Surface modification of zirconia dental implants by laser texturing

Impact of ZrO2 Content on the Formation of Sr-Enriched Phosphates in Al2O3/ZrO2 Nanocomposites for Bone Tissue Engineering

This study investigates the profound impact of the ZrO2 inclusion volume on the characteristics of Al2O3/ZrO2 nanocomposites, particularly influencing the formation of calcium phosphates on the surface. This research, aimed at advancing tissue engineering, prepared nanocomposites with 5, 10, and 15 vol% ZrO2, subjecting them to chemical surface treatment for enhanced calcium phosphate deposition sites. Biomimetic coating with Sr-enriched simulated body fluid (SBF) further enhanced the bioactivity of nanocomposites. While the ZrO2 concentration heightened the oxygen availability on nanocomposite surfaces, the quantity of Sr-containing phosphate was comparatively less influenced than the formation of calcium phosphate phases. Notably, the coated nanocomposites exhibited a high cell viability and no toxicity, signifying their potential in bone tissue engineering. Overall, these findings contribute to the development of regenerative biomaterials, holding promise for enhancing bone regeneration therapies.

Influence of laser intensity and BaTiO3 content on the surface properties of 3YSZ

Zirconia-based dental implants are in direct contact with living tissues and any improvements in their bioactivity and adhesion to the tissues are highly welcome. In this study, different ratios of barium titanate (BT) were added to 3 mol% yttria-stabilized zirconia (3YSZ) through conventional sintering. The laser-texturing technique was also conducted to improve the biological performance of 3YSZ ceramics. The composition and the surface of the prepared composites were characterized by X-ray diffraction and scanning electron microscopy (SEM), respectively. The roughness and surface wettability of the composites were also measured. Furthermore, MC3T3-E1 pre-osteoblast cells were used for the in vitro experiments. Cell viability was evaluated using a commercial resazurin-based method. Morphology and cellular adhesion were observed using SEM. Based on the results, the laser texturing and the barium titanate content influenced the surface characteristics of the prepared composites. The laser-textured 3YSZ/7 mol% BT composites showed a lower water contact angle compared to the other samples, which indicated superior surface hydrophilicity. The cell viability and cell adhesion of 3YSZ/BT composites increased with the rise in the barium titanate content and laser power. An elongated cell morphology and apatite nucleation were also observed by the BT content. Overall, the laser-treated 3YSZ/5 and 7 mol% BT composites may be promising candidates in hard tissue repair due to their good cell response.

Materials and Methods for All-Ceramic Dental Restorations Using Computer-Aided Design (CAD) and Computer-Aided Manufacturing (CAM) Technologies-A Brief Review

The materials used in dentistry for the fabrication of all-ceramic restorations have undergone great and rapid developments over the last two decades. Among the most common ceramic materials in dentistry are those based on zirconium and lithium disilicate. Due to the properties of these materials, they are in great demand in the field of dental restoration production. Thus, dental restorations that will use those materials are commonly machined in CAD/CAM systems, which offer the possibility of manufacturing all-ceramic dental restorations in a very short period of time. This article reviews the modern materials in the field of all-ceramic dental restorations, their manufacturing processes, as well as what determines which ceramic materials are used for the production of CAD/CAM blanks and their production technology.

The Impact of Ultrashort Pulse Laser Structuring of Metals on In-Vitro Cell Adhesion of Keratinocytes

Besides the need for biomaterial surface modification to improve cellular attachment, laser-structuring is favorable for designing a new surface topography for external bone fixator pins or implants. The principle of this study was to observe how bioinspired (deer antler) laser-induced nano-microstructures influenced the adhesion and growth of skin cells. The goal was to create pins that allow the skin to attach to the biomaterial surface in a bacteria-proof manner. Therefore, typical fixator metals, steel, and titanium alloy were structured using ultrashort laser pulses, which resulted in periodical nano- and microstructures. Surface characteristics were investigated using a laser scanning microscope and static water contact angle measurements. In vitro studies with human HaCaT keratinocytes focused on cell adhesion, morphology, actin formation, and growth within 7 days. The study showed that surface functionalization influenced cell attachment, spreading, and proliferation. Micro-dimple clusters on polished bulk metals (DC20) will not hinder viability. Still, they will not promote the initial adhesion and spreading of HaCaTs. In contrast, additional nanostructuring with laser-induced periodic surface structures (LIPSS) promotes cell behavior. DC20 + LIPSS induced enhanced cell attachment with well-spread cell morphology. Thus, the bioinspired structures exhibited a benefit in initial cell adhesion. Laser surface functionalization opens up new possibilities for structuring, and is relevant to developing bioactive implants in regenerative medicine.

LASER as a tool for surface modification of dental biomaterials: A review

In recent years, the application of lasers for modifying the surface topography of dental biomaterials has received increased attention. This review paper aims to provide an overview of the current status on the utilization of lasers as a potential tool for surface modification of dental biomaterials such as implants, ceramics, and other materials used for restorative purposes. A literature search was done for articles related to the use of lasers for surface modification of dental biomaterials in English language published between October 2000 and March 2023 in Scopus, Pubmed and web of science, and relevant articles were reviewed. Lasers have been mainly used for surface modification of implant materials (71%), especially titanium and its alloys, to promote osseointegration. In recent years, laser texturing has also emerged as a promising technique to reduce bacterial adhesion on titanium implant surfaces. Currently, lasers are being widely used for surface modifications to improve osseointegration and reduce peri-implant inflammation of ceramic implants and to enhance the retention of ceramic restorations to the tooth. The studies considered in this review seem to suggest laser texturing to be more proficient than the conventional methods of surface modification. Lasers can alter the surface characteristics of dental biomaterials by creating innovative surface patterns without significantly affecting their bulk properties. With advances in laser technology and availability of newer wavelengths and modes, laser as a tool for surface modification of dental biomaterials is a promising field, with excellent potential for future research.

Surface modification of zirconia or lithium disilicate-reinforced glass ceramic by laser texturing to increase the adhesion of prosthetic surfaces to resin cements: an integrative review

OBJECTIVE

The purpose of this study was to perform an integrative review on laser texturing the inner surface of lithium disilicate-reinforced glass ceramic or zirconia to increase their bond strength to resin-matrix cements.

MATERIALS AND METHOD

A bibliographic review was performed on PubMed using the following search terms: "zirconia" OR "lithium disilicate" AND "laser" AND "surface" OR "roughness" AND "bond strength" AND "luting agent" OR "resin cement." Studies published in English language until March 15, 2023, were selected regarding the purpose of this study.

RESULTS

A total of fifty-six studies were identified althoug thirteen studies were selected. The findings revealed that zirconia surfaces were significantly modified after laser irradiation resulting in macro-scale aligned retentive regions with depth values ranging from 50 to 120 µm. Average roughness values of laser-textured zirconia by Er,Cr:YSGG laser (~ 0.83 µm) were quite similar when compared to grit-blasted zirconia surfaces (~ 0.9 µm) although roughness increased up to 2.4 µm depending on the laser type and parameters. Lithium disilicate-reinforced glass ceramics textured with Er:YAG revealed an average roughness of around 3.5 µm while surfaces textured using Nd:YAG laser revealed an average roughness of 2.69 µm; that was quite similar to the roughness values recorded for etched surfaces (2.64 µm). The shear bond strength (SBS) values of zirconia surfaces textured on Nd:YVO₄ laser irradiation were slightly higher (~ 33.5 MPa) than those recorded for grit-blasted zirconia surfaces (28 MPa). Laser-textured zirconia surfaces on CO₂ laser revealed higher SBS values (18.1 ±0.8 MPa) than those (9.1 ± 0.56 MPa) recorded for untreated zirconia surfaces. On lithium disilicate-reinforced glass ceramics, higher SBS values to resin-matrix cements were recorded for specimens textured with a combination of fractional CO₂ laser irradiation and HF acid etching (~ 22-24 MPa) when compared with grit-blasted specimens (12.2 MPa). Another study revealed SBS values at around 27.5 MPa for Er:YAG-textured lithium disilicate-reinforced glass ceramics to resin-matrix cements.

CONCLUSIONS

The laser irradiation at high power increases the roughness of the inner surface of lithium disilicate-reinforced glass ceramic or zirconia leading to an enhanced bond strength to resin-matrix cements. Thus, the laser type and irradiation parameters can be adjusted to enhance the macro- and micro-scale retention of zirconia and glass ceramic surfaces to resin-matrix cements.

CLINICAL RELEVANCE

Alternative methods for surface modification of lithium disilicate-reinforced glass ceramic and zirconia surfaces have been assessed to provide proper morphological aspects for enhanced adhesion to resin-matrix cements. An increase in the bond strength of glass ceramics or zirconia to resin-matrix cements can improve the long-term performance of cemented prosthetic structures in the oral cavity.

Do zirconia dental implants present better clinical results than titanium dental implants? A systematic review and meta-analysis

INTRODUCTION

The purpose of this systematic review is to determine if the zirconia implants present better clinical results when compared to titanium implants.

METHODS

Searches were conducted in 5 databases including, until March 2022, by 2 independent reviewers, according to the inclusion and exclusion criteria established in the study and according whit this question: Do zirconia dental implants present better clinical results than titanium dental implants?

RESULTS

3235 studies were initially found in the researched databases. 03 randomized clinical trials were included in this systematic review and meta-analysis. A total of 71 patients with 192 implants (87 titanium and 105 zirconia) were evaluated, showing an effectiveness of 87,4% and 78,1% respectively and there was no statistically significant difference in terms of survival rate in the meta-analysis (P = 0.70; I² = 0%). Still in the meta-analysis, there was no statistically significant difference between titanium and zirconia implants in relation to the pink esthetich score or bleeding on probing, however, a favorable difference was observed for titanium in relation to marginal bone loss (P = 0.001; I² = 0%). None of the studies evaluated had a low risk of bias.

CONCLUSION

Oral rehabilitation with zirconia implants showed no advantages over titanium in this systematic review. However, the small number of studies included and the uncertain risk of bias may raise doubts in this interpretation and the results should be analyzed with caution. New studies with greater methodological rigor, follow-up time and number of interventions should be performed in order to safely determine the indication for the use of zirconia implants.

Shear Bond Strength of Two Repair Systems to Zirconia Ceramic by Different Surface Treatments

Introduction: Intraoral repair has been suggested as a treatment option to repair the chipping or fracture of veneered zirconia; the success of the procedure is mainly determined by the bonding between zirconia and composite resin. The present study aimed to investigate and compare the shear bond strength (SBS) of two intraoral repair systems to zirconia ceramic treated with a laser or air-abrasion surface modification. Methods: Ninety tube-shaped samples (diameter of 10 mm and height of 4 mm) were divided into three main groups: Group I (zirconia 100%, n=30); Group II (veneer ceramic 100% n=30); Group III (zirconia with a veneer ceramic n=30). Each main group was subdivided into two subgroups (n=15): Subgroup A: samples repaired with Ceramic Repair N; Subgroup B: samples repaired with the Cimara Repair System. The subgroup samples were further subdivided based on the treated surface (n=5 samples): Control (no surface modification), Er,Cr:YSGG laser surface modification, and air-abrasion surface modification. The SBS was employed using a universal testing machine. The mode of failure was observed using a stereomicroscope. Results: Significant differences were observed in the mean SBS values between the different surface modifications (P˂0.05). Tukey's post hoc test showed that the air-abrasion surface modification of the veneer ceramic repaired with the Ceramic repair N system had the highest mean value (13.74 MPa) among the different groups, while no surface modification of zirconia repaired with the Cimara repair system had the lowest mean value (2.84 MPa). The control group (no surface modification) had the lowest mean value among all the treated groups. Conclusion: The SBS is surface modification-dependent, and higher SBS is obtained by air-abrasion than Er, Cr:YSGG laser surface modifications with the selected parameters. The Ceramic repair N system had significantly higher SBS for all surface-treated substrates than the Cimara repair system.

The influence of inorganic fillers on the light transmission through resin-matrix composites during the light-curing procedure: an integrative review

PURPOSE

The objective of this study was to perform an integrative review on the effect the inorganic fillers on the light transmission through the resin-matrix composites during the light-curing procedure.

METHOD

A bibliographic review was performed on PubMed using the following search terms: "fillers" OR "particle" AND "light curing" OR "polymerization" AND "light transmission" OR "light absorption" OR "light irradiance" OR "light attenuation" OR "light diffusion" AND "resin composite." The search involved articles published in English language in the last 10 years.

RESULTS

Selected studies reported a decrease in biaxial strength and hardness in traditional resin-matrix composites in function of the depth of polymerization. However, there were no significant differences in biaxial strength and hardness recorded along the polymerization depth of Bulk-Fill™ composites. Strength and hardness were enhanced by increasing the size and content of inorganic fillers although some studies revealed a progressive decrease in the degree of conversion on increasing silica particle size. The translucency of glass-ceramic spherical fillers promoted light diffusion mainly in critical situations such as in the case of deep proximal regions of resin-matrix composites.

CONCLUSIONS

The amount of light transmitted through the resin-matrix composites is influenced by the size, content, microstructure, and shape of the inorganic filler particles. The decrease of the degree of conversion affects negatively the physical and mechanical properties of the resin-matrix composites.

CLINICAL RELEVANCE

The type and content of inorganic fillers in the chemical composition of resin-matrix composites do affect their polymerization. As a consequence, the clinical performance of resin-matrix composites can be compromised leading to variable physical properties and degradation. The polymerization mode of resin-matrix composites can be improved according to the type of inorganic fillers in their chemical composition.

Evolution of the Geometric Structure of X39Cr13 Steel upon Thermochemical Treatment Specific to Medical-Grade Steels

This paper presents the results of the multi-aspect surface characterization of X39Cr13 steel samples subjected to technological processes specific to medical instrumentation, such as heat and thermochemical treatment, as well as sterilization, which are implemented in corrosion resistance measurements. The application of numerical methods of fractal analysis to averaged profiles obtained from SEM images resulted in double-log plots of structure function, from which the determination of the fractal parameters of interest was possible. The discussion was focused on the fractal dimension D, which governs relative height variations upon scaling in length, and corner frequency fc, which separates the scaling behavior of different-order structures (particles and their aggregates). The obtained results show that the heat treatment leaves behind a granular structure of steel (D2 = 2.43; fc2 = 1.97 nm), whereas corrosion tests reveal the appearance of pits (D1 = 2.17; fc1 = 0.303 nm; D2 = 2.59; fc2 = 4.76 nm). In turn, the ion nitriding improves the resistance of steel X39Cr13 to local corrosion. The fractal analysis also shows that the structure of the nitrided layer differs insignificantly from that of the untreated material, seen only as a shortening of the radius of the self-similarity area by a factor of two (fc2 = 1 nm).

Orthopedics-Related Applications of Ultrafast Laser and Its Recent Advances

The potential of ultrafast lasers (pico- to femtosecond) in orthopedics-related procedures has been studied extensively for clinical adoption. As compared to conventional laser systems with continuous wave or longer wave pulse, ultrafast lasers provide advantages such as higher precision and minimal collateral thermal damages. Translation to surgical applications in the clinic has been restrained by limitations of material removal rate and pulse average power, whereas the use in surface texturing of implants has become more refined to greatly improve bioactivation and osteointegration within bone matrices. With recent advances, we review the advantages and limitations of ultrafast lasers, specifically in orthopedic bone ablation as well as bone implant laser texturing, and consider the difficulties encountered within orthopedic surgical applications where ultrafast lasers could provide a benefit. We conclude by proposing our perspectives on applications where ultrafast lasers could be of advantage, specifically due to the non-thermal nature of ablation and control of cutting.