Translucent Zirconia Research Articles

Silica infiltration on translucent zirconia restorations: Effects on the antagonist wear and survivability.

To assess potential antagonist wear and survival probability of silica-infiltrated zirconia compared to glass-graded, glazed, and polished zirconia. Table top restorations made of 3Y-TZP (3Y), 5Y-PSZ (5Y), and lithium disilicate (LD) were bonded onto epoxy resin preparations. Each zirconia was divided into five groups according to the surface treatment: polishing; glaze; polishing-glaze; glass infiltration; and silica infiltration. The LD restorations received a glaze layer. Specimens were subjected to sliding fatigue wear using a steatite antagonist (1.25×106 cycles, 200N). The presence of cracks, fractures, and/or debonding was checked every one/third of the total number of cycles was completed. Roughness, microstructural, Scanning electron microscopy, wear and residual stress analyses were conducted. Kaplan-Meier, Mantel-Cox (log-rank) and ANOVA tests were performed for statistical analyses. The survival probability was different among the groups. Silica infiltration and polishing-glaze led to lower volume loss than glaze and glass-infiltration. Difference was observed for roughness among the zirconia and surface treatment, while lithium disilicate presented similar roughness compared to both glazed zirconia. Scanning electron microscopy revealed the removal of the surface treatment after sliding fatigue wear in all groups. Compressive stress was detected on 3Y surfaces, while tensile stress was observed on 5Y. 3Y and 5Y zirconia behaved similarly regarding antagonist wear, presenting higher antagonist wear than the glass ceramic. Silica-infiltrated and polished-glazed zirconia produced lower antagonist volume loss than glazed and glass-infiltrated zirconia. Silica-infiltrated 3Y and lithium disilicate restorations were the only groups to show survival probabilities lower than 85%.

Surface characteristics assessment among layers of different translucent multilayered dental zirconia related to aging

Considering that the surface characteristics and microstructure are relevant factors that may affect the appearance and strength of a material, this study aims to analyse the differences regarding surface roughness and microhardness among layers of three types of dental zirconia: super-high translucent zirconia Ceramill Zolid fx ML (5Y-TZP), super-translucent zirconia STML (4Y-TZP), and IPS e.max ZirCAD CEREC/in Lab MT Multi (4Y + 5Y-TZP), also evaluating the influence of the surface treatment performed by glazing and polishing-before, respectively after aging-by thermocycling. Forty plate-shape specimens were sectioned from the ceramic blocks with a precision disc, polished and sintered according to the manufacturer’s instructions and then, equally divided - the surface of some was finished by polishing and the others by glazing; from each category was formed a control (polished/glazed) group and one subjected to termocycling (polished/glazed) − 30.0000 cycles in a 5˚C and a 55˚C bath with distilled water in a thermocycler, resulting four groups of ten samples, for a material. The assessment of surface roughness (Ra, Rz) was performed with a contact profilometer, with Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM); Vickers hardness (VH) values were recorded with a microhardness tester. The evaluations of the surfaces were achieved in each area: incisal, medium, cervical. For statistical analyses, paired sample t-Test, unpaired sample t-Test, two-way ANOVA test (α = 0.05), Pearson's correlations were used. Both before and after thermocycling, polishing and glazing, as surface treatment have a significant effect on roughness, respectively on microhardness; no statistical differences were observed among areas, on each polished or glazed surface. On the glazed samples, the values recorded for surface roughness were significant higher and for microhardness-lower, compared with those of the polished group. After thermocycling, microrougness increased for STML and all polished specimens and decreased on glazed surfaces of Ceramill Zolid fx ML and IPS e.max ZirCAD CEREC/in Lab MT Multi. Concerning microhardness, the thermocycling procedure had no significant influence. The super-high translucent material was less affected by aging than the super-high translucent zirconia.

Three-year clinical evaluation of zirconia and zirconia-reinforced lithium silicate crowns with minimally invasive vertical preparation technique

ObjectivesLarge part of the tooth is required to be removed during crown preparation. A minimally invasive method for preparing single crowns is required to increase the durability of teeth. The aim of this study was to evaluate the clinical performance of two ceramic systems fabricated with minimally invasive vertical preparation.Materials and methodsForty endodontically treated maxillary premolars were prepared with vertical preparation and received temporary crowns for a period of 21 days. Twenty zirconia-reinforced lithium silicate (Celtra Duo HT, Dentsply Sirona, Germany) and 20 monolithic high translucency zirconia (Katana HT, Kuarary Noritake, Japan) crowns were fabricated by CAD/CAM and cemented with dual-polymerizing luting resin. The crowns were evaluated clinically and radiographically for 36 months following modified FDI criteria. Statistical analysis was conducted with t Student test (Cochran Q).ResultsOver the follow-up period, there was no need to replace any of the study’s crowns. The overall survival rate of the 40 crowns was 100% according to the Kaplan–Meier survival method. The clinical quality of all crowns and the patient’s satisfaction were high. No caries was detected and no adverse soft tissue reactions around the crowns were observed. Periodontal probing depth was reported to be increased at mesial and distal sites more than the facial one in the 36-month follow-up with no statistically significant difference between both materials (P = 0.186).ConclusionsZirconia and zirconia-reinforced lithium silicate could be used as a material for restoration of teeth prepared with vertical preparation technique. Both ceramic materials achieved good esthetic results, promotes healthy and stable soft tissues with no mechanical complications after 3 years of clinical evaluation.Clinical relevanceMonolithic high translucency zirconia and zirconia-reinforced lithium silicate ceramics can be used for the restorations of minimal invasive vertical preparation in premolar area with 0.5 mm margin thickness.

Effect of Hydrothermal Degradation on Flexural Fatigue Strength of Various Cubic-Containing Translucent Zirconia.

The aim of this study is to investigate the fatigue and hydrothermal degradation behavior among the cubic-containing translucent yttrium oxide stabilized tetragonal zirconia polycrystal (Y-TZP). Four groups of commercial Y-TZP (T, ST, XT, and P), containing different amount of cubic crystal, were examined. Artificial aging was accomplished by autoclaving at 122°C under 2 bar pressure for 8 hours. Fatigue simulation parameters were set using an axial 50 N load, a total of 240,000 cycles. Flexural fatigue strength was evaluated. Two-way analysis of variance with Tukey's honestly significant difference test was used to determine the difference in fatigue strength values between various type of zirconia materials within control and aging with a significant level of 5%. Weibull analysis was conducted on the fatigue strength data. All groups showed the mean flexural fatigue strength had no significant difference in hydrothermally aged specimens compared with specimens without aging (p = 0.154). Group T showed significantly higher flexural fatigue strength followed by group ST, XT, and P. Group XT and P showed no significant difference in strength value (p > 0.05). Group T demonstrated a lower probability of failure than group ST, XT, and P whether with or without aging. Weibull modulus in group T and ST with aging condition was increased and higher than all the experimental groups. Cubic-containing zirconia materials (group ST, XT, and P) exhibited lower flexural fatigue strength than non-cubic 3Y-TZP zirconia (group T). However, various cubic-containing translucent zirconia was assumed to have high resistance to hydrothermal degradation.

Development of translucent zirconia by robocasting

Partially translucent zirconia for dental applications was developed by robocasting using aqueous-based inks of zirconia doped with 5 mol.%Y2O3 as feedstock and a printing nozzle with 0.25 mm diameter. The manufactured samples were sintered at 1600 °C-2 h and characterized by crystalline phases, microstructure, mechanical properties and opacity. The sintered samples presented ≈94 % relative density, 12.7 ± 0.3 GPa as Vickers hardness, 3.91 MPa.m1/2 as fracture toughness and, 285 ± 57 MPa as flexural strength. The contrast ratio optical parameter varied in the range of 0.5 to 0.9, according to the material thickness. These optical outcomes are determined by the relative density and the microstructure, namely the presence of sub-micrometre tetragonal grains (26.4 %) and cubic phase grains (73.6 %) with sizes in the order of 1.5 μm, that justified the improved translucency obtained when compared to opaque tetragonal 3Y-TZP ceramics.

Mechanical stability of angulated zirconia abutments supporting maxillary anterior single crowns on narrow-diameter implants.

To investigate the fracture strength of angulated hybrid abutments supporting anterior single crowns on narrow-diameter implants (NDIs). Zirconia abutment with angulations of labial inclination 0° (TZ0Z), 15° (TZ15Z), 30° (TZ30Z) and palatal inclination 15° (TZ - 15Z) was designed on 3.3-mm titanium-zirconium (Ti-Zr) NDIs. Titanium abutment connected with Ti-Zr implant (TZ0T) and 0° zirconia abutment connected with pure titanium (Ti) implant (T0Z) were control groups. Thirty-six un-restored abutments and 36 abutments restored with highly translucent zirconia (HTZ) crowns were tested. Failure loads were compared among 6 groups, and bending moments were calculated for comparison between un-restored and restored abutments. Failure loads of un-restored abutments were affected by the abutment angle. Sixty-seven percent samples in TZ30Z and 83% samples in TZ - 15Z group fractured at the thinnest part of the zirconia abutment and exhibited lower failure load (p < .05). Failure loads of restored abutments were close to or exceeded the maximum bite force of anterior teeth, and no differences were found among six groups (p > .05). Except TZ15Z and TZ0T group, the bending moment increased with the crown construction, especially for TZ30Z and TZ - 15Z groups (p < .001). The fracture strength of hybrid abutments restored with HTZ crown on Ti-Zr NDIs exceeded the bite forces of anterior teeth for all the groups and were not affected by the abutment angle. In terms of fracture strength, Ti-Zr NDIs combined with angulated hybrid abutments and HTZ crowns can be used in the anterior region.

Effect of Staining Drinks on the Color Stability of Grit Blasted and Non-Grit Blasted Monolithic Zirconia: An In Vitro Study

The present study aimed to compare the color stability of different types of zirconia with and without grit blasting (GB) after they were immersed in staining drinks. Two hundred and forty zirconia samples (N = 240) belonging equally to three different types of zirconia (Cercon® xt multilayer, xt extra translucent, and ht high translucent) were used in this study. Forty samples from each zirconia group were roughened with GB, while the other forty remained non-GB (NGB). Eight GB and NGB zirconia samples from each sub-group were immersed in artificial saliva, coffee, protein shake, chlorhexidine mouthwash, and a soft drink. Besides chlorhexidine mouthwash (immersion time: 14 days), the samples were immersed in the liquids for 28 days. A spectrophotometer was utilized to observe the color differences (∆E) at baseline (T0), 7 days post-immersion (T1), 14 days post-immersion (T2), 21 days post-immersion (T3), and 28 days post-immersion (T4). For the multilayer zirconia, the greatest ∆E (8.45 for GB and 5.97 for NGB samples) was observed after immersion in coffee at T4. For the extra translucent zirconia, the greatest ∆E (9.10 for GB and 6.81 for NGB samples) was also observed after immersion into the coffee at T4. For the high translucent zirconia, the greatest ∆E (4.53 for GB and 3.62 for NGB samples) was observed after immersion into the coffee at T4 and T3. Protein shake and soft drink immersion also significantly discolored some zirconia samples. Overall, GB zirconia samples presented with greater ∆E values than their NGB counterparts. It can be concluded that coffee immersion of zirconia samples caused a more significant discoloration (increased ∆E values) than any other liquid. Future clinical studies should be carried out to corroborate the current study’s findings.

Effect of surface treatments on biaxial flexural strength, fatigue resistance, and fracture toughness of high versus low translucency zirconia

BackgroundMechanical surface treatments can deteriorate the mechanical properties of zirconia. This study evaluated and compared the biaxial flexural strength, fracture toughness, and fatigue resistance of high translucency (HT) to low translucency (LT) zirconia after various mechanical surface treatments.MethodsFour hundred eighty zirconia discs were prepared by milling and sintering two HT (Katana and BruxZir) and LT (Cercon and Lava) zirconia blocks at targeted dimensions of 12 mm diameter × 1.2 mm thickness. Sintered zirconia discs received one of the following surface treatments: low-pressure airborne particle abrasion (APA) using 50 µm alumina particles, grinding using 400 grit silicon carbide paper, while as-sintered specimens served as control. Internal structure and surface roughness were evaluated by scanning electron microscope (SEM) and a non-contact laser profilometer, respectively. Half of the discs were tested for initial biaxial flexural strength, while the rest was subjected to 106 cyclic fatigue loadings, followed by measuring the residual biaxial flexural strength. Fractured surfaces were examined for critical size defects (c) using SEM to calculate the fracture toughness (KIC). The effect of surface treatments, zirconia type, and cyclic fatigue on the biaxial flexural strength was statistically analyzed using three-way analysis of variance (ANOVA) and Tukey HSD post hoc tests (α = 0.05). Weibull analysis was done to evaluate the reliability of the flexural strength for different materials.ResultsThe initial biaxial flexural strength of LT zirconia was significantly higher (p < 0.001) than that of HT zirconia in all groups. While low APA significantly increased the biaxial flexural strength of LT zirconia, no significant change was observed for HT zirconia except for Katana. Surface grinding and cyclic fatigue significantly reduced the flexural strength of all groups. High translucency zirconia reported higher fracture toughness, yet with lower Weibull moduli, compared to LT zirconia.ConclusionLT zirconia has higher biaxial flexural strength, yet with lower fracture toughness and fatigue resistance, compared to HT zirconia. Low-pressure APA has significantly increased the biaxial flexural strength in all zirconia groups except BruxZir. Grinding was deteriorating to biaxial flexural strength and fracture toughness in all zirconia types. Cyclic fatigue has significantly decreased the biaxial flexural strength and reliability of HT and LT zirconia.

Effects of Material Thickness and Pretreatment on the Interfacial Gap of Translucent Zirconia Restorations with Self-adhesive Resin Cement.

The first objective was to determine if the dual-curing of self-adhesive resin cement (SAC) with reduced light penetrating through zirconia had an effect on interfacial gap of zirconia restorations. The second purpose was to examine whether pretreatment methods for universal adhesive affected interfacial gap. The last aim was to compare the microhardness of SAC polymerized under different zirconia thicknesses. This study evaluated self-adhesive resin cement (RelyX U200, 3M ESPE) after different pretreatment with universal adhesive (Single Bond Universal, 3M ESPE) under different polymerization conditions. CAD/CAM inlay cavities were prepared on extracted third molars. Translucent zirconia restorations were milled using Katana UTML (Kuraray). The teeth were divided into three groups: Groups I, II, and III in which the restoration thicknesses were 1, 2, and 3 mm. Each Group had three subgroups according to different pretreatment methods. For subgroup-1, no pretreatment was done on the prepared cavity. For subgroup-2, universal adhesive was applied and light-cured before cement placement (precure method). For subgroup-3, universal adhesive was applied; however, light-curing was done after cement placement (cocure method). After thermo-cycling, the interfacial gap at the restoration-tooth interface was investigated using swept-source optical coherence tomography imaging. Finally, microhardness was measured for SAC under different zirconia thicknesses. For statistical analysis, the interfacial gap was analyzed using two-way analysis of variance (ANOVA) to test the effect of cavity depth and pretreatment. In terms of each cavity depth and pretreatment, the interfacial gap was compared using one-way ANOVA and Scheffe's test. One-way ANOVA was also performed for comparison of the Vickers hardness results. Different thicknesses of the restoration resulted in differences in interfacial gaps except between the precure method of Groups I and II (p<0.05). The effect of universal adhesive pretreatment was different depending on the restoration thickness with exceptions in Groups I and III (p<0.05). Vickers hardness number decreased as the low radiant exposure of light was applied (p<0.05). Interfacial gap of zirconia restorations can differ depending on the material thickness, pretreatment, and activation mode. Reduced light intensity penetrating through zirconia may lead to higher interfacial gap percentage and lower microhardness of the self-adhesive resin cement. Application of a universal adhesive showed similar or reduced interfacial gaps in the cement space.

Zirconia Monolithic Veneers

Ceramics have greatly evolved since they came into the eye of the dental community. Currently, there is a demand for a highly aesthetic as well as strong restoration and high translucent zirconia fits that criteria pretty well. This has significantly increased the applicability of zirconia as a restorative material in aesthetically demanding cases. Veneers have an innate disadvantage of lack of strength, decreased fracture resistance and chipping. Using these highly translucent zirconia veneers will help overcome these disadvantages. Therefore, the objective of the case series was to test the effectiveness of adhesively bonded highly translucent zirconia veneers using resin cement. This type of veneers provides satisfactory aesthetic outcomes and decreases the risk of fracturing during the trial and clinical use. However, further studies with long-term follow-ups are needed.

Masking Ability of Two Super High Translucent Zirconia Ceramics Compared with Lithium Disilicate Reinforced Glass Ceramic

Masking Ability of Two Super High Translucent Zirconia Ceramics Compared with Lithium Disilicate Reinforced Glass Ceramic

Effect of Speed Sintering on Low Temperature Degradation and Biaxial Flexural Strength of 5Y-TZP Zirconia.

Translucent zirconia is becoming the material of choice for the esthetic restorative material. We aimed to evaluate the surface structure, phase determination, translucency, and flexural strength of 5Y-TZP Zirconia (Katana STML Block and Disc) between the regular sintering and the speed sintering with and without low-temperature degradation (LTD). A total of 60 zirconia discs (30 per group; regular sintering and speed sintering) were used in this study. A CAM machine was used to mill cylinders out of the zirconia blanks and then cut into smaller discs. For the speed sintering, the zirconia blocks were milled into smaller discs. The zirconia discs were subjected to regular and speed sintering with and without LTD. Scanning electron microscopy was used to characterize the zirconia specimens and the zirconia grain size. Furthermore, the zirconia specimens were analyzed for elemental analysis using energy dispersive spectroscopy and phase identification using X-ray diffraction. The zirconia specimens were subjected to translucency measurements and biaxial flexural strength testing. The results of the zirconia specimens were compared among the groups. Statistical analysis was completed using SPSS version 20.0 to detect the statistically significant differences (p value = 0.05). A one-way ANOVA with multiple comparisons was performed using Scheffe analysis among the groups. The speed sintering presented smaller grain sizes. The zirconia specimens with and without LTD in regular and speed sintering presented a similar surface structure. Regular sintering showed more translucency compared to speed sintering. Multiple comparisons of the translucency parameter were a significant difference (p value < 0.05) between the various groups except for the comparison between speed sintering and speed sintering LTD. The regular sintering showed bigger gain sizes and slightly more translucency compared to speed sintering. The speed sintering showed higher biaxial flexural strengths compared to regular sintering. This shows that speed sintering can be considered a suitable method of sintering zirconia.

Effect of Repeated Firings and Thickness on Optical Properties of Variable Preshaded and Shaded Novel Translucent Zirconia Blocks.

Objective The purpose of this study was to examine the optical properties of translucent zirconia with different thickness during multiple firings. Materials and Methods Three different types of translucent zirconia (Vita YZ HT (HT), Vita YZ ST (ST), Vita YZ XT (XT)) with thickness of 0.5, 1, and 1.5 mm were used in the study. 180 disk-shaped specimens (n = 10) were prepared from preshaded and nonshaded blocks. The coloring liquid (A2, Vita Shade Liquid) was applied with a synthetic nylon brush in the nonshaded group. Then, the specimens were then subjected to 1, 3, and 5 firing times. After consecutive firings, color differences (ΔE) and translucency parameter (TP) were measured. Statistical analysis was carried out by using repeated measure ANOVA followed by Tukey test. Results ANOVA analysis reveals that TP and ΔE were significantly affected by the repeated firings. The highest TP was seen in 0.5 mm XT specimen. For all specimens, TP decreases from 1st to 3rd firing cycles, despite TP increases from 3rd to 5th firing cycles. Although there is a significant change in TP values in 0.5 mm thickness, there is no significant change between firing cycles for 1 and 1.5 mm thickness specimens. The highest ΔE value was observed for shaded specimens between 1st and 5th firings. ΔE values were not significantly different between 1 and 3 firings. Conclusions Changes in thickness and repeated firings of zirconia specimens affected final color and translucency of zirconia specimens. HT blocks are more affected by consecutive firings than ST and XT blocks. ΔE increased as the thicknesses decreased for both types of translucent zirconia specimens tested.

Adhesive Cementation of Zirconia Based Ceramics-Surface Modification Methods Literature Review

Introduction: The conditioning procedures for glass-based ceramic restorations before adhesive cementation are generally recognized. In the case of polycrystalline ceramics, which include zirconium oxide, there is still no standardized protocol. The aim of this work was to present conditioning methods of the cementation surface of zirconium oxide fixed dentures. The new generation high translucency zirconia has been also considered. Material and method: The following keywords for the PUBMED and EMBASE databases were used: zirconium oxide, zirconium oxide with increased translucency, bond strength, bending strength, surface treatment. The inclusion criteria were original papers in English published between 2015–2021. Results: Out of 1537 publications, 53 articles were selected for the study, covering methods of conditioning zirconium ceramics, including new materials with increased translucency. These procedures were divided into 5 main groups. Summary: Due to the widespread use of zirconia ceramics and the introduction of new zirconia-based materials, the use of a predictable and standardized cementation protocol is one of the most important factors contributing to the long-term clinical success of prosthetic restorations. Therefore, the research showed differences in the properties of the covered materials after conditioning. It suggests the need to create separate conditioning protocols for highly translucent and traditional zirconia.

Assessment of Color Difference of Translucent Zirconia Substructure Veneered Using a Layering Technique with Two Different Veneering Thicknesses: An in-vitro study

Background and objectives. The introduction of zirconia to the dental field created a path for development of new designs and applications, but still, a minimum framework thickness of 0.5 mm with the remaining thickness of the restoration used for building the ceramic veneer was always recommended. This might have possibly affected the final shade of the restoration due to the whitish color of Y-TZP. This in vitro study was designed to assess the color difference of translucent zirconia substructure veneered using a traditional layering technique with two different veneering thicknesses. Methods. A total of twenty translucent Ice zirconia disc samples with standardized dimensions 12 mm in a diameter, 0.5mm in thickness were designed and constructed using zirkonzahn system. The samples were classified into two groups: Group I: (n = 10) veneered by 0.5 mm thickness layering technique using IPS emax Ceram dentin shade A2. Group II (n = 10) veneered by 1 mm thickness layering technique using IPS emax Ceram dentin shade A2. Twenty composite resin discs 12mm in diameter and 5mm in thickness in A3 shade, were fabricated to be bonded to ceramic specimens using Dual-curing translucent rely X Unicem automix Self-Adhesive Resin luting cement. Spectrophotometer was used to measure color parameters L*, a*, b* for all samples. ΔE values were measured to determine color differences between the specimens and the A2 VITA classical shade (target shade). ΔE values were compared with an acceptability threshold (ΔE=3.7). Independent t-test was used to analyze data (P&lt;0.05) in this study and was analyzed using (SPSS) software, version 22. Results. The results showed that veneering thicknesses had a significant effect on the mean (ΔE) Values at P ≤ 0.001. The 0.5 mm veneer thickness showed the higher significant mean color difference (∆E) than the 1.0 mm veneering thickness where the recorded mean (ΔE) Values were (4.15±1.31) (2.65±1.39) respectively at p ≤ 0.001. Conclusions. This study concluded that 1.0 mm veneer thickness was the optimum thickness regarding color matching.

Effect of pigmentation techniques on the fatigue mechanical behavior of a translucent zirconia for monolithic restorations

This study aims to characterize the effect of pre- and/or post-sintering pigmentation techniques on the fatigue behavior of a 4YSZ ceramic (4 mol% yttrium stabilized zirconia). First, 4YSZ ceramic discs (IPS e.max ZirCAD, 15 mm diameter, and 1.2 mm thickness) were obtained and allocated according to the ‘pigmentation technique’ factor into 5 groups: Ctrl – unshaded ceramic disc (IPS e.max ZirCAD BL); Manuf – ceramic discs shaded by the manufacturer at block formation (IPS e.max ZirCAD MT A2); Brush – unshaded ceramic disc pigmented in the pre-sintered stage using a brush; Stain – unshaded ceramic disc pigmented in the post-sintering stage using a stain glaze (shade A2); Brush + Stain – combination of Brush and Stain techniques. The specimens were sintered and analyzed by a spectrophotometer (VITA Easyshade) for color differences (ΔE00 calculated according to CIEDE, 2000) to ensure that they present the same perceived color (ΔE00 ≤ 1.77, acceptability threshold). The specimens (n = 15) were submitted to biaxial flexural fatigue testing using a cyclic fatigue method (frequency of 20 Hz; 10,000 cycles per step; initial stress of 200 MPa; and step-size of 25 MPa) until specimen fracture. Fatigue strength (FS) and number of cycles until failure (CFF) were recorded with statistical purposes. Fractographic, complementary topography, elemental and roughness analyses were performed. The Ctrl shown the highest FS, CFF, and survival rates compared to the other conditions (p < 0.05), being only statistically similar to Brush. Stain showed the lowest FS, CFF and survival rates (p < 0.05). The Manuf and Brush + Stain shown intermediary performance. In regards of Weibull moduli, Brush shown the lowest values (lowest structural reliability), for both FS and CFF, being only statistically similar to Manuf. Topography analysis shown a uniform size of zirconia crystals in Ctrl, Manuf and Brush. In addition, a smooth glassy surface with some spots of impregnated pigment was observed in the groups where glaze was applied (Stain and Brush + Stain). This finding was corroborated by elemental analysis. Despite that, Stain and Brush + Stain presented the roughest surface (p < 0.05). In summary, the pigmentation techniques used to provide a Vita classical A2 color shade have a detrimental effect on the mechanical fatigue properties of a 4YSZ ceramic, except for the technique performed with the brush in the block pre-sintering stage. Despite this, the brush technique presents great variability in mechanical performance, resulting in lower structural reliability.

Zirconia Cantilever Fixed Dental Prostheses Supported by One or Two Implants: An In Vitro Study on Mechanical Stability and Technical Outcomes

To evaluate the mechanical stability of highly translucent zirconia (Zr) cantilevered fixed dental prostheses (cFDPs) and to investigate the influence of the number of implants (one versus two) supporting cFDPs with different restorative materials on their mechanical stability and load-bearing capacity. Thirty-two specimens consisting of implant-supported prostheses embedded in resin blocks were fabricated. Sixteen specimens received one implant (bone-level implant, 4.1-mm diameter, 13-mm length; Straumann) to support two-unit cement-retained cFDPs with one extension unit and the other 16 received two implants (bone-level implant, 4.1-mm diameter, 13-mm length; Straumann) positioned corresponding to the missing maxillary central incisors to support three-unit cement-retained cFDPs with one extension unit. Two different prosthetic materials, chromium-cobalt (Cr-Co; Wirobond C+, Bego) and highly translucent Zr (Lava Plus, 3M ESPE) were selected to fabricate the two- and three-unit cFDPs. Standardized twoand three-unit Cr-Co frameworks (CC-I, n = 8; CC-II, n = 8) and highly translucent Zr frameworks (Zr-I, n = 8; Zr-II, n = 8) with a 6-mm cantilever extension were fabricated using CAD/CAM (EOS M 290). Following thermomechanical fatigue loading, the specimens were tested for fracture resistance under static loading. The influence of restoration material and number of supporting implants on fracture resistance were tested using two-way analysis of variance (ANOVA). The level of statistical significance was set below 5% (α < .05). All specimens survived aging. The mean (± standard deviation) fracture resistance values were 416.25 (± 42.71) N for Zr-I, 548.75 (± 75.41) N for Zr-II, 601.0 (± 41.51) N for CC-I, and 664.5 (± 37.59) N for CC-II. CC and Zr group specimens showed significantly different fracture resistance results (P < .001). The number of implants significantly influenced the fracture resistance of Zr groups (P = .001), whereas the influence was not significant for CC groups (P = .089). Within the limitations of this in vitro study, highly translucent zirconia cFDP frameworks demonstrated the potential to withstand reported physiologic occlusal forces applied in the anterior region. The increase in the number of implants supporting zirconia cFDPs significantly contributed to achieving higher fracture resistance values.

Properties of translucent zirconia and lithium disilicate glass-ceramics: a literature review

Properties of translucent zirconia and lithium disilicate glass-ceramics: a literature review

In Vitro Evaluation of the Shading Effect of Various Zirconia Surface Stains on Porcelain Crowns

Human teeth display various colors under natural light. Dental restorations, such as zirconia crowns, are generally used to rehabilitate the oral function of patients with tooth loss due to trauma or natural tooth falls. However, significant improvements in the color and translucency of zirconia are required to meet the clinical needs for dental restoration. In the past, a large amount of ceramic powder has been used to improve the appearance of zirconia. However, the interface between the ceramic powder and zirconia makes them prone to falling off. Therefore, the aesthetics of zirconia crowns remains a major challenge. Recently, substantial advances have been made in the field of dental materials, as special staining agents for zirconia have been introduced as alternatives to ceramic powders. Therefore, this study tested zirconia-specific staining agents that were used to produce zirconia samples with A1 and A3 colors. A dental colorimetric plate was used as the control group to assess the staining effects of the different brands of staining agents. Meanwhile, two hypotheses were proposed: that the staining effects of these special staining agents for zirconia met the criteria for clinical application and that there was no significant difference between the different staining agents for zirconia. The results showed that the coatings of different brands of staining agents were ultrathin, with a thickness of approximately 27–78 µm. In addition, the coloring effects of the zirconia staining agents were not significantly different from those of the colorimetric plates. After staining, the zirconia samples had decreased surface roughness and contact angle values, which improved surface smoothness and cleanliness. In summary, the results support the hypothesis of this study that zirconia stains can be used as an alternative to the current fabrication methods for clinical dental restorations. We sought to identify the clinical techniques that are easier to perform and to overcome the current problem of dental technicians requiring considerable dentin space for staining. It is expected that the results of this study will be useful in clinical dental restorations.

Effect of airborne particle abrasion and primer application on the surface wettability and bond strength of resin cements to translucent zirconia

The purpose of this study was to evaluate the effect of sandblasting and primer application on the immediate and long-term shear bond strength of resin cements to translucent zirconia. Zirconia plates (Katana STML, Kuraray Noritake Dental) were divided into six groups (n = 10) for shear bond strength evaluation using three resin cements (Panavia V5, Kuraray Noritake Dental; Variolink Esthetic LC, Ivoclar-Vivadent; and Panavia SA Cement Universal, Kuraray Noritake Dental). The zirconia was sandblasted or left unabraded. Each cement was used with the indicated primer. Two cylinders of cement were placed on the zirconia, one for evaluation after 24 h and the other after 1 year of storage in water. The fracture pattern and the contact angle were observed on all groups. At 24 h, there were no differences in bond strength of the cements for equal sandblasting conditions. After 1-year, the bond strength of all groups decreased, except for Panavia V5 associated with sandblasting. For all the cements, the unabraded zirconia showed a lower bond strength and a higher rate of adhesive failures. The application of primers reduced the contact angle. Higher bond strength is obtained when primers are combined with sandblasting using aluminum oxide particles. Clinical significance: Translucent zirconia restorations should be treated by airborne particle abrasion and phosphate-based primers before bonding, to improve the wettability of the cements and obtain a more durable bonding between the cement and the zirconia.