A new modified laser pretreatment for porcelain zirconia bonding

Bonding Effectiveness of Veneering Ceramic to Zirconia after Different Grit-Blasting Treatments

Objective: To determine the effect of grit-blasting before and after sintering on the surface roughness of zirconia and the micro-tensile bond strength of a pressable veneering ceramic to zirconia. Methods: Pre-sintered zirconia blocks (IPS e.max ZirCAD, Ivoclar) were divided into four test groups of three specimens each and a control group ('CTR'; no surface treatment). Pre-S-30, Pre-S-50, and Pre-S-110 were grit-blasted with 30-µm SiO2-coated Al2O3, 50-µm Al2O3 and 110-µm Al2O3 particles, respectively, before sintering. Post-S-30 was grit-blasted with 30-µm SiO2-coated Al2O3 after sintering. For each treatment, the surface roughness was measured (Ra, Perthometer M4P, Mahr Perthen). After sintering the zirconia blocks, a liner was applied and a pressable ceramic (IPS e.max ZirPress, Ivoclar) was heat-pressed. Sixteen microbars were obtained from each block and submitted to micro-tensile bond-strength (µTBS) testing. Data were analyzed with one-way ANOVA. Any correlation between Ra and µTBS was evaluated (Sperman test). Results: Grit-blasting before sintering with 110-µm Al2O3 (RaPre-S-110 = 3.4 ± 0.4 µm), 50-µm Al2O3 (RaPre-S-50 = 2.3 ± 0.5 µm), and 30-µm SiO2-coated Al2O3 (RaPre-S-30 = 1.2 ± 0.2 µm) resulted in significantly higher roughness than grit-blasting after sintering with 30-µm SiO2-coated Al2O3 (RaPost-S-30 = 0.5 ± 0.1 µm). The highest µTBS was measured when the sintered zirconia was grit-blasted with 30-μm SiO2-coated Al2O3 (µTBSPost-S-30 = 28.5 ± 12.6 MPa), which was significantly different from that of specimens that were grit-blasted before sintering (µTBSPre-S-30 = 21.8 ± 10.4; µTBSPre-S-50 = 24.1 ± 12.6; µTBSPre-S-110 = 26.4 ± 14.1) or were not grit-blasted (µTBSCTR = 20.2 ± 11.2). Conclusions: Grit-blasting zirconia before sintering enhanced the surface roughness proportionally to the particle size of the sand used. Grit-blasting with 30-µm SiO2-coated Al2O3 after sintering improved bonding of the veneering ceramic to zirconia. Clinical Significance: As grit-blasting with 30-µm SiO2-coated Al2O3 after sintering improved bonding of the veneering ceramic to zirconia, it may reduce veneering ceramic fractures/chipping.

The Effect of Various Lasers on the Bond Strength Between Orthodontic Brackets and Dental Ceramics: A Systematic Review and Meta-Analysis

Background/objective: This systematic review and meta-analysis aimed to assess how laser conditioning affected brackets bonded to dental ceramics' shear bond strength (SBS). Materials and methods: The study was conducted by searching Pubmed/Medline, Scopus, Embase, Web of Science, the Cochrane Library, and Google Scholar up to September 14, 2022. In addition, the reference lists of the relevant articles were checked manually. Articles that compared SBS of laser-treated feldspathic, lithium disilicate, or zirconia surfaces with other standard techniques for bonding metal or ceramic orthodontic brackets were considered. Using a random-effects model, data pooling was carried out as the weighted mean difference (WMD). Results: This study initially contained 1717 reports, and following review, 32 articles were deemed suitable for our meta-analysis. The pooling results showed that the treatments with lasers such as "Er:YAG" [WMD = -1.12 MPa; 95% confidence interval (CI): -1.93 to -0.31], "Er:YAG + Silane" (WMD = -3.08 MPa; 95% CI: -4.77 to -1.40), and "Nd: YAG + Silane" (WMD = -2.58 MPa; 95% CI: -3.76 to -1.40) had statistically significant lower adhesion values compared with controls. Contrarily, "Ti:Sapphire femtosecond" demonstrated significantly higher bonding values (WMD = 0.94 MPa; 95% CI: 0.29-1.60). In contrast, other interventions obtained no statistically significant difference in SBS. Conclusions: Most of the laser groups showed results comparable with those of conventional approaches. Although more research is necessary for definitive conclusions, laser treatment may be an effective option for treating the surfaces of ceramic materials.

Porphyromonas gingivalis can degrade dental zirconia

OBJECTIVES

The aim of present study was to examine the effect of Porphyromonas gingivalis (P.g.) adhesion on dental zirconia by characterizing the physical and chemical properties.

METHODS

Eighty polished-sintered zirconia discs were prepared and randomly distributed to 5 groups (n = 16): Zirconia cultured with - Group 1: broth containing P.g. for - 3 days; Group 2: 7 days; Group 3: broth (alone) for - 3 days; Group 4: 7 days; and Group 5: dry discs (negative control). After experimental period, broths were analyzed for pH and Zr release with inductively coupled plasma-optical emission spectroscopy (ICP-OES). The zirconia surface was evaluated by scanning electron microscope (SEM), atomic force microscopy (AFM), X-ray diffraction (XRD), water contact angle (WCA), and biaxial flexural strength (BFS).

RESULTS

The mean pH with zirconia adhesion to P.g. group was significantly higher than the broth control (p < 0.05). As per ICP-OES, Zr ion/particulate release with P.g. adhesion to zirconia were significantly higher than the controls (p < 0.05). Post-experimental incubation, no defects were found on zirconia surfaces; tetragonal phase remained constant with no transformation to monoclinic phase but lower peak intensities were identified in experimental groups. WCA of zirconia surfaces with P.g. bacteria for 3 days (12.04° ± 2.05°) and 7 days (15.09° ± 2.95°) were significantly higher than zirconia surfaces immersed with broth (only) for 3 days (7.17° ± 1.09°) and 7 days (7.55° ± 0.65°), respectively (p < 0.05). BFS values of zirconia with P.g. for 3 days (632.57 ± 119.96 MPa) and 7 days (656.17 ± 100.29 MPa) were significantly lower than zirconia incubated in broth alone (765.01 ± 20.12 MPa) conditions (p < 0.05).

SIGNIFICANCE

Under the conditions of present study, it can be concluded that P.g. adhesion on zirconia leads to structural alterations of dental zirconia further contributing to zirconia degradation.

Surface Texture Designs to Improve the Core-Veneer Bond Strength of Zirconia Restorations Using Digital Light Processing

Veneered zirconia ceramics are widely used for dental restorations. However, the relatively poor bonding strength between the ceramic core and veneer porcelain remains a common problem in clinical applications. To address this issue, this study focused on enhancing the core-veneer bond strength of zirconia restorations through the implementation of surface textures using digital light processing (DLP) technology. The light intensity was precisely tuned to optimize mechanical strength and minimize light scattering. Subsequently, hexagonal or square grids were printed on the surface of the zirconia ceramic core. Following veneering procedures, the shear bond strength (SBS) test was conducted using a universal testing machine. Dates were compared using analysis of variance (ANOVA) and the least significant difference (LSD) test. Furthermore, optical microscopy and scanning electron microscopy (SEM) were used to examine the failure modes and observe the cross-sectional structures, respectively. The results indicated that the presence of a 0.09 mm high hexagon grid led to a significant 21% increase in the SBS value. However, grids with heights of 0.2 and 0.3 mm showed less improvement, owing to the formation of large defects at the interface during the fusion process. This study demonstrated the potential of DLP technology in preparing zirconia ceramics with complex structures and high mechanical strength, thereby offering promising solutions for overcoming challenges associated with dental applications.

Effect of Surface Treatment of Zirconia on the Shear Bond Strength of Resin Cement: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to evaluate the effect of different surface treatments on the shear bond strength (SBS) values between zirconia and resin cement compared to untreated specimens. The effects of various surface treatments on the bond strength between zirconia and resin cement were investigated by searching relevant articles on PubMed, ScienceDirect, and Google Scholar databases. A total of 13 studies that met the inclusion and exclusion criteria and addressed the research question were selected for statistical analysis. The studies were evaluated for heterogeneity, and a meta-analysis was performed. In total, 13 in vitro studies were included in accordance with the eligibility criteria. All 13 studies consistently demonstrated that silica coating yielded the highest SBS, followed by sandblasting and laser treatments. The meta-analysis using a random-effect model indicated a significant intergroup comparison, except for a few studies. Among the three treatments examined, the silica coating of zirconia was identified as the most effective in enhancing the bond strength between zirconia and resin cement. Further controlled laboratory and clinical studies are necessary to validate these findings and explore additional factors that may influence the effects of these surface treatments.

In vitro comparative study between adhesion forces obtained on zirconia ceramic micromechanically treated with femtosecond laser (1027 nm), carbon dioxide laser (10,600 nm), and aluminum-oxide particles

Conventional surface roughening treatments used for silica-based ceramics in order to improve subsequent adhesion become unreliable for zirconia ceramics. Laser conditioning can be a good alternative. The purpose of this in vitro study was to compare conventional (macro) shear bond strength (SBS) values obtained between resin composite and zirconium oxide ceramic samples grouped according to different micromechanical treatments received, and examine differences in surface roughness. One-hundred and fifty disks of sintered zirconia were randomly divided into 5 groups and roughened as follows: (1) Group NOT, no surface treatment; (2) Group APA, abraded with 50-μm aluminum-oxide (Al2O3) particles; (3) Group TBS, abraded with 30-μm aluminum-oxide particles covered with silica; (4) Group CO2, irradiated with a CO2 laser which emitted in continuous wave mode at 3 W of power; and (5) Group FEM, irradiated with a pulsed femtosecond laser, with an incident energy of 10 μJ, a frequency of 1000 Hz, and a fluence of 1.3 kJ/cm2. All surfaces were treated with a MDP-containing adhesive/silane coupling agent mixture upon which were prepared and light polymerized composite resin cylinders. Shear bond strength was measured and samples were observed by scanning electron microscopy (SEM). Statistically significant differences (p < 0.05) were found among all groups, except between CO2 and FEM, which showed the highest adhesion values (15.12 ± 2.35 MPa and 16.03 ± 2.73 MPa). SEM revealed differences in surface patterns. CO2 laser irradiation can be an alternative to sandblasting, although it could also weaken the ceramic. Suitable surface patterns on zirconia ceramics can be obtained with ultrashort pulsed radiation emitted by a pulsed femtosecond laser.

The Influence of Alumina Airborne-Particle Abrasion with Various Sizes of Alumina Particles on the Phase Transformation and Fracture Resistance of Zirconia-Based Dental Ceramics

The surface of zirconia-based dental ceramic restorations require preparation prior to adhesive cementation. The purpose of this study was to assess the influence of airborne-particle abrasion with different sizes of alumina particles (50 μm, 110 μm, or 250 μm) on the mechanical strength of zirconia-based ceramics' frameworks and on the extent of phase transformations. A fracture resistance test was performed. The central surface of the frameworks was subjected to a load [N]. The identification and quantitative determination of the crystalline phase present in the zirconia specimens was assessed using X-ray diffraction. The Kruskal-Wallis one-way analysis of variance was used to establish significance (α = 0.05). The fracture resistance of zirconia-based frameworks significantly increases with an increase in the size of alumina particles used for air abrasion: 715.5 N for 250 μm alumina particles, 661.1 N for 110 μm, 608.7 N for 50 μm and the lowest for the untreated specimens (364.2 N). The X-ray diffraction analysis showed an increase in the monoclinic phase content after air abrasion: 50 μm alumina particles-26%, 110 μm-40%, 250 μm-56%, and no treatment-none. Air abrasion of the zirconia-based dental ceramics' surface with alumina particles increases the fracture resistance of zirconia copings and the monoclinic phase volume. This increase is strongly related to the alumina particle size.

Effect of different interfacial surface treatments on the shear bond strength of veneering ceramic and zirconia core

BACKGROUND

Several interfacial surface treatments of zirconia surfaces have been proposed to improve adhesion to ceramic veneering. However, information regarding the durability and effect of such treatments on the bond strength following such treatments is lacking.

AIM OF THE STUDY

This study aimed to evaluate the shear bond strength between veneering ceramic and zirconia core after different interfacial surface treatments.

MATERIALS AND METHODS

Fifty-two discs (8 mm in diameter and 3 mm in height) were fabricated from zirconia blanks using a microtome cutting machine. Zirconia discs were divided into four groups (n = 13). Group I was subjected to air-borne abrasion using (Al₂O₃), group II was coated by bioglass, group III was coated with ZirLiner, and group IV was subjected to wash firing (sprinkle technique). A cylinder (4 mm in diameter and 3 mm in height) of veneering ceramic was fired on top of the zirconia core. Shear bond strength (SBS) between zirconia core and veneering ceramic was evaluated by using a universal testing machine. The data was collected and statistically analysed using One-Way ANOVA followed by multiple pairwise comparisons using Bonferroni adjusted significance level. The failure modes were assessed using a stereomicroscope for each group.

RESULTS

The highest mean bond strength was recorded in group III (17.98 ± 2.51 MPa), followed by group II (15.10 ± 4.53 MPa), then group I 14.65 ± 2.97 MPa. The lowest mean bond strength was recorded in group IV (13.28 ± 3.55 MPa).

CONCLUSIONS

Surface treatments had an effect on the zirconia-veneer shear bond strength. Liner coating revealed the highest shear bond strength values, significantly higher in comparison to wash firing (sprinkle technique) .

Effect of Nonthermal Plasma on Shear Bond Strength of Translucent Zirconia in Layering Ceramic

Background

Today, various methods are used to increase the bond strength of zirconia in layering ceramics. This study evaluated the effects of nonthermal argon plasma on zirconia shear bond strength to layering porcelain. Materials and Method. In this experimental study, 42 square blocks of zirconia were prepared and randomly divided into three groups (n = 14) according to the applying surface treatment: (1) the control group (without any surface treatment), (2) the plasma-treated group with argon nonthermal plasma, and (3) the air abrasion group with 50 µm Al₂O₃ particles. All samples were layered with porcelain. One sample from each group was evaluated by electron microscopy (SEM) to examine the cross-sectional area of the zirconia-ceramic bond. The rest of the specimens were subjected to thermocycling with 5,000 baths to imitate the aging process in the mouth and then were tested for shear bond strength. The failure pattern of the samples was examined by stereomicroscope. Bond strength data were analyzed by one-way ANOVA test in three groups and Tamhane post hoc test in pairs. The significance level of p-value was considered 0.05.

Results

The shear bond strength of the plasma-treated group was significantly higher than the control group (p = 0.032) but the shear bond strength between the sandblast and the plasma-treated group was not significantly different (p = 0.656). The shear bond strength between the sandblast and the control group was also not significant (p = 0.202). Regarding the mode of failure, failures were mostly adhesive and then mixed. Examination of the samples under SEM showed that the bond area is the thickest in the sandblast group and also the surface roughness is the highest in the sandblast group and the lowest in the control group.

Conclusion

This study demonstrated that the use of nonthermal argon plasma treatment is an effective way to enhance the quality and quantity of shear bond strength between layering porcelain and zirconia.

Shear bond strength of porcelain to milled and stereolithography additively manufactured zirconia with and without surface treatment: An in vitro study

STATEMENT OF PROBLEM

Delamination of veneering ceramic is one of the most common challenges relating to veneered zirconia restorations. Additive manufacturing (AM) is a fast-expanding technology that has gained widespread acceptance in dentistry and is increasingly being used to produce dental restorations. However, information about bonding of porcelain to AM zirconia is lacking.

PURPOSE

The purpose of this in vitro study was to investigate the shear bond strength (SBS) of porcelain to milled and additively manufactured zirconia, and the effect of surface treatment on bond strength.

MATERIAL AND METHODS

A Ø12×5-mm disk was designed virtually to fabricate all specimens, which were divided into 2 groups according to the manufacturing technique: additively manufactured or milled zirconia. The effect of airborne-particle abrasion and a zirconia liner before porcelain application was investigated in both groups. Veneering porcelain was fired into an alumina ring mold on the zirconia surface. SBS was measured by using a universal testing machine at a crosshead speed of 1 mm/min before and after aging (n=10). SBS data were analyzed with 3-way ANOVA (α=.05) RESULTS: A significant difference was found between milled and AM zirconia. The SBS of porcelain to milled zirconia was significantly higher (1.38 MPa) than to AM zirconia (0.68 MPa) (P<.001). The surface treatment of zirconia had no significant effect on porcelain SBS in either group (P=.254), whereas thermocycling significantly reduced the SBS of porcelain to zirconia in both milled and AM groups (P=.001).

CONCLUSIONS

Porcelain bonding to milled zirconia was better than to AM zirconia. Pretreating the zirconia substrate before porcelain application did not improve the porcelain bond.

Evaluation of the Combination of CO2 Laser and Bifunctional Bonding Agents for Composite Resin Repairs After 1 Year of Aging

Objective: to evaluate the bond strength of repairs to composite resin restorations treated with CO₂ laser and bifunctional monomers after 1 year of aging. Background: Adequate bond strength between a composite restoration and resin repair agent can be achieved through mechanical and/or chemical treatment. However, the longevity of such repairs is unknown. Methods: Resin blocks (volume: 125 mm³) were created. Failure surfaces were either not treated or were treated before the repair with a universal adhesive, a silane bonding agent and/or CO₂ laser. The blocks were distributed into six groups (n = 6 per group): resin+resin group (RRG), universal adhesive+resin group (ARG), silane+universal adhesive group (SAG), laser+silane+universal adhesive group (LSAG), laser+universal adhesive group (LAG), and laser+silane group (LSG). After treatment, repairs were made with another resin composite. "Sticks" (1.0 mm² in area and 1.0 cm in length) were cut from the specimens in each group and immersed in distilled water at 37°C. Microtensile bond strength was evaluated after 1 year of aging. Bond strength values were compared using the Kruskal-Wallis test and Dunn's test. Results: Bond strength was significantly higher in the LSAG compared with the RRG, adhesive system, LSG, whereas statistically similar results were found for the SAG, LSAG, and LAG. Bond strength was lowest in the RRG. The LSAG and LAG presented predominantly cohesive fractures. Conclusions: The bond strength of composite resin repairs was satisfactory over time. Treatment with CO₂ laser contributed to the maintenance of bond strength during the 1-year storage period and bifunctional monomers present in the universal adhesive on the irradiated repair surface were of fundamental importance to the maintenance of bond strength values, as demonstrated by microtensile bond test and fracture pattern analysis.

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.

Effect of Helium Plasma Exposure on Wettability and Shear Bond Strength between the Zirconia Core and Feldspathic Veneering Ceramic: An In Vitro Study

Introduction. The present study aimed to evaluate the effect of helium plasma treatment on the wettability of zirconia surface and on the shear bond strength between the dental zirconia core and feldspathic veneering ceramic. Methods. 128 zirconia specimens were prepared, polished, and then divided into four groups: control, Zr, FC, and Zr/FC. In Zr and Zr/FC groups, the zirconia blocks were treated by helium plasma for 60 s. In FC and Zr/FC, the feldspathic ceramic powder received 60 s of plasma treatment. Then, the feldspathic powder was applied on the zirconia blocks. Half of the specimens in each group were sintered in a tube furnace, and the contact angle between the zirconia core and feldspathic ceramic was measured at different time intervals. The other half were sintered in a ceramic furnace and then subjected to thermocycling. The shear bond strength was measured using a universal testing machine. The failure mode was assessed using a stereomicroscope. Data were analyzed by one-way ANOVA test, and the statistical significance was considered less than 0.05. Results. There was no significant difference in the mean contact angle and the shear bond strength values of the experimental groups ( $P>0.05$ ). The mean contact angle decreased significantly in all groups over time ( $P<0.001$ ). The modes of failure were predominantly mixed in all groups. Conclusion. The helium plasma applied on either dental zirconia core or feldspathic ceramic powder could not improve the zirconia surface wettability and the shear bond strength between the two ceramics.

Effect of different zirconia surface pretreatments on the flexural strength of veneered Y-TZP ceramic before and after in vitro aging

PURPOSE

The investigation of zirconia core surface pretreatments on the flexural strength of bilayered zirconia ceramics before and after artificial accelerating aging.

METHODS

Ninety bar-shaped specimens were manufactured from Yttria Stabilized Tetragonal Zirconia Polycrystal (Y-TZP) and divided in three groups depending on zirconia surface pretreatment before veneering: layering with liner, pretreatment with silane-containing gas flame (SGF) with the Silano-Pen device and alumina air-abrasion. Half of the veneered specimens in each group (n=15) underwent artificial accelerating aging. A 4-point bending test was performed to determine flexural strength. Three specimens from each group were further analyzed using Scanning Electron Microscopy (SEM), X-ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) before veneering and after fracture (aged and non-aged subgroups).

RESULTS

Alumina air-abrasion was correlated to increased phase transformation from tetragonal to monoclinic zirconia phase. Qualitative analysis revealed that with the majority of the specimens pretreated with the silane-containing gas flame, areas of the veneering material remained firmly attached to the zirconia core after flexural strength testing. There was no statistically significant difference on the flexural strength among the groups before or after aging. Artificial accelerating aging resulted in statistically significant higher flexural strength of the specimens after aging.

CONCLUSION

SGF pretreatment can be an acceptable and feasible alternative method before the veneering of Y-TZP zirconia as it presented slightly higher bond strength compared with alumina air-abrasion which was associated with higher tetragonal to monoclinic (t→m) phase transformation. Accelerating aging leads to an increase of the mechanical properties under in vitro conditions.

Effect of different surface treatments on surface roughness, phase transformation, and biaxial flexural strength of dental zirconia

Background. Interfacial failures at the cement‒restoration interface highlights the importance of effective surface treatment with no adverse effect on the zirconia’s mechanical properties. This study aimed to determine the effect of different surface treatments on dental graded zirconia’s surface roughness and certain mechanical properties.

Methods. Forty sintered zirconia specimens were randomly divided into four groups (n=10): control (no surface treatment), sandblasting (SA), grinding with diamond bur (GB), and Er,Cr:YSGG laser (LS). Following surface treatment, the surface roughness and surface topography of the specimens were examined. X-ray diffraction (XRD) was conducted. In addition, the biaxial flexural strengths of specimens were evaluated. The data were analyzed using one-way analysis of variance (ANOVA) and post hoc Tukey tests; the Pearson correlation coefficient was calculated between either volumetric percentage of monoclinic phase or roughness and flexural strength of specimens (α=0.05).

Results. The GB group exhibited significantly greater surface roughness compared to the other groups (P < 0.005). The LS and control groups exhibited a significantly lower volumetric percentage of the monoclinic phase (P < 0.001) than the GB and SA treatments. The SA group exhibited significantly higher flexural strength than the control (P = 0.02) and GB groups (P < 0.01). Furthermore, the Weibull analysis for the LS showed higher reliability for the flexural strength than other treatments.

Conclusion. Er,Cr:YSGG laser treatment, with the lowest extent of phase transformation and reliable flexural strength, can be a promising choice for surface treatment of zirconia.

Surface characterization of different surface treatments associations with plasma and bonding analysis of Y-TZP and the veneering ceramic

OBJECTIVES

To characterize the surface of zirconia (Y-TZP) submitted to different surface treatments (with and without plasma associations) and to evaluate the shear bond strength (SBS) between veneering ceramic (VC) and Y-TZP after different aging methods.

METHODS

301 Y-TZP specimens were fabricated and distributed into 7 groups: C (control): no treatment; Al: airborne abrasion with 27 μm Al₂O₃ particle; L: liner; P: plasma; Al + L: airborne + liner; Al + P: airborne + plasma; P + L: plasma + liner. The Y-TZP surface was characterized by SEM, EDS, AFM, surface profilometry, surface-free energy (SFE), and XRD. SBS between Y-TZP and VC was verified after three aging protocols: initial, after hydrothermal aging (autoclave for 5 h), or thermal fatigue (30,000 baths - 5-55 °C). One- (profilometry, SFE) and two-way ANOVA (SBS), and Tukey's HSD test were used.

RESULTS

For the plasma groups, a full globular surface coverage was observed (SEM, AFM). Si was found for Al, L, Al + L, and P + L. Roughness was lower for C, P, and Al + P. For SFE, the highest values were found when the liner was applied (>74.59 nm/Nm). The highest monoclinic content was observed for Al + L (6.96%) and Al + P (5.86%). For the initial period, Al and P + L presented the lowest SBS values (<5.85 MPa; P > 0.331). The highest SBS values were found for L, P, and P + L (hydrothermal aging) and for P, L, Al + L, and Al + P (thermal fatigue).

SIGNIFICANCE

Changes in Y-TZP topography and the SBS with the VC were found, according to treatments performed. Plasma treatment improved SBS and did not cause phase transformation.

Surface Modifications for Zirconia Dental Implants: A Review

Zirconia-based bioceramic is a potential material for dental implants developed and introduced in dentistry 30 years ago. However, some limitations still exist for zirconia implants caused by several factors, such as manufacturing difficulties, low-temperature degradation (LTD), long-term stability, and clinical experience. Several studies validated that some subtle changes on the zirconia surface might significantly impact its mechanical properties and osseointegration. Thus, attention was paid to the effect of surface modification of zirconia implants. This review generally summarizes the surface modifications of zirconia implants to date classified as physical treatment, chemical treatment, and surface coating, aiming to give an overall perspective based on the current situation. In conclusion, surface modification is an effective and essential method for zirconia implant application. However, before clinical use, we need more knowledge about these modification methods.

A simple solution to recycle and reuse dental CAD/CAM zirconia block from its waste residuals

Purpose To seek a simple solution that can recycle and regenerate dental CAD/CAM zirconia green blanks from its waste residuals.Methods Waste residuals (3M® Lava™ Plus HT) were pulverized after dry milling and cutting, and subsequently sieved before pickling in a 0.5 M nitric acid. These powders were then dry-pressed and pre-sintered into blocks at seven different temperatures in the range 800-1100 °C. New zirconia blocks flagged with the same batch numbers were used as control. These blocks were cut into bars before subjected them to manufacturer-recommended sintering at 1450 °C. Crystalline phases (by XRD), elemental compositions (by EDX), surface morphologies (by SEM), machinability, linear shrinkage rate, relative density, and Knoop microhardness were evaluated before and after sintering, and four-point flexural strengths were also evaluated for the sintered zirconia bars.Results Only tetragonal phases were found in both pre- and fully-sintered recycled zirconia blocks. SEM results showed that pre-sintered samples at 950 °C had smooth and flat surfaces with evenly distributed particles. Recycled and control zirconia blocks had similar elemental compositions. Results from machined surface, linear shrinkage rate, relative density, and Knoop microhardness established that 950 °C and 1000 °C were suitable pre-sintering temperatures for recycling zirconia. Pre-sintered recycled zirconia had no significant differences in flexural strengths, however, samples pre-sintered at 1000 °C exhibited the closest value (897 MPa) compared to that of the control (904 MPa).Conclusions Dental CAD/CAM zirconia can be recycled and reused from its waste residuals by adopting a simple method that requires a pre-sintering at 950 or 1000 °C.

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.

Impact of Sandblasting on Morphology, Structure and Conductivity of Zirconia Dental Ceramics Material

Over the last decade, zirconia (ZrO₂)-based ceramic materials have become more applicable to modern dental medicine due to the sustained development of diverse computer-aided design/computer-aided manufacturing (CAD/CAM) systems. However, before the cementation and clinical application, the freshly prepared zirconia material (e.g., crowns) has to be processed by sandblasting in the dental laboratory. In this work, the impact of the sandblasting on the zirconia is monitored as changes in morphology (i.e., grains and cracks), and the presence of impurities might result in a poor adhesive bonding with cement. The sandblasting is conducted by using Al₂O₃ powder (25, 50, 110 and 125 µm) under various amounts of air-abrasion pressure (0.1, 0.2, 0.4 and 0.6 MPa). There has been much interest in both the determination of the impact of the sandblasting on the zirconia phase transformations and conductivity. Morphology changes are observed by using Scanning Electron Microscope (SEM), the conductivity is measured by Impedance Spectroscopy (IS), and the phase transformation is observed by using Powder X-Ray Diffraction (PXRD). The results imply that even the application of the lowest amount of air-abrasion pressure and the smallest Al₂O₃ powder size yields a morphology change, a phase transformation and a material contamination.

Effects of laser modalities on shear bond strengths of composite superstructure to zirconia and PEEK infrastructures: an in vitro study

In the last decade, demand for metal-free esthetic restorations has grown considerably due to the development of materials to fulfill the need for an esthetic prosthesis. We examined the effects of erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser applications on the shear bond strength (SBS) of nanohybrid composite superstructures to zirconia and PEEK infrastructures. Zirconia and PEEK specimens were prepared with CAD/CAM technology in accordance with ISO 11405 standards. The disc-shaped samples were randomly separated into four groups (n = 8) according to applied laser type: no treatment and Er:YAG, Nd:YAG, and KTP lasers. Nanohybrid composite resin was applied as a veneering material to each infrastructure. After surface treatment of infrastructures by the lasers, the SBS test was carried out to determine the bonding of infrastructures, which were also examined with a stereomicroscope. The SBS were significantly higher in the PEEK specimens treated with the studied lasers. Nd:YAG laser was the most effective method, followed by Er:YAG laser and KTP laser. The lowest SBS value was obtained in the no-treatment group. Stereomicroscopically, the studied lasers produced different irregularities on the infrastructures. PEEK as a framework provides meaningfully higher bonding strength to composite resins compared to zirconia. Nd:YAG, Er:YAG, and KTP, in descending order, are efficacious in increasing the attachment of studied structures.

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.

The application of novel mussel-inspired compounds in dentistry

OBJECTIVE

To give a current review of the mechanism of mussel adhesion, the application of mussel-inspired compounds in dentistry and the challenges associated with clinical application.

METHODS

Inspired by the wet adhesion property of 3,4-dihydroxyphenol-l-alanine (Dopa) in mussel plaques, various chemical compounds have been synthesized to mimic the mussel as an adhesion model for medical applications. Similar to mussels in the marine environment, dental materials in the oral environment have to endure long-term water hydrolysis, mechanical stress and other chemical challenges. These challenges have influenced an increasing number of studies that are exploring the translation of mussel-inspired adhesion to clinical applications. Therefore, this review discusses the mussel adhesion chemistry and its related application in dentistry.

RESULTS

Mussel-inspired compounds have achieved relatively acceptable performances in various dental fields, including surface coating, metal ions chelation, dentin bonding and mucosal adhesion. However, two practical problems remain to be comprehensively addressed, namely the protection of catechol groups from oxidation, and the feasibility for clinical application.

SIGNIFICANCE

The mussel's wet adhesion ability has attracted much research interest in the dental field because of its properties of moisture-resistant adhesion and surface coating. Despite the emergence of several mussel-inspired compounds in recent years, a comprehensive and timely review of their applications in dentistry is lacking. Therefore, the current review hopes to provide valuable information around the application of mussel-inspired compounds in dentistry with their pros and cons discussed.

Surface Modified Techniques and Emerging Functional Coating of Dental Implants

Dental implants are widely used in the field of oral restoration, but there are still problems leading to implant failures in clinical application, such as failed osseointegration, marginal bone resorption, and peri-implantitis, which restrict the success rate of dental implants and patient satisfaction. Poor osseointegration and bacterial infection are the most essential reasons resulting in implant failure. To improve the clinical outcomes of implants, many scholars devoted to modifying the surface of implants, especially to preparing different physical and chemical modifications to improve the osseointegration between alveolar bone and implant surface. Besides, the bioactive-coatings to promote the adhesion and colonization of ossteointegration-related proteins and cells also aim to improve the osseointegration. Meanwhile, improving the anti-bacterial performance of the implant surface can obstruct the adhesion and activity of bacteria, avoiding the occurrence of inflammation related to implants. Therefore, this review comprehensively investigates and summarizes the modifying or coating methods of implant surfaces, and analyzes the ossteointegration ability and anti-bacterial characteristics of emerging functional coatings in published references.

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

This study aimed to investigate the effects of femtosecond laser (Fs) and/or air-abrasion protocols on surface roughness (Ra) of zirconia and resin bond strength. Eighty zirconia samples were randomly divided into eight subgroups according to surface treatment protocols: Control (C), Air-abrasion before sintering (ABS), Air-abrasion after sintering (AAS), Air-abrasion before and after sintering (ABS + AAS), Fs laser before sintering (FBS), Fs laser before sintering + air-abrasion after sintering (FBS + AAS), Fs laser after sintering (FAS), and Fs laser after sintering + air-abrasion after sintering (FAS + AAS). Measurements of Ra values were obtained using a surface profilometer. Surface morphological properties were evaluated with scanning electron microscopy (SEM), and crystallographic changes were examined by X-Ray diffractometry (XRD). Self-adhesive resin cement was bonded to zirconia samples, and shear bond strength (SBS) tests were performed. The data were statistically analyzed by one-way ANOVA, followed by Tamhane tests. The control group displayed the lowest Ra and SBS values among all groups. The highest Ra and SBS values were found in the FBS and FBS + AAS groups. Air-abrasion applied before sintering significantly increased the Ra of specimens. FAS, FAS + AAS, and ABS + AAS groups exhibited higher SBS values than AAS and ABS (p < .05). Air-abrasion applied after Fs laser did not produce any significant change in the Ra and SBS compared to Fs laser alone (p > .05). Femtosecond laser application may be a promising method to enhance the surface roughness of zirconia and improve resin bond strength. Air-abrasion at pre- and post-sintered stages may also be a viable surface treatment option.

Effect of sandblasting on the surface roughness and residual stress of 3Y-TZP (zirconia)

A defined surface roughness is important for the adhesive bonding of veneering ceramic to zirconia frameworks. Thus, we investigated the effects that sandblasting has upon the surface roughness and residual stress of zirconia. So as to achieve well-defined blasting parameters and also generate highly reproducible results; a custom-made, automated sandblasting machine was constructed (based on a 3D-printer construction kit). Thirty-two samples (measuring 30 mm × 35 mm × 0.2 mm) were cut from densely sintered 3Y-TZP blanks and then ground with a 45 µm grinding disc. After undergoing regeneration firing, the samples were sandblasted with varying working parameters: blasting angle (45°, 60° and 90°); blasting pressure (2 bar, 4 bar and 6 bar); and working distance (0.5 cm, 1.0 cm and 1.5 cm). The sandblasting path was chosen so as to create samples with an even surface roughness. Changes in blasting pressure resulted in the greatest changes in the surface roughness, the highest surface roughness values were achieved with sandblastings perpendicular to the sample surface. Furthermore, a correlation was found between the mean surface roughness and the residual stress.

An introduction of biological performance of zirconia with different surface characteristics: A review

Zirconia (ZrO₂) ceramic is widely used in dentistry as a clinical dental biomaterial. In this review, we are focusing on and summarizing the biological performance of zirconia under different surface characteristics. We have included an initial tissue cell attachment study on zirconia and bacterial adhesion on zirconia. Our results suggest that surface modifications applied on zirconia may change the interfacial surface characteristics e.g. surface roughness, surface free energy, and chemistry of zirconia. The modifications also result in advanced biological performance of zirconia, including enhanced tissue cell attachment and reduction of bacterial adhesion. The recent laboratory research has provided many interesting modification methods and showed clinically interesting and promising outcomes. A few of the outcomes are validated and have been applied in clinical dentistry.

Prolonged UV-C Irradiation is a Double-Edged Sword on the Zirconia Surface

Zirconia has become an excellent choice of dental implants because of its excellent mechanical strength, aesthetic, and biocompatibility. Although some studies have shown ultraviolet (UV) irradiation is effective to photofunctionalize dental zirconia that can improve osteoblastic function, the scattered information has not identified the most effective exposure time and wavelength of UV. Herein, this study has investigated the effects of UV irradiation on zirconia after UV-A (365 nm) or UV-C (243 nm) photofunctionalization for different times (15 min, 3 and 24 h). After irradiation, the zirconia surface was analyzed by color spectrophotometry, scanned electron microscopy (SEM), energy-dispersive X-ray spectrometry, water contact angle (WCA) with goniometer, and X-ray diffraction. Osteoblastic (MC3T3-E1) cells were cultured on zirconia discs and evaluated with a CCK-8 test kit for cell proliferation (3 h and 1 day) and with alkaline phosphatase (ALP) activity (14 days). Significant color change (ΔE) was observed by irradiating with UV-C for 15 min (1.99), 3 h (1.92), and 24 h (3.35), whereas only minute changes were observed with UV-A (respectively, ΔE: 0.18, 0.14, 0.57). No surface textural changes were observed nor a monoclinic phase was detected on both the UV-A and UV-C irradiated samples. UV-C significantly decreased the C/Zr ratios and WCA, with irradiating for 24 h presenting the lowest values, and it was the only condition to give significantly higher ALP activity at 14 days (p < 0.05) and CCK-8 values for 1 day culture (p < 0.05). It is concluded that UV-C (but not UV-A) irradiation can significantly change the aesthetic in color, and only prolonged 24 h UV-C irradiation can enhance MC3T3-E1 cell adhesion on zirconia by photofunctionalization.

Glass coatings to enhance the interfacial bond strength between veneering ceramic and zirconia

The purpose of this study was to investigate the tensile bond strength (TBS) and shear bond strength (SBS) between a zirconia core and fluoroapatite-pressed ceramic after the application of glass 46SP6 and AP40 via the ISO-17095:2013 methodology. Sintered zirconia beams (n = 120) were divided into four groups: (a) control: no treatment; (b) ZirL: IPS-E max ceram ZirLiner coating; (c) glass AP40 coating; and (d) glass 46SP6 coating. A fluoroapatite ceramic (IPS e.max Zir Press, Ivoclar Vivadent) beam was injected perpendicularly on top of each zirconia (Zenostar, Wieland Dental) beam forming a cross-bonded specimen. All groups were sub-divided into two for tensile and shear bond strength tests using a universal testing machine. Data were analyzed using the Kruskal-Wallis, Pearson Chi²_, and Mann-Whitney U test (α = 0.05). The failure modes were measured using a stereomicroscope for each group. Scanning electron and atomic force microscopy were also employed. Zirconia surface modification with glass AP40 showed higher TBS values followed by the ZirL group with statistical differences (p < 0.05). SBS values showed no statistical differences between the groups. AFM analysis showed higher roughness values (Ra) in the 46SP6 and AP40 groups (p < 0.05). Glass coating AP40 exhibited promising bond strength results between zirconia and fluorapatite veneering ceramic, making it better for chemical and mechanical interlocking which may improve bilayered restorations longevity.

Effect of repeated laser surface treatments on shear bond strength between zirconia and veneering ceramic

STATEMENT OF PROBLEM

Delamination failure may occur between ceramic frameworks and veneering ceramics, shortening the lifetime of fixed dental prostheses in load-bearing areas.

PURPOSE

The purpose of this in vitro study was to compare the effect of different repeating CO₂ laser treatment methods and conventional approaches on the shear bond strength of zirconia frameworks and veneering ceramics.

MATERIAL AND METHODS

Zirconia disks (N=110) were prepared and divided into 5 groups: milling without surface treatment (group M), airborne-particle abrasion (group APA), single laser treatment (group LX1), 2 laser treatments (group LX2), and 3 laser treatments (group LX3). The specimens in the first 2 groups were treated before the framework was coated using the spraying technique. Specimens in the remaining groups were coated with veneering ceramic using the spraying process, and then subjected to laser treatment. Surface roughness and topography, interface properties, phase transformation, shear bond strength, and fracture modes were investigated. Outcomes were analyzed using a profilometer, a scanning electron microscope (SEM) equipped with energy dispersive spectroscopy (EDS), X-ray diffractometry (XRD), a stereomicroscope, and a universal testing machine for mechanical testing.

RESULTS

The XRD showed that phase transformation from tetragonal to monoclinic occurred after airborne-particle abrasion. This phenomenon was not observed in laser-treated specimens. Groups LX2 and LX3 had the highest surface roughness values, 1.18 ±0.23 μm and 1.21 ±0.22 μm, among all groups, and group LX3 had the highest shear bond strength values for unaged and aged conditions, 32.08 ±2.45 MPa and 31.43 ±2.07 MPa. The mixed-fracture mode was the most common type of fracture observed.

CONCLUSIONS

The results indicated that the shear bond strength between the zirconia framework and veneering ceramic was higher after laser surface treatments than after milling alone or after airborne-particle abrasion. Laser treatment methods, particularly LX2 and LX3, could be considered reliable approaches for zirconia surface treatment.

Novel laser textured surface designs for improved zirconia implants performance

The development of new surface designs to enhance the integration process between surgically placed implants and biological tissues remains a challenge for the scientific community. In this way and trying to overcome this issue, in this work, laser technology was explored to produce novel textures on the surface of green zirconia compacts produced by cold pressing technique. Two strategies regarding line design (8 and 16 lines design) and different laser parameters (laser power and number of laser passages) were explored to assess their influence on geometry and depth of created textures. The produced textures were evaluated with Scanning Electron Microscopy (SEM) and it was observed that well-defined textured surfaces with regular geometric features (cavities or pillars) were obtained by laser combining different strategies lines design and parameters. The potential of proposed textures was also evaluated regarding surface wettability, friction performance (static and dynamic coefficient of friction evolution) against bone, aging resistance and flexural strength. Results demonstrated that all the produced textures display a super hydrophilic or hydrophilic behavior. Regarding the friction behavior, it was experimentally observed a high initial static coefficient of friction (COF) for all produced textures. Concerning the aging resistance, all the textured surfaces revealed a low monoclinic content, less than 25% after 5 h of hydrothermal aging. The flexural strength results showed that the mechanical resistance of zirconia was not significantly compromised with the laser action. Based on the obtained results, it is possible to prove that the processing route used for manufacturing the new and different surface designs (cold pressing technique followed by laser texturing) showed to be particularly effective for the production of zirconia implants with customized surface designs according to the properties required in a specific application. These new surface designs besides to enhance the surface wettability and also to improve the fixation at the initial moment of the implantation, do not significantly compromise the resistance to aging and the mechanical performance of zirconia. Hence, a positive impact on the long-term performance of the zirconia implants may be expected with the proposed novel laser textured surface designs.

Shear Bond Strength Between Zirconia and Veneer Ceramic: Effect of Thermocycling and Laser Treatment

Objective: The purpose of this study is to investigate the effect of various presintering and sintered surface treatments and thermocycling on the bond strength between zirconia and veneer ceramics. Background data: Bond stability between zirconia and veneer ceramic is a major concern, and only limited evidence about its longevity is currently available. Moreover, no study has yet evaluated the influence of thermocycling on the bond strength of veneer ceramic to zirconia after Er,Cr:YSGG laser irradiation at different pulse durations and sandblasting. Materials and methods: In this study, 220 nonsintered zirconia specimens were prepared with CAD/CAM and randomly divided into 2 groups; half of the specimens in each group were stored in water for 1 week, and the other half were thermocycled (5000 cycles) between baths of 5°C and 55°C. Specimens were then divided into five subgroups based on the following surface treatments: control (untreated surface), sandblasting (120 μm Al₂O₃), and Er,Cr: YSGG laser irradiations (3 W-8 Hz, 3 W-15 Hz, and 3 W-20 Hz, MGG 6 laser tip, for 20 sec, distance of 10 mm, water/airflow of 55% and 65%). Morphological assessment was done using atomic force microscopy and scanning electron microscopy, and phase transformation was assessed by X-ray diffractometry. All specimens were then veneered with veneering ceramic, and bond strength test using a universal testing device at a 1 mm/min crosshead speed. Data were evaluated by Kruskal-Wallis variance analysis and the Mann-Whitney U test. Results: There was no significant difference in the bonding strength values among the (p > 0.05). Thermocycling reduced the bond strength, but it was not significant (p > 0.05), except for the presintering 20 Hz group (p < 0.02). Conclusions: Application of thermocycling to sintered zirconia specimens may be detrimental to the shear bond strength of zirconia ceramics. Treating the zirconia surface after sintering is not recommended, due to the decrease in bond strength.

Comparative Effectiveness of Multiple Laser Scanning and Conventional Techniques on Zirconia Shear Bond Strength

This study aimed to compare the impact of different laser scanning with that of conventional methods on zirconia surface treatment through evaluation of shear bond strength (SBS) values. One hundred and thirty-two sintered zirconia cubic-samples were prepared and randomly divided into six study groups: milling control (without surface treatment); grinding; sandblasting; and three-times, four-times, and five-times laser scanning groups. The treatment process for the first three groups was performed before the zirconia coating, while the last three groups were treated after zirconia coating with veneer slurry through a spraying technique. In the current study, the surface roughness Ra, contact angle measurement, phase transformation, topography and interfaces, SBS in unaged and aged conditions, and fracture mode patterns of zirconia cores were investigated. The results were analyzed using laser confocal scanning microscopy, drop analyzer, X-ray diffractometry (XRD), scanning electron microscope (SEM) equipped with energy dispersive spectroscopy (EDS), universal testing machine and stereomicroscope. The results indicated that three-times laser scanned specimens presented higher Ra values than the other studied groups. The minimum contact angle value was detected in the mentioned group, while the control group presented the highest value. The XRD showed phase transformation from tetragonal to monoclinic t–m following grinding and sandblasting. However, the laser scanned specimens and the control group preserved the structural integrity of the zirconia core, presenting the tetragonal phase only. The highest SBS values were recorded in specimens treated with three-times laser scanning in the unaged and aged conditions. A mixed fracture was a common fracture pattern among the studied groups. The results confirmed that SBS could be optimized through three-times laser scanning and it provided better adhesion between zirconia and the veneer ceramic material. Multiple scanning processes of more than three times are not recommended for zirconia surface treatment.

Effect of different combinations of surface treatment on adhesion of resin composite to zirconia

Purpose: The purpose of this laboratory study was to evaluate the effect of different surface treatment combinations on resin zirconia bonding. Materials and methods: One hundred and five pre-sintered zirconia quadrangles were prepared out of zirconia blocks, polished, then sintered and divided into five groups (n=21). Group I (control): samples were untreated, group II: grit-blasting with 50 µm alumina particles, group III: grit-blasting with 100 µm alumina particles, group IV: Er,Cr:YSGG laser, and group V: selective infiltration etching technique. Microstructural analysis was performed using scanning electron microscopy, atomic force microscopy, a diffractometer, and a profilometer. Cylinders of composite resin were luted with Panavia resin composite cementand Clearfil ceramic primer. Shear bond strength (SBS) was determined using a universal testing machine. Results: SBS results were analyzed using one-way ANOVA followed by Tukey post hoc tests for multiple comparisons. The level of significance was set to 0.05. SBS values of the studied groups II, III, IV, and V were 16.2±1.8 MPa, 15.7±3.7 MPa, 14.8±3.4 MPa, and 16.8±3.0 MPa, respectively. All values were significantly higher than the control group (10.48±1.80 MPa), but without a significant difference between them. Group III exhibited the roughest surface, and Group I had a more significantly reduced surface roughness value than any other group. Group III presented the highest significant increase of tetragonal to monoclinic phase transformation (13%). Conclusion: The use of grit-blasting with greater particles size enhanced SBS with resin composite cement, but induced a higher amount of monoclinic phase transformation. The use of primer based on adhesive monomer with the resin cement is required to enhance the bonding efficiency. The use of laser enhanced the surface roughness and the bonding ability to zirconia.

Dental Resin-Zirconia Bonding Promotion Using High-Silica PVD Coating with High Ionization Sputtering Processing

Purpose: To evaluate the effect of high-silica coating deposited by high-silica physical vapor deposition (PVD) as a chemical bonding method on resin-zirconia bond strength under different aging conditions. Methods: Twelve Y-TZP blocks were used as the substrates. Four resin cement stubs were bonded on each Y-TZP block, with a total number of 48 resin cement stubs. Two test groups (n = 24) were evaluated: conventional Tribochemical silica-coating (TSC) and high-silica PVD with high ionization sputtering processing. Experimental silane primer (MPS) was brushed over the surface treated Y-TZP blocks, then a polyethylene mold was placed over the coated Y-TZP blocks and filled with the adhesive resin cement, then light-cured for 40 s. The shear bond strength (SBS) was then evaluated in dry condition and after thermo-cycling for 6000 cycles. Surface roughness, mode of failure, surface topography and elemental analysis were also evaluated. Results: In dry condition, PVD-coated zirconia specimens showed significantly higher mean SBS values (11.7 ± 1.3 MPa) compared to TSC (10.2 ± 1.1 MPa) (p = 0.027). The SBS values of TSC and PVD-coated samples after thermo-cycling were higher than in dry condition, but with no statistical significant difference (p > 0.05). Tetragonal-to-monoclinic phase transformation was detected in TSC, but not in PVD-coated zirconia. Significant decrease in surface roughness of PVD samples compared to TSC samples (p < 0.001). The silica content in PVD coating was 51% as detected by EDX. Conclusions: High-silica PVD coating on zirconia can give a reliable resin-zirconia chemical bond without any phase transformation and surface destruction by conventional grit-blasting.

Zirconia surface modifications for implant dentistry

BACKGROUND

Zirconia has emerged as a versatile dental material due to its excellent aesthetic outcomes such as color and opacity, unique mechanical properties that can mimic the appearance of natural teeth and decrease peri-implant inflammatory reactions.

OBJECTIVE

The aim of this review was to critically explore the state of art of zirconia surface treatment to enhance the biological and osseointegration behavior of zirconia in implant dentistry.

MATERIALS AND METHODS

An electronic search in PubMed database was carried out until May 2018 using the following combination of key words and MeSH terms without time periods: "zirconia surface treatment" or "zirconia surface modification" or "zirconia coating" and "osseointegration" or "biological properties" or "bioactivity" or "functionally graded properties".

RESULTS

Previous studies have reported the influence of zirconia-based implant surface on the adhesion, proliferation, and differentiation of osteoblast and fibroblasts at the implant to bone interface during the osseointegration process. A large number of physicochemical methods have been used to change the implant surfaces and therefore to improve the early and late bone-to-implant integration, namely: acid etching, gritblasting, laser treatment, UV light, CVD, and PVD. The development of coatings composed of silica, magnesium, graphene, dopamine, and bioactive molecules has been assessed although the development of a functionally graded material for implants has shown encouraging mechanical and biological behavior.

CONCLUSION

Modified zirconia surfaces clearly demonstrate faster osseointegration than that on untreated surfaces. However, there is no consensus regarding the surface treatment and consequent morphological aspects of the surfaces to enhance osseointegration.

Effects of laser treatments on surface roughness of zirconium oxide ceramics

BACKGROUND

The aim of this study was to analyze the surface roughness of yttrium stabilized tetragonal polycrystalline zirconia (Y-TZP) ceramics after different laser treatments (CO_2, ER: YAG).

METHODS

5x5x2 mm rectangular prisms of forty eight Y-TZP (Zirkonzahn) ceramic specimens were prepared. In order to standardize surfaces, 600-, 1200- grid silicon carbide papers were used to gradually ground wet on 300 rpm grinding machine for 10 s. Eight groups (n = 6) were randomly formed from the specimens of each ceramic as control (GroupC), sandblasted (GroupS), two different CO₂ laser treatments (Group3W: 3 W and 382 w/cal, Group4W: 4 W and 509w/cal) and four different Er: YAG laser treatments (Group150SP: 150 mJ and 10-Hz with 100μS; Group150SSP: 150 mJ and 10-Hz with 300μS; Group300SP: 300 mJ and 10-Hz with 100μS; Group300SSP: 300 mJ and 10-Hz with 300μS). A profilometer was used to conduct surface roughness measurements (Ra). Surface morphologies of the specimens were evaluated under SEM after laser treatment.

RESULTS

To analyze the data one-way ANOVA and to compare the mean values Tukey HSD tests (α = .05) were used. One - way ANOVA results showed that Group S had the highest Ra value and Group150 SP had the lowest. After sandblasting group the highest value was seen in Group4W. There were no statistically significant differences among Group C, Group3W, Group150SSP, Group300SP, and Group300SSP.

CONCLUSIONS

The study showed that surface roughness of zirconium oxide ceramics was increased with CO2 laser.

Novel Coatings on Zirconia for Improved Bonding with Veneer Ceramics

This study aimed to compare the effects of two surface-coating methods on the shear bond strength (SBS) of veneering ceramics (VC) to zirconia. Eighty pre-sintered zirconia cubes were randomly assigned into four study groups: E60S, E60P, N60S, and N60P. The zirconia surface was coated with a mixture of two types of glaze and alumina (<60 μm) by airbrush spraying and fine- brush painting. Surface roughness (Ra), X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), and SBS measurements (both initial and artificial aged conditions, including one month of water storage) were performed. The Ra results revealed significant differences among all groups (p < 0.001). The N60P group exhibited higher values of Ra (5.717 ± 0.20 µm) and SBS before and after water storage with values of 37.22 ± 4.954 MPa and 34.42 ± 3.977 MPa, respectively. The fine-brush coatings showed significantly higher SBS than that of airbrush coatings, in both initial and artificial conditions. Both coating methods and various coating materials (p < 0.001) produced a significant influence on VC-zirconia SBS. A significant correlation between Ra and SBS (Spearman’s rho = 0.808; p < 0.001) was found. The novel coating by fine-brush painting is a promising surface treatment and an easy technique for obtaining a rougher surface, which subsequently improves the bond strength to VC.

Evaluation of mold-enclosed shear bond strength between zirconia core and porcelain veneer

This study aimed to evaluate the mold-enclosed shear bond strength (ME-SBS) of zirconia to veneering porcelain with different surface treatments. Colored or uncolored zirconia coupons were either highly polished or airborne-particle abraded. The specimens were divided into groups with/without application of liner. Veneering porcelain was fired into an alumina ring mold on the zirconia coupons. The assembled specimens were subjected to the ME-SBS test. The mean ME-SBS for groups ranged from 7-10 MPa with no significant difference (p>0.05). A three-way ANOVA showed that coloring and surface roughening of the zirconia specimen had no significant influence on the ME-SBS value, but liner application exhibited a significant effect with a minor decrease in the MESBS (p=0.049). Surface treatments (coloring, airborne-particle abrasion, and liner application) were found to not cause a significant increase to the zirconia-porcelain bond strength. The application of zirconia liner had a slight negative influence on the ME-SBS results.

Promoting porcelain-zirconia bonding using different atmospheric pressure gas plasmas

OBJECTIVES

To evaluate the effects of different atmospheric-pressure plasma (APP) on the physicochemical properties of yttria-stabilized zirconia, and promoting the adhesion of veneering porcelain.

METHODS

Cercon base zirconia disks were prepared to receive different treatments: as-polished, three APPs (oxygen, OP; argon, AP; and CF₄, CP), and grit-blasted (GB). Their surface roughness and hydrophilicity were measured, and surface morphology was examined either after treatments, after simulated porcelain firing, or additional thermal etching. X-ray photoelectron spectroscopy (XPS) analysis characterized the surface chemical compositions. Shear bond strength (SBS) tests examined the adhesion between veneering porcelain and zirconia either before or after thermocycling. The layered ceramic disks were also sectioned to inspect the porcelain-zirconia interfaces. Statistical analysis was performed with one-way ANOVA and post hoc Duncan's test.

RESULTS

Grit-blasting caused surface damage and increased roughness. All APP-treated disks exhibited deeper grain boundaries and enlarged grain sizes after thermal etching, while CP disks revealed additional particle dispersions. Three APPs rendered the zirconia surface superhydrophilic. XPS spectra of three APP groups revealed increased hydroxyl groups and reduced C-C contents, and CP group especially showed the existence of Z-F bonds. CP exhibited the highest SBS both before and after thermocycling, while AP and GB also showed improved SBSs compared to the as-polished. OP presented reduced SBS, and its cross-sections showed increased microporosities in the veneering porcelain.

SIGNIFICANCE

APP did not change surface morphology but enhanced wettability. CP and AP improved porcelain-zirconia SBSs, primarily through surface hydroxylation. OP induced the microporosities in porcelain and adversely affected the adhesion.

Bond strength enhancement of zirconia-porcelain interfaces via Nd:YAG laser surface structuring

OBJECTIVES

The aim of this study was to evaluate the effect of laser surface structuring on the bond strength of feldspar-based porcelain to zirconia, as compared to conventional sandblasting treatment.

MATERIALS AND METHODS

Thirty cylindrical zirconia substrates, previously sintered, were divided in three groups according to the type of surface conditioning: 1) sandblasting with 50 µm Al₂O₃; 2) laser structuring (Ø25 µm holes); and 3) laser structuring (Ø50 µm holes). Porcelain was injected onto the zirconia substrates. X-ray diffractometry (XRD) was used to evaluate the influence of the laser treatment on zirconia crystallographic phases. Shear bond strength test was performed. Micrographs using SEM were used to evaluate the zirconia surface after each surface treatment and to evaluate the fracture surface after the shear test.

RESULTS

The laser-structured groups presented the highest shear bond strength (65 ± 16 MPa and 65 ± 11 MPa, for the 25 µm and 50 µm holes, respectively). The sandblasting samples presented shear bond strength of 37 ± 16 MPa. XRD analysis showed that there was no phase transformation on the thermally affected surface due to laser action. Microcracks were created at some holes due to the high temperature gradient generated by laser.

SIGNIFICANCE

Laser structuring significantly increased (up to 75%) the shear bond strength of zirconia to veneering porcelain as compared to conventional sandblasting treatment. Therefore, laser structuring arises as a surface conditioning method for producing stronger and long lasting zirconia-porcelain interfaces.

Surface Characterization and Cell Adhesion of Different Zirconia Treatments: An in vitro Study

AIM

The aim of this study was to characterize the surface of zirconia subjected to different treatments and evaluate its effect on cell adhesion and proliferation.

MATERIALS AND METHODS

A total of 80 zirconia disks were divided into four groups (n = 20) according to the surface treatments used: group I: as-sintered (AS), no surface treatment applied; group II: abrasion treatment applied using Rocatec (ROC; 3M ESPE) system with silica-coated alumina powder of grit size 110 μm; group III: erbium, chromium:yttrium, scandium, gallium, garnet (Er, Cr:YSGG) laser (LAS; BIOLASE) was used at a frequency of 20 Hz and output power of 3 W; and group IV: specimens were subjected to the selective infiltration etching (SIE) technique. Surface characterization was evaluated for the different groups (roughness, hardness, and morphology), and cell behavior (adhesion and proliferation) was tested (a = 0.05).

RESULTS

The ROC group reported a significant increase in surface roughness (2.201 ± 0.352) and Vickers hardness (1758 ± 16.6) compared with the other surface treatments. The SIE surface-treated group reported a significantly higher number of cells (64.5 ± 2.6 and 53.5 ± 2.2 respectively) compared with the other surface-treated groups.

CONCLUSION

The SIE is a promising surface treatment for zirconia that significantly enhances cell adhesion and osseointegration.

CLINICAL SIGNIFICANCE

The SIE treatment of zirconia implants may help in a faster and better osseointegration.