Combined application of femtosecond laser and air-abrasion protocols to monolithic zirconia at different sintering stages: Effects on surface roughness and resin bond strength

Different surface treatments and adhesive monomers for zirconia-resin bonds: A systematic review and network meta-analysis

This review examined the efficacy of surface treatments and adhesive monomers for enhancing zirconia-resin bond strength. A comprehensive literature search in PubMed, Embase, Web of Science, Scopus, and the Cochrane Library yielded relevant in vitro studies. Employing pairwise and Bayesian network meta-analyses, 77 articles meeting inclusion criteria were analyzed. Gas plasma was found to be ineffective, while treatments including air abrasion, silica coating, laser, selective infiltration etching, hot etching showed varied effectiveness. Air abrasion with finer particles (25-53 µm) showed higher immediate bond strength than larger particles (110-150 µm), with no significant difference post-aging. The Rocatec silica coating system outperformed the CoJet system in both immediate and long-term bond strength. Adhesives containing 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) were superior to other acidic monomers. The application of 2-hydroxyethyl methacrylate and silane did not improve bonding performance. Notably, 91.2 % of bonds weakened after aging, but this effect was less pronounced with air abrasion or silica coating. The findings highlight the effectiveness of air abrasion, silica coating, selective infiltration etching, hot etching, and laser treatment in improving bond strength, with 10-MDP in bonding agents enhancing zirconia bonding efficacy.

Effect of femtosecond laser induced surface patterns on the flexural strength of monolithic zirconia

To investigate how patterns generated by femtosecond (fs) laser and femtosecond laser power affect the surface roughness (Ra) and biaxial flexural strength (BFS) of monolithic zirconia. Eighty disk-shaped zirconia specimens were divided into eight subgroups (n = 10): Control (C), airborne-particle abrasion (APA), 400 mW fs laser (spiral [SP(400)], square [SQ(400)], circular [CI(400)]), and 700 mW fs laser ([SP(700)], [SQ(700)], [CI(700)]). Ra values were calculated by using a surface profilometer. One additional specimen per group was analyzed with scanning electron microscopy and x-ray diffractometry. BFS values were obtained by using the piston-on-3-ball test. One-way ANOVA and either Tukey's HSD (BFS) or Tamhane's T2 (Ra) tests were used to evaluate data (α = 0.05). Regardless of the pattern and power, fs laser groups had higher Ra than C and APA, while SP groups had lower Ra than CI and SQ groups (p ≤ 0.004). For each pattern, Ra increased with higher laser power (p < 0.001), while the laser power did not affect the BFS (p ≥ 0.793). CI and SQ groups had lower BFS than the other groups (p ≤ 0.040), whereas SP groups had similar BFS to C and APA (p ≥ 0.430). Fs laser microstructuring with spiral surface pattern increased the Ra without jeopardizing the BFS of zirconia. Thus, this treatment might be an option to roughen tested zirconia.

The Effect of Femtosecond Laser Surface Patterns on the Effectiveness of Resin Composite to Zirconia Bonding

This laboratory study aimed to evaluate the effect of different surface patterns using femtosecond laser treatment on the enclosed mold shear bond strength (EM-SBS) of resin composite to zirconia (ZrO2) surfaces and to contrast it with the widely used tribochemical silica coating (TBC) surface conditioning method. A set of fifteen rectangular ZrO2 blocks were randomly divided into five groups according to surface pretreatment: Control G0-no treatment; G1-TBC with silane application; G2-femtosecond laser irradiation with horizontal lines 30 µm apart; G3-femtosecond laser irradiation with horizontal lines 15 µm apart; and G4-femtosecond laser irradiation with cross lines 30 µm apart. The pretreated surfaces were characterized by a surface profilometer, tensiometer and scanning electron microscope. The EM-SBS of resin composite stubs to ZrO2 was measured followed by fractographic analysis. The surface roughness and water contact angle were observed to be statistically higher among the femtosecond laser groups compared to the TBC and control groups. The G4 group exhibited the highest EM-SBS among all the groups, irrespective of the ageing conditions used. At the end of 5000 thermocycles, G4 exhibited EM-SBS of 14.05 ± 4.21 MPa compared to 13.80 ± 3.01 MPa in G1 and 5.47 ± 0.97 MPa in G0. The two-way ANOVA revealed a significant effect of both study groups and ageing conditions on the EM-SBS (p < 0.001). Utilization of femtosecond laser technology holds promise as a potential and alternative mechanical retention approach for enhancing the bonding strength of the resin composite to ZrO2.

In Vitro Biofilm Formation on Zirconia Implant Surfaces Treated with Femtosecond and Nanosecond Lasers

(1) Background: The purpose of this study was to evaluate how a zirconia implant surface treated with laser technology affects the degree of biofilm formation. (2) Methods: Experimental titanium (Ti) disks were produced that were sandblasted with large grit and acid-etched (T), and they were compared with zirconia (ZrO2) discs with a machined (M) surface topography; a hydrophilic surface topography with a femtosecond laser (HF); and a hydrophobic surface topography with a nanosecond laser (HN) (N = 12 per surface group). An in vitro three-species biofilm sample (Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi)) was applied to each disc type, and bacterial adhesion was assessed after 48 and 72 h of incubation using an anaerobic flow chamber model. Statistical significance was determined using the Kruskal-Wallis H test, with Bonferroni correction used for the post-hoc test (α = 0.05). (3) Results: Compared to the T group, the M group exhibited more than twice as many viable bacterial counts in the three-species biofilm samples (p < 0.05). In comparison to the T group, the HF group had significantly higher viable bacterial counts in certain biofilm samples at 48 h (Aa and Pi) and 72 h (Pi) (p < 0.05). The HN group had higher viable bacterial counts in Pi at 48 h (5400 CFU/mL, p < 0.05) than the T group (4500 CFU/mL), while showing significantly lower viable bacterial counts in Pg at both 48 (3010 CFU/mL) and 72 h (3190 CFU/mL) (p < 0.05). (4) Conclusions: The surface treatment method for zirconia discs greatly influences biofilm formation. Notably, hydrophobic surface treatment using a nanosecond laser was particularly effective at inhibiting Pg growth.

Preliminary Study on the Optimization of Femtosecond Laser Treatment on the Surface Morphology of Lithium Disilicate Glass-Ceramics and Highly Translucent Zirconia Ceramics

All-ceramic restorations have become increasingly popular in dentistry. Toward ensuring that these restorations adhere to the tooth structure, this study determines the optimal femtosecond laser (FL) treatment parameters for lithium disilicate glass-ceramics and highly translucent zirconia ceramics with respect to surface morphology. For both the ceramics, the following surface conditions were investigated: (1) as-sintered; (2) Al₂O₃ sandblasted; (3) FL treatment (dot pattern with line distances of 14, 20, and 40 µm); (4) FL treatment (crossed-line pattern with a line distance of 20 and 40 µm). Surface roughness parameters were estimated using a 3D confocal laser microscope; microstructures were analyzed using a scanning electron microscope. Peak fluence (F_peak) values of 4 and 8 J/cm² and irradiation numbers (N) of 20 and 10 shots were selected to create dot patterns in highly translucent zirconia and lithium disilicate glass-ceramics, respectively. Furthermore, F_peak = 8 J/cm² and N = 20 shots were chosen to obtain crossed-line patterns in both ceramics. Our results show that lithium disilicate glass-ceramics and highly translucent zirconia exhibit a similar surface morphology under each of the surface treatment conditions. Therefore, FL irradiation of dot or crossed-line patterns (at a distance of 20 and 40 µm) are potential candidates for future investigations.

Effects of ytterbium laser surface treatment on the bonding of two resin cements to zirconia

Monolithic zirconia crowns bonded to zirconia abutments have become more commonly used in the construction of cement-retained implant superstructures. The present study aimed to examine the effects of laser surface treatments on the bond strength of two resin cements to zirconia. Three types of surfaces were examined: untreated, alumina blasted, and ytterbium laser treated; and two types of resin cements: 4-META/MMA-TBB resin cement and composite resin cement. Half of the specimens were subjected to a thermocycling process. Subsequently, a shear bond test was carried out. In addition, surface roughness was measured for each surface type. The results showed that laser treatment increased zirconia surface roughness and that laser treatment significantly increased shear bond strength after the thermocycling of both cement types compared to no treatment. Our experimental results suggested that ytterbium laser surface treatment of zirconia increased the bond strength of resin cements.

Changes in Crystal Phase, Morphology, and Flexural Strength of As-Sintered Translucent Monolithic Zirconia Ceramic Modified by Femtosecond Laser

Conventional bonding technology suitable for silica-based ceramics is not applicable to zirconia, due to its polycrystalline phase composition, chemical stability, and acid corrosion resistance. The development of an effective treatment to improve its surface roughness and mechanical properties remains an unresolved problem. Therefore, to solve this problem, this in vitro study evaluated the changes in surface morphology and flexural strength of translucent monolithic zirconia surfaces treated with femtosecond laser technology. As-sintered translucent zirconia specimens were subjected to airborne particle abrasion and femtosecond laser treatments, while control group specimens received no treatment. After treatment, the roughness and morphology of the treated zirconia surfaces were examined. The flexural strength and X-ray diffraction of the treated specimens were measured and analyzed. Statistical inferential analysis included one-way analysis of variance at a set significance level of 5%. The surface roughness after femtosecond laser treatment was significantly improved when compared with the control group and the group that received the airborne particle abrasion treatment (p < 0.05). In comparison with the airborne particle abrasion group, the flexural strength of the group that received the femtosecond laser treatment was significantly improved (p < 0.05). The femtosecond laser approach using appropriate parameters enhanced the roughness of the zirconia without reducing its flexural strength; therefore, this approach offers potential for the treatment of zirconia surfaces.