The influence of rotating fatigue on the bond strength of zirconia-composite interfaces

Load, unload and repeat: Understanding the mechanical characteristics of zirconia in dentistry

OBJECTIVES

Zirconia-based dental restorations and implants are gaining attention due to their bioactivity, corrosion resistance and mechanical stability. Further, surface modification of zirconia implants has been performed at the macro-, micro- and nanoscale to augment bioactivity. While zirconia's physical and chemical characteristics have been documented, its relation to mechanical performance still needs to be explored. This extensive review aims to address this knowledge gap.

METHODS

This review critically compares and contrasts the findings from articles published in the domain of 'mechanical stability of zirconia\ in dentistry' based on a literature survey (Web of Science, Medline/PubMed and Scopus databases) and a review of the relevant publications in international peer-reviewed journals. Reviewing the published data, the mechanical properties of zirconia, such as fracture resistance, stress/tension, flexural strength, fatigue, and wear are detailed and discussed to understand the biomechanical compatibility of zirconia with the mechanical performance of modified zirconia in dentistry also explored.

RESULTS

A comprehensive insight into dental zirconia's critical fundamental mechanical characteristics and performance is presented. Further, research challenges and future directions in this domain are recommended.

SIGNIFICANCE

This review extends existing knowledge of zirconia's biomechanical performance and it they can be modulated to design the next generation of zirconia dental restorations and implants to withstand long-term constant loading.

Optimizing Dental Bond Strength: Insights from Comprehensive Literature Review and Future Implications for Clinical Practice

This review examines the modifying factors affecting bond strength in various bonding scenarios, particularly their relevance to the longevity of dental restorations. Understanding these factors is crucial for improving clinical outcomes in dentistry. Data were gathered from the PubMed database, ResearchGate, and Google Scholar resources, covering studies from 1992 to 2022. The findings suggest that for dentin-resin bonds, minimizing smear layers and utilizing MMP inhibitors to prevent hybrid layer degradation are essential. In the case of resin-resin bonds, reversing blood contamination is possible, but preventing saliva contamination is more challenging, underscoring its critical importance during clinical procedures. Additionally, while pretreatment on ceramics has minimal impact on bond strength, the influence of specific colorings should be carefully considered in treatment planning. This comprehensive review highlights that although established practices recognize significant bond strength factors, ongoing research provides valuable insights to enhance the clinical experience for patients. Once confirmed through rigorous experimentation, these emerging findings should be swiftly integrated into dental practice to improve patient outcomes.

Adhesive removable partial denture attachments made from zirconia ceramic: A finite element analysis and in vitro study

STATEMENT OF PROBLEM

Whether adhesive zirconia ceramic removable partial denture attachments are feasible with current technology is unclear.

PURPOSE

The purpose of this finite element analysis and in vitro study was to evaluate the effect of the lever arm, tooth preparation, and aging on the loading of the tooth-zirconia attachment interface.

MATERIAL AND METHODS

Three different finite element analysis (FEA) models allowing for the loading of an adhesive attachment either directly or through a removable partial denture were used. Two models represented a human tooth with 2 different types of attachments, while the third model also included a removable partial denture. For the evaluation of bond strength, a combination of shear and hydrostatic stress was used. In addition, composite resin teeth were fabricated, and zirconia bars were bonded to them with varying tooth preparations and lever arm lengths. In 1 group the influence of aging was analyzed. Fracture load was determined by using a universal testing machine. Statistical analysis was based on the Shapiro-Wilk normality test, ANOVA, and Games-Howell test (α=.05).

RESULTS

The maximum stress of 65 MPa occurring in the bonding area was reduced to 37 MPa by adding a retainer to the attachment. Loading of the denture resulted in a maximum stress of 9 MPa. Mean fracture loads ranged from 33.6 N to 209.1 N. Preparing a flat bonding surface showed a nonsignificant increase (P=.197), whereas aging led to a nonsignificant decrease in fracture load (P=.075). A lever arm extended by 2 mm significantly reduced fracture load (P=.002). The addition of an occlusal-distal (OD) cavity led to a nonsignificant increase (P=.186), which became significant when a mesial-occlusal-distal (MOD) preparation was applied (P=.001).

CONCLUSIONS

Adhesive zirconia attachments should use a MOD cavity and have a cross section of at least 2.5×2.5 mm. The attachment should not extend more than 3 mm.

Bond Strength Stability of Self-adhesive Resin Cement to Etched Vitrified Yttria-stabilized Tetragonal Zirconia Polycrystal Ceramic After Thermomechanical Cycling

The purpose of this study was to evaluate the influence of thermomechanical cycling on the bond strength stability of self-adhesive resin cement to vitrified yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic. Y-TZP ceramic blocks were divided into four groups according to the surface treatments: AS, as sintered; SB, sandblasted with 50-μm Al2O3 particles; LG, vitrification with a low-fusing glaze and etching with 10% hydrofluoric acid; and HC, vitrification with a ceramic liner and etching with 10% hydrofluoric acid. Lithium disilicate ceramic blocks etched with 10% hydrofluoric acid for 20 seconds (EM) were also tested. Blocks of resin composite were cemented on the ceramic block surfaces using a self-adhesive resin cement. Half of the blocks from each group were cut into beams and submitted to microtensile bond strength (μTBS) testing after immersion in water at 37°C for 24 hours and the other half after mechanical (1,200,000 cycles, 98 N, 2.5 Hz) and thermal (10,000 cycles, 5-55°C, 30-second dwell time) cycling (TMC). Data were analyzed using one-way analysis of variance, Tukey's honest significant difference post hoc test, and Student t-test (α=0.05). After 24 hours, EM and LG presented similar and the highest μTBS, whereas AS showed the lowest μTBS (p<0.05). After TMC, EM presented the highest μTBS, followed by LG (p<0.05). Only EM and LG maintained the stability of μTBS after TMC (p>0.05). The bonding to Y-TZP ceramic vitrified with a low-fusing glaze withstood thermomechanical cycling.

Fatigue behavior and surface characterization of a Y-TZP after laboratory grinding and regeneration firing

This study evaluated the effect of grinding and regeneration firing on the flexural fatigue limit and surface characterization of Lava™ Y-TZP ceramic. Forty bar-shaped specimens with 20 × 4.0 × 1.2 mm constituted the as-sintered group (AS = control group), and 80 specimens with 20 × 4.0 × 1.5 mm were ground with cylindrical laboratory stone under water-cooling (WG) or in a dry condition (G) to reach 1.2 mm in thickness. Half of specimens were submitted to regeneration firing (1000 °C, 30 min), forming the groups AS/R, WG/R and G/R. Fatigue limit (500,000 cycles, 10 Hz) was determined by staircase method in a 4-point flexural fixture. Data were analyzed by 2-way ANOVA and Tukey HSD tests (α = 0.05). The surface topography (n = 3) and fracture area (n = 3) were evaluated by SEM. Samples were also analyzed by Rietveld refinement from X-ray diffraction data. ANOVA revealed significant differences (P < .001) for grinding protocol, regeneration firing and their interaction. In the groups not submitted to regeneration firing, the mean flexural fatigue limit of WG was higher (P < .05) than that of G and AS, with no statistical difference between each other (P > .05). After regeneration firing the inequality WG>AS>G (P < .05) was observed. The regeneration firing increased the fatigue limit of AS group and decreased those of G and WG groups (P < .05). Grinding protocols created evident grooves on zirconia surface. Failures initiated on tensile side of all specimens. The percentages (wt%) of monoclinic phase before cyclic loading were: AS (7.4), AS/R (6.5), G (2.8), G/R (0.0), WG (4.4), WG/R (0.0); and after cyclic loading: AS (8.6), AS/R (1.2), G (2.4), G/R (5.7), WG (6.3), WG/R (0.0). Wet grinding did not compromise the fatigue limit of zirconia, increasing its mechanical strength. Regeneration firing reduced the fatigue limit of ground samples, despite reducing the amount of monoclinic phase in all experimental conditions.

Investigation of the fatigue behavior of adhesive bonding of the lithium disilicate glass ceramic with three resin cements using rotating fatigue method

OBJECTIVE

To investigate the fatigue behavior of bonding interface of lithium disilicate ceramic with three different dual cure resin cements.

MATERIAL AND METHODS

Forty five bar shaped ceramic-resin-ceramic specimens were prepared and divided into 3 groups (n=15) according to the resin cement used (group1: Panavia F2.0, group 2: RelyX Ultimate, group 3: Duo-Link Universal). Three specimens of each group were tested using three point bending test and the fracture strength of the resin-ceramic bond was measured. Other specimens of each group were placed in the rotating fatigue testing machine at stresses equal to 30%, 40%, 50% and 60% of the fracture strength. The cyclic loading was continued until fracture or a maximum of 10,000 cycles. For the specimens which did not fail until 10,000 cycles, the cyclic loading was stopped and the remained fracture strength of the specimens was measured.

RESULTS

None of the specimens with cyclic loads of 30% and 40% of the fracture strength, have failed until 10,000 cycles. After 10,000 load cycles, the fracture strength of these specimens was significantly lower than their initial fracture strength. On the other hand, all specimens with cyclic stresses equal to 50% and 60% of the fracture strength have failed before 10,000 cycles so that the numbers of load cycles of RelyX specimens were significantly higher than those of Panavia ones and the numbers of cycles of Panavia specimens were significantly higher than those of Duo-Link specimens.

CONCLUSION

The fatigue resistance of the ceramic-resin interface is significantly lower than its bond strength. Furthermore, RelyX Ultimate showed the highest fatigue resistance and Duo-Link Universal exhibited the weakest fatigue resistance. Since dental restorations are under cyclic loading caused by mastication forces, the results of this research can be used to select fatigue resistant resin cements for bonding of ceramic restorations.