Influence of hot pressing on the microstructure and fracture toughness of two pressable dental glass-ceramics

Recent advances in glass-ceramics: Performance and toughening mechanisms in restorative dentistry

The use of glass-ceramics in the medical field has grown significantly since the 1980s. With excellent aesthetic properties, semi-translucency, outstanding mechanical properties, corrosion resistance, wear resistance and great biocompatibility and workability glass-ceramics is one of the most commonly used materials in restorative dentistry and is widely used in veneers, inlays, onlays, all-ceramic crowns, and implant abutments. This review provides an overview of the research progress of glass-ceramics in restorative dentistry, focusing on the classification, performance requirements, toughening mechanisms and their association with clinical performance, as well as the manufacturing and fabrication of glass-ceramics in restorative dentistry. Finally, the developments and prospects of glass-ceramics in restorative dentistry are summarized and discussed.

Effect of crystal orientation on flexural strength of pressable lithium disilicate glass-ceramics

This study examined the crystal orientation of four kinds of pressable lithium disilicate glass-ceramics and evaluated the effect of crystal orientation on flexural strength. Bar-shaped (24 mm in length, 1.2 mm in thickness, 4.0 mm in width), disk-shaped (12 mm in diameter, 0.5 mm in thickness), and crown-shaped (maxillary first molar) specimens were prepared according to the manufacturer's instructions. Three-point and biaxial flexural strengths were measured for bar- and disk-shaped specimens. Microstructure analysis was performed using X-ray diffractometry and scanning electron microscopy. Three-point flexural strength was improved by parallel crystal orientation along the longitudinal direction of the bar-shaped specimen. There was no relationship between two-dimensional crystal orientation and biaxial flexural strength. The results of this study assumed that biaxial flexural strength was improved by the crystal orientation in the cross-sectional direction. Pressed restorations are expected to possess higher strength than milled restorations due to their crystal orientation.

Evaluation of the Translucency Properties for CAD/CAM Full Ceramic Crowns Fabricated From Glass Ceramics (E.max) or High Translucency Zirconia (Lava Plus): A Clinical Study

Introduction Nowadays, cosmetic demands are the first reason to visit dental clinic. However, most ceramic prostheses need an excessive removal of the dental structure, whether for full crowns or veneer preparation. With the innovation in ceramic materials, high translucent zirconia that demands minimal preparation with high aesthetic results was used for computer-aided design/computer-aided manufacturing (CAD/CAM) Full ceramic crown fabrication. The objective of this study was to compare the translucency properties of CAD/CAM full ceramic crowns fabricated from glass ceramics (E.max) and high translucency zirconia (Lava plus, 3M EPSE). Material and methods The sample consisted of 60 full ceramic crowns divided into two groups; the first group consisted of 30 IPS E.max CAD/CAM full ceramic crowns, while the second one consisted of 30 high translucent zirconia CAD/CAM full ceramic crowns. Translucency for both groups was evaluated directly after cementation by observing the blue light passing through the prostheses. Pearson Chi-Square test was used to study the difference in translucency between the two study groups. Results IPS E.max CAD showed a higher translucency compared to lava plus high translucency zirconia; in addition, this difference was statistically significant (p=0.028). Conclusion Within the limitation of this study, we found that the translucency of dental ceramic was affected by the ceramic material. As IPS E.max CAD was significantly higher in terms of translucency compared to High Translucent Zirconia.

The Effect of Repeated Pressing on the Flexural Strength, Color Stability, Vickers Hardness, and Surface Topography of Heat-Pressed Lithium Disilicate

The aim of this study was to investigate the effect of repressing leftover heat-pressed lithium disilicate material on its mechanical and optical properties. A lithium disilicate ingot (IPS e.max^® Press, IvoclarVivadent, Schaan, Liechtenstein) shade (A1) low translucency was first heat-pressed to yield ceramic bars and disks. Then, the second and third presses were fabricated from the leftovers of the previous pressing cycles. A total of 36 bars and 15 disk specimens were fabricated and divided into three groups according to the number of pressing cycles (n = 12 bars and n = 5 disks): P1: first press (control), P2: second press, and P3: third press. The specimens were tested for flexural strength, color change, Vickers hardness, and surface topography under scanning electron microscopy. One-way ANOVA testing was used to evaluate flexural strength and hardness, while an independent t-test was performed to evaluate color change. There was no significant difference in flexural strength as the number of heat-pressed cycles increased (p = 0.283). Similarly, there was no significant difference in the microhardness values between all groups (p = 0.220). The overall color change ∆E between P1-P2 and P1-P3 were 2.01 and 2.14, respectively. The SEM images showed evenly distributed and densely packed lithium disilicate crystals in the P1 group. However, larger and less densely packed crystals were noticeable in P2 and P3. The IPS e.max Press could be repressed up to two times without an adverse effect on mechanical properties or color stability. These results may support the reuse of pressed lithium disilicate for economical purposes, but further clinical evaluation should be conducted to confirm these findings.

Ceramic and Composite Polishing Systems for Milled Lithium Disilicate Restorative Materials: A 2D and 3D Comparative In Vitro Study

Purpose: This study aims to evaluate the effectiveness of two ceramic and two composite polishing systems for a novel chairside computer-aided design/computer-aided manufacturing (CAD/CAM) lithium disilicate ceramic with three-dimensional and two-dimensional microscopy images. This ceramic material can be used for implant-supported or tooth-borne single-unit prostheses. Materials and Methods: Sixty flat samples of novel chairside CAD/CAM reinforced lithium disilicate ceramic (Amber Mill, Hass Bio) were divided into five groups (n = 15/group) and treated as follows: Group 1 (NoP), no polished treatment; group 2 (CeDi), polished with ceramic Dialite LD (Brasseler USA); group 3, (CeOp) polished with ceramic OptraFine (Ivoclar Vivadent); group 4, (CoDi) polished with composite DiaComp (Brasseler USA), and group 5 (CoAs), polished with composite Astropol (Ivoclar Vivadent). The polished ceramic surface topography was observed and measured with three-dimensional and two-dimensional images. Results: All polishing systems significantly reduced the surface roughness compared with the non-polished control group (Sa 1.15 μm). Group 2 (CeDi) provided the smoothest surface arithmetical mean eight with 0.32 μm, followed by group 3 (CeOp) with 0.34 μm. Group 5 (CoAs) with 0.52 μm provided the smoothest surface among the composite polishing kits. Group 4 (CoDi) with 0.66 μm provided the least smooth surface among all polishing systems tested. Conclusions: Despite the effectiveness of ceramic polishing systems being superior to composite polishing systems of the CAD/CAM lithium disilicate restorative material, both polishing systems significantly improved the smoothness.

Color stability of fully- and pre-crystalized chair-side CAD-CAM lithium disilicate restorations after required and additional sintering processes

PURPOSE

The aim of this study was to investigate shade changes in fully- and pre-crystalized CAD-CAM lithium disilicate crowns after the required and additional firing processes.

MATERIALS AND METHODS

One hundred and five crowns of shade A1 with high translucency were milled out of CAD-CAM lithium disilicate blocks and categorized as follows (n = 15): (1) restorations fabricated from Straumann n!ce with no additional sintering process; (2) restorations fabricated from Straumann n!ce with one additional sintering process; (3) restorations fabricated from Straumann n!ce with two additional sintering processes; (4) restorations fabricated from Amber Mill with one sintering process; (5) restorations fabricated from Amber Mill with two sintering processes; (6) restorations fabricated from IPS e.max CAD with one sintering process; (7) restorations fabricated from IPS e.max CAD with two sintering processes. All restorations were evaluated with a color imaging spectrophotometer.

RESULTS

All restorations presented some color alteration from the original shade both after a single and after two firing processes.

CONCLUSION

The required and additional sintering processes for restorations fabricated with chairside CAD-CAM lithium disilicate blocks cause an alteration of the original shade selected. Shade A1 high translucency restorations tend to change to a more yellowish B1 shade after a sintering process.

Grasping the Lithium hype: Insights into modern dental Lithium Silicate glass-ceramics

OBJECTIVES

Lithium-based glass-ceramics are currently dominating the landscape of dental restorative ceramic materials, with new products taking the market by storm in the last years. Though, the difference among all these new and old products is not readily accessible for the practitioner, who faces the dilemma of reaching a blind choice or trusting manufacturers' marketing brochures. To add confusion, new compositions tend to wear material terminologies inherited from vanguard dental lithium disilicates, disregarding accuracy. Here we aim to characterize such materials for their microstructure, crystalline fraction, glass chemistry and mechanical properties.

METHODS

Eleven commercial dental lithium-based glass ceramics were evaluated: IPS e.max® CAD, IPS e.max® Press, Celtra® Duo, Suprinity® PC, Initial™ LiSi Press, Initial™ LiSi Block, Amber® Mill, Amber® Press, N!CE®, Obsidian® and CEREC Tessera™. The chemical composition of their base glasses was measured by X-Ray Fluorescence Spectroscopy (XRF) and Inductive Coupled Plasma Optical Emission Spectroscopy (ICP-OES), as well as the composition of their residual glass by subtracting the oxides bound in the crystallized fraction, characterized by X-Ray Diffraction (XRD) and Rietveld refinement, and quantified accurately using the G-factor method (QXRD). The crystallization behavior is revealed by differential scanning calorimetry (DSC) curves. Elastic constants are provided from Resonant Ultrasound Spectroscopy (RUS) and the fracture toughness measured by the Ball-on-Three-Balls method (B3B- K Ic). The microstructure is revealed by field-emission scanning electron microscopy (FE-SEM).

RESULTS

The base glasses showed a wide range of SiO₂ /Li₂O ratios, from 1.5 to 3.0, with the degree of depolymerization dropping from ½ to 2/3 of the initial connectivity. Materials contained Li₂SiO₃+Li₃PO₄, Li₂SiO₃+Li₃PO₄+Li₂Si₂O₅, Li₂Si₂O₅+Li₃PO₄+ Cristobalite and/or Quartz and Li₂Si₂O₅+Li₃ PO₄+LiAlSi₂O₆, in crystallinity degrees from 45 to 80 vol%. Crystalline phases could be traced to their crystallization peaks on the DSC curves. Pressable materials and IPS e.max® CAD were the only material showing micrometric phases, with N!CE® and Initial™ LiSi Block showing solely nanometric crystals, with the rest presenting a mixture of submicrometric and nanometric particles. Fracture toughness from 1.45 to 2.30 MPa√m were measured, with the linear correlation to crystalline fraction breaking down for submicrometric and nanometric crystal phases.

SIGNIFICANCE

Dental lithium-based silicate glass-ceramics cannot be all put in the same bag, as differences exist in chemical composition, microstructure, crystallinity and mechanical properties. Pressable materials still perform better mechanically than CAM/CAM blocks, which loose resistance to fracture when crystal phases enter the submicrometric and nanometric range.

Fracture Resistance of Zirconia-Reinforced Lithium Silicate Ceramic Crowns Cemented with Conventional or Adhesive Systems: An In Vitro Study

In recent years, Zirconia-reinforced Lithium Silicate ceramic (ZLS), combining lithium-silicate and zirconia features, has shown to have excellent mechanical and aesthetic characteristics. Thus, the aim of this study was to compare the fracture strength of ZLS single crowns cemented with two different cementation techniques. Twenty crowns were realised and cemented on teeth replicas achieved from an extracted premolar human tooth. The samples were divided into two groups of 10 specimens each, Glass-ionomeric cement (GIC) group and Self-Adhesive Resin Cement (ARC) group. The mechanical test was performed using a universal testing machine. The specimens were then evaluated with a scanning electron microscope (SEM) to identify for all crowns and related abutments the pattern of fracture after the breaking point. The data obtained were statistically analysed. The mean fracture toughness values and standard deviations (±SD) were 2227 ± 382 N and 3712 ± 319 N respectively for GIC and ARC groups. In fact, t-test showed a statistically significant difference between the two groups (p < 0.001). Moreover, the SEM results demonstrated portions of abutments still attached to the crown fragments in the ARC group, whilst these were not present in the GIC group. Within the limitations of this study, these results suggest the use of adhesive cementation for ZLS crowns, which significantly increase the compressive strength of ZLS restorations compared to GIC.

Hydrothermal synthesis and methylene blue adsorption performance of novel 3D hierarchical Li2Si2O5 hydrate particles

Li₂Si₂O₅ are generally obtained in form of granules with unavoidable impurities including Li₂SiO₃ and SiO₂. Here, we demonstrated a facile hydrothermal route to synthesize novel 3D hierarchical Li₂Si₂O₅ hydrate hollow flower-like microstructures assembled by rod subunits with high purity. The crystal growth was accomplished by complete transformation from poorly crystallized metastable phases formed in the initial stage including Li₂SiO₃, SiO₂ and various Li₂Si₂O₅ hydrate species to Li₂Si₂O₅ hydrate rods. The transformation over many times gave a sustainable high chemical potential to direct the anisotropic growth of Li₂Si₂O₅ hydrate rods with large aspect ratios. Besides, the variation of Li/Si molar ratios confirmed that Li₂Si₂O₅ hydrate rods were obtained only at Li/Si = 1. The perfection and aspect ratio of the rods could be controlled very well by adjusting the hydrothermal temperatures and precursor concentrations. Some new points about obtaining pure phase and anisotropic morphology were discussed, including careful selection of precursors and synthetic method. The obtained novel 3D Li₂Si₂O₅ hydrate structures exhibited a characteristic of mesoporous material and had an excellent adsorption capability of methylene blue with high adsorption amount of 49.42 mg·g⁻¹ and color removal of 98.85%, indicating the potential use in wastewater treatment.

Alqahtani N, Alhassan Mujayri F. Effect of Hydrothermal Aging and Beverages on Color Stability of Lithium Disilicate and Zirconia Based Ceramics

Background and Objectives: All-ceramic prosthesis is widely used in modern dental practice because of its improved physico-mechanical and optical properties. These restorations are exposed to coloring agents from various nutrition and beverages in the oral cavity. Long-term color stability is critical for the success of these restorative materials. The purpose of this in vitro study was to assess the effect of common beverages and mouthwash on the color stability of lithium disilicate (LD), monolithic zirconia (MZ) and bilayer zirconia (BZ) surfaces. Materials and Method: Thirty disc-shaped specimens from each material were fabricated; each group was subdivided (n = 10) according to coffee, green tea and chlorhexidine immersion solutions. The baseline color of ceramic discs was recorded according to the CIE L*a*b* system with a portable spectrophotometer. The second measurement was recorded after 3000 thermocycling and immersion in coloring agents for 7 days. The mean color difference was calculated and data were compared with Kruskal-Wallis and Mann-Whitney post hoc tests (0.05). Results: ΔE values for LD with the immersion of coffee, tea, and Chlorhexidine gluconate (CHG) were 1.78, 2.241 and 1.58, respectively. Corresponding ΔE values for MZ were 5.60, 5.19, and 4.86; marginally higher than the clinically acceptable level of 3.5. Meanwhile, BZ showed better color stability compared to MZ with ΔE values of 4.22, 2.11 and 1.43. Conclusions: Among the ceramics evaluated, LD ceramic was found to be more color stable, while MZ ceramics displayed a higher susceptibility to discoloration. MZ and BZ ceramic colors were significantly altered with coffee immersion, while LD ceramics were more affected by green tea.

Advancements in all-ceramics for dental restorations and their effect on the wear of opposing dentition

Tooth wear is a process that is usually a result of tooth to tooth and/or tooth and restoration contact. The process of wear essentially becomes accelerated by the introduction of restorations inside the oral cavity, especially in case of opposing ceramic restorations. The newest materials have vastly contributed toward the interest in esthetic dental restorations and have been extensively studied in laboratories. However, despite the recent technological advancements, there has not been a valid in vivo method of evaluation involving clinical wear caused due to ceramics upon restored teeth and natural dentition. The aim of this paper is to review the latest advancements in all-ceramic materials, and their effect on the wear of opposing dentition. The descriptive review has been written after a thorough MEDLINE/PubMed search by the authors. It is imperative that clinicians are aware of recent advancements and that they should always consider the type of ceramic restorative materials used to maintain a stable occlusal relation. The ceramic restorations should be adequately finished and polished after the chair-side adjustment process of occlusal surfaces.

Current status on lithium disilicate and zirconia: a narrative review

Background

The introduction of the new generation of particle-filled and high strength ceramics, hybrid composites and technopolymers in the last decade has offered an extensive palette of dental materials broadening the clinical indications in fixed prosthodontics, in the light of minimally invasive dentistry dictates. Moreover, last years have seen a dramatic increase in the patients’ demand for non-metallic materials, sometimes induced by metal-phobia or alleged allergies. Therefore, the attention of scientific research has been progressively focusing on such materials, particularly on lithium disilicate and zirconia, in order to shed light on properties, indications and limitations of the new protagonists of the prosthetic scene.

Methods

This article is aimed at providing a narrative review regarding the state-of-the-art in the field of these popular ceramic materials, as to their physical-chemical, mechanical and optical properties, as well as to the proper dental applications, by means of scientific literature analysis and with reference to the authors’ clinical experience.

Results

A huge amount of data, sometimes conflicting, is available today. Both in vitro and in vivo studies pointed out the outstanding peculiarities of lithium disilicate and zirconia: unparalleled optical and esthetic properties, together with high biocompatibility, high mechanical resistance, reduced thickness and favorable wear behavior have been increasingly orientating the clinicians’ choice toward such ceramics.

Conclusions

The noticeable properties and versatility make lithium disilicate and zirconia materials of choice for modern prosthetic dentistry, requiring high esthetic and mechanical performances combined with a minimal invasive approach, so that the utilization of such metal-free ceramics has become more and more widespread over time.

Effect of microstructure on the mechanical properties of lithium disilicate glass-ceramics

The mechanical properties of lithium disilicate glass-ceramics depend on various factors, a prominent one being their microstructure. The aim of this review article is to elucidate the effect of processing parameters such as annealing temperature, holding time, number of heating stages and chemical composition and additives on the microstructure and physical properties of these glass-ceramics.

Three-dimensional characterization and distribution of fabrication defects in bilayered lithium disilicate glass-ceramic molar crowns

OBJECTIVE

To investigate and characterize the distribution of fabrication defects in bilayered lithium disilicate glass-ceramic (LDG) crowns using micro-CT and 3D reconstruction.

METHODS

Ten standardized molar crowns (IPS e.max Press; Ivoclar Vivadent) were fabricated by heat-pressing on a core and subsequent manual veneering. All crowns were scanned by micro-CT and 3D reconstructed. Volume, position and sphericity of each defect was measured in every crown. Each crown was divided into four regions-central fossa (CF), occlusal fossa (OF), cusp (C) and axial wall (AW). Porosity and number density of each region were calculated. Statistical analyses were performed using Welch two sample t-test, Friedman one-way rank sum test and Nemenyi post-hoc test. The defect volume distribution type was determined based on Akaike information criterion (AIC).

RESULTS

The core ceramic contained fewer defects (p<0.001) than the veneer layer. The size of smaller defects, which were 95% of the total, obeyed a logarithmic normal distribution. Region CF showed higher porosity (p<0.001) than the other regions. Defect number density of region CF was higher than region C (p<0.001) and region AW (p=0.029), but no difference was found between region CF and OF (p>0.05). Four of ten specimens contained the largest pores in region CF, while for the remaining six specimens the largest pore was in region OF.

SIGNIFICANCE

LDG core ceramic contained fewer defects than the veneer ceramic. LDG strength estimated from pore size was comparable to literature values. Large defects were more likely to appear at the core-veneer interface of occlusal fossa, while small defects also distributed in every region of the crowns but tended to aggregate in the central fossa region. Size distribution of small defects in veneer obeyed a logarithmic normal distribution.

"Digitally Oriented Materials": Focus on Lithium Disilicate Ceramics

The present paper was aimed at reporting the state of the art about lithium disilicate ceramics. The physical, mechanical, and optical properties of this material were reviewed as well as the manufacturing processes, the results of in vitro and in vivo investigations related to survival and success rates over time, and hints for the clinical indications in the light of the latest literature data. Due to excellent optical properties, high mechanical resistance, restorative versatility, and different manufacturing techniques, lithium disilicate can be considered to date one of the most promising dental materials in Digital Dentistry.

Fracture toughness of chairside CAD/CAM materials - Alternative loading approach for compact tension test

OBJECTIVE

This in-vitro study determined plane-strain fracture toughness (KIC) of five different chairside CAD/CAM materials used for crown fabrication, following alternative innovative loading approach of compact tension test specimens.

METHODS

Rectangular-shaped specimens were cut from CAD/CAM blocks (n=10): Vita Mark II (Vident) (VMII); Lava-Ultimate (3M/ESPE) (LU); Vita Enamic (Vident) (VE); IPS e.max CAD (Ivoclar Vivadent); crystallized and un-crystallized (E-max and E-max-U, respectively); and Celtra Duo (Dentsply) fired and unfired (CD and CD-U, respectively). Specimens were notched with thin diamond disk prior to testing. Instead of applying tensile loading through drilled holes, a specially-made wedge-shaped steel loading-bar was used to apply compressive load at the notch area in Instron universal testing machine. The bar engaged the top ¼ of the notch before compressive load was applied at a cross-head speed of 0.5mm/min. Fracture load was recorded and KIC calculated. Data was statistically-analyzed with one-way ANOVA at 95% confidence level and Tukey's tests.

RESULTS

Means and SDs of KIC in MPam(1/2) for VMII, LU, VE, E-max, E-max-U, CD and CD-U were: 0.73 (0.13), 0.85 (0.21), 1.02 (0.19), 1.88 (0.62), 0.81 (0.25), 2.65 (0.32) and 1.01 (0.15), respectively. ANOVA revealed significant difference among the groups (p<0.001). CD and E-max had significantly highest mean KIC values.

SIGNIFICANCE

Mean KIC values of the tested materials varied considerably, however, none of them reached mean KIC of dentin (3.08MPam(1/2)) previously reported. For E-max and CD, specimens firing significantly increased mean KIC. The modified test arrangement was found to be easy to follow and simplified specimen preparation process.

Effect of heat-pressing temperature and holding time on the microstructure and flexural strength of lithium disilicate glass-ceramics

The present study aimed to evaluate the influence of various heat-pressing procedures (different holding time and heat pressing temperature) on the microstructure and flexural strength of lithium disilicate glass ceramic. An experimental lithium silicate glass ceramic (ELDC) was prepared from the SiO2-Li2O-K2O-Al2O3-ZrO2-P2O5 system and heat-pressed following different procedures by varying temperature and holding time. The flexural strength was tested and microstructure was analyzed. The relationships between the microstructure, mechanical properties and heat-pressing procedures were discussed in-depth. Results verified the feasibility of the application of dental heat-pressing technique in processing the experimental lithium disilicate glass ceramic. Different heat-pressing procedures showed significant influence on microstructure and flexural strength. ELDC heat-pressed at 950℃ with holding time of 15 min achieved an almost pore-free microstructure and the highest flexural strength, which was suitable for dental restorative application.

CO2 Laser Glazing Treatment of a Veneering Porcelain: Effects on Porosity, Translucency, and Mechanical Properties

This work tested CO2 laser as a glazing agent and investigated the effects of irradiation on the porosity, translucency, and mechanical properties of veneering porcelain. Sixty discs (diameter 3.5 × 2.0 mm) of veneering porcelain for Y-TZP frameworks (VM9, VITA Zahnfabrik) were sintered and had one of their faces mirror polished. The specimens were divided into six groups (n=10/group) according to surface treatment, as follows: no treatment-control; auto-glaze in furnace following manufacturer's instructions (G); and CO2 laser (45 or 50 W/cm(2)) applied for four or five minutes (L45/4, L45/5, L50/4, L50/5). Optical microscopy (Shimadzu, 100×) was conducted and the images were analyzed with Image J software for the determination of the following porosity parameters: area fraction, average size, and Feret diameter. The translucency parameter studied was masking ability, determined by color difference (ΔE) over black and white backgrounds (CM3370d, Konica Minolta). Microhardness and fracture toughness (indentation fracture) were measured with a Vickers indenter (HMV, Shimadzu). Contact atomic force microscopy (AFM) (50 × 50 μm(2), Nanoscope IIIA, Veeco) was performed at the center of one sample from each group, except in the case of L45/5. With regard to porosity and translucency parameters, auto-glazed and laser-irradiated specimens presented statistical similarity. The area fraction of the surface pores ranged between 2.4% and 5.4% for irradiated specimens. Group L50/5 presented higher microhardness when compared to the G group. The higher (1.1) and lower (0.8) values for fracture toughness (MPa.m(1/2)) were found in laser-irradiated groups (L50/4 and L45/4, respectively). AFM performed after laser treatment revealed changes in porcelain surface profile at a submicrometric scale, with the presence of elongated peaks and deep valleys.

In vitro fracture toughness of commercial Y-TZP ceramics: a systematic review

PURPOSE

The aim of this review was to assess research methods used to determine the fracture toughness of Y-TZP ceramics in order to systematically evaluate the accuracy of each method with regard to potential influencing factors.

MATERIALS AND METHODS

Six databases were searched for studies up to April 2013. The terms "tough*," "critical stress intensity factor," "zirconi*," "yttri*," "dent*," "zirconia," "zirconium," and "stress" were searched. Titles and abstracts were screened, and literature that fulfilled the inclusion criteria was selected for a full-text reading. Test conditions with potential influence on fracture toughness were extracted from each study.

RESULTS

Ten laboratory studies met the inclusion criteria. There was a significant variation in relation to test method, ambient conditions, applied/indentation load, number of specimens, and geometry and dimension of the specimen. The results were incomparable due to high variability and missing information. Therefore, 10 parameters were listed to be followed to standardize future studies.

CONCLUSIONS

A wide variation in research methods affected the fracture toughness reported for Y-TZP ceramics among the selected studies; single-edge-precracked beam and chevron-notched-beam seem to be the most recommended methods to determine Y-TZP fracture toughness; the indentation methods have several limitations.

CLINICAL SIGNIFICANCE

The accurate calculation of toughness values is fundamental because overestimating toughness data in a clinical situation can negatively affect the lifetime of the restoration.

Correlation of surface texture with the stainability of ceramics

STATEMENT OF PROBLEM

Stainability is an important factor in the long-term clinical success of ceramic restorations. Contour adjustments on restoration surfaces cause differences in ceramic texture that may be affected differently by the staining agent.

PURPOSE

The purpose of this study was to evaluate the surface texture obtained by different surface treatments relevant to the stainability of heat-pressed leucite-reinforced ceramic disk-shaped specimens.

MATERIAL AND METHODS

Sixty-six ceramic disks (IPS Empress Esthetic) (15 × 2 mm) were prepared, glazed, and then assigned to 6 groups. All disks were abraded with a diamond rotary cutting instrument except group GG (control), which was not subjected to any procedure. Group R (rotary diamond cutting instrument) was left untreated after abrasion. Group PB was polished with an abrasive stone, a round polishing brush, and paste with felt wheels. Group PU was polished with 1.0- to 0.5-μm polishing pastes with a goat-hair brush. Group PS was polished with abrasive stone, silicon carbide polishers, and polishing paste with polishing disks. Group GR was reglazed. Surface roughness was measured with a profilometer and evaluated with scanning electron microscopy. A spectrophotometer was used before and after 12 days of immersion in a coffee solution to assess color difference. Data were analyzed by 1-way ANOVA, the Tukey honestly significant difference test, and the Pearson rank correlation tests (α=.05).

RESULTS

Ra values of groups from highest to lowest were, in order, R, PB, PU, PS, GR, and GG (P<.01). Scanning electron microscope images and Ra values were compatible. The color difference (ΔE) values of groups from highest to lowest were, in order, R, PB, PU, PS, GR, and GG. A positive significant relationship of 65.6% between the Ra and ΔE values was found (P<.01).

CONCLUSIONS

Ceramic staining may be related to surface texture. The use of appropriate polishing materials with compatible porcelain may reduce stainability.

How and when does fabrication damage adversely affect the clinical performance of ceramic restorations?

OBJECTIVES

As compared to factory-processed ceramic parts, one unique trait of all-ceramic dental restorations is that they are custom-fabricated, which implies a greater susceptibility to fabrication defects. A variety of processing techniques is now available for the custom fabrication of all-ceramic single and multi-unit restorations, these include sintering, heat-pressing, slip-casting, hard machining and soft machining, all in combination with a final staining or veneering step. All these fabrication techniques, from shaping to firing, are associated with the production of flaws of various shapes and sizes, in conjunction with thermal residual stresses, all of which are capable of inducing failure.

METHODS

This review will examine the various types of fabrication damage inherent to each technique and attempt to establish a relationship between fabrication defects and clinical performance of all-ceramic dental restorations with particular attention to their longevity in vivo.

RESULTS

Failure mechanisms in dental ceramics can be very complex and often involve the combination of physical factors, to which are added patient and clinician-related variables such as restoration design and in vivo conditions.

SIGNIFICANCE

Tremendous progress has been made in understanding the failure mechanisms of all-ceramic dental restorations over the past thirty years. It remains that there is still a need for laboratory tests that usefully simulate clinical conditions.

Effect of Heat-Pressing on the Microstructure and Properties of a Novel Lithium Disilicate Glass-Ceramic

The purpose of this study was to investigate the effects of heat pressing on the microstructure and properties of a novel lithium disilicate glass-ceramic located in Li2O-SiO2-K2O-Al2O3-ZrO2-P2O5 system. Before and after respective heat pressing, the crystalline phase composition and microstructures were analyzed by X-ray diffraction (XRD) and scanning electron microscopy (SEM). Three-point flexural strength of glass-ceramic specimens was measured following the instruction of ISO 6872. The results showed that the bonding strength of the heat-pressed specimens was higher than that of the heat- treated controls. XRD examination showed the main crystallization in specimens after heat pressing was lithium disilicate as controls. SEM examination indicated crysta1s were aligned along the direction of pressing, and while in control groups crystals randomly interlocked. Dental heat pressing procedure leads to an anisotropic structure in lithium disilicate glass-ceramic, which is a useful method to improve the mechanical property. With the results under the present conditions, the novel lithium disilicate glass-ceramic may be considered as a promising candidate material for dental all-ceramic application.

Surface/Interface Morphology and Bond Strength to Glass Ceramic Etched for Different Periods

Increased etching periods may impair the bond strength to ceramics, while the use of an unfilled resin after silane may improve bond strength. The application of a bonding resin may also provide better infiltration to the irregularities created on etched surfaces, irrespective of the conditioning time.

Ceramics for Dental Applications: A Review

Over the past forty years, the technological evolution of ceramics for dental applications has been remarkable, as new materials and processing techniques are steadily being introduced. The improvement in both strength and toughness has made it possible to expand the range of indications to long-span fixed partial prostheses, implant abutments and implants. The present review provides a state of the art of ceramics for dental applications.

Subcritical crack growth in porcelains, glass-ceramics, and glass-infiltrated alumina composite for dental restorations

The objective was to compare fracture toughness (K(Ic)), stress corrosion susceptibility coefficient (n), and stress intensity factor threshold for crack propagation (K(I0)) of two porcelains [VM7/Vita (V) and d.Sign/Ivoclar (D)], two glass-ceramics [Empress/Ivolcar (E1) and Empress2/Ivlocar (E2)] and a glass-infiltrated alumina composite [In-Ceram Alumina/Vita (IC)]. Disks were constructed according to each manufacturer's processing method, and polished before induction of cracks by a Vickers indenter. Crack lengths were measured under optical microscopy at times between 0.1 and 100 h. Specimens were stored in artificial saliva at 37 degrees C during the whole experiment. K(Ic) and n were determined using indentation fracture method. K(I0) was determined by plotting log crack velocity versus log K(I). Microstructure characterization was carried out under SEM, EDS, X-ray diffraction and X-ray fluorescence. IC and E2 presented higher K(Ic) and K(I0) compared to E1, V, and D. IC presented the highest n value, followed by E2, D, E1, and V in a decreasing order. V and D presented similar K(Ic), but porcelain V showed higher K(I0) and lower n compared to D. Microstructure features (volume fraction, size, aspect ratio of crystalline phases and chemical composition of glassy matrix) determined K(Ic). The increase of K(Ic) value favored the increases of n and K(I0).

Microtensile bond strength of different components of core veneered all-ceramic restorations. Part 3: double veneer technique

PURPOSE

The bond strength of zirconia veneer has been considered a weak link in the layered all-ceramic restoration. In a previous study, this bond was improved using a new category of veneering ceramics adopting the pressing technique; however, the resulting esthetic quality lacked the individual characterization built using the layering technique. The aim of this work was to evaluate the effect of combining both press-on and layering veneer ceramics in one restoration on the bond strength with zirconia frameworks.

MATERIALS AND METHODS

Zirconia discs (19.4 mm in diameter, 3-mm thick) were veneered with 3-mm thick press-on veneer ceramic or veneered with 1-mm thick press-on veneer ceramic and an additional 2-mm thick of layering veneer ceramic. Two commercial layering veneer ceramics were tested. The specimens were sectioned into microbars, and the zirconia veneer microtensile bond strength (MTBS) was measured in a universal testing machine. Scanning electron microscopy (SEM) was used to examine core veneer interface quality and to assess failure type. Energy dispersive X-ray microanalysis (EDAX) was used to analyze the chemical structure of the tested veneer ceramics, which may affect the structural integrity of the double veneered restoration. One-way analysis of variance and Tukey HSD post hoc tests were selected to analyze the data (p < 0.05 was significant).

RESULTS

The MTBS of zirconia and press-on ceramic (34.4 +/- 2.9 MPa) was not affected by the addition of a second layer of either veneer ceramic. SEM analysis revealed defect-free zirconia press-on veneer interface, while the interface between the press-on and the layering veneer ceramics demonstrated a different crystal structure and glass matrix, which did not affect wetting and contact between the two materials. EDAX analysis revealed differences, which account for the observed structural differences, in the chemical composition between the tested veneers.

CONCLUSION

The double veneer technique combines the high bond strength and superior interface quality achieved using press-on ceramics with the superior esthetics and individual characterization obtained using layering ceramics. The technique promises superior function and performance of the double veneered restoration.

Fracture toughness determination of two dental porcelains with the indentation strength in bending method

OBJECTIVE

This study was to investigate the influence of the bending test configurations and the crosshead displacement speeds on the fracture toughness (K(Ic)) of dental porcelains obtained with the indentation strength in bending (ISB) method.

METHODS

The strength of the dental veneering porcelains Duceram and Sintagon Zx, Vickers' indented at a load of 2 kg was measured at a crosshead speed of 0.5mm/min with three test configurations, which were 3-point, 4-point, and biaxial bending. Two more groups of Sintagon Zx were tested the same way, but at speeds of 0.1, and 0.05 mm/min, respectively. Both porcelains, the three crosshead speeds, and the three test configurations were compared statistically.

RESULTS

Duceram had a higher toughness than Sintagon Zx with all three test configurations and there was no significant difference between three test configurations with either porcelain. Within the crosshead speed groups of Sintagon Zx, a significant difference was found only in the 0.5mm/min group between the 3-point, and 4-point configurations. Within the configuration groups, significant differences were found between all speeds with the 3-point configuration and only between the highest and lowest speed with the 4-point and the biaxial tests.

CONCLUSION

The crosshead displacement speed can cause statistically different results of fracture toughness obtained with the ISB method.

Relationship between fracture toughness and flexural strength in dental porcelains

The aim of this study was to investigate the correlation between fracture toughness (K(Ic)) and flexural strength (FS) in dental porcelains. Porcelains with different leucite contents and clinical indications were used (A, B, C, D, and E). K(Ic) was determined by surface crack in flexure method (SCF) and FS was determined by four-point-bending test. Microstructural characterization was also carried out. The leucite contents of porcelains A, B, C, D, and E were, respectively, 22, 22, 6, 15, and 0%. Materials with higher leucite content (A and B) presented significantly higher K(Ic) values compared to materials with lower leucite content (C and E). The Weibull moduli (m) of porcelains A and B were statistically higher than those of the other three materials. Regarding characteristic strength (sigma(0)), porcelains D and E showed similar values and statistically higher than those of the other materials which were statistically different from each other. According to the regression analysis, sigma(0) increased with the increase of K(Ic) until approximately 0.75 MPa m(1/2). After that, the increase in K(Ic) was accompanied by a decrease in sigma(0). However, the Weibull modulus increased with the increase in K(Ic), especially for values greater than 0.80 MPa m(1/2).