Translucent Monolithic Zirconia Research Articles

Influence of ceramic crown design (translucent monolithic zirconia vs. bilayered) of implant-supported single crowns after mechanical cycling.

This study aimed to assess the influence of translucent monolithic versus bilayered crowns and whether the use of a CoCr base abutments affects the fatigue and fracture resistance of screwed implant-supported single crowns with external connections under mechanical cycling. Fifty specimens were divided into groups: (1) metal-ceramic (MC) crown, (2) veneered zirconia crown (Zr), (3) veneered zirconia crown with a CoCr base abutment (ZrB), (4) monolithic translucent zirconia crown (MZr), and (5) monolithic translucent zirconia crown with a CoCr base abutment (MZrB). Specimens underwent mechanical cycling (5 × 106 cycles; 150 N) evaluating fatigue resistance (number of failures) and those that failed were subsequently subjected to fractographic analyses (stereomicroscope and scanning electron microscope) to evaluate failure location and area, and maximum fracture load was also measured. The failure-related survival rate (100%) and maximum fracture resistance of the MZrB were significantly higher than those of MC and Zr (50%; p < 0.05). There were no significant differences in the failure rate and fracture resistance when a CoCr base abutment was used or not in the translucent monolithic Zr groups (p > 0.05;MZrB vs. MZr). Failure location, with MC crowns' fractures, noted at the screw area (p = 0.043), while all-ceramic crowns were mostly in the cuspid and to failure area, the Zr group had the largest mean (15.55 ± 9.17 mm2) among the groups, significant difference only when compared with MC (1.62 ± 0.81 mm2) (p = 0.025). Translucent monolithic zirconia crowns exhibited significantly higher fatigue and fracture resistance compared with conventional MC and bilayered crowns. The appropriate choice of material and manufacturing technique is crucial for predicting the higher clinical performance of single crowns. Enhanced mechanical resistance in terms of fatigue and fracture resistance can be achieved by replacing MC and bilayered restorations with computer-aided design and computer-aided manufacturing monolithic zirconia.

Effects of Coloring Liquid Dipping Time and Surface Finishing Procedures on the Optical Properties of Monolithic Zirconia.

Monolithic zirconia restorations can be produced from self-colored or uncolored blocks. The coloring procedure of uncolored blocks and surface treatments may affect the appearance of the restoration. The purpose of this study is to evaluate the effect of liquid coloring and surface treatments on optical properties of translucent monolithic zirconia. All specimens were cut from zirconia blocks with a thickness of 1 mm. Specimens were dipped in the coloring liquids for 3 min, 5 min, and 7 min and then divided into groups of 10 specimens for surface treatments. Glaze and mechanical polishing were applied, and the color of the specimens was measured under the D65 lighting condition with a spectrophotometer device. Color values obtained from the CIE Lab formula and the translucency parameter (TP), opalescence parameter (OP), and contrast ratio (CR) were calculated. The normality of the data was confirmed with the Shapiro-Wilk test. A three-way analysis of variance (ANOVA) was used to assess the effect of dipping time, liquid shade, and surface treatments. The effect of liquid shade and dipping time on the TP, OP, and CR parameters were statistically significant, and the TP values were reduced with the application of coloring liquid. Mechanical polishing groups had higher OP values and lower TP values than glazed groups. In cases where high translucency is required, it may be advisable to use self-colored blocks and apply glaze as a surface treatment to achieve the desired optical properties.

Evaluation of Stress Distributions in All Ceramic Conometric Single Crown Restorations: 3-Dimensional Finite Element Analysis

Objective: The aim of the study is to compare the effect of monolithic translucent zirconia ceramic (TZI) and monolithic lithium disilicate glass ceramic (LDS) restorative materials on stress distributions in implant components and surrounding bone tissues in implant-supported conometric single crown restorations with a conical connection system by using 3D finite element analysis.&#x0D; Methods: Restorations produced with two different all-ceramic materials using a conometric abutment and a conometric cap on the implant with a conical connection system were placed in the maxillary right second premolar region. 3D finite element analysis was used to examine the amount and distribution of stresses in implant components, in cortical and cancellous bone tissues surrounding the implant and in crowns under vertical and oblique loading. For the statistical analysis one-way ANOVA and independent samples t-test were used (p

Effect of Sintering Technique on Shade and Shear Bond Strength of CAD/CAM Monolithic Translucent Zirconia

Effect of Sintering Technique on Shade and Shear Bond Strength of CAD/CAM Monolithic Translucent Zirconia

Effect of Zirconia Thickness, Cement Color, and Titanium Implant Abutment Surface Treatment Type on the Esthetic Outcomes of High Translucency Monolithic Zirconia.

To investigate the esthetic outcomes based on the color differences in zirconia of varying thickness, resin cement color, and types of titanium implant surface treatments. Twenty-eight HTMZ specimens were arranged into four groups based on zirconia thickness: 1.0, 1.5, 2.0, and 2.5 mm (n=7). Each group was tested using two resin cement colors (n=7) (clear and opaque) in combination with six surface-treated titanium groups (n=7): untreated titanium (UT), anodization (AN), 50-μm alumina airborne-particle abrasion followed by AN (SBAN), AN followed by 50-μm alumina airborne-particle abrasion (ANSB), 95% hydrofluoric acid followed by AN (HFAN), and AN followed by 95% hydrofluoric acid (ANHF) for the 48 experimental groups, and using composite resin (n=7) (A2D) for the four control groups. All the specimens were measured using a spectrophotometer and subsequently compared with composite resin (control) with the corresponding zirconia thickness to establish the color differences. A color difference of <2.7 was considered clinically acceptable. The data obtained were statistically analyzed using the analysis of variance and post hoc test (p=0.05). Zirconia thickness, resin cement color, and type of titanium implant surface treatment significantly affected the observed color differences (p<0.05). When using 2.5-mm HTMZ with clear resin cement on AN, UT, SBAN, HFAN, and ANSB, the mean color differences obtained were below the clinically acceptable values. However, when using 2.5-mm HTMZ with clear resin cement on AN, UT, and SBAN, the 95% confidence intervals of color differences obtained were below the clinically acceptable values. HTMZ with a minimum thickness of 2.5 mm and clear resin cement on AN, UT, and SBAN groups potentially result in acceptable color matching with 95% confidence intervals.

The Comparison of Fracture Resistance between Low Translucent and Ultra-High Translucent Monolithic Zirconia Crown

Abstract Objective From the beginning of its discovery, the monolithic zirconia crown was highlighted for its remarkable strength; therefore, only available in opaque color. During the past decade, the translucent monolithic zirconia crown was manufactured to meet the aesthetic and restoration demand but was thought to be the cause of decreasing its strength. This study aimed to compare the fracture resistance between two types of translucent monolithic zirconia crowns, that is, low translucent monolithic zirconia (LT) and ultra-high translucent monolithic zirconia (UHT). Material and Methods The premolar crown model was prepared using a computer-aided design/computer-aided manufacturing system, producing 1 mm of thickness. Ten crown samples were divided into LT and UHT. Then, each sample was measured for its fracture resistance using Universal Testing Machine until a fracture occurred. The differences in fracture resistance were analyzed using an independent t-test with p &lt; 0.05. Result The LT showed a higher fracture resistance than UHT (p &lt; 0.05). Conclusion The LT monolithic zirconia crown has strength and can be used for posterior crown restoration.

Translucent monolithic zirconia titanium-supported FP1 full-arch prosthesis: A novel proof of concept to address esthetic, functional, and biologic challenges.

Despite the wide clinical use of translucent zirconia for full-arch implant prostheses, reduced flexural strength and fracture toughness compared with high-strength opaque zirconia needs to be addressed. A novel proof of concept for FP1 full-arch prosthesis featured by translucent monolithic zirconia and titanium framework was presented. Computer-guided implant planning and surgery were executed and digitally designed FP1 temporary prosthesis prefabricated. Implant and prosthetic placement were achieved with a set of three-dimensional (3D)-printed templates. Implants were immediately loaded. After 4 months intraoral optical scan was taken to record implant coordinates, soft tissue anatomy, and temporary FP1 prosthesis. A novel digital workflow was used to design and mill overlaying translucent zirconia and anatomically shaped titanium framework with a scalloped soft-tissue interface. Final FP1 prosthesis was assembled cementing zirconia jacket on titanium counterpart. Translucent zirconia supported by titanium framework can address esthetic and mechanical requirements of FP1 full-arch prosthesis, minimizing risk of fracture and providing a rigid and passive joint with supporting implants. The smooth and highly polished titanium surface with an anatomic design, tightly matching scalloped soft tissue interface, can limit food impaction, air and saliva leakage and contribute to overall biologic integration of FP1 full-arch prosthesis. Translucent monolithic zirconia featured with anatomically shaped titanium framework with scalloped transmucosal part, combining a pleasant esthetic outcome with increased flexural strength and fracture toughness, may be indicated to increase the clinical performance of FP1 full-arch prosthesis.

Fracture resistance of monolithic translucent zirconia crown bonded with different self-adhesive resin cement: influence of MDP-containing zirconia primer after aging

ObjectivesSuccessful ceramic restorations depend on the strong bonding with resin cement and even stress distribution. The aim of this study was to evaluate the impact of adding MDP-containing zirconia primer before self-adhesive resin cements with different functional acidic monomers on fracture resistance of monolithic zirconia crown.Materials and methodsEighty defect-free human maxillary premolars were divided according to the cement type and application of MDP-containing zirconia primer into eight groups (n = 10): Calibra Universal (C), Calibra Universal combined with zirconia primer (CZ), RelyX U200 (R), RelyXU200 combined with zirconia primer (RZ), Panavia SA Cement Plus (P), Panavia SA Cement Plus combined with zirconia primer (PZ), Multilink Speed (M), and Multilink Speed combined with zirconia primer (MZ). After teeth preparation and fabrication of zirconia crowns, each crown was bonded to its corresponding tooth. All specimens were subjected to 10,000 thermocycles between 5 and 55°C, followed by cyclic load (50 N) for 240,000 cycles. Each specimen was subjected to a static axial load until fracture using universal testing machine and the fracture load was recorded. The fracture mode studied and recorded. The fracture load results were analyzed using two-way ANOVA test (α = 0.05).ResultsA significant interaction (P = 0.038) of combining MDP-containing zirconia primer and cement type on fracture resistance of monolithic zirconia crown was detected. The mean fracture load values of zirconia crown were significantly influenced by the combined application of the MDP-containing zirconia primer with Calibra Universal (P = 0.01), RelyX U200 (P < 0.001), and Multilink Speed (P = 0.038), while there was no significant difference with Panavia SA Cement Plus (P = 0.660). There was significant difference (F = 20.69, P < 0.001) between the mean fracture loads of groups with self-adhesive cements (C, R, P, and M groups). The highest fracture load was recorded with RZ group (2446.90 ± 126.72 N) while the lowest fracture load was recorded with C group (1623.18 ± 149.86 N).ConclusionsThe self-adhesive resin cement with different acidic functional monomer affects the fracture resistance of monolithic zirconia crown. Application of MDP-containing primer could improve the fracture resistance of monolithic zirconia crown with most self-adhesive cements. The application of an MDP-containing primer had no impact on the fracture resistance of monolithic translucent zirconia crown bonded by MDP-containing self-adhesive resin cement.

Comparative Fracture Resistance Analysis of Translucent Monolithic Zirconia Dioxide Milled in a CAD/CAM System

The aim of this study was to evaluate and compare the fracture resistance of definitive zirconia dioxide restorations obtained using a computer-aided design and manufacturing (CAD/CAM) system. Methods: Two groups of ten samples were analyzed for each material (n: 20); the first group was Zolid Gen X Amann Girrbach (ZGX) and the second group was Cercon HT Dentsply Sirona (CDS). The restorations were designed with identical parameters and milled with a CAD/CAM system. Each specimen was load tested at a speed of 0.5 mm/min, with a direction parallel to the major axis of the tooth and with an initial preload of 10 N until fracture using a universal testing machine (Universal/Tensile Testing Machine, Autograph AGS-X Series) equipped with a 20 kN load cell. The results obtained were recorded in Newtons (N), using software connected to the testing machine. Results: Statistically significant differences were found, and the fracture resistance of the monolithic zirconia crowns was lower in the CDS group (1744.84 ± 172.8 N) compared to the ZGX group (2387.41 ± 516 N). Conclusions: The monolithic zirconia CAD-CAM zirconia crowns showed sufficient fracture resistance when used in posterior molar and premolar zones with either material, as they withstood fracture loads greater than the maximum masticatory force.

Effect of multiple firings on the color and translucency of monolithic zirconia

The effects of multiple firings on the color and translucency of monolithic zirconia were investigated in this paper. One hundred specimens were milled using three types of monolithic zirconia: multilayered zirconia (UTML, Katana) (UT), highly translucent zirconia (Organic Translucent, R + K) (OT), and nanosized zirconia (DIAZIR ST9810, Zhong Xin Tang Guo Ye) (ST). The group UT was divided into three subgroups: the incisal (UT-I), middle (UT-M), and cervical (UT-C). After sintering (T0), the specimens of each group (n = 20) were repeatedly fired 3 times. The L*, a*, and b* values were measured by using a spectrophotometer at T0, and after the first (T1), second (T2), and third (T3) firings. The translucency parameter (TP), contrast ratio (CR), opalescence parameter (OP), and color difference (∆E00) were calculated and statistically analyzed (α = 0.05). The surface morphologies of the specimens were observed using SEM. Multiple firings significantly affected the OP and the ∆E00 values of the materials tested (both p &amp;lt; 0.001). The ∆E00 values of group ST at T1-T3 were greater than the 50%:50% acceptability threshold (∆E00 &amp;gt; 1.8). Moreover, multiple firings did not exhibit significant effects on the TP and contrast ratio values of any materials (both p &amp;gt; 0.05). The surface topographies of the specimens after multiple firings were quite similar. Changes in opalescence were found for the multilayered zirconia and nanosized zirconia after multiple firings, but the clinical significance was low. Clinically unacceptable color changes were found in the nanosized zirconia after multiple firings, which were attributed to the higher L* values and the lower b* values after multiple firings. However, the optical properties and composition of surface elements of multilayered 5Y-TZP with over three layers need to be investigated in future studies.

One Year Clinical Evaluation Of Translucent Zirconia Crowns In Dental Esthetic Zone With Biologically Oriented Preparation Technique Versus Conventional Preparation (RCT)

Statement of the problem: Tooth preparation with horizontal finish line requires removal of reasonable amount of tooth structure at the cervical area which affects the remaining tooth structure at this area. Therefore, more conservative preparation design such as biologically oriented preparation technique (BOPT) might be needed to save tooth structure at the cervical area. The Purpose: To Evaluate the effect of Conventional preparation design (horizontal), and Biologically Oriented Preparation Technique (BOPT), on Marginal adaptation, fracture and gingival inflammation score of the translucent zirconia crown in dental esthetic zone. Methodology:, 44 monolithic translucent zirconia single crowns were fabricated inn dental esthetic zone . The patients were separated randomly into two groups. Group1: (horizontal preparation design) Group2: BOPT. After final cementation. The Modified United States Public Health Service (MUSPH) criteria for restoration clinical evaluations were used to assess marginal adaption. Gingival inflammation was assessed using gingival inflammation index. Evaluation of the restoration was at intervals of three, six, nine, and twelve months. Results: Comparison between two groups at different intervals regarding marginal adaptation, fracture and gingival inflammation score revealed statistically insignificant difference. Conclusions: Within limitations of the present one year follow up randomized clinical trial, the following conclusions could be drawn: 1.The conventional and BOPT preparation designs both clinically accepted to provide successful dental restoration The lower gingival inflammation score of the restored teeth with the conventional preparation design compared to that of the BOPT, may not be conclusive as regard the study time frame, indicating that increasing the follow-up period might alter the present finding. Clinical implications: Beyond of all the prosthodontic preparation techniques, knowledge of B.O.P.T. (Biological Oriented Preparation Technique) allows us to achieve predictable and consistent results in terms of periodontal health and gingiva architecture surrounding ceramic restoration. Nevertheless, long term studies are necessary to ensure the benefits of this techniques.

Influences of luting cement shade on the color of various translucent monolithic zirconia and lithium disilicate ceramics for veneer restorations.

The purpose of this study was to assess the effect of resin cement shade on the color of different novel ultratranslucent monolithic zirconia and lithium disilicate veneer materials. For a total of 40 specimens, flat cylindrical discs with a 9-mm diameter and 0.5-mm thickness were created using CAD/CAM technology. The specimens were divided into five groups according to their material (n = 8) (e.max, Prettau, Aidite, Shofu and Dima) using A1 shade. Resin discs with the same diameter and shade as the specimens served as tooth-colored substructures. Three shades (neutral, light and warm) of resin cement try-in pastes (Variolink Esthetic LC) were used as the luting cement material. The color of each material group was measured before and after cementation using the three cement shades, and the CIE L*a*b* coordinates were obtained with a spectrophotometer. Values for the translucency parameter (TP) and color change delta E (E) before (baseline) and after cementation of each specimen were determined. To compare differences among the material groups within each shade of cement and among various shades of cement within each material, the data were analyzed using one-way ANOVA and post hoc testing. Color coordinates L*, a* and b* significantly changed after the application of try-in pastes relative to baseline values, with a noticeable decrease in lightness (L*) (P < .05). A significant color change (ΔE) was observed in all tested materials after cementation, with ΔE values exceeding 3.3 (P < .05). Although TP changed after cementation for most materials tested, these changes were not statistically significant (P > .05). Shofu and Dima ceramics showed the lowest TP values, while Aidite and Prettau showed the highest TP values. For e.max, translucency decreased after cementation with neutral and warm shades, and it significantly increased after cementation with a light shade. The shade of cement significantly altered the final color of the ceramic veneer material to a level above the threshold at which the clinical perception of color change occurred (> 3.3). The TP was not influenced by the cement shade. The translucency levels of the novel ultratranslucent multilayer monolithic zirconia ceramics Aidite and Prettau were higher than that of the lithium disilicate e.max material.

An Evaluation of the Colour Stability and Surface Roughness of High Translucency Zirconia Dental Ceramic after Immersion in Different Acidic Media: An In-vitro Study

Introduction: Demand for increasingly appealing metal-free ceramic restorations drives research. With its exceptional mechanical and biological properties, zirconia crown outperforms other traditional ceramic materials. With outstanding mechanical and biological qualities, zirconia has several therapeutic applications. Temperature, environment, diet, and smoking habits all affect colour and surface roughness of dental restorations. Aim: To investigate the colour stability and surface roughness of high translucency monolithic zirconia following immersion in various acidic solutions. Materials and Methods: This in-vitro study was conducted at Yenepoya Dental College, Mangalore, Karnataka, India. Duration of the study was 6 months, from December 2019 to June 2020. Thirty rectangular samples from a CAD (computer-aided Design)/ Computer Aided Manufacturing (CAM) machined Zirconia blank with 10x8x1 mm dimensions was sintered at 1350°C, tested for colour stability (E) and surface roughness prior to immersion (R). Classified into Groups CO (coffee), TO (tobacco) and CA (citric acid medium). Colour stability and surface roughness were re-evaluated post immersion on all samples using spectrophotometers and profilometer respectively. A significant difference in surface roughness and colour stability between the test groups was assessed using the paired-t test. The data was analysed using Statistical Package for Social Sciences (SPSS) version 24.0. Results: Colour stability and surface roughness variations between the baseline value and three groups were found to be unaltered by different acidic media. The intergroup comparison of spectrophotometric analysis between the three groups had a standard deviation of 0.422 for citric acid medium, 0.316 for Coffee medium and 0.422 for Tobacco medium with an overall p-value of 0.804. The intergroup comparison of profilometric analysis had a standard deviation of 0.316 for Citric acid medium, 0.00 for Coffee medium and 0.00 for Tobacco medium with an overall p-value of 0.381. The paired-t-test study showed that immersion in different acidic media had little effect on surface roughness of samples with a p-value of 0.343 but it was under clinically acceptable range. Conclusion: According to the present study, high translucency monolithic zirconia had greater colour stability when treated with citric acid, followed by tobacco and then with coffee media, whereas, zirconia in coffee media had greater surface roughness, followed by tobacco, and then with citric acid media. However, both the results were clinically acceptable, indicating a 10 year lifespan when properly glazed.

Effect of Polymerization Time and Thickness of Monolithic Zirconia on the Bond Strength of Self-Adhesive Resin Cement

Background and Aim Self-adhesive resin cements are commonly used to lute zirconia restorations. The bond strength between the resin cement dentin and the ceramic material depends upon the degree of conversion of the cement during polymerization. This study was aimed to determine the optimal curing conditions in order to maximize the bond strength between self-adhesive resin cement and highly translucent monolithic zirconia crowns.Method Fifty-two pre-sintered highly translucent zirconia discs of diameter 10 mm each were milled from commercially available blocks Dent Gallop SHT and were grouped into two Group A 1.5 mm thickness Group B 2 mm thickness. Preformed polyethylene moulds were used to fabricate cylinders made of composite resin having a diameter of 6 mm and height 3 mm each. These were cemented onto zirconia discs using self-adhesive resin cement Kerr Maxcem Elite and were cured. Group A and B were divided into two subgroups of 13 samples each based on the curing time of the resin cement. Group A1 was cured for 10 seconds and Group A2 for 20 seconds. Group B1 was cured for 10 seconds and B2 was cured for 20 seconds. The specimens were embedded into resin stamps of 1x1 cm and subjected to shear load test.Results One-way ANOVA was used to compare the mean shear bond strength. The 1.5 mm highly translucent zirconia cured for 20 seconds showed highest and 2 mm cured for 10 seconds showed the least strength.Conclusion The study concluded that highly translucent zirconia reduces the curing light attenuation and when curing time is increased within the limits the shear bond strength of resin cement increases.

Sintering mode of a translucent Y-TZP: Effects on its biaxial flexure fatigue strength, surface morphology and translucency.

This investigation evaluated the effect of two sintering modes of a translucent zirconia (Y-TZP) on its surface roughness, topography, phase-transformation (t → m), translucency and biaxial flexure fatigue strength. To do so, 50 Y-TZP discs (Ø=15 mm; thickness=1.2 mm; IPS e.max ZirCAD LT) were prepared and divided into two groups: Standard mode (SM) and Fast mode (FM). Staircase fatigue testing was performed (piston-on-three balls set-up, ISO 6872:2015), as well as surface roughness, profilometry, scanning electron microscopy (SEM-FEG), energy dispersive X-ray spectroscopy (EDX), phase transformation (t → m) using X-ray diffraction analysis (XRD), translucency parameter analysis (TP and TP00 ) and fractography. The results showed no statistical significant differences for roughness parameters (p > 0.05, SM: Ra=0.13 ± 0.02, Rz=1.21 ± 0.26 and RSm=24.91 ± 2.19; FM: Ra=0.14 ± 0.03, Rz=1.32 ± 0.25 and RSm=24.68 ± 2.16) or flexural fatigue strength (SM: 512 (464-560) MPa; FM: 542 (472-611) MPa) between the groups. In addition, similarity in surface morphological features (SEM and profilometry), composition and phases (EDX and XRD) was observed between the firing protocols. Fractography showed that the failure origin occurred on the tensile side. Sintering mode did not affect the TP (F=0.001, p=0.97) and TP00 (F=0.12, p=0.72). Therefore, the fast-sintering mode is suggested as a viable alternative to the standard mode since it does not influence the evaluated surface morphology, microstructure, fatigue strength and translucency of a translucent monolithic zirconia. The fast sintering mode is a viable alternative for zirconia without compromising its topography, microstructure, mechanical performance or translucency.

Influence of the Type and Thickness of Cervical Margins on the Strength of Posterior Monolithic Zirconia Crowns: A Review

AbstractThe aim of this research is to review the literature for the influence of the thickness and shape of cervicalmargins on the strength of posterior monolithic zirconia crowns. Studies to assess the fracture resistance of monolithic zirconia crowns with different types of cervical margins, published from 2014 to 2020, were searched using the electronic database PubMed and Google Scholar using the following keywords: “monolithic zirconia,” “translucent,” “shoulderless,” and “margin preparation design.” Analysis of studies has shown that overall the design of the margin would have a significant effect on the strength of these crowns. Monolithic zirconia crowns with a knife-edge margin have shown a breaking load higher than the maximum chewing force of humans. It would be safe to suggest the utilization of posteriormonolithic zirconia crowns with vertical preparation. As the new translucent monolithic zirconia crowns are recent, further studies would be needed to guide the selection of the appropriate minimum thickness of the knife-edge margin to meet the clinical guidelines for their use.

Fracture Resistance and Fracture Behaviour of Monolithic Multi-Layered Translucent Zirconia Fixed Dental Prostheses with Different Placing Strategies of Connector: An in vitro Study

PurposeTo evaluate the effect of different placing strategies performed in the connector area on fracture resistance and fracture behaviour of monolithic multi-layered translucent zirconia fixed dental prostheses (FDPs).Materials and MethodsThirty 3-unit monolithic FDPs were produced and divided into three groups (n = 10) based on the different strategies for placing the connector area of FDPs in multi-layered zirconia blank with varying contents of yttria ranging from 4 to 5 mol%. The groups were as follows: FDPs with connectors placed in dentin layer with 4 mol% yttria content, FDPs with connectors placed in gradient layer, and FDPs with connectors placed in translucent layer with 5 mol% yttria content. A final group (n = 10) of conventional monolithic zirconia with a monolayer of yttria content (4 mol%) has been used as a control group. The specimens were artificially aged using thermocycling and pre-loading procedures and subsequently loaded to fracture using a universal testing machine. Fracture loads and fracture behaviour were analyzed using one-way ANOVA and Fisher’s exact tests and statistically evaluated (p ≤ 0.05).ResultsThere were no significant differences in fracture loads among the groups based on the placing strategies of the connector area of the FDPs in the multi-layered translucent zirconia blank (p > 0.05). There was no significant difference in fracture loads between monolithic multi-layered translucent zirconia and conventional monolithic translucent zirconia materials (p > 0.05). Fracture behaviour of FDPs with connector area placed in translucent layer differed significantly compared to FDPs with connector area placed in dentin layer and FDPs in control group (p = 0.004).ConclusionThe placing strategies of the connector used in the computer aided design and manufacturing procedures do not considerably affect fracture resistance of monolithic FDPs made of multi-layered translucent zirconia. Monolithic FDPs made of multi-layered translucent zirconia show comparable strength to FDPs made of conventional translucent zirconia, but with different fracture behaviour.

Fracture resistance and failure mode of layered translucent zirconia with different crown designs.

This study investigated the impact of different veneering design on the fracture resistance and failure mode of layered translucent zirconia crowns, compared to the full monolithic zirconia crowns. Ninety crowns with different designs were divided into six groups (n=15); one fully contoured monolithic crown (FMC), one fully veneered with porcelain (FVC), or four partially veneered designs. All crowns were thermo-cycled, and then loaded to failure in a universal testing machine. The fracture resistance (N) and fracture modes were assessed. One-way ANOVA was performed followed by Tukey's multiple comparison (α<0.05). Results demonstrated that all the tested partially veneered designs exhibited enhanced fracture resistances and were comparable to that of the full-contour monolithic translucent zirconia crowns.

Prospective Clinical Evaluation of Posterior Third-Generation Monolithic Zirconia Crowns Fabricated with Complete Digital Workflow: Two-Year Follow-Up.

Clinical studies on the behavior of posterior translucent monolithic zirconia restorations are lacking. We assessed the clinical outcome and survival rate of posterior third-generation monolithic zirconia crowns over a 2-year period. A total of 24 patients, requiring 30 posterior full-contour restorations were selected. All abutments were scanned, and crowns were milled and cemented with a self-adhesive dual cure cement. Crowns were assessed using the California Dental Association’s criteria. Gingival status was assessed by evaluating the gingival index, plaque index, periodontal probing depth of the abutments and control teeth, and the margin index of the abutment teeth. Statistical analyses were performed using the Friedman and the Wilcoxon signed-rank tests. During the 2-year follow-up, no biological or mechanical complications were observed, and the survival and success rate was 100%. All restorations ranked as satisfactory throughout the follow-up period. The gingival index and plaque index were worse at the end of the 2-year follow-up. The margin index was stable during the 2 years of clinical service. No significant differences were recorded in periodontal parameters between crowns and control teeth. Third-generation monolithic zirconia could be a reliable alternative to posterior metal–ceramic and second-generation monolithic zirconia posterior crowns.

Effects of abutment tooth and luting agent colors on final color of high-translucent zirconia crowns.

This study aimed to evaluate the effects of the tooth portion evaluated and the colors of the abutment tooth and resin luting agent on the final color of monolithic zirconia crowns. Monolithic zirconia crowns were fabricated for left maxillary central incisors using two shades (A2 and A3) of highly translucent monolithic zirconia disks. A model of the abutment tooth was fabricated using resin core materials (white: W; dentin: D). The color of the crowns was measured with try-in pastes (clear: C; brown: B) as a resin-luting agent substitute. The measurement was performed after placing the crown on the model with the attached abutment tooth with try-in paste. The color of three labial portions (cervical, body, and incisal) was evaluated using a dental spectrophotometer. The color difference (ΔE) between the CIELab values of the zirconia disks and the final measurement of zirconia crowns was calculated. The ΔE between the crown of the A2 shade and the zirconia disk of the A2 shade had the highest ΔE value in the body portion with W-B (ΔE=3.92). Similarly, the A3 shade had the highest ΔE value in the cervical portion, with W-B (ΔE=4.27). The results of three-way ANOVA showed that the ΔE values were influenced by the tooth portion evaluated and the color of the abutment tooth. The final color of the monolithic zirconia crowns was significantly influenced by the tooth portion evaluated and the color of the abutment tooth.