Low-temperature degradation of Y-TZP ceramics: A systematic review and meta-analysis

Effect of air-abrasion at pre- and/or post-sintered stage and hydrothermal aging on surface roughness, phase transformation, and flexural strength of multilayered monolithic zirconia

This study aimed to evaluate the effect of air-abrasion/sintering order and autoclave aging on the surface roughness (Ra), phase transformation, and biaxial flexural strength (BFS) of monolithic zirconia. A total of 104 monolithic zirconia specimens (Katana ML) were divided into eight groups according to airborne-particle abrasion protocols and hydrothermal aging: control (non-aged: C-, aged: C+), air-abrasion before sintering (BS-, BS+), air-abrasion after sintering (AS-, AS+), and air-abrasion before and after sintering (BAS-, BAS+). A steam autoclave was used for accelerated aging, and Ra values were measured with a surface profilometer. All specimens were analyzed by X-ray diffraction to determine any phase transformation on the zirconia surface. BFS was measured by using the piston-on-three-balls method. Scanning electron microscopy and atomic force microscopy were performed on one specimen per group. BS and BAS groups showed higher Ra values compared with groups C and AS. The aging process significantly increased the monoclinic phase content of all specimens. Lower monoclinic levels were found in AS+ and BAS+ compared with other aged groups. The AS groups exhibited higher flexural strength values relative to control groups, whereas BS groups exhibited significantly lower flexural strength values (p < .05). There was no reduction in flexural strength by using the BAS protocol. Air-abrasion of zirconia at the pre-sintered stage only is not recommended in clinical use because of the remarkable decrease in flexural strength.

Effect of surface finishing and polishing procedures on color properties and translucency of monolithic zirconia restorations at varying thickness

OBJECTIVE

This study aimed to assess the impact of monolithic zirconia thickness on its color properties after different surface finishing and polishing procedures, and following aging in coffee solution.

MATERIALS AND METHODS

Two types of monolithic zirconia brands [Prettau Anterior (PA) and DD Cubex2 (DDC)] with three different thicknesses: 0.5, 1, and 1.5, and 10 mm diameter were tested. The color properties were evaluated after various surface finishing procedures (glazing, adjusting with burs + glaze, polishing, adjusting with burs + polishing) and after 5,000 cycles in a coffee solution were evaluated. The differences in color (ΔE) and translucency, were calculated and statistically analyzed by three-way ANOVA and pairwise comparison (α = 0.05).

RESULTS

The brand, material thickness, and surface finishing protocol before and after coffee thermocycling had significant effect on color variations (p < 0.001). For translucency, 3-way ANOVA revealed a significant interaction between the material thickness and surface finishing protocol following aging in coffee solution (p < 0.001), however no significant interaction was observed following the surface finishing protocols (p = 0.247).

CONCLUSIONS

The optical properties of monolithic zirconia ceramics can be influenced by the material brand, material thickness and the procedure of surface finishing and polishing.

CLINICAL SIGNIFICANCE

Clinicians should take into consideration the potential change of the color properties of monolithic zirconia restorations following both contouring and occlusal adjustment procedures and coffee intake.

Flexural strength and crystalline stability of a monolithic translucent zirconia subjected to grinding, polishing and thermal challenges

The objective of this study is to investigate the magnitude of structural degradation of a monolithic translucent zirconia caused by clinically relevant grinding and polishing procedures, when associated or not with low temperature degradation (LTD), induced by accelerated hydrothermal aging using autoclave or thermocycling Ninety disks (Ø12 × 1 mm) were prepared from dental zirconia for monolithic restorations (Vipi Block Zirconn Translucent, Vipi). The specimens were divided into 3 groups (n = 30) according to surface treatment: As Sintered (untreated), Grind (diamond bur), Grind + Polish (diamond bur + polish); and then subdivided according to aging method (n = 10): Baseline (no aging), Autoclave (134°C, 2.2 kgf/cm² pressure for 5 h), and Thermocycling (200,000 cycles, 5°C and 55°C, for 15 s each). Roughness, biaxial flexural strength and percentage of monoclinic phase were evaluated. Regarding surface treatment, the Grind group presented higher roughness and greater flexural strength compared to As Sintered group, while Grind + Polish showed intermediate roughness and flexural strength similar to Grind group. Aging had little effect on roughness, but yielded a significant reduction in flexural strength. Tetragonal to monoclinic phase transformation was observed in all groups, caused by both mechanical stresses (grinding and polishing) and LTD, which was similarly induced by the traditional autoclave method, as well as the thermocycling method The use of diamond burs to grind zirconia surface may result in deleterious effects on the surface quality of monolithic zirconia restorations, yet has a potential toughening effect by phase transformation. However, when zirconia is exposed to LTD, regardless of the surface treatment, degradation of the surface quality and strength are observed.

Effect of artificial aging on high translucent dental zirconia: simulation of early failure

Higher yttria content enhances the translucency and appearance of dental zirconia materials. Alterations in material composition also affect mechanical properties. The aim of this study was to compare the fracture load after artificial short-term aging of monolithic, full-contour zirconia crowns with different amounts of yttria-stabilization. Sixty crowns (thirty super high translucent crowns (5Y-Z) and thirty high translucent crowns (3Y-Z)) were produced to fit a model of a premolar with a shallow chamfer preparation. The crowns were cemented with self-adhesive resin cement on composite abutments. For each zirconia type, three groups of crowns (n = 10) were allocated to: (i) cyclic loading (200 N, 1 Hz, 30,000 cycles), (ii) hydrothermal aging (3 × 20 min, 134°C 3.2 bar), or (iii) no treatment (control). Surviving crowns from the aging process were quasistatically loaded until fracture. The 3Y-Z crowns had statistically significantly higher fracture values (3,449 N) than the 5Y-Z crowns (1,938 N). The aging procedures did not affect load at fracture. Fractographic analysis showed that fractures started either at the crown margin or at the occlusal intaglio area. Higher yttria content leads to a reduction in material strength and damage tolerance, and this should be reflected in recommendations for clinical use.

Microstructural, mechanical, and optical characterization of an experimental aging-resistant zirconia-toughened alumina (ZTA) composite

OBJECTIVE

To evaluate the effect of aging on the microstructural, mechanical, and optical properties of an experimental zirconia-toughened alumina composite with 80%Al₂O₃ and 20%ZrO₂ (ZTA Zpex) compared to a translucent zirconia (Zpex) and Alumina.

METHODS

Disc-shaped specimens were obtained by uniaxial and isostatic pressing the synthesized powders (n = 70/material). After sintering and polishing, half of the specimens underwent aging (20 h, 134 °C, 2.2 bar). Crystalline content and microstructure were evaluated using X-ray diffraction and scanning electron microscopy, respectively. Specimens underwent biaxial flexural strength testing to determine the characteristic stress, Weibull modulus, and reliability. Translucency parameter (TP) and Contrast ratio (CR) were calculated to characterize optical properties.

RESULTS

ZTA Zpex demonstrated a compact surface with a uniform dispersion of zirconia particles within the alumina matrix, and typical alumina and zirconia crystalline content. ZTA Zpex and alumina exhibited higher CR and lower TP than Zpex. ZTA Zpex and Zpex showed significantly higher characteristic stress relative to alumina. While aging did not affect optical and mechanical properties of ZTA Zpex and alumina, Zpex demonstrated a significant increase in translucency, as well as a in characteristic stress. Alumina reliability was significantly lower than others at 300 MPa, ZTA Zpex and Zpex reliability decreased at 800 MPa, except for aged Zpex.

SIGNIFICANCE

While aging did not affect the mechanical nor the optical properties of ZTA Zpex and alumina, it did alter both properties of Zpex. The results encourage further investigations to engineer ZTA as a framework material for long span fixed dental prostheses specially where darkened substrates, such as titanium implant abutments or endodontically treated teeth, demand masking.

Hydrothermal degradation methods affect the properties and phase transformation depth of translucent zirconia

OBJECTIVES

To characterize the optical and mechanical properties of a commercial and in-house translucent Y-TZP before and after aging in autoclave or hydrothermal reactor.

METHODS

In-house experimental discs were obtained through uniaxial and isostatic pressing a translucent Y-TZP powder and sintering at 1,550 °C/1 h. Commercial discs were milled from pre-sintered blocks fabricated with the same powder through uniaxial and isostatic pressing and sintering. Discs were allocated into three groups according to aging condition: immediate, aged via autoclave, or reactor (134 °C, 20 h, 2.2 bar). Crystalline content and microstructure were evaluated using X-ray diffraction (XRD) and scanning electron microscopy (SEM). Residual compressive stress (CS) was determined by Raman spectroscopy. Optical properties were determined by the contrast ratio (CR) and translucency parameter (TP) using reflectance data. Mechanical properties were assessed by Vickers hardness, fracture toughness and biaxial flexural strength tests.

RESULTS

XRD and SEM revealed a typical Y-TZP crystalline content, chiefly tetragonal phase, and a dense crystalline matrix for both processing protocols. Reactor aging triggered a more pronounced t-m transformation relative to autoclave. In-house and commercial Y-TZPs demonstrated similar CR and TP, with reactor aging significantly increasing their translucency. Similarly, reactor aging influenced Vickers hardness and fracture toughness. In-house processed Y-TZP clearly demonstrated the presence of CS, whereas commercial Y-TZP showed no presence of CS. Non-aged in-house Y-TZP resulted in significantly lower characteristic strength relative to commercial Y-TZP. While aging protocols significantly increased the characteristic strength of in-house Y-TZP, reactor significantly decreased commercial Y-TZP characteristic strength. Both Y-TZP processing protocols demonstrated high reliability at high-stress missions, with no detrimental effect of aging.

CONCLUSIONS

Laboratory aging methodology significantly influenced optical and mechanical properties of a commercial and in-house translucent Y-TZP.

Surface Characterization and Optical Properties of Reinforced Dental Glass-Ceramics Related to Artificial Aging

The development of various dental glass-ceramic materials and the evolution of novel processing technologies lead to an essential change in the clinical and technical workflow. The long-term success of a dental restoration treatment is defined by its durability, which is directly influenced by the oral environment. This study's purpose was to evaluate the artificial aging behavior of nanostructured, respective microstructured ceramics related to surface topography, roughness, and optical properties. Six monolithic restoration materials were selected: milled lithium disilicate glass-ceramic (LDS-M) MT (medium translucency), hot-pressed lithium disilicate glass-ceramic (LDS-P) MT and HT (high translucency), milled zirconia-reinforced lithium silicate ceramic (ZLS-M) MT and hot-pressed zirconia-reinforced lithium silicate ceramic (ZLS-P) MT and HT, resulting n = 96 surfaces. All the samples were artificially aged by thermal cycling, and all investigations were made before and after thermal cycling. In terms of optical properties, differences recorded between ZLS and LDS ceramics are not significant. Thermal cycling increases the translucency of ZLS and LDS glass-ceramic materials significantly, with the most harmful effect on the pressed and polished samples. Micro- and nano roughness are significantly influenced by in vitro aging and a negative correlation was recorded. Glazed samples are characterized by significant rougher surfaces for all types of materials. On nanolevel, ZLS materials are significantly smoothed by thermal cycling.

Dynamics of Radiation Damage in AlN Ceramics under High-Dose Irradiation, Typical for the Processes of Swelling and Hydrogenation

The use of nitride ceramics, in particular AlN, as structural materials for nuclear power is primarily limited by their resistance to swelling and hydrogenation processes due to the accumulation of poorly soluble helium and hydrogen ions in the structure of the surface layer. In this regard, research in this area is of great importance not only from a fundamental point of view, but also practical, since any new data on radiation resistance can make a great contribution to the development of the theory of resistance to radiation influences of structural materials of a new generation. This work is devoted to a systematic study and comparative analysis of the dynamics of radiation damage during high-dose irradiation with protons and helium ions in nitride ceramics, which have great potential for use as structural materials for GenIV reactors. The choice of irradiation doses of 1 × 1017–5 × 1017 ion/cm2 is due to the possibility of modeling the processes of radiation damage characteristic of displacements of 10–50 dpa. During the study, the dependences of the change in the dielectric and conductive characteristics of nitride ceramics depending on the radiation dose, as well as on the type of ions, were established. The kinetics of degradation and accelerated aging was determined depending on the type of exposure. The mechanical and strength properties of ceramics were determined.

Aging resistant ZTA composite for dental applications: Microstructural, optical and mechanical characterization

OBJECTIVE

To synthesize a zirconia toughened alumina (ZTA) composite with 70% alumina reinforced by 30% zirconia for dental applications and to characterize its microstructure and optical properties for comparison with the isolated counterpart materials and a first-generation 3Y-TZP.

METHODS

Disc-shaped specimens were divided in four groups (n = 70/material): (1) 3YSB-E (first generation 3Y-TZP), (2) Zpex (second generation 3Y-TZP), (3) alumina, and (4) ZTA-Zpex 70/30. After synthesis, ceramic powders were pressed, and green-body samples sintered following a predetermined protocol. Specimens were polished to obtain a mirror surface finish. Apparent density was measured by Archimedes principle. X-ray diffraction (XRD) and scanning electron microscope (SEM) were used to characterize the crystalline content and microstructure. Reflectance tests were performed to determine the contrast-ratio (CR) and translucency-parameter (TP). Mechanical properties were assessed by biaxial flexural strength (BFS) test. All analyses were conducted before and after artificial aging (20 h, 134 °C, 2.2 bar). Optical parameters were evaluated through repeated-measures analysis of variance and Tukey tests (p < 0.05). BFS data were analyzed using Weibull statistics (95% CI).

RESULTS

High density values (95-99%) were found for all ceramic materials and SEM images exhibited a dense microstructure. While XRD patterns revealed the preservation of crystalline content in the ZTA composite, an increase in the monoclinic peak was observed for pure zirconias after aging. Significantly higher CR and lower TP values were observed for the ZTA composite, followed by alumina, 3YSB-E, and Zpex. The highest characteristic stress was recorded for 3YSB-E, followed by intermediate values between ZTA and Zpex, and the lowest for alumina. Aging affected the optical and mechanical properties of both zirconias, while remained stable for ZTA composite and alumina.

SIGNIFICANCE

The synthesis of experimental 70-30% ZTA composite was successful and its relevance for dental applications relies on its higher masking ability, aging resistance, and strength similar to zirconia.

Flexural strength and Weibull characteristics of stereolithography additive manufactured versus milled zirconia

STATEMENT OF PROBLEM

Zirconia restorations can be processed by using stereolithography additive manufacturing (AM) technologies. However, whether additive manufactured zirconia could achieve flexural strength values comparable with those of milled zirconia is unclear.

PURPOSE

The purpose of this in vitro study was to compare the flexural strength and Weibull characteristics of milled and additive manufactured zirconia.

MATERIAL AND METHODS

A total of 40 zirconia bars (25×4×1.2 mm) were obtained by using 2 manufacturing procedures, subtractive (CNC group) (IPS e.max ZirCAD; Ivoclar Vivadent AG) and additive manufacturing (AM group) (3DMix ZrO₂; 3DCeram) technologies and assigned to 2 subgroups according to accelerating artificial aging procedures (mastication simulation): nonaged and aged (n=10). Flexural strength was measured in all specimens by using 3-point bend tests according to ISO/CD 6872.2 with a universal testing machine (Instron Model 8501; Instron Corp). Two-parameter Weibull distribution values, including the Weibull modulus, scale (m), and shape (0) were calculated. Flexural strength values were analyzed by using 2-way ANOVA and Student t statistical tests (α=.05).

RESULTS

The manufacturing procedure (P<.001), the mastication simulating aging procedure (P<.001), and the interaction between them (P<.001) significantly affected flexural strength values. The CNC group exhibited statistically higher flexural strength values than those in the AM group when the specimens were tested before performing an aging procedure (P<.001) and after mastication simulation (P<.001). Moreover, mastication simulation produced a significant reduction in flexural strength for both the CNC group (P<.039) and the AM group (P<.001).

CONCLUSIONS

The manufacturing process reported a significant effect on the flexural strength of the zirconia material tested. Mastication simulation as a means of accelerating artificial aging resulted in the significantly decreased flexural strength values of milled and additively manufactured zirconia material, with the Weibull moduli being significantly higher for the milled groups versus the milled specimens.

Boron nitride nanoplatelets as reinforcement material for dental ceramics

OBJECTIVE

The main goal of this research was to demonstrate the potential value of boron nitride nanoplatelets (BNNPs), which have excellent mechanical properties and biocompatibility, as a suitable reinforcement for dental materials.

METHODS

The BNNPs were prepared by exfoliating h-BN via high-energy ball-milling and dispersion on a zirconia matrix. Then the composite powder was consolidated using spark plasma sintering. Fracture toughness, flexural strength and wear resistance were the mechanical properties explored. Agar diffusion-based biocompatibility testing was carried out. Low temperature degradation tests were also performed in a steam environment in an autoclave.

RESULTS

The BNNPs dispersed zirconia exhibited improved strength (up to 27.3%), and fracture toughness was also increased (up to 37.5%) with the addition of 1-1.5 vol.% BNNPs. Tribological properties were also enhanced by the addition of BNNPs. The cytotoxicity tests confirmed that the BNNPs do not have obvious toxicity. The accelerated low-temperature degradation experiment revealed the barrier properties of the BNNPs, whose addition almost fully inhibited the degradation of the zirconia matrix in a humid environment.

SIGNIFICANCE

The main contribution of this study is the introduction of an advanced material, BNNP, which can be used as a biocompatible reinforcement for dental materials, resulting in enhanced mechanical properties of the system due to its unique structure and extraordinary properties.

Effects of low-temperature degradation on the surface roughness of yttria-stabilized tetragonal zirconia polycrystal ceramics: A systematic review and meta-analysis

STATEMENT OF PROBLEM

A wide range of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics have been applied for dental restorations. However, whether hydrothermal aging affects the surface roughness of Y-TZP is unknown.

PURPOSE

The purpose of this systematic review and meta-analysis was to evaluate the effects of low-temperature degradation (LTD) on the surface roughness of Y-TZP ceramics.

MATERIAL AND METHODS

This report follows the Preferred Reporting Items for Systematic Reviews and Qualitative Analyses statement. The literature search was conducted with Medline through the PubMed, Web of Science, and Cochrane Library with no publication year limits. The screening and quality assessment were performed by 2 independent reviewers. The studies comparing the surface roughness of Y-TZP ceramics after LTD by using steam autoclave aging were included in the meta-analysis. Meta-analyses were conducted with a random-effects model (α=.05) by using Review Manager Software (Cochrane Collaboration).

RESULTS

Of the 203 potentially relevant studies, 32 full texts were assessed for eligibility. A total of 17 articles were included in the systematic review, and 15 were included in the qualitative analyses. The results showed no significant difference in the arithmetic average height (R_a) values between the nonaged and aged Y-TZP (P=.670; mean difference=0.01; 95% confidence interval=-0.03 to 0.05). Subgroup analyses revealed that the aging duration (P=.003) and specimen preparation (P=.010) contributed significantly to the changes in the surface roughness of the Y-TZP ceramics.

CONCLUSIONS

Although LTD was found to have no significant effects on the surface roughness of Y-TZP ceramics, the effects of LTD depended on the duration of the steam autoclave process and the specimen preparation.

Biological and physicochemical implications of the aging process on titanium and zirconia implant material surfaces

STATEMENT OF PROBLEM

Changes in physicochemical properties because of implant material aging and natural deterioration in the oral environment can facilitate microbial colonization and disturb the soft-tissue seal between the implant surfaces.

PURPOSE

The purpose of this in vitro study was to investigate the effect of aging time on the physicochemical profile of titanium (Ti) and zirconia (ZrO₂) implant materials. Further microbiology and cell analyses were used to provide insights into the physicochemical implications of biological behavior.

MATERIAL AND METHODS

Disk-shaped specimens of Ti and ZrO₂ were submitted to roughness, morphology, and surface free energy (SFE) analyses before nonaging (NA) and after the aging process (A). To simulate natural aging, disks were subjected to low-temperature degradation (LTD) by using an autoclave at 134 ºC and 0.2 MPa pressure for 20 hours. The biological activities of the Ti and ZrO₂ surfaces were determined by analyzing Candida albicans (C. albicans) biofilms and human gingival fibroblast (HGF) cell proliferation. For the microbiology assays, a variance analysis method (ANOVA) was used with the Tukey post hoc test. For the evaluation of cellular proliferation, the Kruskal-Wallis test followed by Dunn multiple comparisons were used.

RESULTS

Ti nonaging (TNA) and ZrO₂ nonaging (ZNA) disks displayed hydrophilic and lipophilic properties, and this effect was sustained after the aging process. Low-temperature degradation resulted in a modest change in intermolecular interaction, with 1.06-fold for TA and 1.10-fold for ZA. No difference in biofilm formation was observed between NA and A disks of the same material. After 48 hours, the viability of the attached HGF cells was very similar to that in the NA and A groups, regardless of the tested material.

CONCLUSION

The changes in the physicochemical properties of Ti and ZrO₂ induced by the aging process do not interfere with C. albicans biofilm formation and HGF cell attachment, even after long-term exposure.

Effect of finishing/polishing techniques and low temperature degradation on the surface topography, phase transformation and flexural strength of ultra-translucent ZrO2 ceramic

OBJECTIVE

To investigate the effect of different surface finishing and polishing regimes and low temperature degradation on flexural strength, phase transformation and surface topography of ultra-translucent ZrO₂ ceramic.

METHODS

300 (n=15/group) of conventional zirconia (Z: Ice Zirkon Transluzent) and ultra-translucent zirconia (UT: Prettau Anterior) bar-specimens were made and divided according to the "Finishing/Polishing" - (C - Control, B - diamond rubber polishers, P - adjusting with burs, PB - adjusting with burs+diamond polishers, PG - adjusting with burs+glaze), "Low temperature Degradation (LTD)" (with or without a treatment at 127°C, 1.7bar/24h). Then, a 3-point mini flexural test was performed in a universal testing machine (1mm/min, 500kgf load cell). SEM, EDS, XDR, AFM, optical profilometry and Weibull analysis were performed. Data were analyzed by 3-way ANOVA and Tukey's post-test (5%).

RESULTS

Groups ZPB_D (1670±253MPa), ZB_D (1664±217MPa), and ZB (1655±3678MPa) showed significantly higher flexural strength than the UTPG group (372±56MPa). The Weibull modulus was significantly higher for the ZP_D group compared to the UB, UC_D, UP_D and UPB_D, while UTB, UTC_D and UTP_D had the lowest value. Monoclinic phases were observed only in the conventional zirconia groups and were more evident after LTD. Diamond rubber polishers presented less roughness for both zirconias.

SIGNIFICANCE

The use of diamond rubber polishers is the most suitable finishing/polishing method for zirconia ceramic restorations and that final glazing reduces the fracture resistance of these materials.

Influence of the mechanical properties of biomaterials on degradability, cell behaviors and signaling pathways: current progress and challenges

We have clarified the influence of the mechanical properties of biomaterials on degradability and cell response, and also mechanical design targets and approaches.

Influence of Aging on Biaxial Flexural Strength and Hardness of Translucent 3Y-TZP

The purpose of this research was to evaluate the influence of aging and surface treatment on surface roughness, biaxial flexural strength (BFS), and Vickers hardness (VHN) of translucent dental zirconia. Half of 80 disc-shaped zirconia specimens (1.2 mm thickness and 12 mm diameter) were aged (group A) in an autoclave for 20 h (134 °C and 0.2 MPa) and the other half were not aged (group N). Specimens were subjected to: no surface treatment (SIN), particle air-abrasion with 50 µm alumina particles at 1 bar (0.1 MPa) and 2.5 bar (0.25 MPa), or polishing down to 1 µm (POL). Specimens were analyzed using X-ray diffraction, laser scanning microscope, BFS, and VHN tests. Three groups (N-SIN, N-POL, and A-POL) showed almost no monoclinic phase. While other groups showed monoclinic phase ratios ranging from 7.5 vol. % ± 2.4 vol. % (N-0.1 MPa) to 41.5 vol. % ± 0.3 vol. % (A-0.1 MPa). Aging and particle air-abrasion increased significantly the BFS, ranging from 720 ± 37 MPa (N-SIN) to 1153 ± 92 MPa (N-0.1 MPa). The hardness was not influenced significantly by aging. A certain amount of monoclinic phase at the surface strengthens the high translucent dental zirconia, while hardness and roughness are not influenced. The pressure of particle air-abrasion showed no influence on the evaluated properties.

Biomaterial and biomechanical considerations to prevent risks in implant therapy

This paper is aimed to present a biomaterials perspective in implant therapy that fosters improved bone response and long-term biomechanical competence from surgical instrumentation to final prosthetic rehabilitation. Strategies to develop implant surface texturing will be presented and their role as an ad hoc treatment discussed in light of the interplay between surgical instrumentation and implant macrogeometric configuration. Evidence from human retrieved implants in service for several years and from in vivo studies will be used to show how the interplay between surgical instrumentation and implant macrogeometry design affect osseointegration healing pathways, and bone morphologic and long-term mechanical properties. Also, the planning of implant-supported prosthetic rehabilitations targeted at long-term performance will be appraised from a standpoint where personal preferences (eg, cementing or screwing a prosthesis) can very often fail to deliver the best patient care. Lastly, the acknowledgement that every rehabilitation will have its strength degraded over time once in function will be highlighted, since the potential occurrence of even minor failures is rarely presented to patients prior to treatment.

Reporting quality in systematic reviews of in vitro studies: a systematic review

Background: Systematic reviews (SRs) and/or meta-analyses of in vitro research have an important role in establishing the foundation for clinical studies. In this study, we aimed to evaluate the reporting quality of SRs of in vitro studies using the PRISMA checklist.Method: Four databases were searched including PubMed, Virtual Health Library (VHL), Web of Science (ISI) and Scopus. The search was limited from 2006 to 2016 to include all SRs and/or meta-analyses (MAs) of pure in vitro studies. The evaluation of reporting quality was done using the PRISMA checklist.Results: Out of 7702 search results, 65 SRs were included and evaluated with the PRISMA checklist. Overall, the mean overall quality score of reported items of the PRISMA checklist was 68%. We have noticed an increasing pattern in the numbers of published SRs of in vitro studies over the last 10 years. In contrast, the reporting quality was not significantly improved over the same period (p = .363). There was a positive but not significant correlation between the overall quality score and the journal impact factor of the included studies.Conclusions: The adherence of SRs of in vitro studies to the PRISMA guidelines was poor. Therefore, we believe that using reporting guidelines and journals paying attention to this fact will improve the quality of SRs of in vitro studies.

Impact of different pretreatments and aging procedures on the flexural strength and phase structure of zirconia ceramics

OBJECTIVE

To test the impact of zirconia pretreatment and aging on flexural strength and phase structure.

METHODS

For flexural strength measurements, 180 3Y-TZP_0.25 specimens were fabricated and pretreated: (i) air-abraded (105-μm alumina, 0.25MPa), (ii) air-abraded (50-μm alumina, 0.25MPa), (iii) air-abraded (30-μm silica-coated alumina, 0.28MPa) (iv) non-pretreated. Each pretreated group (n=15) was aged: (a) hydrothermal (134°C, 0.23MPa, 2h) (b) in a mastication simulator (1,200,000×, 5/55°C) and (c) not aged. The fractured specimens were stored dry for 5 years (23°C) for analysis of phase transformation. Additionally, specimens were fabricated from 3Y-TZP_0.25 (n=12) and 3Y-TZP_0.05 (n=8), pretreated (i, ii, iii, iv), and hydrothermally aged. Each air-abrasion method was alternated using 0.05, 0.25 and 0.4MPa pressure. The phase transformation was examined by Raman spectroscopy and surface topography by scanning electron microscope. Data were analyzed using univariate ANOVA with the Scheffé post hoc test and partial-eta-squared (ƞ_p²) (α=0.05).

RESULTS

The highest impact on flexural strength was exerted by the pretreatment (η_P²=0.261, p<0.001), followed by interactions between pretreatment and aging (η_P²=0.077, p=0.033). Non-pretreated and non-aged specimens showed the lowest monoclinic percentage. Hydrothermal aging and 5 years of storage at room temperature increased the monolithic percentage of 3Y-TZP_0.25. The highest phase transformation was observed in groups air-abraded with 105-μm alumina particles. Increasing pressure during the air-abrading process increased the content of the monoclinic phase in zirconia surfaces.

SIGNIFICANCE

Air-abrasion with 30-μm silica-coated alumina powder can be recommended for pretreatment of 3Y-TZP_0.25 and 3Y-TZP_0.05. For air-abrasion using alumina powder lower pressure should be used.

Effects of Pretreatment, Specimen Thickness, and Artificial Aging on Biaxial Flexural Strength of Two Types of Y-TZP Ceramics

OBJECTIVES

To evaluate the effects of surface treatment, specimen thickness, and aging on the biaxial flexural strength (BFS) of two types of yttria-stabilized, tetragonal zirconia polycrystal (Y-TZP) ceramics.

METHODS AND MATERIALS

Disc-shaped specimens, 0.4 and 1.3 mm thick, made from hot isostatic pressed (Denzir) and non-hot isostatic pressed (ZirPlus) Y-TZP, were sandblasted, heat treated, and autoclaved. The surface topography was assessed in accordance with European Standard 623-624:2004 and the BFS tests in accordance with International Organization for Standardization Standard 6872:2008. For statistical analyses, one-way Shapiro-Wilk test, analysis of variance (post hoc: least significant differences), Mann-Whitney U-test, and Pearson correlation tests (p<0.05) were used.

RESULTS

As delivered, the BFS of the 0.4-mm ZirPlus was >1.3-mm ZirPlus (p<0.01), and the BFS of the 0.4-mm Denzir was >1.3-mm Denzir (p<0.001). Sandblasting with 0.2 MPa reduced the BFS of the ZirPlus and Denzir discs (p<0.01), whereas sandblasting with 0.6 MPa increased the BFS of the 0.4-mm Denzir (p<0.001) and reduced the BFS of the 0.4-mm ZirPlus (p<0.05). Heat treatment significantly reduced the BFS of all the groups except for the 0.6 MPa sandblasted 0.4-mm ZirPlus. Autoclaving reduced the BFS of the as-delivered ZirPlus and Denzir specimens (p<0.001), whereas autoclaving the 0.6 MPa sandblasted and heat-treated specimens had no effect (p>0.05) on the BFS. The 0.6 MPa sandblasted, heat-treated, and autoclaved 0.4-mm Denzir exhibited higher BFS than the 0.6 MPa sandblasted, heat-treated, and autoclaved 0.4-mm ZirPlus (p<0.05).

CONCLUSIONS

Thickness and surface treatment of Y-TZP-based ceramics should be considered since those factors could influence the BFS of the material.

Effects of Finish Line Design and Fatigue Cyclic Loading on Phase Transformation of Zirconia Dental Ceramics: A Qualitative Micro-Raman Spectroscopic Analysis

Objectives: Stresses produced during the fabrication of copings and by chewing activity can induce a tetragonal-to-monoclinic (t–m) transformation of zirconia. As a consequence, in the m-phase, the material is not able to hinder possible cracks by the favorable mechanism known as “transformation toughening”. This study aimed at evaluating if different marginal preparations of zirconia copings can cause a premature phase transformation immediately after manufacturing milling and after chewing simulation. Methods: Ninety copings using three commercial zirconia ceramics (Nobel Procera Zirconia, Nobel Biocare Management AG; Lava Classic, 3M ESPE; Lava Plus, 3M ESPE) were prepared with deep-chamfer, slight-chamfer, or feather-edge finish lines (n = 10). Specimens were tested in a chewing simulator (CS-4.4, SD Mechatronik) under cyclic occlusal loads simulating one year of clinical service. Raman spectra were acquired and analyzed for each specimen along the finish lines and at the top of each coping before and after chewing simulation, respectively. Results: Raman analysis did not show any t–m transformation both before and after chewing simulation, as the typical monoclinic bands at 181 cm⁻¹ and 192 cm⁻¹ were not detected in any of the tested specimens. Conclusions: After a one-year simulation of chewing activity, irrespective of preparation geometry, zirconia copings did not show any sign of t–m transformation, either in the load application areas or at the margins. Consequently, manufacturing milling even in thin thickness did not cause any structural modification of zirconia ceramics “as received by manufacturers” both before and after chewing simulation.

Evaluation of the color and translucency of glass-infiltrated zirconia based on the concept of functionally graded materials

STATEMENT OF PROBLEM

Infiltrated zirconia has promising mechanical properties. However, information about its optical behavior is scarce.

PURPOSE

The purpose of this in vitro study was to evaluate the color and translucency of zirconia submitted to infiltration and aging.

MATERIAL AND METHODS

Sixty zirconia disks were machined. Ten disks received no treatment (NT group), 10 disks were immersed in a coloring liquid (A2 group), and 10 disks were immersed in a fluorescent liquid (F group). The other 30 disks were submitted to the same treatments plus glass infiltration (NT+I, A2+I, and F+I groups). The coordinates L*, a*, and b* and the Y tristimulus values were obtained to calculate the color (ΔE₀₀), lightness, chroma, and hue differences; the translucency parameter (TP); and the contrast ratio (CR) associated with the specimens. After aging in an autoclave for 4 hours (T1), new measurements were made. Two- and 3-way ANOVAs were used to analyze color differences, TP, and CR. The lightness, chroma, and hue differences were evaluated by a repeated measures ANOVA. Multiple comparisons were made with the Tukey honestly significant difference (HSD) test (α=.05).

RESULTS

The greatest color differences were observed in the A2+I group (11.23 ΔE₀₀) (P<.001). Aging affected the chroma of the colored groups (P=.013 and P=.001) but did not affect their translucency (P=.347 for TP and P=.132 for CR). The greatest TP values were found in the NT and NT+I groups (2.54 and 2.34, respectively), whereas the CR was equal to or close to 1 in all groups.

CONCLUSIONS

Color differences were observed in the glass-infiltrated groups. The TP and CR were affected by infiltration. Aging did not influence the optical behavior of the specimens.

Effect of hydrothermal aging on the optical properties of precolored dental monolithic zirconia ceramics

STATEMENT OF PROBLEM

The long-term color stability of precolored monolithic zirconia has not been thoroughly investigated.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of hydrothermal aging on the optical properties, phase transformation, and surface topography of precolored monolithic zirconia ceramics.

MATERIAL AND METHODS

Precolored monolithic zirconia specimens (17.0×17.0×1.5 mm, n=50) and lithium disilicate glass-ceramic specimens (16.0×16.0×1.5 mm, n=50) were artificially aged in an autoclave at 134°C under 0.2 MPa for 0, 1, 3, 5, or 10 hours (n=10). CIELab color parameters were obtained from spectral measurements. The translucency parameter (TP) and CIEDE2000 color differences (ΔE₀₀) were calculated. The microstructural and surface properties were analyzed by X-ray diffraction (XRD), atomic force microscope (AFM), and scanning electron microscope (SEM). Data were analyzed with 2-way ANOVA and pairwise comparison (α=.05).

RESULTS

Significant interactions were found between aging time and ceramic material on L*, a*, b*, and TP (P<.001) as follows: b* partial eta squared [η_p²]=0.689; L* η_p²=0.186; a* η_p²=0.176; and TP η_p²=0.137. The b* values significantly decreased after aging for zirconia (P<.001), whereas TP increased after aging for zirconia (P<.014) except at 10 hours (P=.389) and for lithium disilicate (P<.001). The ΔE₀₀ values relative to baseline ranged from 2.03 to 2.52 for aged zirconia and from 0.07 to 0.23 for aged lithium disilicate. XRD analysis revealed that hydrothermal aging promoted an increase in m-phase contents. AFM and SEM demonstrated surface alterations after aging.

CONCLUSIONS

Optical properties and microstructures of precolored monolithic zirconia ceramics were affected by hydrothermal aging, and translucency increased slightly with aging time.

Y-TZP surface behavior under two different milling systems and three different accelerated aging protocols

BACKGROUND

To evaluate the influence of aging and milling system on zirconia surface roughness (SR) and phase transformation.

METHODS

Eighty crowns were divided in two groups according to yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramic milling system (CAD-Neodent or MAD-Zirkonzahn). The crowns were submitted to different aging protocols (N.=10): 1) no aging; 2) autoclaving; 3) pH cycling; or 4) thermocycling. Next, the samples were submitted to an optical profilometry analysis to determine differences in the SR (µm). An X-ray diffraction analysis (XRD) was performed to quantify the percentage of monoclinic phase transformation. SR data was analyzed by two-way ANOVA (α=0.5%).

RESULTS

Aging protocol (P=0.42) and milling system (P=0.08) had no influence on the SR. However, the number of monoclinic phases was influenced by the autoclaving and pH cycling.

CONCLUSIONS

The surface roughness of zirconia-based crowns was not influenced by low temperature degradation or milling system. Regarding the phase transformation, autoclaving and pH-cycling aging presented a monoclinic phase increase when compared to the control group and thermocycled groups.

Antagonist enamel wear of tooth-supported monolithic zirconia posterior crowns in vivo: A systematic review

STATEMENT OF PROBLEM

An assessment of the evidence for the antagonist enamel wear of tooth-supported monolithic zirconia posterior crowns is lacking.

PURPOSE

The purpose of this systematic review was to identify and summarize clinical studies related to the antagonist enamel wear of tooth-supported monolithic zirconia posterior crowns.

MATERIAL AND METHODS

PubMed, Embase, and Cochrane library searches were performed and complemented by manual searches from database inception to December 25, 2017, for title and abstract analysis.

RESULTS

Initially, 198 articles were obtained through database searches. Twenty-one articles were selected for full-text analysis, and 5 studies met the inclusion criteria. Because of the heterogeneity in design, surface treatment, measurement methods, and wear parameters, a meta-analysis was not possible. The selected studies were analyzed regarding the antagonist natural enamel wear of zirconia, measurement methods, and surface treatment. The results of the antagonist enamel wear varied widely, which made comparing them scientifically with absolute values difficult.

CONCLUSIONS

This review indicated that the antagonist enamel wear of zirconia was similar to or more than that of natural teeth but less than that of metal-ceramics. Additional properly designed, longer follow-up clinical trials with larger sample sizes are needed to evaluate the antagonist enamel wear of monolithic zirconia crowns in vivo.

Current status of zirconia implants in dentistry: preclinical tests

PURPOSE

This systematic review aimed to provide an overview of zirconia implants as well as regarding the outcome of the implant-restorative complex in preclinical studies.

STUDY SELECTION

An electronic search of the literature prior to July 2017 was performed to identify all articles related to preclinical research on zirconia implants. The search was conducted using MEDLINE (National Library of Medicine) and PubMed without restrictions concerning the date of publication. The search terminology included: zirconia implant, osseointegration, bone-to-implant contact, soft tissue, histology, histomorphometry, surface modification, surface roughness, surface characteristics, and restoration (connecting multiple keywords with AND, OR).

RESULTS

Fifty-seven studies were finally selected from an initial yield of 654 titles, and the data were extracted. The identified preclinical studies focused on several aspects related to zirconia implants, namely biocompatibility, mechanical properties, implant design, osseointegration capacity, soft tissue response, and restorative options. Due to heterogeneity of the studies, a meta-analysis was not possible. The most frequently used zirconia material for the fabrication of implants is yttria-stabilized tetragonal zirconia polycrystal. The resistance-to-fracture for zirconia implants ranged between 516-2044N. The mostly investigated parameter was osseointegration, which is compared to that of titanium. A lack of evidence was found with other parameters.

CONCLUSIONS

Due to its good biocompatibility as well as favorable physical and mechanical properties, zirconia implants are a potential alternative to titanium implants. However, knowledge regarding the implant-restorative complex and related aspects is still immature to recommend its application for daily practice.

Mechanical reliability, fatigue strength and survival analysis of new polycrystalline translucent zirconia ceramics for monolithic restorations

This study characterized the mechanical properties (static and under fatigue), the crystalline microstructure (monoclinic - m, tetragonal - t and cubic - c phase contents) and the surface topography of three yttrium-stabilized zirconia (YSZ) materials with different translucent properties, before and after aging in an autoclave (low temperature degradation). Disc-shaped specimens were produced from second generation (Katana ML/HT - high-translucent) and third generations (Katana STML - super-translucent and UTML - ultra-translucent) YSZ ceramics (Kuraray Noritake Dental Inc.), following ISO 6872-2015 guidelines for biaxial flexural strength testing (final dimensions: 15 mm in diameter and 1.2 ± 0.2 mm in thickness), and then subjected to the respective tests and analyses. ML was mainly composed of tetragonal crystals, while STML and UTML presented cubic content. Aging increased the monoclinic content for ML and did not affect STML and UTML. Topographical analysis highlights different grain sizes on the ceramic surface (UTML > STML > ML) and aging had no effect on this outcome. Weibull analysis showed the highest characteristic strength for ML both before and after aging, and statistically similar Weibull moduli for all groups. ML material also obtained the highest survival rates (ML > STML > UTML) for both fatigue strength and number of cycles to failure. All fractures originated from surface defects on the tensile side. Third generation zirconia (Katana STML and UTML) are fully stabilized materials (with tetragonal and cubic crystals), being totally inert to the autoclave aging, and presented lower mechanical properties than the second-generation zirconia (Katana ML - metastable zirconia).

Mechanical and Surface Properties of Monolithic Zirconia

Purpose:

This study compared monolithic zirconia with conventional ones based on mean roughness (Ra), Vickers hardness (VHN), topography, transmittance, grain size, flexural strength (FS), Weibull modulus, and fractographic behavior.

Methods and Materials:

One monolithic (Prettau Zircon [PR group]) and two conventional (ICE Zirkon Transluzent [IZ group] and BloomZir [BL group]) zirconias were used. Specimens were tested using a profilometer, a microhardness tester, a scanning electron microscope, a spectrophotometer, and a Universal Testing Machine (EMIC DL 2000). Ra, VHN, grain size, and transmittance were analyzed using the Kruskal-Wallis test associated with Dunn test (α=0.05). FS was analyzed using one-way analysis of variance with the Tukey honestly significant difference test (α=0.05).

Results:

Means and standard deviations of roughness, after sintering (Ra, in μm) and VHN, were, respectively, 0.11 ± 0.01, 1452.16 ± 79.49, for the PR group; 0.12 ± 0.02, 1466.72 ± 91.76, for the IZ group; and 0.21 ± 0.08, 1516.06 ± 104.02, for the BL group. BL was statistically rougher (p&lt;0.01) than PR and IZ. Hardness was statistically similar (p=0.30) for all groups. Means and standard deviations of FS (in MPa) were 846.65 ± 81.97 for the PR group, 808.88 ± 117.99 for the IZ group, and 771.81 ± 114.43 for the BL group, with no statistical difference (p&gt;0.05). Weibull moduli were 12.47 for the PR group, 7.24 for the IZ group, and 6.31 for the BL group, with no statistical differences. The PR and BL groups had higher transmittance values and grain sizes than the IZ group (p&lt;0.05). Although the BL group had some fractures that originated in the center of the tensile surface, fractographic analyses showed the same fracture pattern.

Conclusions:

All tested zirconia showed similar VHN, and the monolithic zirconia had similar roughness compared to one of the conventional zirconias. In addition, the monolithic zirconia showed similar flexural strength and Weibull modulus compared to the others even though its mean grain size was larger. The total transmittance of monolithic zirconia was higher than only one of the conventional zirconias tested.

Zirconia toughened mica glass ceramics for dental restorations

OBJECTIVE

The objective of the present study is to understand the role of yttria stabilized zirconia (YSZ) in achieving the desired spectrum of clinically relevant mechanical properties (hardness, elastic modulus, fracture toughness and brittleness index) and chemical solubility of mica glass ceramics.

METHODS

The glass-zirconia mixtures with varying amounts of YSZ (0, 5, 10, 15 and 20wt.%) were ball milled, compacted and sintered to obtain pellets of glass ceramic-YSZ composites. Phase analysis was carried out using X-ray diffraction and microstructural characterization with SEM revealed the crystal morphology of the composites. Mechanical properties such as Vickers hardness, elastic modulus, indentation fracture toughness and chemical solubility were assessed.

RESULTS

Phase analysis of sintered pellets of glass ceramic-YSZ composites revealed the characteristic peaks of fluorophlogopite (FPP) and tetragonal zirconia. Microstructural investigation showed plate and lath-like interlocking mica crystals with embedded zirconia. Vickers hardness of 9.2GPa, elastic modulus of 125GPa, indentation toughness of 3.6MPa·m^1/2, and chemical solubility of 30μg/cm² (well below the permissible limit) were recorded with mica glass ceramics containing 20wt.% YSZ.

SIGNIFICANCE

An increase in hardness and toughness of the glass ceramic-YSZ composites with no compromise on their brittleness index and chemical solubility has been observed. Such spectrum of properties can be utilised for developing a machinable ceramic for low stress bearing inlays, onlays and veneers.

Effect of Grinding and Multi-Stimuli Aging on the Fatigue Strength of a Y-TZP Ceramic

Abstract This study aimed to investigate the effect of grinding and multi-stimuli aging on the fatigue strength, surface topography and the phase transformation of Y-TZP ceramic. Discs were manufactured according to ISO-6872:2008 for biaxial flexure testing (diameter: 15 mm; thickness: 1.2 mm) and randomly assigned considering two factors “grinding” and “aging”: C- control (as-sintered); CA- control + aging; G- ground; GA- ground + aging. Grinding was carried out with coarse diamond burs under water-cooling. Aging protocols consisted of: autoclave (134°C, 2 bars pressure, 20 hours), followed by storage for 365 days (samples were kept untouched at room temperature), and by mechanical cycling (106 cycles by 20 Hz under a load of 50% from the biaxial flexure monotonic tests). Flexural fatigue strengths (20,000 cycles; 6 Hz) were determined under sinusoidal cyclic loading using staircase approach. Additionally, surface topography analysis by FE-SEM and phase transformation analysis by X-ray Diffractometry were performed. Dixon and Mood methodology was used to analyze the fatigue strength data. Grinding promotes alterations of topographical pattern, while aging apparently did not alter it. Grinding triggered t-m phase transformation without impacting the fatigue strength of the Y-TZP ceramic; and aging promoted an intense t-m transformation that resulted in a toughening mechanism leading to higher fatigue strength for as-sintered condition, and a tendency of increase for ground condition (C < CA; G = GA). It concludes that grinding and aging procedures did not affect deleteriously the fatigue strength of the evaluated Y-TZP ceramic, although, it promotes surface topography alterations, except to aging, and t-m phase transformation.

Mechanical behavior of yttria-stabilized tetragonal zirconia polycrystal: Effects of different aging regimens

This study aimed to characterize and compare the effect of different aging regimens on surface characteristic (topography and roughness), structural stability (phase transformation) and mechanical performance (Weibull analysis) of a Y-TZP ceramic. Discs (15 × 1.2 mm; VITA In-Ceram YZ) were prepared according to ISO 6872-2015 for biaxial flexural strength testing and randomly assigned into five groups (n = 30): as-sintered, no aging treatment (CTRL); 20 h in autoclave at 134°C, 2 bar pressure (AUT); intermittent mechanical loading at 20 Hz/106 load pulses (MechLoad); AUT followed by MechLoad (AUT+MechLoad); and storage in distilled water at 37°C, for 1 year (STO). The following analyses were performed: roughness (n = 30), surface topography (n = 2), phase transformation (n = 2) and biaxial flexure strength (n = 30). Phase transformation (increase of m-phase content) was shown to be a spontaneous, unavoidable and time-dependent process, occurring even under ambient conditions (dry storage after 1 year = 6.0% increase), and is considerably accelerated in the presence of moisture (STO = 17.6%; AUT= 63.1%; and AUT+MechLoad = 59.9%). For roughness parameters, only Ra was affected by aging, and the highest values were observed for AUT+MechLoad (0.25 ± 0.07 µm). For Weibull analysis, structural reliability (Weibull moduli) and characteristic strength were not impaired after aging, and some aging conditions led to increased values (highest weibull moduli in AUT, and highest characteristic strength in STO). Phase transformation proves to be a time-dependent spontaneous mechanism that is accelerated in the presence of different stimuli. However, none of the aging regimens had a negative effect on the characteristic strength and structural reliability of Y-TZP ceramic.

Grinding With Diamond Burs and Hydrothermal Aging of a Y-TZP Material: Effect on the Material Surface Characteristics and Bacterial Adhesion

The aim of this study was to evaluate the effect of grinding with diamond burs and low-temperature aging on the material surface characteristics and bacteria adhesion on a yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) surface. Y-TZP specimens were made from presintered blocks, sintered as recommended by the manufacturer, and assigned into six groups according to two factors—grinding (three levels: as sintered, grinding with extra-fine diamond bur [25-μm grit], and grinding with coarse diamond bur [181-μm grit]) and hydrothermal aging—to promote low-temperature degradation (two levels: presence/absence). Phase transformation (X-ray diffractometer), surface roughness, micromorphological patterns (atomic force microscopy), and contact angle (goniometer) were analyzed. Bacterial adhesion (colony-forming units [CFU]/biofilm) was quantified using an in vitro polymicrobial biofilm model. Both the surface treatment and hydrothermal aging promoted an increase in m-phase content. Roughness values increased as a function of increasing bur grit sizes. Grinding with a coarse diamond bur resulted in significantly lower values of contact angle (p&lt;0.05) when compared with the extra-fine and control groups, while there were no differences (p&lt;0.05) after hydrothermal aging simulation. The CFU/biofilm results showed that neither the surface treatment nor hydrothermal aging simulation significantly affected the bacteria adherence (p&gt;0.05). Grinding with diamond burs and hydrothermal aging modified the Y-TZP surface properties; however, these properties had no effect on the amount of bacteria adhesion on the material surface.

Effects of small-grit grinding and glazing on mechanical behaviors and ageing resistance of a super-translucent dental zirconia

OBJECTIVES

The purpose of this study is to elucidate the effects of small-grit grinding on the mechanical behaviors and ageing resistance of a super-translucent dental zirconia and to investigate the necessity of glazing for the small-grit ground zirconia.

METHODS

Small-grit grinding was performed using two kinds of silicon carbide abrasive papers. The control group received no grinding. The unground surfaces and the ground surfaces were glazed by an experienced dental technician. Finally, the zirconia materials were thermally aged in water at 134°C for 5h. After aforementioned treatments, we observed the surface topography and the microstructures, and measured the extent of monoclinic phase, the nano-hardness and nano-modulus of the possible transformed zone and the flexural strength.

RESULTS

Small-grit grinding changed the surface topography. The zirconia microstructure did not change obviously after surface treatments and thermal ageing; however, the glaze in contact with zirconia showed cracks after thermal ageing. Small-grit grinding did not induce a phase transformation but improved the flexural strength and ageing resistance. Glazing prevented zirconia from thermal ageing but severely diminished the flexural strength. The nano-hardness and nano-modulus of the surface layer were increased by ultrafine grinding.

CONCLUSIONS

The results suggest that small-grit grinding is beneficial to the strength and ageing resistance of the super-translucent dental zirconia; however, glazing is not necessary and even impairs the strength for the super-translucent dental zirconia.

CLINICAL SIGNIFICANCE

This study is helpful to the researches about dental grinding tools and maybe useful for dentists to choose reasonable zirconia surface treatments.

On the bulk degradation of yttria-stabilized nanocrystalline zirconia dental implant abutments: an electron backscatter diffraction study

Degradation of yttria-stabilized zirconia dental implants abutments due to the tetragonal to monoclinic phase transformation was studied in detail by microstructural characterization using Electron Back Scatter Diffraction (EBSD). The amount and distribution of the monoclinic phase, the grain-size distribution and crystallographic orientations between tetragonal and monoclinic crystals in 3 mol.% yttria-stabilized polycrystalline zirconia (3Y-TZP) were determined in two different types of nano-crystalline dental abutments, even for grains smaller than 400 nm. An important and novel conclusion is that no substantial bulk degradation of 3Y-TZP dental implant abutments was detected after 1 year of clinical use.

The effects of mechanical and hydrothermal aging on microstructure and biaxial flexural strength of an anterior and a posterior monolithic zirconia

OBJECTIVES

To evaluate the effect of hydrothermal aging (H), mechanical cycling (M), and the combination of hydrothermal plus mechanical cycling (H+M) on biaxial flexural strength (BFS) and microstructure of two monolithic zirconias, indicated for anterior (AMZ) or posterior restorations (PMZ) and a conventional zirconia (IZr).

METHODS

Disc specimens of each material (n=12) were submitted to: i) H (8h in autoclave at 134°C); ii) M (10⁶ cycles, at 40% of BFS); and iii) H+M. BFS was measured (ISO-6872) and Weibull modulus (m) and the characteristic strength (σ⁰) were calculated. crystalline phase composition analyzed by XRD, and grain size measured by MEV analysis.

RESULTS

XRD analysis showed AMZ was not susceptible to monoclinic transformation in any treatment. Conventional zirconia (IZr) and PMZ had monoclinic transformation only after H and H+M. BFS of AMZ was lower than PMZ and IZr. Cubic phase was found in all conditions for AMZ and IZr, while it was identified in PMZ only after H and H+M. BFS of AMZ was affected by M and H+M. For IZr and PMZ the unique difference detected in BFS was in the comparison of H to M. H treatment induced lower Weibull modulus, but characteristic strength was compatible with the BFS results. AMZ grain size (μm²) was 8.6 times larger than PMZ grains, and 13.6 times larger than IZr grains.

CONCLUSIONS

AMZ showed the largest mean grain size, had the lowest BFS values, and was affected when mechanical cycling was involved. Monoclinic transformation was not found in any treatment for AMZ, but was found in IZr and PMZ when hydrothermal aging was used alone or when combined with mechanical cycling. PMZ showed similar behavior to the IZr. H induced to higher fracture probability.

CLINICAL SIGNIFICANCE

Translucent monolithic dental zirconia available on the market may behave differently under simulated oral aging. The relationship between composition and microstructure determines their properties presumably, and clinical performance.

Mechanical behavior of yttria-stabilized tetragonal zirconia polycrystalline ceramic after different zirconia surface treatments

This study investigated the effects of different zirconia surface conditioning methods on the biaxial flexure strength, surface characteristics and fractographic analysis of a Y-TZP ceramic. Disc-shaped specimens were manufactured according to ISO 6872-2008 for biaxial flexure strength testing, and then randomly assigned into seven groups (n=30). Control (CTRL): without treatment; Tribochemical silica coating (TBS): specimens were sandblasted with silica-coated aluminum oxide particles (CoJet-Sand) for 10s; Silica nanofilm (SNF): specimens were silica coated with a 5nm SiO₂ nanofilm; and four protocols of low-fusing porcelain glaze (GLZ): etching with 10% hydrofluoric acid gel (HF) for 1min (GLZ₁), 5min (GLZ₅), 10min (GLZ₁₀) and 15min (GLZ₁₅). Phase transformation, roughness, micro-morphological, flexural analysis tests, and fractographic analyses were performed. X-ray diffraction (XRD) analysis showed that the TBS promoted the highest m-phase content (20.35). However, for the GLZ groups, XRD analysis was not sensitive enough to obtain an accurate reading for phase transformation. The GLZ group had the highest roughness values. The TBS group had the highest characteristic strength (1291.38MPa), followed by SNF (999.26MPa). These results suggest that (TBS) and (SNF) treatments did not reduce the mechanical properties, while (GLZ) led to a degradation in the mechanical properties.

CAD/CAM machining Vs pre-sintering in-lab fabrication techniques of Y-TZP ceramic specimens: Effects on their mechanical fatigue behavior

This study evaluated the effects of different pre-sintering fabrication processing techniques of Y-TZP ceramic (CAD/CAM Vs. in-lab), considering surface characteristics and mechanical performance outcomes. Pre-sintered discs of Y-TZP ceramic (IPS e.max ZirCAD, Ivoclar Vivadent) were produced using different pre-sintering fabrication processing techniques: Machined- milling with a CAD/CAM system; Polished- fabrication using a cutting device followed by polishing (600 and 1200 SiC papers); Xfine- fabrication using a cutting machine followed by grinding with extra-fine diamond bur (grit size 30 μm); Fine- fabrication using a cutting machine followed by grinding with fine diamond bur (grit size 46 μm); SiC- fabrication using a cutting machine followed by grinding with 220 SiC paper. Afterwards, the discs were sintered and submitted to roughness (n=35), surface topography (n=2), phase transformation (n=2), biaxial flexural strength (n=20), and biaxial flexural fatigue strength (fatigue limit) (n=15) analyses. No monoclinic-phase content was observed in all processing techniques. It can be observed that obtaining a surface with similar characteristics to CAD/CAM milling is essential for the observation of similar mechanical performance. On this sense, grinding with fine diamond bur before sintering (Fine group) was the best mimic protocol in comparison to the CAD/CAM milling.