tested variable on the changes in color and translucency. Results: The surface finishing techniques had a significant effect on the color and translucency of the monolithic zirconia materials. Glazing resulted in higher color differences and lower translucency values compared to polishing. For backgrounds of the same color, no significant differences were detected between the glazed zirconia groups for the same condition ( p > .016). Conclusion: Overall, the study demonstrated the importance of selecting the appropriate surface finishing technique and translucency property of the monolithic zirconia materials to obtain the optimal esthetic results in dental restorations.

The Effects of Different Beverages on Fracture Resistance of CAD/CAM Monolithic PEEK and Monolithic Zirconia Crowns

Aim: To assess the impact of various beverages on the fracture resistance of CAD/CAM polyetheretherketone (PEEK) and monolithic zirconia materials. Materials and Method: We fabricated eighty CAD/CAM materials from PEEK polymer (CopraPeek; Whitepeaks Dental Solutions GmbH, Germany) and monolithic zirconia (inCoris TZI; Dentsply Sirona Systems GmbH, Bensheim, Germany), with ten samples per group. These samples were submerged in either distilled water, cola, coffee, or red wine and stored at 37°C for 12 days. We utilized a universal testing machine (Lloyd LRX; Lloyd Instruments Ltd., West Sussex, UK) to measure each sample’s fracture resistance. The t-test provided a comparison of normally distributed variables between the two groups. For multiple group comparisons, we executed an analysis of variance (ANOVA). Results: A statistically significant difference was observed between the PEEK and zirconia groups in terms of maximum load and elastic load-bearing capacity values (p˂0.05), with zirconia materials yielding higher values. However, there was no critical difference in these measures obtained from different solutions for neither PEEK nor zirconia samples (p>0.05). Conclusion: CAD/CAM monolithic PEEK material stored in various solutions demonstrated lower fracture resistance and elastic strength than monolithic zirconia materials. Despite this, PEEK exhibited the highest fracture resistance to intraoral occlusal forces. Accordingly, due to its chemically inert nature and superior force absorption, we recommend PEEK as a viable alternative material for posterior crowns in fixed restorations.

The metameric effect of monolithic zirconias with varying yttrium ratios.

To evaluate the metameric disparities among monolithic zirconia materials with differing yttrium compositions across various lighting conditions. Thirty-six square-shaped zirconia samples measuring 10 × 10 × 0.5 mm were prepared from monolithic zirconia materials with three different yttrium contents. A 0.2 mm thick layer of polymerized dual-polymerizable self-adhesive resin cement was created using a silicone mold with the same dimensions as the prepared zirconia specimens. To evaluate metamerism, color measurements were conducted using a spectrophotometer device on a neutral gray background in a color measurement cabinet that offers four different illumination environments. All samples underwent aging by subjecting them to 10000 thermal cycles using a thermal cycle tester. Following thermal aging, color measurements were taken once more, and the data were recorded using the CIE L*, a*, b* color system. Two-way ANOVA and Post-hoc Bonferroni tests were employed to analyze the data. It was observed that there was no statistical difference among the color measurements made in different illumination environments of the monolithic zirconia ceramics used to evaluate metamerism (P > .05). This observation remained consistent both before and after thermal aging. After thermal aging, the color of monolithic zirconia materials exhibited a tendency towards red and yellow hues, accompanied by a decrease in brightness levels. It can be stated that different illumination conditions did not affect the metamerism of monolithic zirconia materials, but there was a color change in monolithic zirconia materials after a thermal aging period equivalent to one year.

Evaluation of Marginal and Internal Adaptation of Crowns Fabricated with Three Different Zirconia CAD/CAM Materials.

Marginal and internal adaptation are key factors that determine the clinical success of dental restorations. The aim of this study is to evaluate the marginal and internal fit of crowns fabricated with three different CAD-CAM zirconia materials; two monolithic zirconia materials and one veneered zirconia copings in comparison with conventional metal-ceramic crowns. Ninety-six extracted molars (n = 96) were selected. Teeth were randomly divided into four groups (n = 24), and the following restorations were fabricated: Metal-ceramic crowns (Control group) (Group CG); monolithic zirconia crowns (GC initial) (Group MZ1); monolithic zirconia crowns (InCoris TZI),(Group MZ2); bilayered zirconia crowns, cores (InCoris ZI) veneered with a low-fusing glass-ceramic (IPS Emax Ceram),(Group BZ). Internal and marginal adaptations were evaluated using the silicone replica technique. A total of 20 points were recorded for every tooth under the light microscope at 20x magnifications. Results were compared using one-way analysis of variance (ANOVA) and the posthoc Tukey's test at a significance level of 0.01. Marginal, marginal-internal, axial, and occlusal gaps between CG, MZ1, MZ2, and BZ crowns showed statistically significant differences (P < 0.01). Monolithic zirconia groups showed better marginal adaptation compared with the veneered zirconia crowns.

Effect of two sintering protocols on translucency and flexural strength of different monolithic zirconia materials: An In vitro study

Effect of two sintering protocols on translucency and flexural strength of different monolithic zirconia materials: An In vitro study

Fracture strength and energy-dispersive spectroscopy analysis of 3-unit fixed partial dentures fabricated from different monolithic zirconia materials

Statement of problemMastication forces in different regions affect the survival of multiunit posterior restorations. The fracture strength of 3-unit posterior monolithic zirconia fixed partial dentures (FPDs) and their fracture patterns require investigation. PurposeThe purpose of this in vitro study was to evaluate and compare the fracture strength and fracture pattern of 3-unit posterior FPDs fabricated from different monolithic zirconia materials. Material and methodsThirty 3-unit FPDs were fabricated from BruxZir, FireZr, and Upcera (n=10 per group). Energy-dispersive spectroscopy analysis was performed on 2 selected specimens from each group. All specimens were exposed to a mastication simulator for 1.2×106 cycles and then monotonically loaded to fracture at a crosshead speed of 1 mm/min. The surfaces of a selected fractured specimen were examined at magnifications of ×25 and ×500 with scanning electron microscopy. Conformity to normal distribution was evaluated with the Shapiro-Wilk test. One-way analysis of variance was used to compare the normally distributed initial crack formation load F initial (Fi) and catastrophic failure strength F maximum (Fm) means by group. Weibull statistics were calculated by using the maximum likelihood estimation method. The chi-square test was used to compare shape and scale parameters (α=.05). ResultsThe mean Fm values were fail1878.9 N for Upcera, 2177.8 N for BruxZir, and 2229.4 N for FireZr. Upcera and BruxZir showed statistically significant differences for the Fm mean values (P=.039). The differences between the fracture type distributions according to the groups were statistically similar (P>.05). For Fi, Upcera presented the highest Weibull modulus value (2.199), FireZr had the lowest (1.594), while for Fm, BruxZir had the highest Weibull modulus value (9.267) and FireZr the lowest (6.572). ConclusionsUsing the zirconia materials BruxZir, FireZr, and Upcera resulted in high Fm values after aging procedures. With all materials, the fractures were most commonly found in the connector areas in the tested FPDs.

64 - Color Stability of Pre-shaded and Internally Shaded Monolithic Zirconia Materials

64 - Color Stability of Pre-shaded and Internally Shaded Monolithic Zirconia Materials

Durability of cantilever inlay-retained fixed dental prosthesis fabricated from multilayered zirconia ceramics with different designs

PurposeThe purpose of this in-vitro study was to investigate the effect of framework design on fracture resistance and failure modes of cantilever inlay-retained fixed partial dentures (IRFDPs) fabricated from two multilayered monolithic zirconia materials. Materials and methodsSeventy-two natural premolar teeth were prepared as abutments for cantilever IRFDPs using three designs: mesial-occlusal (MO) inlay with short buccal and palatal wings (D1), MO inlay with long palatal wing (D2), MO inlay with long palatal wing and occlusal extension (D3). Full-contoured IRFDPs were fabricated from two monolithic zirconia materials; IPS e.max ZirCAD Prime and Zolid Gen-X. Adhesive surfaces were air-abraded and bonded with MDP-containing resin cement. Specimens were subjected to thermocycling (5–55 °C, 5000 cycles); then, mechanical loading (1.2 × 10⁶ cycles, 49 N). Surviving specimens were loaded until failure in the universal testing machine. All specimens were examined under stereomicroscope, and two samples from each group were evaluated using Scanning Electron Microscope. ResultsMean failure loads were not significantly different between different framework designs or between two materials. However, IPS e.max ZirCAD Prime showed significantly higher failure rate than Zolid Gen-X during dynamic fatigue (p = 0.009). Samples with D1 design showed higher debonding rate, D2 failed mainly by fracture of the palatal wing and debonding, and D3 failed mainly by fracture of the abutment tooth. Debonded restorations showed mainly mixed failures. ConclusionCantilever IRFDPs with framework designs that maximize adhesion to enamel exhibited promising results. IPS e.max ZirCAD Prime was more susceptible to fractures with the long palatal wing design.

Influence of Different Treatments and Conditions on Optical Properties of Monolithic Zirconia: A Systematic Review

The present systematic review aimed to evaluate the influence of different treatments and conditions on the optical properties of monolithic zirconia. An electronic search was performed using the following databases: PubMed (National Library of Medicine, Bethesda, MD, USA), Web of Science (Clarivate, London, UK), Scopus (Elsevier, Amsterdam, Netherlands), Google Scholar (Google, Mountain View, CA, USA), and Embase (Elsevier, Amsterdam, Netherlands), with no restrictions on publication year and language. Based on the PICO format, the primary research question of this review was: “What is the impact of different treatments and conditions on the optical properties of monolithic zirconia?” From 145 relevant articles, 12 studies were chosen for systematic review (qualitative synthesis). A modified version of the “Guidelines for Reporting Pre-Clinical In-Vitro Studies on Dental Materials” was used to assess the overall quality of the included studies and any bias within them. The included studies assessed the optical properties (such as color stability, translucency, and surface gloss) of monolithic zirconia and other relevant ceramic materials using different treatments and conditions including aging (i.e., artificial, simulated, chemical, and hydrothermal), grinding/occlusal adjustment, glazing/external staining, toothbrushing, bleaching, and artificial gastric acid exposure. All the included studies (100%) reported a significant decrease (p &lt; 0.05) in the optical properties of monolithic zirconia samples as compared to those of other relevant ceramic materials. Overall, different treatments and conditions had a negative impact on the optical properties of monolithic zirconia. In conclusion, the optical features assessed for monolithic zirconia, such as color stability, translucency, and surface gloss, appeared to be significantly compromised by different treatments and conditions including aging, grinding/occlusal adjustment, glazing/external staining, toothbrushing, bleaching, and artificial gastric acid exposure. However, the change was clinically not perceivable in 25% (n = 3/12) of the included studies. Due to the heterogenic parameters in the included studies, it is recommended to perform future studies using standardized conditions with different stains of zirconia over an extended duration to obtain conclusive evidence.

Temperature Changes in Oral All-Ceramic Materials with Different Optical Properties under Er:YAG Laser Irradiation.

Objectives This in vitro study is aimed at assessing the oral all-ceramic materials energy transmission and temperature changes after Er:YAG laser irradiation of monolithic zirconia all-ceramic materials with varying optical properties. Materials and Methods Two monolithic zirconia materials, Zenostar T and X-CERA TT (monolithic Zirconia), were studied. Specimens were divided into four groups, with a thickness of 1.0, 1.5, 2.0, and 2.5 mm, respectively. The chemical elemental composition of the two materials was determined using X-ray spectroscopy and Fourier transform infrared spectroscopy. The light transmittance of specimens with different thicknesses was measured using a spectrophotometer at three wavelength ranges: 200–380, 380–780, and 780–2500 nm. Irradiation with Er:YAG laser was performed, and the resultant temperature changes were measured using a thermocouple thermometer. Results Compositional analysis indicated that Si content in X-CERA TT was higher than that in Zenostar T. The light transmittance of both materials decreased as specimen thickness increased. Er:YAG laser irradiation led to temperature increase at both Zenostar T (26.4°C–81.7°C) and X-CERA TT (23.9°C–53.5°C) specimens. Both optical transmittance and temperature changes after Er:YAG laser irradiation were consistent with exponential distribution against different thickness levels. Conclusion Er:YAG laser penetration energy and resultant temperature changes were mainly determined by the thickness and composition of the examined monolithic zirconia materials.

How home bleaching agents affect the color and translucency of CAD/CAM monolithic zirconia materials.

To assess the effect of 10% carbamide peroxide (CP) and 6% hydrogen peroxide (HP) home bleaching agents on the translucency and color of monolithic zirconia. Ninety disc specimens were fabricated (diameter, 10 mm) from multi-layered (ML), ultra translucent multi-layered (UTML), and super translucent multi-layered (STML) zirconia blocks at three thicknesses (0.4,1,1.5 mm) (n=5). The samples were divided into two subgroups, which were treated with 6% HP (45 min per day) or 10% CP (8 h per day) for 14 days. The color of specimens was measured before bleaching (T0) and after bleaching on the third (T3), seventh (T7), and 14th (T14) day. Color (∆E) and translucency (TP) changes were calculated. The thickness varieties used in the samples and the bleaching agent types used created statistically significant differences only in TP and ∆E00, respectively (p<0.05). Bleaching agents can affect TP and ∆E. Patients who have zirconia restorations should be careful when using home bleaching agents.

Effect of artificial aging on the translucency of monolithic zirconia materials sintered at different temperatures

Statement of problemTranslucent zirconia materials were developed as an alternative to lithium disilicate materials. However, the effect of sintering temperature and artificial aging on the translucency of zirconia materials is unclear. PurposeThe purpose of this in vitro study was to investigate the translucency of recently developed zirconia materials after different sintering temperatures and the effect of artificial aging. Material and methodsDisk-shaped specimens (Ø15×1 mm) of 3 different monolithic zirconias (Katana UTML, Prettau Anterior, VITA YZ XT) and a control lithium disilicate reinforced glass-ceramic (IPS e.max CAD LT) were evaluated. The zirconia specimens were divided into 2 subgroups with different sintering temperatures (1450 °C, 1550 °C) (n=5, N=35). The specimens were artificially aged in a thermocycle tester and a mastication simulator. The translucency parameter (TP) was calculated by measuring with a spectrophotometer. Kruskal-Wallis and Wilcoxon signed-rank tests were used to analyze the data (α=.05). ResultsWhile the overall TP of monolithic zirconia increased after artificial aging, the lithium disilicate specimens did not show a statistically significant difference (P=.35). The Prettau Anterior and VITA YZ XT specimens had a statistically significant higher TP than Katana UTML (P=.009). Sintering temperature did not have a statistically significant effect on the TP value of monolithic zirconia materials (P>.05). ConclusionsArtificial aging increased the TP, and the sintering temperature did not affect the TP of monolithic zirconia. The use of fully stabilized zirconia may be an alternative to lithium disilicate in esthetic restorations in clinical practice.

Effect of sintering regimes and thickness on optical properties of zirconia ceramics for dental applications

AbstractIn dentistry, monolithic zirconia restorations have been preferred over all‐ceramic restorations in recent years. Translucency is an aesthetic demand in dental restorations, and it can be identified with translucency parameter (TP). Zirconia thickness, Y2O3 content, and sintering conditions are important parameters that influence the translucency of the restorations. It is crucial to investigate monolithic zirconia ceramics under different sintering regimes and reveal the critical parameters for dental restorations. The aim of this study was to determine the optical and microstructural behaviors of monolithic zirconia ceramics containing different amounts of yttria depending on various sintering regimes and thicknesses. Therefore, a conventional zirconia CopranZri (CZI) and two monolithic zirconia materials, CopraSupreme (CSP), CopraSmile (CSM) were used. Slow, normal, speed, and translucency sintering regimes with thicknesses of 0.7, 1.0, 1.3 mm were selected. TP of the specimens was calculated, and statistical analyses were performed by using one‐way ANOVA and Tukey‐Kramer post hoc tests. Characterization of the specimens was performed by X‐ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive X‐ray (EDX) techniques. The results showed that the effect of different sintering programs is more critical for CSP and CSM in terms of translucency variations and translucency program led to the most grain growth.

Effect of glazing on translucency, color, and surface roughness of monolithic zirconia materials.

To assess the effect of material, thickness and glazing upon the color, translucency, and roughness of monolithic zirconia. Sixty discs (0.8, 1.5, and 2 mm thickness) were fabricated from A1 translucent zirconia (IPS e.max ZirCAD/MT, Katana/HT, Vita YZ/HT, Cercon/HT) and glazed. Roughness (Ra) was assessed with a profilometer and color coordinates were measured with a spectrophotometer on a black, white, and tooth-shaded background before and after glazing. Relative translucency parameter (RTP), color differences (CIEDE2000) and differences in translucencies between materials, before and after glazing were calculated. RTP, Ra, color differences were statistically analyzed using ANOVA. Any significant interaction between factors was further analyzed using Tukey's HSD. RTP values were significantly different between materials (P < .001) and thicknesses (P < .001), with the interaction effect between material type and thickness, also significant (P < .001). However, glazing did not have a significant effect on RTP values (P = .782). Color differences resulted after glazing were significantly different between materials (P < .001), and thicknesses (P < .001) with the interaction effect also significant (P < .001). Glazing influenced roughness, Ra decreasing for all materials (P < .001). As a result of glazing, only color changes were statistically significant. Translucency varied among brands of precolored monolithic zirconia; the differences increased for greater thicknesses. Glazing is an important step in the technological process of ceramic restorations; however, it can influence the final optical appearance of the restoration as color changes could be expected after the application of the glaze.

The effect of restoration thickness and resin cement shade on the color and translucency of a high-translucency monolithic zirconia

Statement of problemInformation regarding the influence of cements and material thickness on the final color of monolithic zirconia restorations is lacking. PurposeThe purpose of this in vitro study was to examine the effect of varying resin cement colors and material thicknesses on the color and translucency of a high-translucency monolithic zirconia and to compare these effects with those reported in similar studies that examined other dental zirconia materials. Material and methodsKatana High Translucent (Kuraray) was used as a monolithic zirconia material. A total of 80 disk specimens (10 mm in diameter) were made in 4 different thicknesses of 0.5 mm, 1 mm, 1.5 mm, and 2 mm (n=20 per thickness). The color of the specimens (Commission Internationale de l'Eclairage [CIE] L*, a*, b* values) before cementation was measured using a spectrophotometer. Specimens within each thickness were further divided into 2 groups: transparent (n=10) and opaque (n=10). A transparent or opaque self-etch adhesive resin cement (Panavia V5) was then applied to each specimen. After cementation, the color was measured again. The translucency parameter (TP) and ΔE were calculated and evaluated with the color measurements by using descriptive statistics, correlation analysis, single specimen t test, 2-way ANOVA, and the Tukey Honestly Significant Difference (HSD) test. ResultsStatistically significant (P<.001) changes were found with the increasing thicknesses of the high-translucency zirconia specimens. The TP, L*, and b* values decreased, whereas the a* values increased. In both the transparent and opaque groups, statistically significant (P<.001) increases in L*, a*, and b* values and a significant decrease in TP were found with cementation. The lowest ΔE value (1.19 for 2 mm) was observed for monolithic zirconia-clear cement. The highest ΔE value (8.05 for the 0.5 mm) was observed for the monolithic zirconia and opaque cement combination. ConclusionsMaterial thickness and cement color affected the color and translucency of high-translucent monolithic zirconia, with effects similar to those observed with other monolithic zirconia materials.

Evaluation of Dual-Cure Resin Cement Polymerization under Different Types and Thicknesses of Monolithic Zirconia.

Purpose The aim of the present study was to investigate the effects of the type and thickness of the zirconia material on the microhardness of the underlying dual-cure resin cement. Materials and Methods Eight disk-shaped zirconia specimens with a 4-mm diameter and four varying thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were fabricated from two different monolithic zirconia materials: posterior monolithic zirconia (Prettau) and anterior monolithic zirconia (Prettau Anterior). Dual-cure resin cement specimens with a 4-mm diameter and 5-mm height were prepared using Teflon cylinder molds and activated by light beneath the eight zirconia disks and without any zirconia disk for 20 s (n=12). A total of 108 specimens were embedded in acrylic. Vickers hardness of each specimen was measured at three different depths using a microhardness device with a 50-g load. All data were statistically evaluated using three-way ANOVA, one-way ANOVA, independent samples t-tests, and Bonferroni corrected post hoc tests (α=.05). Results Dual-cure resin cement's microhardness was significantly higher for the samples polymerized beneath anterior monolithic zirconia compared to posterior monolithic zirconia. The hardness decreased as the thickness increased for both types of zirconia; the latter was attributed to an attenuated curing efficiency. Conclusion Microhardness of the dual-cure resin cement is influenced by both the type and the thickness of the monolithic zirconia restoration. Polymerization efficiency for resin cement cured under anterior monolithic zirconia may be superior to cured beneath posterior monolithic zirconia.

Computable translucency as a function of thickness in a multi-layered zirconia

Statement of problemDetermining the relationship between variable thicknesses and the translucency of dental ceramics is essential for optimizing esthetics in different clinical situations. PurposeThe purpose of this in vitro study was to analyze the relationship between layer thickness and translucency of 2 multi-layered monolithic zirconia materials and to develop an equation by which the grade of translucency can be calculated dependent on the materials' layer thicknesses in advance. Material and methodsTwo semisintered multi-layered zirconia blanks, namely KATANA Zirconia Super Translucent Multi-Layered Disk (Noritake Dental Supply Co, Ltd) and Zirconia Ultra Translucent Multi-Layered Disk (UTML) (Noritake Dental Supply Co, Ltd), were sectioned (N=96) to separate the 4 layers (n=12 per layer): enamel layer, transition layer 1, transition layer 2, body layer. All specimens were sintered in a furnace (M2 Plus; Thermo-Star) at 1500°C for 2 hours and automatically polished under water cooling up to P2400 for the thicknesses of 1.6, 1.3, 1.0, 0.7, and 0.4 mm. Transmittance of visible light was measured using a spectrophotometer (Lambda 35; Perkin Elmer). Data were analyzed using the Kolmogorov-Smirnov, 2-way ANOVA, and Scheffé post hoc tests (α=.01) and curve fitting. ResultsAnalyzing the fitting of the values of the 8 material groups to the linear, exponential, and logarithmic curves, 7 of the 8 groups (not UTML body layer) fitted the most (R-square value closer to 1.0) to the logarithmic curve. Constants were obtained from the distance to the x-axis and the curvature. ConclusionsThe methodology of this study provided the materials' specific constants a and b by analyzing the translucency behavior of KATANA Super Translucent Multi-Layered Disk and Ultra Translucent Multi-Layered Disk in different thicknesses, allowing further translucency calculation by applying the developed formula and the constants.

Effects of dynamic aging on the wear and fracture strength of monolithic zirconia restorations

BackgroundThe purpose of this study is to evaluate the wear and fracture strength of crowns and three-unit partial fixed dental prosthesis (FDP) fabricated using by Bruxzir and Incoris TZI as recently introduced monolithic zirconia materials.MethodsA total of sixteen crowns and sixteen three-unit FDPs were fabricated using Bruxzir and Incoris TZI (n = 8). All specimens were subjected to a 2-body wear test in a dual axis chewing simulator for 1,200,000 loading cycles against steatite antagonist balls. The fracture strength and volumetric loss were recorded. The obtained data were statistically analyzed by 2-way ANOVA testing (α = 0.05).ResultsThe mean volumetric loss of the crowns was higher than that of the three-unit FDPs (p < 0.05). Of the two monolithic systems, Incoris TZI exhibited more wear than Bruxzir. The fracture strengths of Bruxzir crowns and FDPs were found to be higher than those of the crowns and FDPs fabricated with Incoris TZI (p < 0.05).ConclusionIn in vitro test conditions, Bruxzir and Incoris TZI monolithic zirconia systems are fracture-resistant for the crown and FDP application against physiologic chewing forces owing to dynamic aging. Among newly developed monolithic zirconia materials, Bruxzir is found to be more resistant to fracture compared to the Incoris TZI.

BIAXIAL FLEXURAL STRENGTH OF UN-SHADED AND SHADEDMONOLITHIC TRANSLUCENT ZIRCONIA

INTRODUCTION: The natural white color of zirconia together with the veneer chipping problem has led to the development of tooth colored monolithic (full-anatomic) zirconia. In order to optimize esthetics shading of monolithic zirconia were done by two main approaches, either by powder mixing method or by infiltration technique. The influence of infiltration technique on mechanical properties of zirconia has been reviewed previously, while the influence of powder mixing method on the mechanical properties of shaded zirconia, specially the biaxial flexural strength has not been widely studied before. OBJECTIVES: To evaluate and compare the biaxial flexural strength and the crystal structure of shaded CAD/CAM monolithic translucent zirconia by powder mixing method with un-shaded ones. MATERIALS AND METHODS: Twenty fully sintered discs of un-shaded [T 0] and shaded [T S] monolithic translucent zirconia of diameter 12 mm and thickness 1 mm has been divided into 2 parallel groups of 10 discs each. Their biaxial flexural strength was measured using a ball-on-ring test fixture and universal testing machine at room temperature. Statistical significance was measured using One-Way ANOVA test. Then crystallographic analysis was done for both groups using X-ray diffraction. Finally the nature of failures of the tested specimens was examined using confocal laser microscopy. RESULTS: Biaxial flexural strength test showed no significant difference between un-shaded and shaded specimens. X-ray diffraction spectrum only showed crystals of tetragonal zirconia with no evidence of neither monoclinic zirconia crystals nor coloring oxides crystal phases. Confocal laser microscopy images of both groups showed the classic fracture patterns of monolithic zirconia materials. CONCLUSIONS: shading of zirconia blocks by powder mixing methods does not significantly (P≥0.05) affect either biaxial flexural strength or crystallographic structure of monolithic translucent zirconia

Fracture Strength and Precision of Fit of Implant-Retained Monolithic Zirconia Crowns.

New monolithic zirconia materials can be used to fabricate full-contour fixed dental prostheses with the computer-aided design/computer-aided manufacturing (CAD/CAM) method. The aim of this study was to examine the fracture strength and precision of fit of screw-retained monolithic zirconia crowns made directly on implants or by cementing on prefabricated titanium (Ti) bases. Monolithic screw-retained implant crowns (n = 6) were produced by CAD/CAM method using partially (PSZ) and fully stabilized (FSZ) zirconia. Industrially produced zirconia crowns were used as a reference. A lateral incisor study model was made onto an implant replica. Crowns were produced either directly on the implant or through cementing on a prefabricated titanium base (PSZ+Ti, FSZ+Ti). The crowns were tightened to implant replicas with a torque of 35 Ncm. The gap between the replica and the abutment or crown was measured from ×400 scanning electron microscope images for precision of fit. Mechanical testing until failure was completed with a universal testing machine with loading angle of 45°. Statistical analysis was performed (analysis of variance). Mean (±SD) failure loads were 259 ± 23 (PSZ), 140 ± 13 (FSZ), 453 ± 25 (PSZ+Ti), 439 ± 41 (FSZ+Ti), and 290 ± 39 (Procera). Mean (±SD) gap values were 2.2 ± 0.2 (PSZ), 2.5 ± 1.0 (FSZ), 7.0 ± 1.0 (PSZ+Ti), 7.7 ± 1.6 (FSZ+Ti), and 6.7 ± 1.7 (Procera). Monolithic zirconia crowns with a Ti base clearly show higher fracture strengths than the crowns fixed directly on the implant surface. Better marginal fit can be achieved with direct zirconia crowns than with crowns on a titanium base or industrially produced zirconia crowns.