The effect of zirconia sintering temperature on flexural strength, grain size, and contrast ratio

Current prospect of dental zirconia recycling: A scoping review

PURPOSE

This scoping review aimed to identify and discuss the recyclability of dental zirconia residuals along with the factors influencing the properties of dental recycled zirconia.

STUDY SELECTION

In vitro studies written in both English and Chinese that evaluated the recyclability of dental zirconia residue were selected. A literature search was conducted in Medline, PubMed, Web of Science, and Cochrane Library databases with no restrictions on the publication year.

RESULTS

Sixteen studies were included in this review. Residual dental zirconia can be recycled. Cold isostatic pressing improved the density of recycled zirconia compared with uniaxial pressing. Recycled zirconia powder with fine particles enhanced the performance of recycled zirconia compared with coarse particles. A presintering temperature of 950 to 1100°C was suitable for preparing recycled zirconia presintered bodies. Recycled zirconia may require a higher sintering temperature (≥1500°C) compared with commercially available zirconia. Additionally, recycled zirconia powder can enhance the properties of polymethylmethacrylate as a reinforcing filler and can be combined with alumina powder to obtain an alumina/zirconia composite material.

CONCLUSIONS

Despite a limited body of literature, the recycling and reutilization of dental zirconia residuals are feasible and reliable, and can reduce economic and environmental losses. Nevertheless, several factors influence the recycling effect, including the particle size, molding techniques, and sintering parameters. In addition, recycled zirconia powder can act as a reinforcing filler, potentially enhancing the mechanical properties of other materials. To realize commercially viable recycled zirconia materials, further studies are essential to comprehensively explore and understand their recycling performance.

Effect of speed sintering process on the microstructure, flexural strength and translucency of zirconia

Objectives

To determine the impact of the speed sintering program on the microstructure, flexural strength and translucency of zirconia in comparison with those of the conventional sintering program.

Materials and methods

rectangular shape specimens (12.5 × 15.5 × 1.2 mm) were prepared from four commercial pre-sintered zirconia ceramics (KATANA HTML, KATANA STML, InCoris TZI and InCoris ZI) that were sintered with conventional and speed sintering programs according to the manufacturer's instructions. The phase composition of the sintered specimens was determined by X-ray diffraction (XRD). The grain size was evaluated using scanning electron microscopy (SEM), while the three-point flexural strength was assessed based on the ISO 6872: 2015 standard. Translucency was assessed using a spectrophotometer. The data were analyzed using independent t tests (α = 0.05) and one-way ANOVA.

Results

The XRD patterns were similar for all the groups, indicating that there was no phase transformation. SEM revealed that the average grain size was lower than 1 μm. The grain size, flexural strength and translucency results showed increasing trends when speed sintering is compared with the conventional one but the differences were not significant (P > 0.05).

Conclusions

The results of this research indicate that the speed sintering program had no significant impact on the microstructure, flexural strength and translucency of the examined zirconia, a speed-sintering program can process the ceramic material within a short time with slightly increase their flexural strength and translucency Therefore, a speed-sintering program is appropriate for zirconia (Y-TZP).

Effect of sintering cycle on the strength and translucency of multilayered zirconia

PURPOSE

A newly introduced sintering protocol promises to offer higher translucency while not significantly compromising the flexural strength of the material. However, the effect of the novel sintering protocol has not been thoroughly validated. The purpose of this study was to measure and compare the effect of two sintering protocols on the translucency and flexural strength of two multilayered zirconia materials.

MATERIALS AND METHODS

Two types of multilayered zirconia materials (ZirCAD Prime and Prime esthetic) were selected. Presintered disk specimens were obtained from Translucent, Gradient, and Dentin layers (n = 20). The disks were allocated to 2 groups: standard sintering protocol (peak temperature 1500°C) and high translucency sintering protocol (peak temperature 1600°C). After the sintering process, 10 specimens from each group were randomly selected. The optical values (L*, a*, b*) were measured and used to assess translucency using the relative translucency parameter (RTP00) and translucency differences (ΔRTP00). Then, all 20 specimens were tested for biaxial flexural strength. The outcomes were analyzed. The analysis of variance is used to analyze any significant effects on translucency and flexural strength. Then, any significant difference in the translucency and flexural strength between all pairs of materials was analyzed using Bonferroni-corrected Student's t-test (α = 0.05).

RESULTS

The high translucency sintering protocol significantly decreased biaxial strength in the Prime translucent and dentine layer, Prime esthetic translucent, and gradient layer. RTP00 was significantly reduced in the Prime gradient and Prime esthetic gradient layer when sintered with a high translucency protocol. The lowest ΔRTP00 was observed in the Prime dentine layer, while the highest ΔRTP00 was observed in the Prime esthetic dentin layer.

CONCLUSIONS

High translucency protocol significantly lowers the biaxial flexural strength of both multilayered materials, but the alteration in translucency is within clinically acceptable thresholds (TAT00 = 2.62).

In Vitro Evaluation of Speed Sintering and Glazing Effects on the Flexural Strength and Microstructure of Highly Translucent Multilayered 5 mol% Yttria-Stabilized Zirconia

This study aimed to investigate the impact of speed sintering and glazing on the flexural strength and microstructure of multilayered 5 mol% yttria-stabilized (5Y-) zirconia, which remains unknown. Bar-shaped specimens (N = 600) were fabricated from 5Y-zirconia (FX; Ceramill Zolid FX ML, ST; Katana STML) by cutting, polishing, sintering (conventional and speed sintering), and then glazing. A flexural strength test (n = 30/group), field emission scanning electron microscopy (FE-SEM) observation (n = 2/group), and an X-ray diffraction (XRD) study with Rietveld refinement (n = 1/group) were performed. The flexural strength was analyzed using three-way ANOVA and a post hoc Scheffé test. The grain size was analyzed using the Kruskal-Wallis H test and Bonferroni-Dunn post hoc test. Flexural strength slightly decreased in the nonglazed FX after speed sintering (p < 0.05). Glazing with and without glazing paste did not affect flexural strength at both sintering speeds (p > 0.05). Speed sintering and glazing minimally changed the Weibull modulus and phase fraction, and did not affect grain size (p > 0.05). ST had a larger grain size and lower tetragonal phase content than FX and had a lower flexural strength than FX in most groups (p < 0.05). Overall, the multilayered 5Y-zirconia is considered suitable for dental application using speed sintering and glazing.

Effect of hydrothermal aging on color stability and translucency of two zirconia generations compared to lithium disilicate ceramics

Background

An esthetically acceptable ceramic restoration should have optical properties like the teeth and reflect, transmit, and absorb light. The present investigation compared how hydrothermal aging affected the properties of two types of zirconia and lithium disilicate.

Methods

Thirty rectangular samples (12×14×1 mm) were prepared and sectioned from three different ceramic blocks/blanks (n=10), then assigned into three groups according to the ceramic type: group Z: IPS e.max ZirCAD prime, gradient zirconia (3Y/5Y-TZP); group K: Katana UTML (5Y-TZP); and group E: IPS e.max CAD (lithium disilicate). Color analysis of samples was performed before and after hydrothermal aging (1, 3, and 5 hours) using a spectrophotometer. Color difference (∆E00), translucency parameter (TP00), and contrast ratio (CR) were evaluated. The microstructural analysis was performed using x-ray diffraction (XRD). Data were statistically analyzed at a significance level of P<0.05.

Results

A statistically significant variation was observed across means of ∆E00, TP00, and CR at different times. Group Z displayed the highest statistically significant mean ∆E00. Group E demonstrated the greatest statistically significant mean TP00. Group K exhibited the most statistically significant mean CR.

Conclusion

Hydrothermal aging significantly affected the optical characteristics of lithium disilicate and zirconia ceramics. The translucency of samples increased with aging.

Zirconia specimens printed by vat photopolymerization: Mechanical properties, fatigue properties, and fractography analysis

PURPOSE

The mechanical and fatigue properties of zirconia specimens printed by vat photopolymerization (VPP) were evaluated and compared with those of zirconia specimens milled by computer numerical control (CNC).

MATERIALS AND METHODS

Bar-shaped specimens were printed by stereolithography (SL) and digital light processing (DLP). CNC-milled specimens were used as control samples. The fracture toughness, hardness, and flexural strength properties of the zirconia specimens were evaluated via single edge V-notch beam tests, Vickers hardness tests, and 3-point bending tests. Dynamic fatigue tests were carried out in distilled water using a step-stress test. After static bending and dynamic step-stress testing, fractography analysis was performed. Statistical analysis was carried out to compare the fracture toughness, hardness, flexural strength, and fatigue cycle results of each group (α = 0.05).

RESULTS

The fracture toughness values did not significantly differ among the groups (p > 0.05). The flexural strength was 894.10 MPa for SL, 831.46 MPa for DLP, and 1140.39 MPa for CNC. The flexural strength of CNC was greater than that of SL and DLP (p < 0.01). The mean fatigue cycles were 23498.07 for SL, 19858.60 for DLP, and 31566.80 for CNC. The mean fatigue failure strength was 643.13 MPa for SL, 530.63 MPa for DLP, and 903.75 MPa for CNC. The fatigue failure strength of CNC was greater than that of SL and DLP (p < 0.05). Fractography analysis revealed material defects at the fracture origin for each group. A partially fused structure of the incompletely debonded resin could be observed in SL, and a porous region of incompletely sintered zirconia grains could be observed in CNC.

CONCLUSIONS

The fracture toughness and hardness of zirconia printed by VPP are comparable to those of zirconia milled by CNC. However, zirconia milled by CNC has superior static flexural strength and dynamic fatigue resistance. Further studies are needed to explore the clinical applications of VPP-printed zirconia.

The physical-mechanical properties of 3D-printed versus conventional milled zirconia for dental clinical applications: A systematic review with meta-analysis

AIM OF STUDY

This systematic review aimed to compare the physical-mechanical properties of 3D-printed (additively manufactured (AM)) zirconia compared to conventionally milled (subtractive manufactured: SM) zirconia specimens.

MATERIALS AND METHODS

A thorough search of Internet databases was conducted up to September 2023. The search retrieved studies that evaluated AM zirconia specimens and restorations regarding the physical-mechanical properties and mechanical behavior of zirconia. The main topic focused on 3Y-TZP. However, records of 4YSZ and 5YSZ were also included to gather more comprehensive evidence on additively manufactured zirconia ceramic. The quality of studies was assessed using the ROB2 tool, Newcastle Ottawa scale, and the Modified Consort Statement. Of 1736 records, 57 were assessed for eligibility, and 38 records were included in this review, only two clinical trials meet the inclusion criteria and 36 records were laboratory studies. There were no signs of mechanical complications and wear to antagonists with short-term clinical observation. SM thin specimens ≤1.5 mm showed statistically significant higher flexural strength than AM zirconia (p ≤ 0.01), while thicker specimens showed comparable outcomes (p > 0.5). The fracture resistance of dental restorations was dependent on the aging protocol, restoration type, and thickness. The bond strength of veneering ceramic to zirconia core was comparable.

CONCLUSIONS

The results pooled from two short-term clinical trials showed no signs of mechanical or biological complications of additively manufactured 3Y-TZP zirconia crowns. The flexural strength might depend on the specimens' thickness, but it showed promising results to be used in clinical applications, taking into account the printing technique and orientation, material composition (yttria content), solid loading, and sintering parameters. 3D-printed restorations fracture resistance improved when adhered to human teeth. The veneering ceramic bond was comparable to milled zirconia specimens. Long-term RCTs are recommended to confirm the mechanical behavior of 3D-printed restorations.

Additive manufacturing of dental ceramics in prosthodontics: The status quo and the future

PURPOSE

This review aims to summarize the available technologies, material categories, and prosthodontic applications of additive manufacturing (AM) dental ceramics, evaluate the achievable accuracy and mechanical properties in comparison with current mainstream computer-aided design/computer-aided manufacturing (CAD/CAM) subtractive manufacturing (SM) methods, and discuss future prospects and directions.

STUDY SELECTION

This paper is based on the latest reviews, state-of-the-art research, and existing ISO standards on AM technologies and prosthodontic applications of dental ceramics. PubMed, Web of Science, and ScienceDirect were amongst the sources searched for narrative reviews.

RESULTS

Relatively few AM technologies are available and their applications are limited to crowns and fixed partial dentures. Although the accuracy and strength of AM dental ceramics are comparable to those of SM, they have the limitations of relatively inferior curved surface accuracy and low strength reliability. Furthermore, functionally graded additive manufacturing (FGAM), a potential direction for AM, enables the realization of biomimetic structures, such as natural teeth; however, specific studies are currently lacking.

CONCLUSIONS

AM dental ceramics are not sufficiently developed for large-scale clinical applications. However, with additional research, it may be possible for AM to replace SM as the mainstream manufacturing technology for ceramic restorations.

Impact of the sintering parameters on the grain size, crystal phases, translucency, biaxial flexural strength, and fracture load of zirconia materials

OBJECTIVES

To investigate the influence of the zirconia and sintering parameters on the optical and mechanical properties.

METHODS

Three zirconia materials (3/4Y-TZP, 4Y-TZP, 3Y-TZP) were high-speed (HSS), speed (SS) or conventionally (CS) sintered. Disc-shaped specimens nested in 4 vertical layers of the blank were examined for grain size (GS), crystal phases (c/t'/t/m-phase), translucency (T), and biaxial flexural strength. Fracture load (FL) of three-unit fixed dental prostheses was determined initially and after thermomechanical aging. Fracture types were classified, and data statistically analyzed.

RESULTS

4Y-TZP showed a higher amount of c + t'-phase and lower amount of t-phase, and higher optical and lower mechanical properties than 3Y-TZP. In all materials, T declined from Layer 1 to 4. 3/4Y-TZP showed the highest FL, followed by 3Y-TZP, while 4Y-TZP showed the lowest. In 4Y-TZP, the sintering parameters exercised a direct impact on GS and T, while mechanical properties were largely unaffected. The sintering parameters showed a varying influence on 3Y-TZP. Thermomechanical aging resulted in comparable or higher FL.

CONCLUSION

3/4Y-TZP presenting the highest FL underscores the principle of using strength-gradient multi-layer blanks to profit from high optical properties in the incisal area, while ensuring high mechanical properties in the lower areas subject to tensile forces. With all groups exceeding maximum bite forces, the examined three-unit FDPs showed promising long-term mechanical properties.

Color Characteristics of High Yttrium Oxide-Doped Monochrome and Multilayer Partially Stabilized Zirconia upon Different Sintering Parameters

OBJECTIVES

 Sintering influences the optical properties of zirconia. This study examined the effect of altering sintering temperature and time of monochrome (Mo) and multilayer (Mu) 5 mol% yttria-partially stabilized zirconia (5Y-PSZ) on color characteristics.

MATERIALS AND METHODS

 Three hundred specimens (width × length × thickness = 10 × 20 × 2 mm) were prepared from Mo and Mu (with cervical [C], middle [M], and incisal [I] region) 5Y-PSZ and randomly sintered at decreasing (Td: 1,450°C), regular (Tr: 1,500°C), and increasing (TI: 1,550°C) sintering temperature, with extremely short (He: 10 minutes), ultrashort (Hu: 15 minutes), short (Hs: 30 minutes), and regular (Hr: 135 minutes) sintering time (n = 15/group). Color appearance (EW ), translucency parameter (TP), contrast ratio (CR), opalescence parameter (OP), and color appearance difference (∆E diff) were evaluated in the CIE L*a*b* system. Microstructures were evaluated by scanning electron microscope (SEM) and X-ray diffractometer (XRD).

STATISTICAL ANALYSIS

 Analysis of variance (ANOVA) and Bonferroni comparisons were determined for significant differences (p < 0.05).

RESULTS

 Significant differences in color parameters upon zirconia type, sintering temperature, and sintering time, and their interactions were indicated (p < 0.05). Increasing sintering temperature and extended sintered time resulted in larger grain, reduced tetragonal-to-monoclinic phase transformation, and significantly increased the TP and OP, but decreased the CR and ∆E diff (p < 0.05). Decreasing sintering temperature and time led to clinically unacceptable color appearance.

CONCLUSION

 Mo was found to be more translucent than Mu. To achieve the most favorable optical properties, increasing sintering temperature and extending sintering time are recommended. Decreasing sintering temperature is not suggested. However, shortened sintering time is feasible, but it needs sintering with increasing sintering temperature to achieve a promising color appearance.

Comparative assessment of flexural strength of monolithic zirconia with different thicknesses and two sintering techniques

OBJECTIVES

This study aimed to compare the flexural strength of monolithic zirconia with different thicknesses and two sintering techniques.

MATERIALS AND METHODS

This in vitro, experimental study was conducted on 28 monolithic zirconia discs with 10 mm diameter and 0.5 (n = 14) and 1.2 mm (n = 14) thickness. Each group was divided into two subgroups (n = 7) for fast (60 min) and conventional (120 min) sintering at 1450°C. After sintering, the specimens were thermocycled and their flexural strength was measured by piston-on-3-balls technique in a universal testing machine (0.5 mm/min, 1.2 mm pin diameter). Data were analyzed by the Weibull test, one-way analysis of variance, and Tukey's test (α = .05).

RESULTS

The flexural strength of specimens with 1.2 mm thickness was significantly higher than that of specimens with 0.5 mm thickness (p < .05). The flexural strength of 1.2 mm/120-min group was slightly, but not significantly, higher than that of 1.2 mm/60-min group (p > .05). The flexural strength of 0.5 mm/120-min group was slightly, but not significantly, higher than that of 0.5 mm/60-min group (p > .05).

CONCLUSION

The increase in thickness of monolithic zirconia increases its flexural strength; however, increasing the sintering time appears to have no significant effect on the flexural strength of monolithic zirconia.

Comparative effects of glazing versus polishing on mechanical, optical, and surface properties of zirconia ceramics with different translucencies

OBJECTIVES

This study compared the effects of glazing versus polishing on mechanical, optical, and surface properties of zirconia ceramics with different translucencies.

MATERIALS AND METHODS

In this in vitro study, 120 bar-shaped specimens (25 × 4 × 1.2 mm) were fabricated from three different types of zirconia with different translucencies (n = 40, DD Bio ZW, ZX2, and Cube X2). After sintering, each zirconia group was randomly divided into five subgroups of control (glazing), glazing + bur abrasion, glazing + bur abrasion + polishing with EVE Diacera® kit, glazing + bur abrasion + reglazing, and glazing + bur abrasion + polishing with EVE Diacera® kit + reglazing. The specimens underwent surface roughness, hardness, flexural strength, and translucency tests, as well as X-ray diffraction (XRD) and scanning electron microscopy (SEM) for assessment of surface topography. Data were analyzed by one-way analysis of variance, Tukey test, and Pearson test (α = .05).

RESULTS

Flexural strength, surface hardness, and translucency were significantly correlated with zirconia type. ZW zirconia had significantly higher flexural strength and surface hardness and significantly lower translucency than Cube X2 and ZX2 (p < .001). Surface roughness had no significant correlation with zirconia type (p = .274). Polishing created the smoothest, and bur abrasion created the roughest surface (p < .001). Flexural strength and hardness in most experimental groups were significantly lower than in the control group (p < .001). Translucency was not significantly different in bur abrasion and polishing groups, compared with the control group; however, reglazing significantly increased the translucency (p < .001). SEM micrographs confirmed the surface roughness results. XRD showed monoclinic phase only in reglazed groups.

CONCLUSION

Of different surface treatments, polishing improved the surface properties and caused the smallest change in mechanical properties of zirconia with different translucencies.

Flexural Strength of Two Multilayered and Monochromatic High Yttria Containing Zirconia Materials Following Different Sintering Parameters

OBJECTIVES

 Sintering parameters influence the properties of zirconia. This study examined the effect of altering sintering temperature and time of monochrome and multilayer 5 mol% yttria-partially stabilized zirconia (5Y-PSZ) on flexural strength.

MATERIALS AND METHODS

 Three hundred specimens (width × length × thickness = 10 × 20 × 2 mm) were prepared from monolayer (ZX) and multilayer (ZM) 5Y-PSZ and randomly sintered at decreasing (TD: 1,450°C), regular (TR: 1,500°C), and increasing (TI: 1,550°C) sintering temperature, with extremely short (HE: 10 minutes), ultrashort (HU: 15 minutes), short (HS: 30 minutes), and regular (HR: 135 minutes) sintering time (n = 15/group). The precrack was induced on the tension side before testing for flexural strength (σ).

STATISTICAL ANALYSIS

 Analysis of variance and Tukey's test were used for significant differences of σ at p < 0.05. The microstructure and crystalline (monoclinic; m, tetragonal; t, cubic; c) phase were evaluated by scanning electron microscope (SEM) and X-ray diffractometer (XRD).

RESULTS

 ZXTIHS indicated the highest σ for ZX (315.81 ± 18.91 MPa), whereas ZMTIHS indicated the highest σ for ZM (335.21 ± 36.18 MPa). There was no significant difference for σ between ZX and ZM (p > 0.05). Sintering zirconia at TI or HR indicated significantly higher σ than sintering at TD or TR or with HS, HE, or HU for both ZX and ZM (p < 0.05). There was no significant difference for σ between TRHR and TIHS, TIHU, and TIHE (p > 0.05). SEM indicated intergranular and transgranular fractures. XRD revealed predominately c- and t-phases and minor amounts of m-phase.

CONCLUSION

 Increasing sintered temperature with decreasing time offers acceptable strength to regular sintering. Raising sintering temperature with decreasing time is suggested to facilitate chairside restorative reconstruction.

The effect of deviations in sintering temperature on the translucency and color of multi-layered zirconia

OBJECT

This study aimed to investigate the changes in the translucency and color of four different multi-layered zirconia materials when the sintering temperature were inaccurate.

MATERIALS AND METHODS

Two hundred zirconia samples (11 × 11 × 1.0 mm) of four multi-layered zirconia, Upcera TT-GT (UG), Upcera TT-ML (UM), Cercon xt ML (CX), and Lava Esthetic (LE), were divided into five subgroups according to the sintering temperature: L1 (5% lower temperature), L2 (2.5% lower temperature), R (recommended sintering temperature), H2 (2.5% higher temperature), H1 (5% higher temperature). After sintering, color coordinates were measured. Then the translucency parameter (TP) values, and the color differences (between the inaccurate sintering temperature and the recommended temperature) of each zirconia specimen were calculated. Statistical analysis was performed by using three-way ANOVA tests, the one-way ANOVA, and Tukey's post hoc test.

RESULTS

Three-way ANOVA results showed that material type, sintering temperature, specimen section, and their interactions significantly influenced the TP values (except for the interactions of specimen section and sintering temperature) (P < .05). TP values of zirconia specimens were significantly different in the inaccurate sintering temperatures (P < .05), except for the cervical and body sections of UG group (P > .05). Compared with recommended sintering temperature, higher sintering temperature caused higher TP values for CX, but lower for LE. Three-way ANOVA results showed that material type, sintering temperature, and their interactions significantly influenced the ∆E00 values (P < .05). There were no significant differences in ∆E00 values of UM and CX groups at different inaccurate sintering temperatures, and were clinical imperception (except for UM-L1) (∆E00 < 1.25). ∆E00 values of all zirconia specimens showed clinically acceptable (∆E00 < 2.23).

CONCLUSION

The deviations in sintering temperature significantly influenced the translucency and color of tested multi-layered zirconia. The trends of translucency in the multi-layered zirconia depended on material type and the color changes of all zirconia materials were clinically acceptable at inaccurate sintering temperatures.

Translucency of recent zirconia materials and material-related variables affecting their translucency: a systematic review and meta-analysis

BACKGROUND

Recent forms of translucent zirconia material have been developed, offering a wide range of options and varieties for enhancing aesthetics, making it a preferred choice in the field of prosthetic dentistry. However, there is insufficient understanding regarding the recent types of zirconia materials and their optical behavior. Understanding the variables that influence the translucency of zirconia and identifying strategies to enhance its esthetics are crucial.

PURPOSE

The current systemic review highlights a comprehensive understanding of different zirconia generations in relation to their optical characteristics and evaluates material-related variables affecting their translucency.

METHODS

The present review studied in-vitro studies that evaluated the optical characteristics of different yttria content of yttria stabilized materials. The topics explored were: (1) the different zirconia material generations and their optical behavior; (2) material-related factors that affect their translucency. The research was restricted to online publication in the English language from July 1, 2010, to July 31, 2023, using PubMed, Scopus, and Science Direct resources. The search key terms and their combinations were "zirconia," "translucent zirconia," "cubic zirconia," "highly translucent zirconia," "yttria partially stabilized zirconia," "monolithic zirconia," "translucency," "optical properties," and "light transmission."

RESULTS

The data obtained from fifty-three studies addressed the optical characteristics of various zirconia generations. They reported that changing yttria content had a significant impact on translucency. Different kinds of zirconia ceramics of the same generation have varying translucencies. Achieving optimum aesthetics with monolithic zirconia is challenging due to factors related to material aspects such as the presence of additives, point defects, microstructure, thickness, phase distribution, and sintering conditions.

CONCLUSIONS

Newly developed monolithic dental zirconia ceramics have improved aesthetics and translucency. However, additional research is necessary to evaluate their performance and long-term durability.

TRIAL REGISTRATION

This systematic review was registered in PROSPERO, under number CRD42023474482.

The effect of phase contents on the properties of yttria stabilized zirconia dental materials fabricated by stereolithography-based additive manufacturing

The aim is to investigate the impact of phase contents on mechanical properties, translucency, and aging stability of additively manufactured yttria partially stabilized zirconia ceramics. For that purpose, we evaluated two PSZ materials. The first type was prepared utilizing commercially available 5 mol% yttria-stabilized zirconia(5Y-PSZ), while the second type, denoted as 3Y+8Y-PSZ ceramics, was fabricated by blending 3 mol% and 8 mol% yttria-stabilized zirconia powders. Compared to 5Y-PSZ (39.90 wt% tetragonal phases and c/a2 = 1.0141), 3Y+8Y-PSZ is characterized by a greater abundance of tetragonal phases (47.68 wt%), which display higher tetragonality (c/a2 = 1.0165) and lower yttrium oxide content (2.25mol%). As a result, the 3Y+8Y-PSZ demonstrates elevated strength (816.52 MPa) and toughness (4.32 MPa m1/2), accompanied by reduced translucency(CR:0.47) and it exhibits greater susceptibility to aging. The phase contents, yttrium oxide content, and lattice parameters in the tetragonal phase play a crucial role in determining the mechanical properties, translucency, and aging stability of PSZ ceramics.

Effect of sintering programs and surface treatments on monolithic zirconia

PURPOSE

To investigate the effect of sintering programs and surface treatments on surface properties, phase transformation and flexural strength of monolithic zirconia.

MATERIALS AND METHODS

Zirconia specimens were sintered using three distinct sintering programs [classic (C), speed (S), and superspeed (SS)] (n = 56, each). One sample from each group underwent scanning electron microscopy (SEM) and grain size analysis following sintering. Remaining samples were divided into five subgroups (n = 11) based on the surface treatments: control (CL), polish (P), glaze (G), grind + polish (GP), and grind + glaze (GG). One sample from each subgroup underwent SEM analysis. Remaining samples were thermally aged. Monoclinic phase volume, surface roughness, and three-point flexural strength were measured. Monoclinic phase volume and surface roughness were analyzed by Kruskal-Wallis and Dunn tests. Flexural strength was analyzed by two-way ANOVA and Weibull analysis. The relationships among the groups were analyzed using Spearman's correlation analysis.

RESULTS

Sintering program, surface treatment, and sintering × surface treatment (P ≤ .010) affected the monoclinic phase volume, whereas the type of surface treatment and sintering × surface treatment affected the surface roughness (P < .001). Type of sintering program or surface treatment did not affect the flexural strength. Weibull analysis revealed no significant differences between the m and σo values. Monoclinic phase volume was positively correlated with surface roughness in the SGG and SSP groups.

CONCLUSION

After sintering monolithic zirconia in each of the three sintering programs, each of the surface treatments can be used. However, for surface quality and aging resistance, G or GG can be recommended as a surface finishing method.

Flexural strength, flexural modulus and microhardness of milled vs. fused deposition modeling printed Zirconia; effect of conventional vs. speed sintering

BACKGROUND

Various methods can be used for creating zirconia dental restorations, including 3-dimensional (3D) printing and computer-aided design/ computer-aided manufacturing (CAD/CAM) milling. The fused deposition modeling (FDM) printing method for zirconia presents numerous advantages, albeit research on the mechanical properties of these materials and resultant restorations remains scarce. Such developments are undeniably intriguing and warrant further investigation. The objective of the present study was to evaluate the impact of the sintering firing cycle (Conventional vs. Speed sintering) on the flexural strength, flexural modulus, and Vickers Microhardness of milled vs. FDM printed zirconia.

METHODS

A total of 60 bars (2 × 5 × 27 mm) were fabricated for flexural strength testing, along with 40 discs (12 × 1.5 mm) for Vickers microhardness testing. Half of the specimens underwent conventional sintering, while the other half underwent a speed sintering cycle. The flexural strength and modulus were determined by a three-point bending test in a universal testing machine. The microhardness of the specimens was evaluated using a Vickers microhardness tester. Statistical analysis was performed using a two-way ANOVA test with a post-hoc Tukey test (p < 0.05).

RESULTS

CAD/CAM milled zirconia had significantly higher flexural strength and modulus than FDM-printed zirconia. The sintering process did not significantly affect the flexural strength or modulus of milled or FDM-printed zirconia. The milled speed sintering group had significantly higher values in the Vickers microhardness test compared to the other groups.

CONCLUSIONS

The mechanical properties of FDM-printed zirconia specimens were not found to be comparable to those of milled zirconia. Speed sintering cycle may produce milled zirconia restorations with similar flexural strength and modulus to conventional sintering, and even higher Vickers Microhardness values.

Mechanical characteristics of zirconia produced additively by 3D printing in dentistry - A systematic review with meta-analysis of novel reports

OBJECTIVES

This study was aimed at comparing the mechanical parameters of ceramics made using the addition and subtraction technique.

METHODS

A search was performed on four search engines on 5th April 2023. Quality assessment was performed using study type-specific scales. Where possible, a meta-analysis was performed.

SOURCES

Data were extracted from four search engines: PubMed, PubMed Central, Embase, Web of Science, Scopus.

STUDY SELECTION

The search strategy identified 686 potential articles. 19 papers were subject to qualitative analysis, and data from 11 papers were meta-analysed. The included studies were of high or medium quality. All included papers were in-vitro studies. No clinical trials were found in the literature.

SIGNIFICANCE

Ceramics made in the additive technology in terms of mechanical parameters can compete with ceramics made in the milling technology. There are no clinical studies yet that would indicate the use of this type of material for permanent restorations in patients. Studies presented in the literature vary greatly in terms of study design and reporting of results. The research did not receive external funding.

The Effect of Sintering on Zirconia Manufactured via Suspension-Enclosing Projection Stereolithography for Dental Applications: An In Vitro Study

BACKGROUND

Zirconia is a widely used material in the dental industry due to its excellent mechanical and aesthetic properties. Recently, a new 3D printing process called suspension-enclosing projection stereolithography (SEPS) was introduced to fabricate zirconia dental restorations. However, the effect of the sintering time and temperature on the properties of zirconia produced via SEPS has not been fully investigated.

METHODS

Zirconia slurries were prepared with varying percentages of zirconia powders and 3D printing resins, and 5Y-TZP (5 mol% yttria-stabilized zirconia) (n = 40) and 3Y-TZP (3 mol% yttria-stabilized zirconia) (n = 40) bar specimens were fabricated via SEPS manufacturing. The specimens were sintered at different temperatures and dwell times, and their flexural strength, density, and phase composition were measured. The viscosity of the slurries was also measured. Statistical analysis was performed using Welch's ANOVA and Kruskal-Wallis tests to evaluate the impact of the sintering conditions.

RESULTS

Significant differences in flexural strength (p < 0.01) were observed between the 5Y-TZP samples, with those sintered at 1530 °C for 120 min showing an average strength of 268.34 ± 44.66 MPa, compared to 174.16 ± 42.29 MPa for those sintered at 1450 °C for 120 min. In terms of density, significant differences (p < 0.01) were noted for the 3Y-TZP specimens, with an average density of 6.66 ± 0.49 g/cm3 for samples sintered at 1530 °C for 120 min, versus 5.75 ± 0.55 g/cm3 for those sintered at 1530 °C for 10 min. X-ray diffraction confirmed the presence of a predominantly tetragonal phase in both materials.

CONCLUSIONS

Zirconia printed via SEPS manufacturing can be sintered at a higher temperature with shorter dwell times, thereby producing high density samples. Different sintering conditions can be used to fully sinter 3D-printed zirconia for potential dental applications.

Evaluation of mechanical properties of dental zirconia in different milling conditions and sintering temperatures

STATEMENT OF PROBLEM

The dry processing of zirconia has the disadvantage of dust dispersal during milling; thus, wet milling may be preferable. However, research on the mechanical properties of dental zirconia milled under different conditions and sintered at different temperatures is lacking.

PURPOSE

The purpose of this in vitro study was to evaluate changes in the mechanical properties of zirconia specimens after milling under dry and wet conditions at different sintering temperatures.

MATERIAL AND METHODS

Four hundred Ø20.0×1.5-mm presintered zirconia specimens were prepared by using a computer-aided design and computer-aided manufacturing (CAD-CAM) system and divided into 8 groups (n=50) based on the sintering (1230, 1330, 1430, and 1530 °C) and milling conditions (dry or wet). The mechanical properties (Vickers hardness, biaxial flexural strength, and fracture toughness) and physical properties (linear shrinkage and density) were examined. The microstructures of the specimens were observed with a scanning electron microscope. The crystal phases of the sintered green bodies were analyzed by using an X-ray diffractometer. The data were analyzed with descriptive statistics and 1-way and 2-way analyses of variance with Tukey HSD tests (α=.05).

RESULTS

The mechanical properties of all specimens increased with increasing sintering temperature, except for 1530 °C and the dry milling condition. The mechanical properties of the groups fabricated under wet milling conditions were better than those of the groups fabricated under dry milling conditions. Microscopic examination of the structure showed that the porosity decreased with increasing sintering temperature regardless of the milling conditions.

CONCLUSIONS

Higher sintering temperatures increased the mechanical properties (biaxial flexural strength, Vickers hardness, fracture toughness). However, phase transformation from tetragonal to cubic was observed for dry milled specimens sintered at 1530 °C, with decreased mechanical properties. Specimens fabricated by wet milling exhibited better mechanical properties than those fabricated by dry milling.

Does speed-sintering affect the optical and mechanical properties of yttria-stabilized zirconia? A systematic review and meta-analysis of in-vitro studies

Zirconia restorations are increasingly popular in dental treatment. Yttria-stabilized zirconia (YSZ) needs to be sintered for clinical applications and novel speed-sintering protocols are being developed for chairside treatments. Whether the properties of speed-sintered YSZ meet clinical requirements, however, remains unclear. Therefore, we conducted a systematic review and meta-analysis on the influence of speed-sintering on the optical and mechanical properties of dental YSZ according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A literature search was conducted using PubMed, Embase, and Web of Science databases for relevant articles published between January 1, 2010 and February 28, 2022 in English, Chinese, or Japanese. After full-text evaluation and quality assessment, 26 articles were selected. Meta-analysis revealed that speed-sintering does not significantly affect the CIEDE2000-based translucency parameter, contrast ratio, three-point flexural strength, biaxial flexural strength, or fracture toughness of YSZ (p < 0.01) compared to conventional sintering. However, the CIELab-based translucency parameter of conventionally sintered YSZ is higher than that of speed-sintered YSZ. The descriptive analysis indicated that speed-sintering does not affect the hardness of YSZ compared to that of conventionally sintered YSZ. The results indicate that speed-sintering is suitable for preparing YSZ for dental restorations.

Effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia fixed partial dentures: An in vitro study

STATEMENT OF PROBLEM

Strength-gradient zirconia combining 3 zirconia formulations with different flexural strengths has been reported to have outstanding mechanical properties. However, data concerning the effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia fixed partial dentures (FPDs) are sparse.

PURPOSE

The purpose of this in vitro study was to test the effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia FPDs.

MATERIAL AND METHODS

Two custom-made stainless-steel master dies were designed to replicate a mandibular right second premolar and second molar prepared to receive a 3-unit monolithic zirconia FPD. Thirty monolithic zirconia FPDs were milled from gradient zirconia blanks and allocated to 3 groups (n=10) according to the sintering protocols: high-speed sintering, speed sintering, and conventional sintering. The FPDs were cemented onto the corresponding dies with traditional glass ionomer cement. All FPDs were cyclic loaded (600 000 cycles/49 N/1.7 Hz) in a mastication simulator. Fracture load measurements for each FPD were determined by using a universal testing machine. Scanning electron microscopy (SEM) at ×80 magnification was used to examine a fractured FPD from each group. A representative specimen from each group was examined with SEM at ×30 000 magnification to determine the grain size. One-way ANOVA, pair-wise Tukey honestly significant difference (HSD), and Pearson correlation tests were used for statistical analysis of the data (α=.05).

RESULTS

The high-speed sintered FPDs recorded the highest statistically significant fracture load mean ±standard deviation value (2526 ±300 N), followed by the speed sintered FPDs (2136 ±127 N), while the lowest statistically significant fracture load mean value was recorded with the conventionally sintered FPDs (1361 ±181 N) (P<.001). In addition, the mean ±standard deviation grain size values were 488 ±272 nm for the high-speed sintered specimen, 578 ±409 nm for the speed sintered specimen, and 832 ±551 nm for the conventionally sintered specimen (P<.001). A significant negative correlation was found between fracture strength and grain size among the 3 groups.

CONCLUSIONS

The fracture strength of 3-unit monolithic gradient zirconia FPDs sintered by using a high-speed protocol was significantly higher than that of speed and conventionally sintered FPDs (P<.001). The high-speed sintering protocol reduced the mean grain size of gradient zirconia FPDs compared with that of both speed and conventional sintering protocols.

Effect of sintering time on microstructure and optical properties of yttria-partially stabilized monolithic zirconia

OBJECTIVES

To evaluate the impact of speed sintering on the microstructure and optical properties of 3 and 5 mol% yttria-partially stabilized monolithic zirconias.

METHODS

120 plate-shaped zirconia specimens (10x10x 0.4 mm) were prepared from three commercial 5 mol% yttria-partially stabilized zirconia blocks (5Y-PSZs); Katana UTML (Kuraray Noritake), Cercon xtML (Dentsply Sirona), and Zolid FX white (Amann Girrbach), and two commercial 3 mol% yttria-partially stabilized zirconia blocks (3Y-PSZs); Lava Plus (3 M ESPE) and InCoris (Sirona, GmbH). Specimens were either conventional sintered (CS) using a 7-hour program or speed sintered (SS) using a quick 90-minute program. The microstructure was inspected with a scanning electron microscope (SEM), and phase fractions were detected using x-ray diffraction analysis (XRD). Translucency (TP00), and contrast ratio (CR) were obtained using a spectrophotometer (VITA Easyshade V). Color difference (ΔE00) between both sintering processes was calculated with the CIEDE2000 formula. ΔE00 up to 1.8 was set as the acceptability threshold. Data were analyzed using two-way ANOVA, Krusakll-Wallis, and Mann-Whitney U tests. (n = 12, α = .05).

RESULTS

Grain size was significantly decreased after SS for all tested materials (P < .0001). The average grain sizes of 5Y-PSZs were significantly larger than those of 3Y-PSZs. The atomic structure, microstructure, and transparency of CS and SS were all affected by the amount of yttria, the size of the crystals, and tetragonality. SS significantly reduced TP00 (F = 7135.95, P < 0.0001) and increased CR (F = 453.21, P < 0.0001). The CS Katana presented the highest TP00 and lowest CR value. ΔE00 between the CS and SS groups were clinically acceptable except for Lava, which had values above the set threshold (1.89).

SIGNIFICANCE

SS altered the grain size and internal structure of the tested materials, which was reflected in translucency.

Effect of sintering speed, aging processes, and different surface treatments on the optical and surface properties of monolithic zirconia restorations

STATEMENT OF PROBLEM

Advances in dentistry have led to more esthetic and biocompatible restorative materials such as translucent zirconia and to faster and more accurate manufacturing methods. How changes in the surface and optical properties of translucent zirconia affect the esthetics and durability of these restorations under different conditions and manufacturing processes is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of the sintering speed, aging process, and different surface treatments on the translucency and surface structure of monolithic zirconia restorations.

MATERIAL AND METHODS

Prepared typodont teeth were scanned, and 40 three-unit fixed partial dentures (FPDs) and 40 disk specimens were designed and prepared from monolithic zirconia blanks. The specimens were divided into traditional or speed sintering groups (20 FPDs and 20 disks each); half of each group (10 FPDs and 10 disks) was polished with a handpiece at 10 000 rpm, and the other half was glazed. Half of the specimens were thermocycled with 3500 cycles in 5 °C and 55 °C water baths, and the remaining half were not thermocycled. Translucency was measured with a spectrophotometer. Surface free energy was calculated in mNm with a contact angle device; surface roughness was measured in nm with an atomic force microscope. Translucency data were analyzed by the Kruskal-Wallis and Mann-Whitney tests, while surface free energy and surface roughness data were analyzed by 3-way ANOVA (α=.05).

RESULTS

The highest transmittance was in the speed sintered, polished, nonthermocycled group, and the lowest transmittance was in the speed sintered, polished, thermocycled group (P=.029). The transmittance of the traditionally sintered, polished, nonthermocycled group was significantly higher than that in all the speed sintered, glazed groups; the traditionally sintered, glazed groups; and the traditionally sintered, polished, thermocycled group (P=.029). The transmittance of the traditionally sintered, polished, thermocycled group was significantly higher than that of all traditionally sintered, glazed groups (P=.029). The mean surface free energy in the traditionally sintered groups was higher than that in the speed sintered groups (P=.002); also, it was higher in the glazed groups than in the polished groups (P<.001). The aging process decreased surface free energy (P=.023). The mean surface roughness in the speed sintered groups was significantly lower than that in the traditionally sintered groups (P=.004). No significant difference in surface roughness was found between the polished and glazed groups and between the 2 variables of the aging process (P>.05).

CONCLUSIONS

Speed sintering and polishing may decrease the surface free energy and increase the translucency of the monolithic zirconia restoration. Also, speed sintering creates a smoother surface. Aging had a more significant effect on decreasing the surface free energy of the specimens and could make the least translucent restorations.

Effect of multiple firings on the marginal fit of monolithic zirconia crowns: An in vitro study

STATEMENT OF PROBLEM

Speed sintering was introduced to save chair time and produce monolithic zirconia restorations in a single visit. Multiple firings are usually required clinically for both speed-sintered and conventionally sintered monolithic zirconia crowns. However, the effects of multiple firings on the marginal fit of speed-sintered and conventionally sintered monolithic zirconia crowns are unknown.

PURPOSE

The purpose of this in vitro study was to investigate the effect of multiple firings on the marginal fit of speed-sintered and conventionally sintered monolithic zirconia crowns.

MATERIAL AND METHODS

Twenty conventionally sintered and 20 speed-sintered monolithic zirconia crowns were milled, sintered, and repeatedly fired by using conventional sintering and speed sintering furnaces. The absolute marginal discrepancy of the crowns was measured with a measuring microscope at ×100 magnification after sintering (T0) and after the first (T1), second (T2), and third firings (T3). Two-way repeated-measures ANOVA was used to detect the impact of multiple firings on the absolute marginal discrepancy of conventionally sintered and speed-sintered monolithic zirconia crowns and the differences between the 2 materials (α=.05).

RESULTS

Multiple firings improved the absolute marginal discrepancy of conventionally sintered and speed-sintered monolithic zirconia crowns (P<.001). The absolute marginal discrepancy of conventionally sintered monolithic zirconia crowns at T2 and T3 was significantly smaller than that at T1 (P=.008 and 0.016, respectively), and the absolute marginal discrepancy of speed-sintered monolithic zirconia crowns at T2 was significantly smaller than that at T1 (P=.015). The speed-sintered monolithic zirconia crowns had a better marginal fit than conventionally sintered monolithic zirconia crowns (P=.008). No significant interaction was found between the multiple firings and material types on the absolute marginal discrepancy of monolithic zirconia crowns (P=.914).

CONCLUSIONS

Multiple firing cycles can significantly improve the marginal fit of conventionally sintered and speed-sintered monolithic zirconia crowns. The speed-sintered monolithic zirconia crowns have a better marginal fit (both vertically and horizontally) than the conventionally sintered monolithic zirconia crowns.

Fatigue resistance of anterior monolithic crowns produced from CAD-CAM materials: An in vitro study

STATEMENT OF PROBLEM

Lithium disilicate and 5 mol% yttria partially stabilized zirconia (5Y-PSZ) are commonly used for anterior restorations. However, studies comparing the durability of 5Y-PSZ and lithium disilicates are sparse.

PURPOSE

The purpose of this in vitro study was to investigate the fracture load of anterior monolithic crowns made of 2 lithium disilicates and a 5Y-PSZ under dynamic loading.

MATERIAL AND METHODS

Titanium abutments of the maxillary incisors were prepared (N=48, 8 for each group). Monolithic anterior crowns were made from the lithium disilicates (e.max CAD, Rosetta SM) and 5Y-PSZ (Katana UTML). After cementation, the specimens were stored in water for 24 hours and then thermocycled 10 000 times. Dynamic loading (70 N, 200 000 cycles, 1 Hz) was applied to half the specimens. The fracture load was measured by using a universal testing machine. The fracture patterns were analyzed and fractography applied. Two-way ANOVA and the Fisher exact test were used for statistical analysis (α=.05).

RESULTS

The material and dynamic loading affected the fracture load of the anterior monolithic crowns (P<.05). However, there was no interaction between the material and the dynamic loading (P=.079). Both lithium disilicates had higher fracture loads than 5Y-PSZ (P<.05). The fracture load of each specimen was reduced after dynamic loading (P<.05). Lithium disilicate showed marginal and bulk fractures, and 5Y-PSZ presented catastrophic fractures (P<.001).

CONCLUSIONS

5Y-PSZ materials with large grains and low flexural strength may be less resistant to fractures under dynamic loading than lithium disilicates.

Microstructural features, physicο-mechanical properties, and wear behavior of dental translucent polychromic multilayer zirconia of hybrid composition prepared by milling technology

OBJECTIVE

The present study determined the mechanical properties and the wear behavior, as results of the micro(nano)structure, of the enamel, transition, and dentine layers, which comprise the polychromic multilayer zirconia materials of hybrid composition fabricated by milling technology.

MATERIALS AND METHODS

Prismatic blocks were fabricated from two commercial pre-sintered dental polychromic multilayer zirconia materials of hybrid composition, IPS e.max ZirCAD Prime (medium and high translucency, from the dentine to the incisal layer) and 3D Pro ML (translucency gradient, from the dentine to the incisal layer) by milling technique, and then, cut into 3 distinct parts to separate the enamel, transition, and dentine layers. The samples were sintered, thermally treated (similarly to the glazing procedure), and polished for characterization. Their microstructure, mechanical properties (determined by nanoindentation and microhardness), and wear behavior (evaluated by scratch test), were examined.

RESULTS

The produced materials had a homogeneous and dense nanostructure, where the grain size decreased from the enamel to dentine layer. The mechanical properties decreased from the dentine to enamel layer. However, the three layers manifested similar dynamic friction coefficient.

CONCLUSION

The differences in the above properties in the three layers negligibly influenced the wear behavior of the entire multilayer zirconia material.

CLINICAL SIGNIFICANCE

The properties of dental restorations produced from polychromic multilayer zirconia of hybrid composition by milling technology (i.e., strong, non-fragile, and esthetic materials), anticipate good performance in oral cavity.

Effect of superspeed sintering on translucency, opalescence, microstructure, and phase fraction of multilayered 4 mol% yttria-stabilized tetragonal zirconia polycrystal and 6 mol% yttria-stabilized partially stabilized zirconia ceramics

STATEMENT OF PROBLEM

The optical properties of recently developed multilayer zirconia have mainly been studied for the effects of conventional sintering and speed sintering but not as much for the effect of superspeed sintering. As superspeed sintering protocols typically require a higher sintering temperature and higher heating and cooling rates than speed- and conventional sintering protocols, the optical properties of superspeed sintered zirconia may be affected differently.

PURPOSE

The purpose of this in vitro study was to investigate the effect of superspeed sintering on the optical properties, microstructure, and phase fraction of multilayered 4 mol% yttria-stabilized (4Y-) and 6 mol% yttria-stabilized (6Y-) zirconia.

MATERIAL AND METHODS

Multilayered 4Y- and 6Y-zirconia were sectioned. After conventional and superspeed sintering, the translucency parameter (TP), and opalescence parameter (OP) were measured with a spectrophotometer (n=10). To obtain the grain sizes from the field emission scanning electron microscopy (FE-SEM) images for each layer (n=2), more than 500 (6Y-zirconia) and 800 grains (4Y-zirconia) were measured by linear intercept methods. The phase fractions were obtained through X-ray diffraction (XRD) analysis by using the Rietveld method (n=1). The results were analyzed by 3-way ANOVA and post hoc Tukey honest significant difference tests (TP and OP) and by 3-way ANOVA and post hoc Scheffé tests (grain size) (α=.05).

RESULTS

No layers exhibited a significant difference in TP after superspeed sintering, except the dentin layer (DL) and transition layer 2 (T2) of 4Y- and 6Y-zirconia, respectively. The TP increased (P<.05) in DL for superspeed sintered 4Y-zirconia and decreased (P<.05) in T2 for the superspeed sintered 6Y-zirconia. However, the difference in TP by superspeed sintering was lower than the perceptibility thresholds of 50:50%. The OP decreased (P<.05) in the DL and T2 of 4Y-zirconia after superspeed sintering. For 6Y-zirconia, the OP decreased (P<.05) in all layers except for the transition layer 1 (T1) after superspeed sintering. However, the difference in OP values was minimal, with only a 1.1 difference observed for Zolid Gen-X (4Y) and a range of 1.22 to 1.62 for Katana UTML (6Y) when using superspeed sintering. No significant change was found in the grain size after superspeed sintering of either zirconia. Regardless of the sintering speed, the average grain size of the 6Y-zirconia (conventional: 2.09 to 2.21 μm; superspeed: 2.11 to 2.20 μm) was larger than that of the 4Y-zirconia (conventional: 0.50 to 0.52 μm; superspeed: 0.52 to 0.54 μm). Owing to superspeed sintering, the metastable tetragonal (T') phase content increased while the tetragonal (T) phase decreased in 4Y-zirconia; in 6Y-zirconia, the cubic (C) phase content increased, while the T'-phase content decreased.

CONCLUSIONS

Superspeed sintering did not result in any clinically significant changes in the translucency and opalescence of 4Y- or 6Y-zirconia.

Entering a New Dimension in Powder Processing for Advanced Ceramics Shaping

Filigree structures can be manufactured via two-photon polymerization (2PP) operating in the regime of nonlinear light absorption. For the first time, it is possible to apply this technique to the powder processing of ceramic structures with a feature size in the range of the critical defect sizes responsible for brittle fracture and, thus, affecting fracture toughness of high-performance ceramics. In this way, tailoring of advanced properties can be achieved already in the shaping process. Traditionally, 2PP relies on transparent polymerizable resins, which are diametrically opposed to the usually completely opaque ceramic resins and slurries. Here a transparent and photocurable suspension of nanoparticles (resin) with very high mass fractions of yttria-stabilized zirconia particles (YSZ) is presented. Due to the extremely well-dispersed nanoparticles, scattering of light can be effectively suppressed at the process-relevant wavelength of 800 nm. Sintered ceramic structures with a resolution of down to 500 nm are obtained. Even at reduced densities of 1-4 g cm^-3 , the resulting compressive strength with 4.5 GPa is equivalent or even exceeding bulk monolithic yttria-stabilized zirconia. A ceramic metamaterial is born, where the mechanical properties of yttria-stabilized zirconia are altered by changing geometrical parameters, and gives access to a new class of ceramic materials.

Optical Properties, Microstructure, and Phase Fraction of Multi-Layered Monolithic Zirconia with and without Yttria-Gradient

The differences in the optical properties of multi-layered zirconia with and without yttria-gradient are not fully understood. This study aimed to evaluate and compare the optical properties, related microstructures, and phase fractions of multi-layered zirconia with and without yttria-gradient. For this, multi-layered zirconia of 5 mol% yttria (5Y) stabilized (Katana STML) and 4Y/5Y stabilized (e.max MT Multi) were cut layerwise, sintered, and analyzed using the opalescence parameter (OP), average transmittance (AT%), translucency parameter (TP), and contrast ratio (CR). The average grain size and phase fractions were obtained from field-emission scanning electron micrographs and X-ray diffraction patterns, respectively. Although the TP values of Katana STML and e.max MT Multi did not show a significant difference (except for transition layer 1), the results of AT and CR showed that the translucency of e.max MT Multi was slightly higher than that of Katana STML (p < 0.05). The opalescence gradient was higher in Katana STML than in the e.max MT Multi. In both zirconia types, translucency increased from the dentin to enamel layer based on the AT, TP, and CR results, while OP decreased (p < 0.05). The higher translucency from the dentin to enamel layer in Katana STML was caused by the pigmentation gradient, while in e.max MT Multi, it was caused by the difference in phase fraction and the pigmentation gradient.

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

OBJECTIVE

This investigation evaluated the effect of two sintering modes of a translucent zirconia (Y-TZP) on its surface roughness, topography, phase-transformation (t → m), translucency and biaxial flexure fatigue strength.

MATERIALS AND METHODS

To do so, 50 Y-TZP discs (Ø = 15 mm; thickness = 1.2 mm; IPS e.max ZirCAD LT) were prepared and divided into two groups: Standard mode (SM) and Fast mode (FM). Staircase fatigue testing was performed (piston-on-three balls set-up, ISO 6872:2015), as well as surface roughness, profilometry, scanning electron microscopy (SEM-FEG), energy dispersive X-ray spectroscopy (EDX), phase transformation (t → m) using X-ray diffraction analysis (XRD), translucency parameter analysis (TP and TP₀₀ ) and fractography.

RESULTS

The results showed no statistical significant differences for roughness parameters (p > 0.05, SM: Ra = 0.13 ± 0.02, Rz = 1.21 ± 0.26 and RSm = 24.91 ± 2.19; FM: Ra = 0.14 ± 0.03, Rz = 1.32 ± 0.25 and RSm = 24.68 ± 2.16) or flexural fatigue strength (SM: 512 (464-560) MPa; FM: 542 (472-611) MPa) between the groups. In addition, similarity in surface morphological features (SEM and profilometry), composition and phases (EDX and XRD) was observed between the firing protocols. Fractography showed that the failure origin occurred on the tensile side. Sintering mode did not affect the TP (F = 0.001, p = 0.97) and TP₀₀ (F = 0.12, p = 0.72).

CONCLUSIONS

Therefore, the fast-sintering mode is suggested as a viable alternative to the standard mode since it does not influence the evaluated surface morphology, microstructure, fatigue strength and translucency of a translucent monolithic zirconia.

CLINICAL SIGNIFICANCE

The fast sintering mode is a viable alternative for zirconia without compromising its topography, microstructure, mechanical performance or translucency.

Chemical Composition and Flexural Strength Discrepancies Between Milled and Lithography-Based Additively Manufactured Zirconia

PURPOSE

To evaluate the chemical composition, flexural strength, and Weibull characteristics of milled and lithography-based additively manufactured (AM) zirconia.

MATERIALS AND METHODS

A virtual design of a bar (25×4×2 mm) was completed using a software program. The standard tessellation language file was used to manufacture all the specimens: 3Y-TZP zirconia (Priti multidisc ZrO₂ monochrome) milled (M group) and 3Y-TZP zirconia (LithaCon 3Y 210) lithography-based AM (CeraFab System S65 Medical) (AM group) bar specimens (n = 20). The chemical composition of the specimens was determined by using energy dispersive X-ray (EDAX) elemental analysis in a scanning electron microscope. Flexural strength was measured in all specimens using 3-point bend test according to ISO/CD 6872.2 with a universal testing machine (Instron Model 8501). Two-parameter Weibull distribution values were calculated. The Shapiro-Wilk test revealed that the data were normally distributed (p < 0.05). Flexural strength values were analyzed using independent Student's t-test (α = 0.05).

RESULTS

There were no major chemical composition differences observed between M and AM groups. The AM specimens (1518.9 ± 253.9 MPa) exhibited a significantly higher flexural strength mean value compared to the milled (980.5 ± 130.3 MPa) specimens (DF = 13, T-value = -5.97, p < 0.001). The Weibull distribution presented the highest shape for M specimens (11.49) compared to those of AM specimens (6.95).

CONCLUSIONS

There was no significant difference in the chemical composition of milled and AM zirconia material tested. AM zirconia tested exhibited significantly higher flexural strength compared with the milled zirconia evaluated.

Effect of sintering time on the marginal and internal fit of monolithic zirconia crowns containing 3–4 mol% Y2O3

Background

Short-term sintering may offer advantages including saving time and energy but there is limited evidence on the effect that altering sintering time has on the accuracy of monolithic zirconia crowns. The purpose of this in vitro study was to investigate the effect of shortened sintering time on the marginal and internal fit of 3Y-TZP and 4Y-TZP monolithic crowns.

Methods

Sixty monolithic zirconia crowns were fabricated for the maxillary first molar tooth on the prefabricated implant abutment. Groups were created according to the material composition: 3Y-TZP Generation 1, 3Y-TZP Generation 2 and 4Y-TZP. Two different sintering protocols were performed: same final sintering temperature (1500 °C) and various rates of heating (10 °C/min and 40 °C/min), cooling down speed (− 10 °C/min and − 40 °C/min), holding time (45 and 120 minutes), and total sintering time (approximately 2 and 7 hours, respectively). The marginal and internal fit of the crowns were determined using the silicone replica technique. Comparisons between groups were analyzed using two-way ANOVA. Pairwise multiple comparisons were performed using t-test (p < 0.05).

Results

The mean marginal gap values of 4Y-TZP zirconia revealed statistically significant increase for the short-term sintering protocol (p < 0.0001), while no difference was observed between the sintering protocols for the mean marginal gap values of 3Y-TZP groups. Although all groups showed clinically acceptable gap values, altering the sintering time had an effect on marginal fit of the crowns manufactured from 4Y-TZP zirconia.

Conclusions

Shortening the sintering time may lead to differences within clinically acceptable limits. The manufacturer’s recommendations according to material composition should be implemented with care.

Physiomechanical and Surface Characteristics of 3D-Printed Zirconia: An In Vitro Study

The objective of this study is to examine the physiomechanical and surface properties of 3D-printed zirconia in comparison to milled zirconia. A total of 80 disc-shaped (14 × 1.5 ± 0.2 mm) specimens (20 milled and 60 3D-printed (at three different orientations; horizontal, vertical, and tilted)) were manufactured from 3-mol% yttria-stabilized tetragonal zirconia. Five specimens per group were evaluated for crystalline phase, grain size, density, porosity, surface roughness, wettability, microhardness, and SEM analysis of the surface. Biaxial flexural strength (BFS) was measured (n = 15) followed by Weibull analysis and SEM of fractured surfaces. Statistical analysis was performed using one-way ANOVA and Tukey’s post hoc test at α = 0.05. All groups showed a predominant tetragonal phase, with a 450 nm average grain size. There was no significant difference between groups with regards to density, porosity, and microhardness (p > 0.05). The tilted group had the highest surface roughness (0.688 ± 0.080 µm), significantly different from the milled (p = 0.012). The horizontal group presented the highest contact angle (89.11 ± 5.22°), significantly different from the milled and tilted (p > 0.05). The BFS of the milled group (1507.27 ± 340.10 MPa) was significantly higher than all other groups (p < 0.01), while vertical and tilted had a similar BFS that was significantly lower than horizontal (p < 0.005). The highest and lowest Weibull modulus were seen with tilted and milled, respectively. Physical properties of all groups were comparable. The surface roughness of the tilted group was higher than milled. The horizontal group had the highest hydrophobicity. Printing orientations influenced the flexural strength of 3D-printed zirconia. Clinical implications: This study demonstrates how the printing orientation affects the physiomechanical characteristics of printed zirconia.

Grain size, crystalline phase and fracture toughness of the monolithic zirconia

PURPOSE

This study evaluated the relationship among translucency, crystalline phase, grain size, and fracture toughness of zirconia.

MATERIALS AND METHODS

Four commercial zirconia - Prettau®Anterior® (PA), Prettau® (P), InCorisZI (ZI), and InCorisTZI (TZI)- were selected for this study. The bar specimens were prepared to determine fracture toughness by using chevron notched beam method with four-point bending test. The grain size was evaluated by a mean linear intercept method using a scanning electron microscope. X-ray diffraction and Rietveld refinement were performed to evaluate the amount of tetragonal and cubic phases of zirconia. Contrast ratio (CR) was measured to investigate the level of translucency.

RESULTS

PA had the lowest fracture toughness among other groups (P < .05). In addition, the mean fracture toughness of P was significantly less than that of ZI, but there was no difference compared with TZI. Regarding grain size measurement, PA had the largest average grain size among the groups. P obtained larger grain size than ZI and TZI (P < .05). However, there was no significant difference between ZI and TZI. Moreover, PA had the lowest CR value compared with the other groups (P < .05). This means PA was the most translucent material in this study. Rietveld refinement found that PA presented the greatest percentage of cubic phase, followed by TZI, ZI, and P, respectively.

CONCLUSION

The different approaches are used by manufacturers to fabricate various types of translucent zirconia with different levels of translucency and mechanical properties, which should be concerned for material selection for successful clinical outcome.

Effect of surface treatments on biaxial flexural strength, fatigue resistance, and fracture toughness of high versus low translucency zirconia

BACKGROUND

Mechanical surface treatments can deteriorate the mechanical properties of zirconia. This study evaluated and compared the biaxial flexural strength, fracture toughness, and fatigue resistance of high translucency (HT) to low translucency (LT) zirconia after various mechanical surface treatments.

METHODS

Four hundred eighty zirconia discs were prepared by milling and sintering two HT (Katana and BruxZir) and LT (Cercon and Lava) zirconia blocks at targeted dimensions of 12 mm diameter × 1.2 mm thickness. Sintered zirconia discs received one of the following surface treatments: low-pressure airborne particle abrasion (APA) using 50 µm alumina particles, grinding using 400 grit silicon carbide paper, while as-sintered specimens served as control. Internal structure and surface roughness were evaluated by scanning electron microscope (SEM) and a non-contact laser profilometer, respectively. Half of the discs were tested for initial biaxial flexural strength, while the rest was subjected to 10⁶ cyclic fatigue loadings, followed by measuring the residual biaxial flexural strength. Fractured surfaces were examined for critical size defects (c) using SEM to calculate the fracture toughness (K_IC). The effect of surface treatments, zirconia type, and cyclic fatigue on the biaxial flexural strength was statistically analyzed using three-way analysis of variance (ANOVA) and Tukey HSD post hoc tests (α = 0.05). Weibull analysis was done to evaluate the reliability of the flexural strength for different materials.

RESULTS

The initial biaxial flexural strength of LT zirconia was significantly higher (p < 0.001) than that of HT zirconia in all groups. While low APA significantly increased the biaxial flexural strength of LT zirconia, no significant change was observed for HT zirconia except for Katana. Surface grinding and cyclic fatigue significantly reduced the flexural strength of all groups. High translucency zirconia reported higher fracture toughness, yet with lower Weibull moduli, compared to LT zirconia.

CONCLUSION

LT zirconia has higher biaxial flexural strength, yet with lower fracture toughness and fatigue resistance, compared to HT zirconia. Low-pressure APA has significantly increased the biaxial flexural strength in all zirconia groups except BruxZir. Grinding was deteriorating to biaxial flexural strength and fracture toughness in all zirconia types. Cyclic fatigue has significantly decreased the biaxial flexural strength and reliability of HT and LT zirconia.

Effect of Speed Sintering on Low Temperature Degradation and Biaxial Flexural Strength of 5Y-TZP Zirconia

Translucent zirconia is becoming the material of choice for the esthetic restorative material. We aimed to evaluate the surface structure, phase determination, translucency, and flexural strength of 5Y-TZP Zirconia (Katana STML Block and Disc) between the regular sintering and the speed sintering with and without low-temperature degradation (LTD). A total of 60 zirconia discs (30 per group; regular sintering and speed sintering) were used in this study. A CAM machine was used to mill cylinders out of the zirconia blanks and then cut into smaller discs. For the speed sintering, the zirconia blocks were milled into smaller discs. The zirconia discs were subjected to regular and speed sintering with and without LTD. Scanning electron microscopy was used to characterize the zirconia specimens and the zirconia grain size. Furthermore, the zirconia specimens were analyzed for elemental analysis using energy dispersive spectroscopy and phase identification using X-ray diffraction. The zirconia specimens were subjected to translucency measurements and biaxial flexural strength testing. The results of the zirconia specimens were compared among the groups. Statistical analysis was completed using SPSS version 20.0 to detect the statistically significant differences (p value = 0.05). A one-way ANOVA with multiple comparisons was performed using Scheffe analysis among the groups. The speed sintering presented smaller grain sizes. The zirconia specimens with and without LTD in regular and speed sintering presented a similar surface structure. Regular sintering showed more translucency compared to speed sintering. Multiple comparisons of the translucency parameter were a significant difference (p value < 0.05) between the various groups except for the comparison between speed sintering and speed sintering LTD. The regular sintering showed bigger gain sizes and slightly more translucency compared to speed sintering. The speed sintering showed higher biaxial flexural strengths compared to regular sintering. This shows that speed sintering can be considered a suitable method of sintering zirconia.

The Effect of Yttria Content on Microstructure, Strength, and Fracture Behavior of Yttria-Stabilized Zirconia

Yttria-stabilized zirconia (YSZ) is well-known as a material with perfect mechanical, thermal, and electrical properties. It is used for manufacturing various high-temperature components for aerospace and energy generation, as well as wear- and corrosion-resistant devices in medicine. This work investigated the effect of a Y2O3 addition to ZrO2 on the microstructure and mechanical properties of YSZ ceramics produced by one sintering schedule. ZrO2 ceramics doped with 3, 4, 5, 6, 7, and 8 mol% Y2O3 (designated 3YSZ through to 8YSZ) were prepared by using conventional sintering at 1550 °C for 2 h in argon. The effect of yttria content was analyzed with respect to grain size, morphology of the microstructural features, phase composition, parameters of fracture surface, and flexural strength. The 7YSZ ceramics sintered at 1550 °C for 2 h showed the highest level of flexural strength due to the formation of the fine-grained microstructure containing mainly the monoclinic and tetragonal zirconia phases. The fracture micromechanism in the studied YSZ ceramics is discussed.

Impact of the material and sintering protocol, layer thickness, and thermomechanical aging on the two-body wear and fracture load of 4Y-TZP crowns

OBJECTIVES

The aim of this study is to investigate the influence of the material and corresponding sintering protocol, layer thickness, and aging on the two-body wear (2BW) and fracture load (FL) of 4Y-TZP crowns.

MATERIALS AND METHODS

Multi-layer 4Y-TZP crowns in three thicknesses (0.5 mm/1.0 mm/1.5 mm) were sintered by high-speed (Zolid RS) or conventional (Zolid Gen-X) sintering. 2BW of ceramic and enamel antagonist after aging (1,200,000 mechanical-, 6000 thermal-cycles) was determined by 3D-scanning before and after aging and subsequent matching to determine volume and height loss (6 subgroups, n = 16/subgroup). FL was examined initially and after aging (12 subgroups, n = 16/subgroup). Fractographic analyses were performed using light-microscope imaging. Global univariate analysis of variance, one-way ANOVA, linear regression, Spearman's correlation, Kolgomorov-Smirnov, Mann-Whitney U, and t test were computed (alpha = 0.05). Weibull moduli were determined. Fracture types were analyzed using Ciba Geigy table.

RESULTS

Material/sintering protocol did not influence 2BW (crowns: p = 0.908, antagonists: p = 0.059). High-speed sintered Zolid RS presented similar (p = 0.325-0.633) or reduced (p < 0.001-0.047) FL as Zolid Gen-X. Both 4Y-TZPs showed an increased FL with an increasing thickness (0.5(797.3-1429 N) < 1.0(2087-2634 N) < 1.5(2683-3715 N)mm; p < 0.001). For most groups, aging negatively impacted FL (p < 0.001-0.002). Five 0.5 mm specimens fractured, four showed cracks during and after aging.

CONCLUSIONS

High-speed sintered crowns with a minimum thickness of 1.0 mm showed sufficient mechanical properties to withstand masticatory forces, even after a simulated aging period of 5 years.

CLINICAL RELEVANCE

Despite the manufacturer indicating a thickness of 0.5 mm to be suitable for single crowns, a minimum thickness of 1.0 mm should be used to ensure long-term satisfactory results.

Effect of Cooling Rate on Mechanical Properties, Translucency, Opalescence, and Light Transmission Properties of Monolithic 4Y-TZP during Glazing

A standard cooling rate has not been established for glazing; therefore, the effects of the cooling rate on the properties of zirconia need to be evaluated to predict outcomes in clinical practice. 4Y-TZP glazed at three different cooling rates was analyzed to estimate the effect of cooling rate during glazing on the mechanical and optical properties. Hardness tests, field-emission scanning electron microscopy analysis, X-ray diffraction analysis, flexural strength measurement, and optical property evaluations were performed. When 4Y-TZP was glazed at a higher cooling rate (Cooling-1) than the normal cooling rate (Cooling-2), there was no significant difference in grain size, flexural strength, average transmittance, and translucency parameters. The hardness was slightly reduced. The opalescence parameter was reduced for the 2.03 mm thick specimens. When 4Y-TZP was glazed at a lower cooling rate (Cooling-3) than the normal cooling rate, there was no significant difference in hardness, grain size, flexural strength, and translucency parameters. In addition, the average transmittance and opalescence parameters were slightly reduced for the 0.52 and 2.03 mm specimens, respectively. The effects of the cooling rate during glazing on the mechanical and optical properties of 4Y-TZP appear to be minimal and clinically insignificant. Therefore, even if the cooling rate cannot be strictly controlled during glazing, the clinical outcomes will not be significantly affected.

Composition, processing, and properties of biphasic zirconia bioceramics: relationship to competing strength and optical properties

A study is made of relationships between composition, processing, structure and properties of biphasic zirconia bioceramics. The focus is on zirconia compositions with different yttria dopant contents used in modern dental restorations, namely 3 - 5 mol% yttria stabilized zirconia (3YSZ, 4YSZ, and 5YSZ). Crystallographies and densities are surveyed, sintering conditions examined, and microstructures characterized. Strength and optical tests are conducted on each YSZ, and dependencies on sintering temperature, cubic content and grain size analyzed. Strength correlates with the amount of tetragonal zirconia (t-ZrO2) crystals with large lattice distortions (tetragonality). YSZ translucency correlates with content of cubic zirconia (c-ZrO2) and t-ZrO2 with low levels of tetragonality. Consistent with literature reporting, the materials rank in decreasing order 3YSZ, 4YSZ to 5YSZ for strength but increasing order for translucency. However, for a given composition, the data suggest that the strengths of densely sintered 3YSZ and 4YSZ actually increase with translucency, although that of 5YSZ remains undiminished. These trends are in apparent contradiction to prevailing experience, and offer potential future processing routes to optimization of clinical materials.

Preparation of Calcium Phosphate Compounds on Zirconia Surfaces for Dental Implant Applications

Titanium is widely used in medical implants despite the release of heavy metal ions over long-term use. Zirconia is very close to the color of teeth; however, its biological inertness hinders bonding with bone tissue. Alkaline treatment and coatings of calcium phosphate can be used to enhance bone regeneration adjacent to dental implants. This study examined the effects of alkaline treatment, calcium phosphate coatings, and sintering, on the physical properties of implant material. Our analysis confirmed that the calcium phosphate species were octacalcium phosphate (OCP). The sintering of calcium phosphate was shown to create B-type HAP, which is highly conducive toward the differentiation of mesenchymal stem cells (MSCs) into osteoblasts for the facilitation of bone integration. Conclusions: This study demonstrated the room-temperature fabrication of dental implants with superhydrophilic surfaces to enhance biocompatibility.

Effect of artificial aging on the translucency of monolithic zirconia materials sintered at different temperatures

STATEMENT OF PROBLEM

Translucent zirconia materials were developed as an alternative to lithium disilicate materials. However, the effect of sintering temperature and artificial aging on the translucency of zirconia materials is unclear.

PURPOSE

The purpose of this in vitro study was to investigate the translucency of recently developed zirconia materials after different sintering temperatures and the effect of artificial aging.

MATERIAL AND METHODS

Disk-shaped specimens (Ø15×1 mm) of 3 different monolithic zirconias (Katana UTML, Prettau Anterior, VITA YZ XT) and a control lithium disilicate reinforced glass ceramic (IPS e.max CAD LT) were evaluated. The zirconia specimens were divided into 2 subgroups with different sintering temperatures (1450 °C, 1550 °C) (n=5, N=35). The specimens were artificially aged in a thermocycle tester and a mastication simulator. The translucency parameter (TP) was calculated by measuring with a spectrophotometer. Kruskal-Wallis and Wilcoxon signed-rank tests were used to analyze the data (α=.05).

RESULTS

While the overall TP of monolithic zirconia increased after artificial aging, the lithium disilicate specimens did not show a statistically significant difference (P=.35). The Prettau Anterior and VITA YZ XT specimens had a statistically significant higher TP than Katana UTML (P=.009). Sintering temperature did not have a statistically significant effect on the TP value of monolithic zirconia materials (P>.05).

CONCLUSIONS

Artificial aging increased the TP, and the sintering temperature did not affect the TP of monolithic zirconia. The use of fully stabilized zirconia may be an alternative to lithium disilicate in esthetic restorations in clinical practice.

Comparative analysis on intaglio surface trueness, wear volume loss of antagonist, and fracture resistance of full-contour monolithic zirconia crown for single-visit dentistry under simulated mastication

PURPOSE

This analysis aimed to evaluate the intaglio surface trueness, antagonist’s wear volume loss, and fracture resistance of full-contour crowns of (Y, Nb)-stabilized fully-sintered zirconia (FSZ), 4 mol% or 5 mol% yttria-stabilized partially sintered zirconia (4YZ or 5YZ) with high-speed sintering.

MATERIALS AND METHODS

A total of 42 zirconia crowns were separated into three groups: FSZ, 4YZ, and 5YZ (n = 14). The intaglio surface trueness of the crowns was evaluated at the inner surface, occlusal, margin, and axial areas and reported as root-mean-square, positive and negative average deviation. Half of the specimens were aged for 120,000 cycles in the chewing simulator, and the wear volume loss of antagonist was measured. Before and after chewing, the fracture load was measured for each group. The trueness values were analyzed with Welch's ANOVA, and the wear volume loss with the Kruskal-Wallis tests. Effect of the zirconia type and aging on fracture resistance of crowns was tested using two-way ANOVA.

RESULTS

The intaglio surface trueness measured at four different areas of the crown was less than 50 µm, regardless of the type of zirconia. No significant P in wear volume loss of antagonists were detected among the groups (P > .05). Both the type of zirconia and aging showed statistically significant effects on fracture resistance (P < .05).

CONCLUSION

The full-contour crowns of FSZ as well as 4YZ or 5YZ with high-speed sintering were clinically acceptable, in terms of intaglio surface trueness, antagonist’s wear volume loss, and fracture resistance after simulated mastication.

An In Vitro Study to Evaluate the Effect of Artificial Aging on Translucency, Contrast Ratio, and Color of Zirconia Dental Ceramic at Different Sintering Levels

Increasing demands for aesthetically pleasing dental restorations have promoted the use of materials that display superior optical properties. Zirconia-based all-ceramic systems have good optical properties, thus providing the desired esthetics for dental restorations. The altered oral conditions impact the physical properties of these materials. Multiple studies have been conducted to evaluate the effect of aging on the mechanical properties of computerized-aided design and computerized-aided manufacturing (CAD/CAM)-based zirconia; however, there is a scarcity of literature discussing the effect of aging on change in translucency, contrast ratio, and color. Therefore, this research aimed to evaluate the effect of accelerated artificial aging on translucency parameter (TP), contrast ratio (CR), and color of CAD/CAM zirconia at different sintering temperatures. Twenty-eight rectangular-shaped specimens were obtained by CAD/CAM milling of zirconia blank. Sintering of the samples was carried out at four different temperatures 1350 °C, 1400 °C, 1450 °C, and 1500 °C, respectively. Thermocycling of the samples was performed in a thermocycler. TP, CR, and color evaluation of all the samples was done again using a Spectrophotometer. Data acquired were statistically evaluated by one-way ANOVA and Post Hoc test. The highest amount of change in TP was recorded for specimens sintered at 1400 °C (1.86), whereas the least change was attributed to 1350 °C (0.51). The highest change in CR was observed in specimens sintered at 1500 °C (0.0971), and the least change in CR was observed at 1450 °C (0.0086). The highest ΔE values were recorded for 1400 °C against both white (1.86) and black background (2.17), whereas the least change was attributed to 1350 °C against white (0.86) and against a black background (1.41). The changes in TP were significant, but CR did not show any significant change. ΔE values for all the experimental groups were significant, but were below the clinically perceptible range. An increase in sintering temperature increased the translucency.

Influence of heat treatment on the microstructure and the physical and mechanical properties of dental highly translucent zirconia

PURPOSE

Microstructural and physico-mechanical characterization of highly translucent zirconia, prepared by milling technology (CAD-CAM) and repeated firing cycles, was the main aim of this in vitro study.

MATERIALS AND METHODS

Two groups of samples of two commercial highly-translucent yttria-stabilized dental zirconia, VITA YZ-HTWhite (Group A) and Zolid HT + White (Group B), with dimensions according to the ISO 6872 "Dentistry - Ceramic materials", were prepared. The specimens of each group were divided into two subgroups. The specimens of the first subgroups (Group A1 and Group B1) were merely the sintered specimens. The specimens of the second subgroups (Group A2 and Group B2) were subjected to 4 heat treatment cycles. The microstructural features (microstructure, density, grain size, crystalline phases, and crystallite size) and four mechanical properties (flexural strength, modulus of elasticity, Vickers hardness, and fracture toughness) of the subgroups (i.e. before and after heat treatment) were compared. The statistical significance between the subgroups (A1/A2, and B1/B2) was evaluated by the t-test. In all tests, P values smaller than 5% were considered statistically significant.

RESULTS

A homogenous microstructure, with no residual porosity and grains sized between 500 and 450 nm for group A and B, respectively, was observed. Crystalline yttria-stabilized tetragonal zirconia was exclusively registered in the X-ray diffractograms. The mechanical properties decreased after the heat treatment procedure, but the differences were not statistically significant.

CONCLUSION

The produced zirconia ceramic materials can be safely (i.e., according to the ISO 6872) used in extensive fixed prosthetic restorations, such as substructure ceramics for three-unit prostheses involving the molar restoration and substructure ceramics for prostheses involving four or more units. Consequently, milling technology is an effective manufacturing technology for producing zirconia substructures for dental fixed all-ceramic prosthetic restorations.

Revolution of Current Dental Zirconia: A Comprehensive Review

The aim of this article is to comprehensively review the revolution of dental zirconia (Zir), including its types, properties, applications, and cementation procedures. A comprehensive search of PubMed and Embase was conducted. The search was limited to manuscripts published in English. The final search was conducted in October 2021. Newly developed monolithic Zir ceramics have substantially enhanced esthetics and translucency. However, this material must be further studied in vitro and in vivo to determine its long-term ability to maintain its exceptional properties. According to the literature, monolithic translucent Zir has had promising results and a high survival rate. Thus, the utilization of this material is indicated when strength and esthetics are needed. Both the materials and methods used for cementation of monolithic Zir have significantly improved, encouraging dentists to use this material, especially when a conservative approach is required. Zir restorations showed promising outcomes, particularly for monolithic Zir crowns supported with implant and fixed dental prostheses.