Effect of Er:YAG laser application on the shear bond strength and microleakage between resin cements and Y-TZP ceramics

Influence of Different Surface Treatments on the Bond Strength of Yttria-Stabilized Tetragonal Zirconia Ceramic

Objective: This in vitro study evaluates the shear bond strength (SBS) of yttria-stabilized tetragonal zirconia (Y-TZP) and resin cement after different surface treatments. Materials and methods: Forty-eight ceramic cubes were divided into four groups (n = 12): G1 (control) sandblasting with Al2O3; G2-sandblasting with silica-coated Al2O3 (Rocatec); G3-Rocatec + CO2 laser; and G4-CO2 laser + Rocatec. A metallic primer was applied to the pretreated ceramic. A rubber ring was adapted on the central area, and then, the resin cement was inserted into the matrix and photoactivated. The samples were evaluated regarding surface roughness (Ra), SBS, failure type, and qualitatively with scanning electron microscopy (SEM). The data were analyzed by one-way analysis of variance followed by Tukey's test (p < 0.05). Results: The mean values of Ra (μm) were as follows: G1-4.52a, G2-4.24a,b, G3-4.10a,b, and G4-2.90b and the mean values of SBS (MPa) were as follows: G1-7.84a , G2-4.41b , G3-4.61b and G4-6.14a,b. SEM analyses showed superficial irregularities for all groups, being more prominent for G1. The presence of silica deposits was observed for G2, G3, and G4, but in the last two groups there were some linear areas, promoted by the fusion of silica, due to the thermomechanical action of the CO2 laser. Conclusions: The surface treatment with CO2 laser + Rocatec, using one MDP-based cement, can be an alternative protocol for the adhesion cementation of Y-TZP ceramic since it was as effective as the conventional pretreatment with aluminum oxide sandblasting.

Effect of Surface Treatment with Alkaline Agents at Two Different Temperatures on Microshear Bond Strength of Zirconia to Composite Resin

Background

Zirconia, with its excellent mechanical properties, has become a popular choice for esthetic and durable restorations due to the increasing demand of patients. It has overcome most of the limitations of all ceramic restorations. However, bonding to zirconia remains a challenge.

Objectives

This study is aimed at assessing the effect of surface treatment with alkaline agents at two different temperatures on microshear bond strength (μSBS) of zirconia to composite resin.

Materials and Methods

This in vitro, experimental study was conducted on zirconia blocks measuring 2 × 4 × 8 mm. The blocks were sandblasted with alumina powder and randomly assigned to 5 groups (n = 16 each). The blocks in groups 1 and 2 underwent surface treatment with sodium hydroxide (NaOH) and groups 3 and 4 with zirconium hydroxide (Zr(OH)4) at room temperature and 70°C. Group 5 served as the control group and did not receive any surface treatment. After the application of bonding agent and its light-curing, composite cylinders in plastic tubes were bonded to the surface of each block and cured. After incubation, they underwent μSBS test. Data were analyzed by one-way ANOVA and Tukey's test (alpha = 0.05).

Results

The μSBS was significantly higher in all intervention groups than that in the control group (P < 0.05). The μSBS in Zr(OH)4 groups was significantly higher than that in NaOH groups (P < 0.05). The mean μSBS of heated groups was slightly, but not significantly, higher than the corresponding room temperature groups (P > 0.05).

Conclusion

Surface treatment of zirconia with NaOH and Zr(OH)4 alkaline agents can increase its μSBS to composite resin; Zr(OH)4 was significantly more effective than NAOH for this purpose, but heating did not have a significant effect on μSBS.

The enhanced shear bond strength of resin cement to zirconia with ordered conical spots through the CO2 laser process

In this study, a new shear bonding system was created that uses a CO₂ laser to form a pattern of conical spots on a zirconia prosthesis surface to improve mechanical interlocking. Four types of zirconia substrates were employed, which underwent particle abrasion after being polished, machined, spotted, and spot-particle abraded. The surface roughness of each substrate was measured via scanning electron microscopy and X-ray diffraction (XRD). A shear bond strength test was performed with the zirconia-based material and a composite resin assuming abutment construction. XRD did not indicate that forming spots caused a phase transformation in zirconia with respect to machined zirconia. The shear bond strength was approximately twice that of the machined samples and approximately 2.3 times that of the samples that underwent particle and spot-particle abrasion. Surface modification by spotting improved the mechanical fitting force. However, no significant difference was observed between particle abrasion and spot-particle abrasion.

Roughness of the Surface of Zirconia Reinforced Lithium Disilicate Ceramic Treated by Different Procedures

Lithium disilicate and zirconia are the two most popular materials for aesthetic and dental prosthetic work; however, due to their limitations, a new material is being researched, namely zirconia-reinforced lithium disilicate, the surface of which is treated with different procedures to achieve the best possible surface properties. In this study, the surface of zirconia-reinforced lithium disilicate glass-ceramic was treated using different methods (conventional and laser) to determine the effects of the treatment procedures on the surface properties and surface roughness to achieve a higher strength of adhesion from the self-adhesive resin cement to zirconia-reinforced lithium disilicate. The treated surfaces were investigated using profilometry, X-ray diffraction and energy dispersive X-ray fluorescence. The results obtained were statistically evaluated. The results show that the surface roughness is highest for the samples treated with Er:YAG (erbium-doped yttrium aluminium garnet laser) and silanisation. Furthermore, the surface treatment procedures applied did not change the composition of the surface.

Effect of Er:YAG laser pretreatment on glass-ceramic surface in vitro

This study investigated the feasibility of using an Er:YAG laser to pretreat glass-ceramic surface and evaluate the effect of the treatment on the bonding strength and marginal adaptation between glass-ceramic and dentin. Glass-ceramic samples (CEREC Blocs) and third molars were cut into 6 mm × 6 mm × 2 mm plates. Thirty ceramic plates were randomly divided into 5 groups: group A (control), group B (pretreated with 9.6% hydrofluoric acid [HF]), group C (pretreated with the Er:YAG laser at 300 mJ and 15 Hz), group D (pretreated with the Er:YAG laser at 400 mJ and 15 Hz), and group E (pretreated with the Er:YAG laser at 500 mJ and 15 Hz). The surface morphologies of the samples in each group were studied under a scanning electron microscope, and the sample displaying optimal etching parameters was selected for subsequent experiments. Based on the surface treatments, 30 ceramic and dentin plates were randomly allocated into 3 groups: the control, laser, and acid-etching groups. After bonding a ceramic plate to a dentin plate, the microleakage and bonding strength were measured, and the pretreatment effects of the Er:YAG laser and 9.6% HF were compared. Group E exhibited an etching effect that was more pronounced and uniform than that in groups C and D. Microleakage and bonding strength analyses revealed that the laser and acid-etching groups differed significantly from the control group in dye penetration depth and shear strength (P < 0.05), although the laser and acid-etching groups did not differ from each other. Both 9.6% hydrofluoric acid and Er:YAG laser pretreatments can coarsen glass-ceramic surfaces, improve the marginal adaptation and bonding strength between the glass-ceramic and dentin, and decrease microleakage of the materials. The two treatments showed no apparent differences in pretreatment outcomes.

Effect of Er:YAG laser irrigation with different etching modes on the push-out bond strength of fiber posts to the root dentine

The objective of this study was to evaluate the effect of Er:YAG laser irrigation on the push-out bond strength of fiber posts to the root dentine. Sixty extracted human mandibular first premolars were collected and decoronated. The residual roots received endodontic treatment. The treated roots were randomly divided into three groups according to different irrigation protocols: group LAI (Er:YAG laser–activated irrigation), group PUI (passive ultrasonic irrigation, positive control), and group CSI (conventional syringe irrigation, negative control) (n = 20). Each group was divided into two subgroups, either total-etching modes or self-etching modes (n = 10). After fiber post restoration, all roots were sectioned into seven 1.0-mm-thick slices. The slices received a push-out test by a universal test machine. The resin tag on the segments’ bonding interfaces was observed by scanning electron microscope. There were significant differences in the effects of the irrigation method, bonding modes, and root regions on the push-out bond strength among the groups (p < 0.05). The specimens with Er:YAG laser–activated irrigation and self-etching mode showed significantly the highest bonding strength (p < 0.001). The lengths and densities of resin tags in group PUI or group LAI with self-etching modes were longer than those in group CSI with total-etching modes. The laser-activated irrigation with self-etching modes improved the bond strength of fiber post to root dentine compared to the passive ultrasonic irrigation or conventional syringe irrigation with total or self-etching modes.

Influence of Different Surface Pretreatments of Zirconium Dioxide Reinforced Lithium Disilicate Ceramics on the Shear Bond Strength of Self-Adhesive Resin Cement

Aim

To analyze the influence of different surface pretreatments of zirconium dioxide reinforced lithium disilicate ceramics on the shear bond strength of self-adhesive resin cement.

Materials and methods

Eighty-four zirconium reinforced lithium disilicate disc Vita suprinity (Vita Zahnfabrick, Bad Säckingen, Germany) 14x12x2 mm specimens were fabricated according to the manufacturer's recommendations. The specimens were embedded in acrylic resin blocks and randomly divided in seven groups (n=12/each) accorrding to the treatment: Group 1- 10% hydrofluoric acid; Group 2- silane; Group 3- hydrofluoric and silane; Group 4- sandblasting with silane; Group 5- Er: YAG laser+ silane; Group 6- Nd: YAG laser + silane; and the control group, in which the specimens were not treated. Round shape composite discs (Filtek Bulk fill, 3M ESPE, St.Paul, Minnesota, USA) with 3.5 mm diameter, were made for shear bond strength testing, and then cemented to the ceramic sample surface using composite cement (RelyX U200 Automix, 3M ESPE, Neuss, Germany). After cementing the composite disc on the sample, the samples were subjected to shear bond strength test of 10 N with a “stress rate” of 1 MPa / s. To determine the nature of the fracture (adhesive, cohesive or adhesive-cohesive), the broken samples were examined under a stereomicroscope. The ANOVA test and the Tukey test were used to compare the values ​​of the bond strength characteristics between different types of materials. All tests were performed with a significance level of α = 0.05.

Results

There was a significant difference in the shear bond strength of self-adhesive cement to dental lithium-disilicate ceramics reinforced with zirconium dioxide after different preparation protocols (p<0, 05). The treatment of lithium disilicate ceramics reinforced with zirconium dioxide by silanization, sandblasting + silanization, Nd: YAG + silanization resulted in significantly higher bond strength compared to the control group. There was statistically higher bond strength of self-adhesive cement after pretreatment of lithium disilicate ceramics Nd: YAG + silanization compared to Er: YAG + silanization (p <0.05). Adhesive fracture dominated in the control group, sandblasting + silanization group, and in the laser groups, while mixed fracture dominated in other groups.

Conclusion

Under the limitations of this study, the Nd:YAG irradiation with silanization could be used as pretreatment for providing greater shear bond strength of self-adhesive resin cement to zirconium reinforced lithium disilicate.

Effect of laser irradiation on bond strength between zirconia and resin cement or veneer ceramic: A systematic review and meta-analysis

Aim:

This systematic review with meta-analysis aimed to evaluate the effect of the laser treatment on bond strength between Y-TZP and the resin cement or with the veneering ceramic, and the effect on the alteration of the Y-TZP surface roughness.

Settings and Design:

Systematic review and meta analysis following PROSPERO guidelines.

Materials and Methods:

A comprehensive review was performed up to September 2020 on four databases (PubMed/MEDLINE, Embase, Scopus, and Cochrane Library), using the combination of keywords: “laser AND zirconia AND surface treatment AND bond strength”.

Statistical Analysis Used:

The meta-analysis was based on the Mantel–Haenszel and inverse variance methods. The continuous outcome was evaluated by mean difference and the corresponding 95% confidence intervals.

Results:

A total of 37 studies were identified for the inclusion of data, with only in vitro studies. The types of laser reported in the studies were: Er:YAG, Nd:YAG, Er,Cr:YSGG, CO2, Femtosecond, and Yb lasers. A random-effect model found statistically significant differences between lasers and control groups of Y-TZP (P < 0.00001; MD: 3.08; 95% CI: 2.58 to 3.58). Only the bond strength with the Er:YAG laser did not present statistical difference (P = 0.51; MD: 0.22; 95% CI: −0.44–0.88). In another analysis, a random-effect model found a statistically significant difference between the laser and control groups on surface roughness (P < 0.00001; MD: 0.96; 95% CI: 0.86 to 1.06).

Conclusions:

Laser irradiation is capable to improve the Y-TZP surface roughness and the bond strength of zirconia with resin cement and veneering ceramics. However, there is a lack of laser protocol for the zirconia surface, a fact that makes a simple and direct comparison difficult.

The Use of Lasers in Dental Materials: A Review

Lasers have been well integrated in clinical dentistry for the last two decades, providing clinical alternatives in the management of both soft and hard tissues with an expanding use in the field of dental materials. One of their main advantages is that they can deliver very low to very high concentrated power at an exact point on any substrate by all possible means. The aim of this review is to thoroughly analyze the use of lasers in the processing of dental materials and to enlighten the new trends in laser technology focused on dental material management. New approaches for the elaboration of dental materials that require high energy levels and delicate processing, such as metals, ceramics, and resins are provided, while time consuming laboratory procedures, such as cutting restorative materials, welding, and sintering are facilitated. In addition, surface characteristics of titanium alloys and high strength ceramics can be altered. Finally, the potential of lasers to increase the adhesion of zirconia ceramics to different substrates has been tested for all laser devices, including a new ultrafast generation of lasers.

Adhesion to Zirconia: A Systematic Review of Surface Pretreatments and Resin Cements

This systematic review aims to evaluate the different pretreatments of the zirconia surface and resin cement in order to determine a valid operative protocol for adhesive cementation. Methodologies conducted for this study followed the Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. An electronic search was performed in four databases. The established focus question was: “What type of surface conditioning method is the one that obtains the best adhesion values to zirconia over time by applying a resin cement?” Forty-five relevant papers were found to qualify for final inclusion. In total, 260 different surface pretreatment methods, mainly combinations of air-abrasion protocols and adhesive promoters, were investigated. Altogether, the use of two artificial aging methods, three types of cement and four testing methods was reported. The results showed that mechanicochemical surface pretreatments offered the best adhesive results. Self-adhesive cement and those containing 10-MDP obtained the best results in adhesion to zirconia. Artificial aging reduced adhesion, so storage in water for 30 days or thermocycling for 5000 cycles is recommended. A standardized adhesive protocol has not been established due to a lack of evidence

Bond Integrity of Titanium Surface to Resin Cement After Conditioning with Different Photobiomodulataion Therapy (PBT)

The aim of the present study was to evaluate the efficacy of interfacial bonding between resin cement and titanium alloy conditioned with different Photobiomodulataion Therapy (PBT) in comparison with conventional regimes. Seventy-five samples of titanium bar were segmented polished; and based on conditioning regime divided into five groups (15 each specimens). Group 1: No treatment (control), Group 2: Sand blasting with 120 µm Al2O3, Group 3: Er,Cr:YSGG (ECL), Group 4: Er:YAG laser (EYL), Group 5: Nd:YAG laser (NYL). After different conditioning regimes, resin cement was mixed and applied. All specimens were thermocycled for 500 cycles and positioned on universal testing machine for shear bond strength testing. Modes of failure was assessed by a single examiner using stereomicroscope at 40× magnification. Three pairs of specimens in each group were sputter coated and scanning electron microscope (SEM) images were taken at 1000× magnification using 20 Kv. The highest SBS values were observed in group 2 (14.25±2.29 MPa) and the lowest bond values were displayed in group 1 (6.98 ±0.59 MPa). Titanium alloy abutments conditioned with different laser prototypes ECL (11.22±1.40 MPa), EYL (9.29±1.22 MPa) and NYL (9.12 ±1.84 MPa) exhibited comparable SBS (p > 0.05). Adhesive failures were primarily dominant among all experimental groups. Photo-biomodulation in the form of ECL lasers has the potential to be used as a supplement to sandblasting procedure in conditioning of cement retained titanium alloy implant abutments.

Nanosecond pulsed fiber laser irradiation for enhanced zirconia crown adhesion: Morphological, chemical, thermal and mechanical analysis

The increasing demand for aesthetics, together with advancements in technology, have contributed to the rise in popularity of all-ceramic restorations. In the last two decades, the continuous progression in ceramic materials science for dental applications has permitted the fabrication of high-strength materials. Amongst these, zirconia-based ceramics have improved in terms of fracture resistance and long-term viability in comparison with other silica-based materials. Unfortunately, while bonding of resin cement-silica ceramics can be strengthened through creation of a porous surface by applying hydrofluoric acid (5%-9.5%) and a subsequent silane coupling agent, the glass-free polycrystalline microstructure of zirconia ceramics does not allow such a reaction. The aim of the present in vitro study was to observe the effect of 1070 nm fiber nanosecond pulse laser irradiation on zirconia samples through morphological analysis (profilometry, SEM), thermal recording with Fiber Bragg Gratings (FBGs), elemental composition analysis (EDX) and bond strength testing (mechanical tests) in order to evaluate the possible advantages of this kind of treatment on zirconia surfaces, as well as to show the potential side effects and changes in chemical composition. Despite laser irradiation with a 1070 nm wavelength fiber laser and correct process parameters demonstrating suitable outcomes in terms of improved surface roughness and minimal thermal damage, comparison between irradiated and unirradiated samples did not exhibit statistically significant differences in terms of bonding strength.

Laser surface texturing of zirconia-based ceramics for dental applications: A review

Laser surface texturing is widely explored for modifying the surface topography of various materials and thereby tuning their optical, tribological, biological, and other surface properties. In dentistry, improved osseointegration has been observed with laser textured titanium dental implants in clinical trials. Due to several limitations of titanium materials, dental implants made of zirconia-based ceramics are now considered as one of the best alternatives. Laser surface texturing of zirconia dental implants is therefore attracting increasing attention. However, due to the brittle nature of zirconia, as well as the metastable tetragonal ZrO₂ phase, laser texturing in the case of zirconia is more challenging than in the case of titanium. Understanding these challenges requires different fields of expertise, including laser engineering, materials science, and dentistry. Even though much progress was made within each field of expertise, a comprehensive analysis of all the related factors is still missing. This review paper provides thus an overview of the common challenges and current status on the use of lasers for surface texturing of zirconia-based ceramics for dental applications, including texturing of zirconia implants for improving osseointegration, texturing of zirconia abutments for reducing peri-implant inflammation, and texturing of zirconia restorations for improving restoration retention by bonding.

Novel Femto Laser Patterning of High Translucent Zirconia as an Alternative to Conventional Particle Abrasion

Background: currently applied surface treatments for zirconia bonding may create undesired microcracks and surface flaws. The aim of the present study was to evaluate the efficacy of alternative surface treatments on the shear bond strength of high translucency zirconia to 10-Methacryloyloxydecyl dihydrogen phosphate (MDP)-containing resin-based cement. Methods: fifty disk-shaped specimens (10 mm × 5 mm) were fabricated from a commercial yttria-stabilized zirconia with 5 mole% yttrium oxide tetragonal zirconia polycrystal (5Y-TZP), and underwent air-abrasion with alumina particles (50 μm-AL50 and 90 μm-AL90), glass beads (GB 10–60 μm), and ablation with femtosecond laser (FEMTO). Shear bond strength was evaluated with a universal testing machine under a crosshead speed of 0.5 mm/min until fracture. Fracture type was evaluated with an optical stereomicroscope. Differences among groups were evaluated by one-way ANOVA and Bonferroni pairwise comparison tests (p < 0.05). Results: the highest shear bond strength values were presented by the laser treated group (23.97 ± 3.7 MPa). No statistically significant differences were found among the Cl, Al50, Al90 and FEMTO groups. The lowest mean value was presented by the glass-beads treated group (11.93 ± 2.88 MPa) which was significantly lower compared to all other groups (p < 0.001). Conclusions: under the limitations of this in vitro study, femtosecond laser treatment of High-translucent monolithic zirconia (HTZ) ceramics is a promising alternative method for the mechanical retention of resin cements.

Influence of Er:YAG laser surface treatment on flexural and bond strengths to glass-infiltrated zirconia-reinforced ceramic

To evaluate the effect of Er:YAG laser conditioning of a glass-infiltrated alumina-based zirconia-reinforced ceramic on its flexural strength and on bonding to a resin cement. Sixteen blocks (5 × 5 × 4 mm) and 50 discs (Ø 12 mm, 1 mm thickness) of In-Ceram Zirconia (ICZ) obtained from CAD-CAM blocks were infiltrated with glass. For the microtensile bond strength (μTBS) test, all blocks were treated with aluminum oxide (AOX) and divided into 4 groups (n = 4): G1 (AOX), no combined surface treatment; G2 (ROC), tribochemical silica-coating; G3 (EY200), Er:YAG laser 200 mJ/15 Hz; and G4 (EY250), Er:YAG laser 250 mJ/10 Hz. The ceramic blocks were silanated and cemented with a resin cement (Panavia F2.0/Kuraray) to composite resin blocks and subjected to the μTBS test. For the flexural strength evaluation, the discs were divided into 5 groups (n = 10) as described above, in addition to a control group (G5 - CTRL, mirror-polished without further treatment). Each surface treatment was submitted to qualitative evaluation under SEM. One-way ANOVA (α = 5%) revealed the highest bond strength value for EY200 with no significant difference from ROC. The groups AOX and EY250 showed similar μTBS values that were statistically lower than those of EY200. For flexural strength, ROC was the only group with significantly lower values when compared with the CTRL. The use of Er:YAG laser at 200 mJ/15 Hz can be considered an innovative and effective alternative for surface conditioning of ICZ since it did not reduce the flexural strength of the ceramic and improved the resin cement bond to this substrate.

Effect of Er:YAG Laser Etching on the Shear Bond Strength and Microleakage of Self-Glazed Zirconia Ceramics

Objective: To investigate the effect of Er:YAG laser irradiation on the shear bond strength (SBS) and microleakage of self-glazed zirconia (SZ) ceramics. Background: SZ is a novel type ceramic; laser irradiation has started to be used in the surface treatment of different ceramics, while SZ has been rarely studied to improve the bond quality. Methods: One hundred twenty blocks (5 mm × 5 mm × 5 mm) of SZ ceramics were produced and split into eight groups following different surface treatments (n = 15): Group A: no treatment; Group B: standard grid processing; and Group C-H: different Er:YAG laser power settings (100, 200, 300, 400, 500, and 600 mJ). Ten blocks of each group received the measurement of SBS and fracture mode analysis, three blocks underwent the evaluation of the microleakage depths, and the other two blocks were observed under the scanning electronic microscopy (SEM). Results: Group F obtained the highest SBS and the lowest microleakage depth without damaging the ceramic surface structure, which was statistically significant compared with the control group and gridding group (p < 0.05), whereas the difference was not statistically significant (p > 0.05) between group E and group F. The results of bonding performance were consistent with failure types and observation of surface characterizations in SEM images. Conclusions: According to the results here, Er:YAG irradiation had effect on surface treatment. In addition, 400 mJ Er:YAG could increase the SBS and decrease the microleakage depth on SZ ceramics without damaging the surface structure.

Shear Bond Strength of Al₂O₃ Sandblasted Y-TZP Ceramic to the Orthodontic Metal Bracket

As the proportion of adult orthodontic treatment increases, mainly for aesthetic reasons, orthodontic brackets are directly attached to yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) restorations. This, study analyzed the shear bond strength (SBS) between various surface treated Y-TZP and orthodontic metal brackets. The Y-TZP specimens were conditioned by 110 μm Al₂O₃ sandblasting, or sandblasting followed by coating with one of the primers (silane, MDP, or an MDP-containing silane primer). After surface treatment, the orthodontic metal bracket was bonded to the specimen using a resin cement, and then 24 h storage in water and thermal cycling (5000 cycles, 5-55 °C), SBS was measured. Surface roughness was analyzed for surface morphology, and X-ray photoelectron spectroscopy (XPS) was employed for characterization of the chemical bond between the Y-TZP and the MDP-based primers (MDP, MDP containing silane primer). It was found that after surface treatment, the surface roughness of all groups increased. The groups treated with 110 μm Al₂O₃ sandblasting and MDP, or MDP-containing silane primer showed the highest SBS values, at 11.92 ± 1.51 MPa and 13.36 ± 2.31 MPa, respectively. The SBS values significantly decreased in all the groups after thermal cycling. Results from XPS analysis demonstrated the presence of chemical bonds between Y-TZP and MDP. Thus, the application of MDP-based primers after Al₂O₃ sandblasting enhances the resin bond strength between Y-TZP and the orthodontic metal bracket. However, bonding durability of all the surface-treated groups decreased after thermal cycling.

Alkaline nanoparticle coatings improve resin bonding of 10-methacryloyloxydecyldihydrogenphosphate-conditioned zirconia

Creating an alkaline environment prior to 10-methacryloyloxydecyldihydrogenphosphate (MDP) conditioning improves the resin bonding of zirconia. The present study evaluated the effects of four alkaline coatings with different water solubilities and pH values on resin bonding of MDP-conditioned zirconia. Two alkaline nanoparticle coatings were studied in particular. Thermodynamics calculations were performed to evaluate the strengths of MDP-tetragonal phase zirconia chemical bonds at different pH values. Zirconia surfaces with and without alkaline coatings were characterized by scanning electron microscope (SEM)/energy dispersive spectrometer and Fourier transform infrared spectroscopy; alkaline coatings included NaOH, Ca(OH)₂, nano-MgO, and nano-Zr(OH)₄. A shear bond strength (SBS) test was performed to evaluate the effects of the four alkaline coatings on bonding; the alkaline coatings were applied to the surfaces prior to conditioning the zirconia with MDP-containing primers. Gibbs free energies of the MDP-tetragonal zirconia crystal model coordination reaction in different pH environments were −583.892 (NaOH), −569.048 [Ca(OH)₂], −547.393 (MgO), and −530.279 kJ/mol [Zr(OH)₄]. Thermodynamic calculations indicated that the alkaline coatings improved bonding in the following order: NaOH > Ca(OH)₂ > MgO > Zr(OH)₄. Statistical analysis of SBS tests showed a different result. SBSs were significantly different in groups that had different alkaline coatings, but it was not influenced by different primers. All four alkaline coatings increased SBS compared to control groups. Of the four coatings, nano-Zr(OH)₄ and -MgO showed higher SBS. Therefore, preparing nano-Zr(OH)₄ or -MgO coatings prior to conditioning with MDP-containing primers may potentially improve resin bonding of zirconia in the clinic.

Improvement in the Tensile Bond Strength between 3Y-TZP Ceramic and Enamel by Surface Treatments

This study examined the effects of 3 mol % yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) ceramic surface treatments on the tensile bond strength and surface characteristics of enamel. To measure the tensile bond strength, the 3Y-TZP and tooth specimens were manufactured in a mini-dumbbell shape and divided into four groups based on the type of 3Y-TZP surface treatment: polishing (P), 110 µm alumina sandblasting (S), 110 µm alumina sandblasting combined with selective infiltration etching (SS), and 110 µm alumina sandblasting combined with MDP (10-methacryloyloxydecyl dihydrogen phosphate)-containing silane primer (SP). After surface treatment, the surface roughness, wettability, and surface changes were examined, and the tensile bond strength was measured. The mean values (from lowest to highest) for tensile bond strength (MPa) were as follows: P, 8.94 ± 2.30; S, 21.33 ± 2.00; SS, 26.67 ± 4.76; and SP, 31.74 ± 2.66. Compared to the P group, the mean surface roughness was significantly increased, and the mean contact angle was significantly decreased, while wettability was increased in the other groups. Therefore, surface treatment with 110 µm alumina sandblasting and MDP-containing silane primer is suitable for clinical applications, as it considerably improves the bond strength between 3Y-TZP and enamel.

Effects of Laser Treatment on the Bond Strength of Differently Sintered Zirconia Ceramics

OBJECTIVE

The purpose of this study was to investigate the effects of carbon dioxide (CO2) and Erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiations on the shear bond strength (SBS) of differently sintered zirconia ceramics to resin cement.

MATERIALS AND METHODS

Eighty zirconia specimens were prepared, sintered in two different periods (short = Ss, long = Ls), and divided into four treatment groups (n = 10 each). These groups were (a) untreated (control), (b) Er:YAG laser irradiated with 6 W power for 5 sec, (c) CO2 laser with 2 W power for 10 sec, (d) CO2 laser with 4 W power for 10 sec. Scanning electron microscope (SEM) images were recorded for each of the eight groups. Eighty composite resin discs (3 × 3 mm) were fabricated and cemented with an adhesive resin cement to ceramic specimens. The SBS test was performed after specimens were stored in water for 24 h by an universal testing machine at a crosshead speed of 1 mm/min. Data were statistically analyzed with two way analysis of variance (ANOVA) and Tukey honest significant difference (HSD) test (α = 0.05).

RESULTS

According to the ANOVA, the sintering time, surface treatments and their interaction were statistically significant (p < 0.05). Although each of the laser-irradiated groups were significantly higher than the control groups, there was no statistically significant difference among them (p > 0.05).

CONCLUSIONS

Variation in sintering time from 2.5 to 5.0 h may have influenced the SBS of Yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramics. Although CO2 and Er:YAG laser irradiation techniques may increase the SBS values of both tested zirconia ceramics, they are recommended for clinicians as an alternative pretreatment method.

Evaluation of the bond strength of resin cements used to lute ceramics on laser-etched dentin

OBJECTIVE

The purpose of this study was to investigate the shear bond strength (SBS) of two different adhesive resin cements used to lute ceramics on laser-etched dentin.

BACKGROUND DATA

Erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) laser irradiation has been claimed to improve the adhesive properties of dentin, but results to date have been controversial, and its compatibility with existing adhesive resin cements has not been conclusively determined.

MATERIALS AND METHODS

Two adhesive cements, one "etch-and-rinse" [Variolink II (V)] and one "self-etch" [Clearfil Esthetic Cement (C)] luting cement, were used to lute ceramic blocks (Vita Celay Blanks, Vita) onto dentin surfaces. In total, 80 dentin specimens were distributed randomly into eight experimental groups according to the dentin surface-etching technique used Er,Cr:YSGG laser and Er:YAG laser: (1) 37% orthophosphoric acid+V (control group), (2) Er,Cr:YSGG laser+V, (3) Er,Cr:YSGG laser+acid+V, (4) Er:YAG laser+V, (5) Er:YAG laser+acid+V, (6) C, (7) Er,Cr:YSGG laser+C, and (8) Er:YAG laser+C. Following these applications, the ceramic discs were bonded to prepared surfaces and were shear loaded in a universal testing machine until fracture. SBS was recorded for each group in MPa. Shear test values were evaluated statistically using the Mann-Whitney U test.

RESULTS

No statistically significant differences were evident between the control group and the other groups (p>0.05). The Er,Cr:YSGG laser+A+V group demonstrated significantly higher SBS than did the Er,Cr:YSGG laser+V group (p=0.034). The Er,Cr:YSGG laser+C and Er:YAG laser+C groups demonstrated significantly lower SBS than did the C group (p<0.05).

CONCLUSIONS

Dentin surfaces prepared with lasers may provide comparable ceramic bond strengths, depending upon the adhesive cement used.

The Effect of Sandblasting, Er:YAG Laser, and Heat Treatment on the Mechanical Properties of Different Zirconia Cores

OBJECTIVE

The purpose of this study was to evaluate the effect of surface and heat treatments on the mechanical properties and phase transformation of yttria-stabilized tetragonal zirconia (Y-TZP) materials.

BACKGROUND DATA

Zirconia is exposed to several treatments during dental application process. Knowing the effect of applied treatments on zirconia is essential for clinical success.

MATERIAL AND METHODS

Forty disk specimens of Zirkonzahn (Z) and DC-Zirkon (DC) materials were fabricated. The specimens were randomly divided into four groups according to surface [control, sandblasting, Erbium: Yttrium Aluminum Garnet (Er:YAG) laser irradiation] and heat (firing) treatments. The surface roughness (Ra, μm) was measured using a surface profilometer. The relative amount of the transformed monoclinic (m) phase was analyzed by X-ray diffractometry (XRD). Biaxial flexural strength was tested using piston-on-three-ball technique. The data were analyzed with the Kruskal-Wallis H test with Bonferroni correction, and the Mann-Whitney U test was used for pairwise comparisons.

RESULTS

There were no significant differences in surface roughness among the treated groups (p > 0.05), whereas sandblasting showed higher surface roughness than other treatments for both materials. Scanning electron microscopic (SEM) analyses revealed changes in surface morphology after surface treatments, especially in laser groups with the formation of cracks, and in sandblasting groups with the formation of microretentive grooves. The greatest amount of the monoclinic phase was measured after sandblasting (8.13%) for Z and (19.8%) for DC. The monoclinic phase reverted to the tetragonal phase after heat treatment. Heat treatment groups showed significantly lower flexural strength than other treatments (p < 0.05).

CONCLUSIONS

Heat and surface treatments influenced the mechanical properties of zirconia ceramic. The biaxial flexural strength and crystalline phase of materials decreased after heat treatments.

Radiopacity of Esthetic Post Materials: Evaluation with Digital Analysis Technique

PURPOSE

To evaluate the radiopacity of five post materials using a digital image analysis method.

MATERIALS AND METHODS

Twelve specimens from each post type (two zirconia and three fiber based) of 2 mm in thickness were obtained using a diamond blade mounted on a cutting machine, and digital radiographs were taken along with aluminum step-wedge and dentin discs under standard exposure conditions. The mean gray-values of specimens were measured using a computer graphics program. Data were analyzed using one-way ANOVA followed by Holm-Sidak multicomparison test (p = 0.05).

RESULTS

The highest radiopacity was observed in custom zirconia (5.842 millimeters of equivalent Al [mmAl]), and the lowest value was detected with FRC-Postec (Ivoclar Vivadent) (1.716 mmAl). Significant differences were revealed between the radiopacity values among all groups (p < 0.05), except the Zr post materials (p = 0.56).

CONCLUSIONS

All tested post materials had higher radiopacity than dentin. Further studies will be required to clarify optimum radiopacity properties of the post materials to provide a precise clinical observation.

Effects of Different Surface Treatment Methods and MDP Monomer on Resin Cementation of Zirconia Ceramics an In Vitro Study

INTRODUCTION

Resin cements are generally preferred for cementation of zirconia ceramics. Resin bonding of zirconia ceramics cannot be done with the same methods of traditional ceramics because zirconia is a silica-free material. In recent years, many methods have been reported in the literature to provide the resin bonding of zirconia ceramics. The purpose of this in vitro study is to evaluate effects of different surface treatments and 10-metacryloxydecyl dihydrogen phosphate (MDP) monomer on shear bond strength between zirconia and resin cement.

METHODS

120 zirconia specimens were treated as follows: Group I: sandblasting, group II: sandblasting + tribochemical silica coating + silane, group III: sandblasting + Nd:YAG (neodymium: yttrium-aluminum-garnet) laser. One specimen from each group was evaluated under scanning electron microscope (SEM). Specimens in each group were bonded either with conventional resin cement Variolink II or with a MDP containing resin cement Panavia F2.0. Subgroups of bonded specimens were stored in distilled water (37°C) for 24 hours or 14 days. Following water storage shear bond strength test was performed at a crosshead speed of 1 mm/min in a universal test machine. Then statistical analyses were performed.

RESULTS

Highest shear bond strength values were observed in group II. No significant difference between group I and III was found when Panavia F2.0 resin cement was used. When Variolink II resin cement was used group III showed significantly higher bond strength than group I. In group I, Panavia F2.0 resin cement showed statistically higher shear bond strength than Variolink II resin cement. In group II no significant difference was found between resin cements. No significant difference was found between specimens stored in 37°C distilled water for 24 hours and 14 days. In group I surface irregularities with sharp edges and grooves were observed. In group II less roughened surface was observed with silica particles. In group III surface microcracks connecting each other were observed.

CONCLUSION

Tribochemical silica coating is an effective method for achieving an acceptable bond between zirconia and resin cement. Use of a MDP monomer containing resin cement increases the bond strength of sandblasted zirconia.

Effect of different temporary crown materials and surface roughening methods on the shear bond strengths of orthodontic brackets

OBJECTIVE

The aim of this study was to evaluate the effect of different temporary crown materials (TCMs) and surface roughening methods on the shear bond strength (SBS) of orthodontic brackets.

BACKGROUND DATA

TCMs are widely used during orthodontic treatment in teeth in need of prosthetic treatment, to prevent damage to the final restoration. However, there is no consensus considering the best method for roughening of the surface of TCMs.

METHODS

Five different TCMs [Dentalon Plus-(D), Basworth Trim II-(B), Voco Structure Premium-(V), 3M ESPE Protempt 4-(P), and Revotek LC-(R)] were used in this study. Different surface roughening methods (37% phosphoric acid, sandblasting, and Er:YAG laser) were employed in three subgroups (n=20). The SBS test was used to assess the durability of all groups. Scanning electron microscopy (SEM) analysis was performed on a representative specimen in each group.

RESULTS

The highest mean SBS value was observed in group V, followed by groups D and P, regardless of the surface treatment. The lowest SBS values were observed in group B. The laser-irradiated groups had higher SBS values than the sandblasted and acid-etched groups. Furthermore, a significant difference in SBS values was observed between the laser-irradiated group V and all other groups (p<0.005).

CONCLUSIONS

The effects of the chemical nature of TCMs on the SBS values appeared to be clinically negligible, whereas the type of surface treatments had a significant influence on bond strengths. Er:YAG laser irradiation caused a significant increase in bond strength between the TCMs and orthodontic brackets.

Evaluation of surface roughness and bond strength of quartz fiber posts after various pre-treatments

PURPOSE

Debonding at the post-adhesive interface is a major problem for quartz fiber posts. The objective of this study was to evaluate surface roughness and bond strength of quartz fiber posts after various surface treatments.

MATERIALS AND METHODS

Sixty-six quartz fiber posts were randomly divided into six experimental groups (n = 11) including group C, untreated (control); group SB, sandblasted; group SC, silica coated; group HF, hydrofluoric acid-etched; group N, Nd:YAG laser irradiated; group E, Er:YAG laser irradiated. Surface roughness of the posts was measured before and after pre-treatment. They were then bonded to resin cement and tensile bond strength was determined in a universal testing machine. Furthermore, two-way ANOVA and post hoc comparison tests (α = 0.05) were performed on all data.

RESULTS

The highest mean force value was observed in group SB and followed by group E. Tukey's HSD test showed that there was no statistical difference between group SB and group E (p = 0.673). The highest mean roughness value was observed in group SB and a significant difference was found between group SB and all other groups (p < 0.001). This study reveals that sandblasting and Er:YAG laser irradiation provided a significant increase in bond strength between quartz fiber posts and resin cement.

CONCLUSIONS

Sandblasting or Er:YAG laser-irradiation of the surface of the quartz fiber post before cementation is recommended for increasing retention.

Adhesion between glass fiber posts and resin cement: evaluation of bond strength after various pre-treatments

PURPOSE

To evaluate surface roughness and bond strength of glass fiber posts to a resin cement after various surface treatments.

MATERIALS AND METHODS

Sixty individually formed glass fiber posts with a diameter of 1.5 mm and a length of 20 mm were used for this study. They were randomly assigned to six groups of pre-treatment (n = 10/group): Group C, untreated (control); Group SB, sandblasted; Group SC, silica coated; Group HF, hydrofluoric acid-etched; Group N, Nd:YAG laser irradiated; Group E, Er:YAG laser irradiated. Surface roughness of the posts was measured before and after pre-treatment. The posts were then bonded to resin cement and tensile bond strengths were determined in a universal testing machine. For statistical analysis, two-way ANOVA and post-hoc comparison tests (α = 0.05) were performed.

RESULTS

The highest bond strength value was observed in group HF, followed by group SC. There was a statistically significant difference in bond strength between group C and groups HF, SC and E (p < 0.001, p = 0.002 and p = 0.041, respectively). Posts of group SB and group N showed the highest surface roughness.

CONCLUSIONS

The findings of the present study reveal that hydrofluoric acid-etching, silica coating and Er:YAG laser irradiation provided a significant increase in bond strength between glass fiber posts and resin cement.

Effect of four surface treatment methods on the shear bond strength of resin cement to zirconia ceramics- a comparative in vitro study

BACKGROUND

Improving the retention of zirconia-based ceramics is desirable in order to avoid the failure of crowns and fixed partial dentures .This can be achieved by creating micromechanical retention using surface treatments. Therefore, it becomes necessary to constantly compare and re-evaluate the influence of different surface treatment methods on the bond strength .

AIM

To evaluate the effect of four different surface treatments on shear bond strength between zirconia surface and resin cements.

SETTINGS AND DESIGN

Observational study.

MATERIALS AND METHODS

Twenty five zirconia plate samples were prepared based on ISO standards and were divided into five groups and each group was subjected to following five different surface treatments : no treatment, sandblasting with 110 μm alumina, sandblasting with 250 μm alumina, acid etching with 9.6% hydrofluoric acid and laser radiation on the surface. All the samples were surface disinfected and were embedded in blocks of autopolymerising resin to check shear bond strength on the universal testing machine. Statistical analysis used-data was analyzed using one-way ANOVA and a Post Hoc Bonferroni test.

RESULTS

Analysis of the data showed that the highest shear bond strength values were obtained with laser treatment (18.120 ± 0.8159 Mpa). The lowest values were obtained with control group (9.166 ± 0.569 Mpa). Laser treatment increased the shear bond strength values significantly (p<0.05).

CONCLUSION

Surface treatments increased the bond strength between zirconia and resin cement and carbon dioxide laser could be an effective surface treatment for increasing bond strength.

Bond strength of resin cement to CO2 and Er:YAG laser-treated zirconia ceramic

Objectives

It is difficult to achieve adhesion between resin cement and zirconia ceramics using routine surface preparation methods. The aim of this study was to evaluate the effects of CO₂ and Er:YAG laser treatment on the bond strength of resin cement to zirconia ceramics.

Materials and Methods

In this in-vitro study 45 zirconia disks (6 mm in diameter and 2 mm in thickness) were assigned to 3 groups (n = 15). In control group (CNT) no laser treatment was used. In groups COL and EYL, CO₂ and Er:YAG lasers were used for pretreatment of zirconia surface, respectively. Composite resin disks were cemented on zirconia disk using dual-curing resin cement. Shear bond strength tests were performed at a crosshead speed of 0.5 mm/min after 24 hr distilled water storage. Data were analyzed by one-way ANOVA and post hoc Tukey's HSD tests.

Results

The means and standard deviations of shear bond strength values in the EYL, COL and CNT groups were 8.65 ± 1.75, 12.12 ± 3.02, and 5.97 ± 1.14 MPa, respectively. Data showed that application of CO₂ and Er:YAG lasers resulted in a significant higher shear bond strength of resin cement to zirconia ceramics (p < 0.0001). The highest bond strength was recorded in the COL group (p < 0.0001). In the CNT group all the failures were adhesive. However, in the laser groups, 80% of the failures were of the adhesive type.

Conclusions

Pretreatment of zirconia ceramic via CO₂ and Er:YAG laser improves the bond strength of resin cement to zirconia ceramic, with higher bond strength values in the CO₂ laser treated samples.

Evaluation of the surface roughness of zirconia ceramics after different surface treatments

OBJECTIVE

This study aimed to investigate the effects of different mechanical surface treatments of pre-sintered zirconium oxide (ZrO2) in an attempt to improve its bonding potential.

MATERIALS AND METHODS

One hundred and twenty IPS e-max ZirCAD (Ivoclar Vivadent) pre-sintered zirconia blocks (7 mm diameter, 3 mm height) received six different surface treatments (n = 20): Group C was untreated (control); Group E was Er:YAG laser irradiated; Group N was Nd:YAG laser irradiated; Group SB was sandblasted, Group SN was sandblasted and Nd:YAG laser irradiated; and Group SE was sandblasted and Er:YAG laser irradiated. After the surface treatments, the average surface roughness (Ra, µm) of each specimen was determined with a profilometer, then all the specimens were sintered. The surface roughness values were analysed through one-way ANOVA and Tukey's test. Changes in the morphological characteristics of ZrO2 were examined through scanning electron microscopy (SEM).

RESULTS

Sintered sandblasted, Er:YAG laser treatment, sandblasted + Er:YAG laser and sandblasted + Nd:YAG laser irradiation resulted in a rougher surface than the other treatments.

CONCLUSION

Nd:YAG laser irradiation alone was not effective in altering the zirconia surface morphology.

Transmission of Er:YAG laser through different dental ceramics

OBJECTIVE

The aim of this study was to determine the erbium-doped yttrium aluminum garnet (Er:YAG) laser transmission ratio through different dental ceramics with different thicknesses.

BACKGROUND DATA

Laser debonding procedure of adhesively luted all-ceramic restorations is based on the transmission of laser energy through the ceramic and the ablation of resin cement, because of the transmitted laser energy.

METHODS

Five different dental ceramics were evaluated in this study: sintered zirconium-oxide core ceramic, monolithic zirconium-oxide ceramic, feldspathic ceramic, leucite-reinforced glass ceramic, and lithium disilicate-reinforced glass ceramic. Two ceramic discs with different thicknesses (0.5 and 1 mm) were fabricated for each group. Ceramic discs were placed between the sensor membrane of the laser power meter and the tip of the contact handpiece of an Er:YAG laser device with the aid of a custom- made acrylic holder. The transmission ratio of Er:YAG laser energy (500 mJ, 2 Hz, 1 W, 1000 μs) through different ceramic discs was measured with the power meter. Ten measurements were made for each group and the results were analyzed with two way analysis of variance (ANOVA) and Tukey honestly significant difference (HSD) tests.

RESULTS

The highest transmission ratio was determined for lithium disilicate-reinforced ceramic with 0.5 mm thickness (88%) and the lowest was determined for feldspathic ceramic with 1 mm thickness (44%). The differences among the different ceramics and between the different thicknesses were significant (p<0.05).

CONCLUSIONS

Ceramic type and thickness should be taken into consideration to adjust the laser irradiation parameters during laser debonding of adhesively luted all-ceramic restorations.