Vita In-Ceram Research Articles

Four-point flexural strength and microtensile bond strength of digitally and conventionally veneered zirconia.

This study intended to evaluate the effect of digital veneering on four-point flexural strength (FS) and microtensile bond strength (μTBS) of veneered zirconia. Two different zirconia blocks, a lithium disilicate and a feldspathic ceramic block, and two different layering ceramics were used. IPS e.max Zir CAD (ZC) and Vita In-Ceram YZ (YZ) with yttria stabilized tetragonal zirconia polycrystals (3Y-TZP) were used as substructures. IPS e.max CAD (LD), Vita Mark II (VMII), IPS e.max Ceram (EC) and Vita VM9 (VM9) were used for veneering. Resin cement and fusion ceramic were placed between veneer and zirconia substructure for digital veneering. A total of one hundred and fifty specimens in five groups (n=30) were prepared for FS and tested in universal machine at 1.0 mm/min. One hundred specimens in five groups (n=20) were obtained for the μTBS and tested at 1.0 mm/min. Statistical analysis was made by one way ANOVA and Tukey HSD. Conventional veneering showed statistically significant FS. ZC veneered with EC had the highest mean FS and the lowest was obtained in groups veneered through resin cement. YZ layered with VM9 had the highest mean μTBS. ZC veneered through fusion ceramic and YZ veneered through resin cement showed significantly lower and similar μTBS.

Cytotoxicity and Bonding Property of Bioinspired Nacre-like Ceramic-Polymer Composites.

For clinical applications, non-cytotoxicity and good bonding property of dental restorative materials are the most essential and important. The aim of this study was to evaluate the potential for clinical applications of two novel bioinspired nacre-like ceramic (yttria-stabilized zirconia)-polymer (polymethyl methacrylate) composites in terms of the cytotoxicity and bonding property. The relative growth rates (24 h) of the Lamellar and Brick-and-mortar composites measured by CCK8 were 102.93%±0.04 and 98.91%±0.03, respectively. According to the results of cytotoxicity and proliferation experiments, the two composites were not cytotoxic to human periodontal ligament fibroblasts (HPDLFs) in vitro. Both composites exhibited improved bonding strength as compared to the Control group (Vita In-Ceram YZ). As the polymer content in the composite material increases, its bonding strength also increases, which enhances the application potential of the material in the field of dental restoration. Meanwhile, by controlling the direction of loading force in the shear test, the effect of microstructure on the bonding strength of anisotropic composites was studied. After sandblasted, the bonding strengths of the Lamellar group in the longitudinal and transverse shear directions were 17.56±1.56 MPa and 18.67±1.92 MPa, respectively, while of the Brick-and-mortar group were 16.36±1.30 MPa and 16.99±1.67 MPa, respectively. The results showed that the loading direction had no significant effect on the bonding strength of the composites.

Shear Bond Strength of Ceramic Veneers to Zirconia–Calcium Silicate Cores

Improving the bond strength of veneering ceramics to ZrO2-based cores remains a challenge. The purpose of this study was to evaluate the shear bond strength of different ZrO2 cores containing calcium silicate (CaSi) to veneering ceramics. Five types of ZrO2-based cores (n = 230) were divided into two groups: with or without oxygen plasma treatment. These were bound to two veneering ceramics (IPS e.max Ceram or VITA VM9). Shear bond strength of veneering ceramics to various cores was measured (n = 10), in addition to phase composition, surface morphology and contact angle of the cores. The results indicated that the plasma treatment had a significant effect on the water contact angle of the ZrO2-based cores, but had little effect on the bond strength. Regardless of plasma treatment, the highest strength value was recorded in the ZrO2 core specimen containing 20 wt % CaSi, when all cores were adhered to VITA VM 9 veneer. When using IPS e.max Ceram veneer, the shear bond strength of the plasma-treated 20 wt % CaSi-containing ZrO2 core was 16.6 ± 0.9 MPa higher than that of VITA In-Ceram YZ core control (13.4 ± 1.0 MPa) (p < 0.05). We conclude that the presence of 20 wt % CaSi in ZrO2 can improve the shear bond strength of zirconia-based cores to veneering ceramic.

Adhesion between zirconia and resin cement: A critical evaluation of testing methodologies

This study aimed to analyze different methodologies (tensile, microtensile, shear, microshear, and interfacial toughness) for evaluation of the bond strength between zirconia (Y-TZP) and resin cement. Zirconia ceramic blocks (VITA in-Ceram® YZ, VITA Zahnfabrik, Germany) were obtained, substrate surfaces were air-abraded with aluminum oxide (50 μm) for 10 s (2 bar pressure, distance: 10 mm, angle: 90°). Then, the specimens were washed with distilled water, dried, and coated with Clearfil Ceramic Primer that was actively applied with a microbrush for 20 s. The specimens were then cemented with resin cement under a load of 750 g, followed by photo-polymerization (40 s on each surface). After cementation, the specimens were aged in thermocycling (8000 cycles, 5–55 °C, 30 s for each bath) and subjected to tensile, microtensile, shear, microshear or interfacial toughness tests. All specimens were inspected for failure modes. The microtensile test showed the highest bond value (18.29 N/mm2). The microshear tests showed the highest coefficient of variation (0.59) and highest number of pre-test failures. The interfacial energy to fracture test showed that as the shear stress increased its interaction in the adhesive interface, the coefficient of variation also increased. The bond strength of Y-TZP showed different results according to the methodology, as well as its interfacial energy to fracture varied according to the angulation/type of stress specimen was submitted. The lower the shear stress at the adhesive interface of the mixed tests (interfacial energy to fracture), the lower was the variability of the test.

The Importance of MDP Priming, Silica Blasting or Glazing on the Retention Force of Y-TZP Copings to Varying Geometry Tooth Abutments

To evaluate the influence of the convergence angle of tooth preparations and abutments height and several surface treatments for zirconia copings through the tensile retention test. 120 crown preparations were made in Nema G10 with the maxillary first molar anatomy. In total, 60 abutments of 5 mm height were divided into two groups of 6° and 20° convergence angles of tooth preparations, and 60 abutments with a convergence angle of tooth preparations of 12° were divided into groups of 4 and 6 mm heights. Three surface treatments used were MDP-primer (10-Methacryloyloxydecyl dihydrogen phosphate), glazing or silica blasting. The abutments were scanned to make zirconia copings (3Y-TZP–Yttria-Stabilized Tetragonal Zirconia Polycrystals, Vita In-Ceram YZ). After cementation, the mechanical cycling (2 × 106 cycles, 3 Hz, 100 N) was performed to aging. After cycling, the copings were tested in tensile (1 kN load cell; 0.5 mm/s speed). Both abutments support base and copings were embedded in acrylic resin with the aid of a device that maintained the long axis perpendicular to the horizontal plane. Data were analyzed with the two-way ANOVA and Tukey test (95%). ANOVA revealed that the convergence angle influenced the tensile retention (p = 0.0232), but the abutments height showed no statistically significant difference (p = 0.086). The MDP-primer and silica blasting showed higher retention forces in the specimens with height variations. For bonded zirconia crowns, the retention force provided by high convergence angle preparation is critical and cannot be improved by surface treatments. For short and long crown preparations, MDP-based Primers or Silica blasting are advisable to aid restoration longevity.

Influence of time and hydration (ageing) on flexural strength of Yttrium stabilized Zirconia polycrystals (Y-TZP) fabricated with different CAD-CAM Systems.

Objectives:To evaluate the effect of time and hydration (ageing) on flexural strength of yttrium-stabilized zirconia polycrystals (Y-TZP) zirconia fabricated from three different materials.Methods:This in-vitro study was performed from June to September 2019. Y-TZP bars, measuring 2 x 3 x 20 mm were prepared and sintered from three different materials, Group-1: LAVA™ Zirconia (3M ESPE, US) (control) Group-2: Vita In-Ceram YZ (VITA, Germany) and Group-3: Aadva™ Zirconia (Zr) (GC Advanced technologies Inc.). 30 zirconia bars per group were prepared using sectioning of blocks with isomet saw. Followed by sintering in furnaces for recommended temperature cycles. One side of bars were polished and beveled for flexural testing. Groups of specimens were divided into subgroups of 3 (n=10) based on the ageing (distilled water in the incubator at 37ºC) durations (48 Hrs and two and half years). Ten specimens in each material groups were not aged (controls). Samples were exposed to a static force in a three-point bend test using a universal instron-testing machine until fracture. Scanning electron microscopic assessment was performed for fractured specimens for ageing. Data was analyzed using ANOVA and Tukey post hoc test.Results:The mean flexural strength at baseline for Group-1: LAVA™ Zirconia, group (632.7 ± 136.5 MPa) 2: Vita In-Ceram YZ (1036.3 ± 229.6 MPa), and Group-3: Aadva™ Zirconia (1171.3 ± 266.3 MPa) were significantly different. Group-2 and Group-3 specimens showed higher strength compared to Group-1 specimens, irrespective of the ageing duration (p<0.05). Analysis of pooled data for flexural strength for materials by aging period (baseline, after 48 hours and after 2 and ½ years) showed that there was significant reduction of strength with increasing duration (p<0.05).Conclusions:Y-TZP showed variations in flexural strength depending on the material type. Ageing duration exhibited significant influence on the flexural strength of Y-TZP when comparing no ageing to two and half years. Vita In-Ceram YZ and Aadva Zirconia (Zr) showed higher and clinically acceptable flexural strength outcomes.

Influence of contemporary CAD-CAM milling systems on the fit and adaptation of partially stabilized Zirconia fixed partial dentures.

Objective:To evaluate marginal fit and internal adaptation of three-unit Zr frameworks fabricated from four Zr CAD/CAM milling systems.Methods:Fixed partial denture models were replicated (40 stone models) using Polyvinyl Siloxane impression material (PVS) and type IV stone for Zr framework fabrication. FPDs were milled with four CAD/CAM systems, Group-II: LAVAL Zirconia milled by LAVA , Group-2: Vita In-Ceram YZ milled by Cerec®, Group-3: Zirconia milled by GM1000 and Group-4: Zirconia milled by DWX-50N. Twelve marginal gap measurements per framework were performed at pre-established points, with a metallurgical microscope (Zeiss, Germany) at 500X magnification. Eight measurements of cement space per section were performed for adaptation. Data was analyzed using ANOVA and Tukey post hoc test.Results:Zirconia FPD frameworks exhibited gaps ranging from 16 to 50.1 µm for marginal fit and 26.8 to 102.5 µm for internal adaptation. Group-3 [20.8 (8.3) µm & 50.3 (11.4) µm] and Group-4 [16.0 (4.0) µm & 40.2 (8.8) µm] specimens showed significantly lower marginal fit and internal adaptation gaps compared to Group-I [50.1 (13.4) µm & 100.5 (16.7) µm] and Group-2 [38.9 (8.2) µm & 102.5 (13.4) µm] specimens respectively.Conclusions:Different CAD-CAM systems for fabrication of Zr FPD frameworks displayed a significant influence on marginal fit and internal adaptation of restorations.

Fatigue behavior and colorimetric differences of a porcelain-veneered zirconia: effect of quantity and position of specimens during firing

To evaluate the influence of quantity and positioning of veneered zirconia specimens during firing of porcelain on their fatigue performance and colorimetric differences. Bilayer discs (Ø=15 mm) were made, following ISO 6872 guidelines, using a Y-TZP core (yttria-stabilized tetragonal zirconia polycrystal ceramic; VITA In-Ceram YZ) and a feldspathic veneering material (VITA VM9), being both layers with 0.7 mm thickness. Y-TZP discs were sintered, the veneering material was applied over it, and the bilayer specimens were fired according to two factors (n=20): 'quantity' (1 or 5 samples per firing cycle; G1 and G5 groups respectively) and 'positioning' of the specimens inside the furnace (center or periphery of the refractory tray; G5C and G5P groups, respectively). The CIEL*a*b* parameters were recorded with a spectrophotometer and the color difference (ΔE 00 ) and translucency (TP 00 ) were calculated using CIEDE2000 equations. The step-stress fatigue test was performed with the veneer facing down (region of tensile stress concentration), 10 Hz frequency, initial tension of 20 MPa for 5,000 cycles, followed by steps of 10,000 cycles using a step size of 10 MPa, up to 100 MPa; data from strength and number of cycles for failure were recorded for statistical analysis. Unacceptable color differences (ΔE 00 >1.8) were observed comparing G5C vs. G1 (quantity) and G5C vs. G5P (positioning), meanwhile translucency parameters were not affected. Besides, only the 'quantity' factor influenced the fatigue performance (G1>G5C). None of the tested specimens survived beyond 90N and/or 75000 cycles. The quantity and position of the specimens during firing influence the final color of porcelain-veneered zirconia, and firing one specimen per cycle improved the fatigue performance of the bilayer system.

The number of specimens in a furnace affects the biaxial flexural strength of veneered zirconia specimens after sintering

This study evaluated the effect of the number of specimens in a furnace during the firing of porcelain-zirconia (Y-TZP) discs on their biaxial flexural strength. Eighty bilayer disc-shaped specimens (∅: 15mm; thickness: 1.2 mm, ISO 6872) of zirconia (Vita In-Ceram YZ Cubes/Vita) and porcelain (Vita VM9) ceramics, were prepared and divided into four groups (n = 20) according to the number of specimens in a furnace for each porcelain sintering: G1- one disc/20 sintering cycles.; G2 – two discs/10 sintering cycles.; G5-five discs/4 sintering cycles; and G10 – ten discs/2 sintering cycles. Then, the specimens were submitted to biaxial flexure testing (BFS) (1 mm/min, water). The data (MPa) were analyzed with Kruskal-Wallis test followed by the Dunn's post hoc analysis at a 95% level of confidence (α = 0.05). Kruskal-Wallis showed that the number of samples in the furnace affected flexural strength (p < 0.0001). The highest BFS was observed for the G5 (132.3 MPa)A, which was significantly higher than G1 (53.6 MPa)B. No significant difference was observed for the Weibull moduli and characteristic strength among the groups. In terms of flexural strength, approximately five specimens at a time can be placed in a furnace for sintering.

Zirconia and radioactivity: An in vitro study to establish the presence of radionuclides in dental zirconia

Statement of problemDental zirconia possesses concentrations of radionuclides, but their possible radioactivity is unknown. PurposeThe purpose of this in vitro study was to evaluate the radioactivity and radionuclide concentration in dental zirconia. Material and methodsThree specimens were obtained from commonly used dental yttria-stabilized tetragonal zirconia polycrystal materials: Vita In-Ceram YZ, Zirkonzahn, and Zirkonzahn Prettau—producing a powder for the evaluation of radioactivity through gamma spectrometry. For the determination of radioactivity, a group of radionuclides (Ac-228, Pb-212, Tl-208, Pb-214, Bi-214, and Be-7) was evaluated. ResultsThe measurements of all the specimens reported that most activity came from the decay chain of uranium, radium, and thorium, obtaining a radioactivity of 11.082 Bq/kg for Vita In-Ceram YZ, <11.63 Bq/kg for Zirkonzahn, and <34.91 Bq/kg for Zirkonzahn Prettau. ConclusionsAlthough all specimens contained radionuclides, their radioactivity was below the limit established by the International Atomic Energy Agency.

Effect of a Home Bleaching Agent on the Ion Elution of Different Esthetic Materials.

To investigate the effect of a 16% carbamide peroxide home bleaching agent on the ion elution of different esthetic restorative materials and to determine if the released ions exceed the minimal risk levels. Ceramic materials comprising a low-fusing porcelain (Vita VM7), lithium disilicate glass-ceramics (IPS e.max Press and IPS e.max CAD), zirconium substructure materials (IPS e.max ZirCAD and Vita In-Ceram YZ for InLab), and ceromers (Estenia and Tescera ATL) were chosen. Thirty disk-shaped specimens (2 mm thickness and 10 mm diameter) were fabricated from each material and then were divided into 3 experimental groups to receive one of the following solutions: acetic acid (positive control), a bleaching agent and distilled water (negative control) (n = 10/group). For the bleaching agent, the specimens were subjected to a 16% carbamide peroxide solution (VOCO Perfect Bleach) for 2 hours per day for 14 days. A 4% acetic acid solution was applied at 80°C for 16 hours according to the ISO 6872:2015 protocol and specimens of negative control group were immersed in distilled water for 16 hours. Ion elution measurements were conducted with inductively coupled plasma atomic emission spectroscopy (ICP-AES) after immersion in the solutions, and the weight loss of the materials was measured with a precision scale. Changes in the surface topography were investigated by a scanning electron microscopy (SEM).The results were evaluated using multivariate analysis of variance (MANOVA). Among the specimens tested, the most ion elution was observed in the Tescera ATL group, and the least ion elution was observed in the e.max ZirCAD group in all solutions. Ion elution was found to be greater in the bleaching agent than in the acetic acid and distilled water groups. Sodium was the most released ion, and zinc and lithium were the least released among the elements tested. It should be noted that the bleaching-related ion release may exceed toxic doses even if restorative materials meet ISO 6872 standards, and the materials should be protected before home bleaching to prevent ion elution.

Comparing the Repair of Veneered Zirconia Crowns with Ceramic or Composite Resin: An in Vitro Study.

Statement of problem: Current techniques for repairing porcelain-chipped restorations have several limitations. With advances in CAD/CAM technology, the combination of resin cements and high-strength ceramic materials might offer new options for repairing the chipping of veneering ceramic. Purpose: The purpose of this study is to compare the load-to-failure of veneered zirconia crowns repaired by different materials. Material and Methods: Veneered zirconia crowns were made on aluminum dies (n = 10/group). Feldspathic porcelain (Vita VM9, Vident) was applied to the zirconia coping (Vita In-Ceram YZ, Vident) in a cylindrical shape (Ø 10.5 mm, height 7.5 mm). A bevel cut on the porcelain veneer (45 degree, 3 mm width) was made at one side of each crown to simulate porcelain chipping. The crowns were then divided into four different groups according to the repair materials: 1. Conventional resin composite (A; Tetric EvoCeram, Ivoclar Vivadent); 2. Flowable resin composite (B; G-aenial Universal Flo, GC america); 3. CAD/CAM milled feldspathic ceramic (C; Vita Trilux Forte, Vident); 4. CAD/CAM milled lithium disilicate glass-ceramic (D; IPS e.max CAD, Ivoclar Vivadent). Resin cement (Multilink Automix, Ivoclar Vivadent) was used to cement the CAD/CAM ceramic materials to the beveled crowns. Each crown underwent 5000 cycles of thermocycling. The strength test was performed on an Instron universal testing machine by loading force on the center of repaired part to record load-to-failure. Data were analyzed by ANOVA and Tukey HSD post-hoc tests (α = 0.05). Results: Mean loads-to-failure (in Newton +/− SD) of repaired veneered zirconia crowns were: Gr. A: 660.0 ± 200.5; Gr. B: 681.7 ± 175.9; Gr. C: 1236.0 ± 188.8; Gr. D: 1536.3 ± 286.1. Catastrophic failure was the most dominant failure mode in every group. Few specimens exhibited cohesive failure. Only one specimen in group D had adhesive failure. Conclusions: Within the limitation of the study, veneered zirconia crowns repaired with CAD/CAM ceramic materials have significantly higher load-to-failure than veneered crowns repaired with resin composite (p ≤ 0.05). Clinical Implications: Traditionally, porcelain-chipped restorations are often repaired with resin composite and bonding technique. Repairing chipped porcelain with CAD/CAM ceramics fitting the fractured parts can be alternative option with potential advantages. More well-designed studies are necessary to justify this novel repair technique.

Comparative Study on the Degree of Bacterial Biofilm Formation of Dental Bridges Made from Three Types of Materials

The aim of this study was to compare the biofilm formation on three types of dental crown materials using adenosine triphosphate (ATP) driven bioluminescence as an innovative tool for the rapid chairside enumeration of oral bacteria and assessment of oral hygiene. The study group included 60 patients with fixed prosthodontics, made of three types of dental crown materials (BioHpp - Bredent, Ceramics - VITA VMK Master, and Zirconia - Vita In-Ceram) from which we have collected 60 specimen values using a luciferase-based assay system (system SURE II). The values of ATP were obtained with System SURE II device and statistically analyzed with Anova and Wilcoxon Test. The lowest value was shown for Zirconia, comparing with ceramics and BioHpp, but in time we have seen the increase of ATP for all three dental crown materials.

Effect of Thermomechanical and Static Loading on the Load to Fracture of Metal-Ceramic, Monolithic, and Veneered Zirconia Posterior Fixed Partial Dentures.

To evaluate the influence of static (not preloaded) and thermomechanical loading on the load to fracture of metal-ceramic, monolithic and veneered zirconia computer-aided design/computer-aided manufacturing (CAD/CAM) posterior fixed partial dentures (FPDs). One hundred standardized specimens with 2 abutments screwed onto a platform were prepared from stainless steel to receive a posterior 3-unit FPD with an intermediate pontic. Specimens were randomly divided into 5 groups (n = 20): Metal-ceramic (control group), Lava Zirconia system, Vita In-Ceram YZ, IPS e.max ZirCAD, and Lava Plus. Half of the specimens of each group (n = 10) underwent no preloading, and the other half were subjected to thermomechanical loading in a masticatory simulator, and then all FPDs were loaded until fracture using a universal testing machine at a 1 mm/min crosshead speed. The load to fracture of the veneering ceramic and the load to fracture of framework (total fracture) were recorded for each specimen. Data were statistically analyzed using 2-way ANOVA, Tukey's HSD post-hoc test, Student's t test, and Weibull statistics, α = 0.05. Significant differences were recorded between the metal-ceramic and veneered zirconia groups for the veneering ceramic load (p < 0.001; f = 36.62; f = 57.76) in no preloading and thermomechanical loading subgroups, respectively, but no differences were observed between the static and thermomechanical loading conditions. No differences were observed among the veneered zirconia groups. For the total load to fracture, significant differences were observed according to the material (p < 0.001; f = 500.8), between the metal-ceramic and Lava Plus group and the other zirconia groups in no preloading subgroup, and between metal-ceramic and the other groups (p < 0.001; f = 303.33) in thermomechanical loading subgroup. For the type of preloading, significant differences were observed (p = 0.02; f = 5.24) between the Lava Plus group and the other groups. Thermomechanical loading significantly decreased the fracture load of the Lava Plus group (p = 0.005). The Weibull statistics corroborated the results. Monolithic zirconia restorations provided the highest load to fracture values among the zirconia groups tested; however, the results indicate that they must be used in the oral environment with caution, because their load to fracture was influenced by the aging simulation.

Effect of airborne particle abrasion and sintering order on the surface roughness and shear bond strength between Y-TZP ceramic and resin cement.

This study examined the surface roughness (Ra) and shear bond strength (SBS) of Yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramic after airborne particle abrasion at different pressures and particle sizes, pre- and post-sintering. Ninety specimens, prepared from Y-TZP ceramic blocks (Vita In-Ceram YZ, Vita Zahnfabrik), were divided into nine subgroups: control, and 50 and 110 µm Al2O3 airborne particle abrasion at 3 and 4 bar pressure, before and after sintering, respectively. According to the sintering order, before and after surface treatments, Ra values were measured using a profilometer. SBS to Y-TZP was assessed after thermocycling, using self-adhesive resin cement (Rely X U200, 3M ESPE). Scanning electron microscopy (SEM) and X-ray diffractometry (XRD) were performed on one specimen per group. All surface-treated samples were rougher than the controls. ABS50-4 (50 µm Al2O3 airborne particle abrasion at 4 bar pressure before sintering), ABS110-3, and ABS110-4 showed the highest Ra values, among all cohorts. The controls displayed lower SBS values than the treated groups (p<0.05), which had statistically similar results to each other. Airborne particle abrasion of pre-sintered Y-TZP, followed by sintering, increased the tetragonal structure contents.

Load-bearing capacity under fatigue and survival rates of adhesively cemented yttrium-stabilized zirconia polycrystal monolithic simplified restorations

This study evaluated the fatigue failure load, number of cycles for failure and survival probability of 2nd and 3rd generation yttrium-stabilized zirconia (YSZ) adhesively cemented to a dentin analogue substrate. Disc-shaped specimens (n = 10; Ø = 10 mm; thickness = 1.0 mm) were produced from four 2nd generation YSZs (Lava Plus, 3M ESPE; Vita In-Ceram YZ-HT, VITA Zahnfabrik; Zirlux FC, Ivoclar Vivadent; Katana ML-HT, Kuraray) and two 3rd generation YSZs (Katana UTML and Katana STML, Kuraray). Each YSZ disc was adhesively cemented (Multilink Automix System) onto its dentin analogue pair (epoxy resin, Ø = 10 mm; thickness = 2.5 mm). Fatigue tests were conducted through step-stress approach (load ranging from 400 to 2600 N; step-size of 200 N; 20,000 cycles per step, 20 Hz) and the obtained data were analyzed using Kaplan Meier and Mantel-Cox tests. Surface topography and phase transformation (m-, t-, and c-phases) inspections after particle air-abrasion of the YSZs were performed, as well as fractographic analysis of the failed specimens. Second-generation zirconia materials presented higher fatigue failure load, number of cycles for failure, and survival probability than 3rd generation. Similar topographical characteristics of the YSZs could be noted. Phase transformation (t- to m-phase) after YSZ air-abrasion was only observed for 2nd generation materials. All failures started from the surface/sub-surface defects located at the cementation interface. 2nd generation zirconia presented higher load-bearing capacity under cyclic loading than 3rd generation materials.

Polishing of Ground Y-TZP Ceramic is Mandatory for Improving the Mechanical Behavior.

It evaluated the effect of aging by Low Temperature Degradation (LTD), executed after post- processing surface treatments (polishing, heat treatment and glazing), on the surface characteristics (micromorphology and roughness) and on the structural stability (phase transformation and mechanical behavior-flexural strength and structural reliability) of a ground yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic. Discs of Y-TZP (VITA In-Ceram YZ) were manufactured (ISO:6872-2015; 15 mm in diameter and 1.2 ± 0.2 mm in thickness) and randomly assigned into 10 groups according two factors: "aging" in 2 levels (with or without) and "surface treatment" in 5 levels (Ctrl: as-sintered; Gr: grinding with coarse diamond bur; Gr + HT: grinding plus heat treatment; Gr + Pol: grinding plus polishing; Gr + Gl: grinding plus glazing). Roughness (n=30), biaxial flexural test (n=30), phase transformation (n=2), and surface topography (n=2) analyses were performed. Aging led to an intense increase in monoclinic (m) phase content for all the tested conditions, being the as-sintered samples (Ctrl= 65.6%) more susceptible to the t-m phase transformation. Despite of increasing the m-phase content, aging was not detrimental for characteristic strength (except to the grinding condition). There was no significant reduction in the Weibull modulus after surface treatments. Additionally, heat treatment and glazing after grinding led to a decrease in characteristic strength, while polishing presented the highest characteristic strength values. Thus, polishing is mandatory after grinding the Y-TZP ceramic, while performing glazing or heat-treatment alone after grinding lead to the worst mechanical performance.

Effect of primer-cement systems with different functional phosphate monomers on the adhesion of zirconia to dentin

PurposeThe objective of this study was to evaluate the effect of primer-cement systems with different functional phosphate monomers on the adhesion of zirconia to dentin with and without aging protocols. Materials and methodsBovine teeth (N = 180) were embedded in acrylic resin after sectioning their roots with with their coronal parts exposed. The buccal surface of each tooth was polished with silicon carbide papers (#200, 400, 600) until dentin exposure. Sintered zirconia cylinders (N = 180) (Ø: 3.4 mm; height: 4 mm) (Vita In-Ceram 2000) were prepared and distributed into 18 groups (n = 10 per group) considering the following factors: “Cementation System” (Panavia F - PAN; RelyX Ultimate - ULT, Multilink N - MULT) and “aging” (water storage in distilled water at 37 °C for 24 h (control, C); 30 days (30D); 6 months (6 M) and thermocycling for 5000 (5TC), 10,000 (10TC) and 20,000 (20TC) thermal cycles (5–55 °C; dwell time: 30 s)”. Zirconia and dentin cementation surfaces were conditioned according to the recommendations of the manufacturers of each resin cement. The cylinders were adhesively cemented to the dentin surfaces and the specimens were submitted to the aging protocols. After aging, the specimens were subjected to shear bond strength test (SBS) (1 mm/min) in a Universal Testing Machine and failure types were analyzed. The data (MPa) were statistically using Kruskal-Wallis followed by the Dunn test (α = 5%). The degree of conversion (DC) rates of the cementing systems were also measured. ResultsWhile without aging (24 h) no significant difference was found between the cement systems (p > 0.05), after 30D (4.3–5.4), the highest decrease in all groups were observed after 5TC (1.5–2.3) (p < 0.05). Overall, MULT and ULT presented significantly higher results than that of PAN (p < 0.05). Pre-test failures during TC were more frequent in the PAN group. Complete adhesive failures at the cement/dentin interface were more frequent for MULT (30–80%) and PAN (10–70%) and for ULT (20–90%) at the cement/ceramic interface. DC of the tested cements did not show significant difference. ConclusionAdhesion performance of the primer-cement systems with different functional phosphate monomers on zirconia-dentin complex varied as a function of aging strategies with MULT and ULT delivering higher bond strength values. When failure types considered, none of the cement systems performed well on both ceramic and dentin.

Non-thermal plasma increase bond strength of zirconia to a resin cement

Objective: This study investigated the influence of different surface treatments on zirconia surface energy, roughness and microshear bond strength. Material and Methods: Forty eight slices of Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP- VITA In-Ceram® YZ for inLab®) (6.4 x 3.2 x 1.6 mm) were divided into 3 groups according to the surface treatment (n = 16): YTZP_control -untreated; YTZP_plasma -surface treatment with non-thermal oxygen plasma; YTZP_primer - coating with ceramic primer. Surface energy (n = 6) was measured with a goniometer; and surface roughness (n = 10) was analyzed with a 3D profilometer were performed over zirconia surface. On the same specimens of surface roughness, on the treated zirconia's surface, resin cement (PANAVIA V5 - Kuraray Noritake Dental) was built up by inserting the resin cement into Tygon tubes (1 mm of internal diameter X 1 mm length). After 24 h storage, microshear test was assessed. Data were analyzed by one-way ANOVA and Tukey post-hoc test (p &lt; 0.05). Results: Non-thermal oxygen plasma treated specimens exhibited higher statistically significant surface energy (p = 0.00) and bond strength (p = 0.00) when compared to control and primer groups. Roughness test (p = 0.897) could not detect statistical difference among the tested groups. Conclusion: Non-thermal oxygen plasma should be a suitable alternative for zirconia surface treatment prior to luting hence it improved microshear bond strength and provided higher surface energy without affecting surface roughness. Keywords Adhesion; Non-thermal plasma; Surface treatment.

Fracture load of metal-ceramic, monolithic, and bi-layered zirconia-based posterior fixed dental prostheses after thermo-mechanical cycling

ObjectivesThis study aims to evaluate the fracture load of differently fabricated 3-unit posterior fixed dental prostheses (FDPs) with an intermediate pontic. MethodsFifty sets of two stainless-steel abutments were randomly assigned to five groups (n = 10 each) depending on the material and technique used for manufacturing the FDPs: (1) Metal-ceramic (MC, control); (2) Lava Zirconia (LZ, bi-layered); (3) Lava Plus (LM, monolithic); (4) VITA In-Ceram YZ (YZ, bi-layered); and (5) IPS e-max ZirCAD (ZZ, bi-layered). After being luted to the dies, all FDPs were submitted to thermo-mechanical cycling (120,000 masticatory cycles, 50 N; plus 774 thermal cycles of 5 °C/55 °C, dwell time: 30 s). Samples were then subjected to a three-point bending test until fracture in a universal testing machine (cross-head speed: 1 mm/min). Fracture load of the veneering ceramic (VF) and total fracture load (TF) were recorded. Microstructure and failure patterns were assessed. Data was analysed using one-way ANOVA and Tukey HSD post-hoc tests (α = 0.05). ResultsMC restorations recorded higher VF and TF values than did zirconia FDPs (p = 0.0001), which showed no between-group differences. Within the bi-layered groups, TF was significantly higher than VF. LM pieces registered lower average grain size than did LZ specimens (p = 0.001). Overall, the connector was the weakest part. ConclusionsAll of the groups tested could withstand clinical chewing forces in terms of average fracture load. Zirconia-based samples performed similarly to each other, but showed lower mean fracture load values than did metal-ceramic ones. Clinical significanceMonolithic zirconia may be recommendable for solving the chipping problem.