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Huang B, Chen M, Wang J, Zhang X. Advances in zirconia-based dental materials: Properties, classification, applications, and future prospects. J Dent 2024; 147:105111. [PMID: 38866229 DOI: 10.1016/j.jdent.2024.105111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVES Zirconia (ZrO2) ceramics are widely used in dental restorations due to their superior mechanical properties, durability, and ever-improving translucency. This review aims to explore the properties, classification, applications, and recent advancements of zirconia-based dental materials, highlighting their potential to revolutionize dental restoration techniques. STUDY SELECTION, DATA AND SOURCES The most recent literature available in scientific databases (PubMed and Web of Science) reporting advances of zirconia-based materials within the dental field is thoroughly examined and summarized, covering the major keywords "dental zirconia, classification, aesthetic, LTD, applications, manufacturing, surface treatments". CONCLUSIONS An exhaustive overview of the properties, classifications, and applications of dental zirconia was presented, alongside an exploration of future prospects and potential advances. This review highlighted the importance of addressing challenges such as low-temperature degradation resistance and optimizing the balance between mechanical strength and translucency. Also, innovative approaches to improve the performances of zirconia as dental material was discussed. CLINICAL SIGNIFICANCE This review provides a better understanding of zirconia-based dental biomaterials for dentists, helping them to make better choice when choosing a specific material to fabricate the restorations or to place the implant. Moreover, new generations of zirconia are still expected to make progress on key issues such as the long-term applications in dental materials while maintaining both damage resistance and aesthetic appeal, defining the directions for future research.
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Affiliation(s)
- Bo Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Mengbing Chen
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Xin Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Li Q, Yang Y, Chen K, Jiang Y, Swain MV, Yao M, He Y, Liang Y, Jian Y, Zhao K. Effect of low-temperature degradation on the fatigue performance of dental strength-gradient multilayered zirconia restorations. J Dent 2024; 142:104866. [PMID: 38281620 DOI: 10.1016/j.jdent.2024.104866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/16/2024] [Accepted: 01/25/2024] [Indexed: 01/30/2024] Open
Abstract
OBJECTIVES Fatigue and low-temperature degradation (LTD) are the main factors contributing to zirconia restoration failure. This study evaluated the effect of LTD on the fatigue performance of the novel "strength & shade-gradient" multilayered zirconia restorations. METHODS Discs (15 mm × 1.2 mm) of each yttria content layer from a newly developed strength-gradient multilayered zirconia were fabricated and under accelerated aging in an autoclave at 134℃ for 0 h, 32 h, and 64 h. Then, the phase transformation, microstructure, and mechanical properties after LTD were assessed. In addition, the crown samples, including the multi-Zir, 3Y-Zir, and 5Y-Zir were fabricated, and their monotonic and fatigue load before and after LTD, percentage of fatigue degradation (Sd) and the fracture morphology were investigated. Statistical analyses were performed using paired samples t-test (α' = α/3 = 0.017), one-way ANOVA and Weibull analysis. RESULTS After LTD, the phase transformation, surface roughness, depth of transformed zone, and residual stress were increased and inversely associated with the yttria content. The indentation elastic modulus and hardness after LTD decreased; however, there was no significant difference between the different yttria content layers. The monotonic and fatigue load of multi-Zir restorations decreased, but their Weibull modulus increased, and Sd decreased, similar to 3Y-Zir. The crack origin was associated with the cervical region. CONCLUSION These results show that although LTD reduces the absolute fatigue strength of strength-gradient multilayered zirconia restorations, it also reduces the effect of cyclic fatigue itself on the strength of zirconia (relative to monotonic strength), which might be due to the increase of residual stress. CLINICAL SIGNIFICANCE The novel "strength & shade-gradient" multilayered zirconia restorations show a promising performance during in vitro LTD and fatigue test and their reliability to some extent is comparable to 3Y-Zir. Yet, further in vivo longitudinal studies are warranted to confirm their precise performance.
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Affiliation(s)
- Qiulan Li
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Yunxu Yang
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Kuangyao Chen
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Yingyu Jiang
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Michael V Swain
- Don State Technical University, Rostov-on-Don 344000, Russia; AMME, Sydney University, Sydney, Australia
| | - Mianfeng Yao
- Xiangya Hospital Central South University, Changsha 410008, China
| | - Ying He
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
| | - Yujie Liang
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China.
| | - Yutao Jian
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China; Institute of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China.
| | - Ke Zhao
- Hospital of Stomatology, Sun Yat-Sen University, Guangzhou 510055, China; Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China.
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Steiner R, Scott S, Wiesmüller V, Lepperdinger U, Steinmassl O, Schnabl D, Schwindling S. Effect of zirconia surface conditioning before glazing on the wear of opposing enamel: an in vitro study. Clin Oral Investig 2024; 28:128. [PMID: 38294555 DOI: 10.1007/s00784-024-05522-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024]
Abstract
OBJECTIVES This in vitro study aimed to evaluate the wear of natural teeth opposing 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) with different surface conditions. MATERIALS AND METHODS Sixty 3Y-TZP specimens were randomly assigned to six groups (n = 10), differing in surface condition. In three groups, the samples underwent glazing-with the glaze applied to roughened (i.e., 106-µm-grit diamond-finished), as-sintered, and polished zirconia. The three remaining groups consisted of unglazed specimens: solely polished samples and diamond-finished samples (106-µm-grit and 46-µm-grit) without further conditioning. Two-body wear was evaluated at extracted, non-carious molars (n = 60), which served as antagonists in chewing simulation (10,000 masticatory cycles, 49N load). As a control, natural teeth with intact enamel surfaces were tested against natural molars (n = 10). All samples were 3D-scanned before and after the chewing simulation (7 Series, Straumann). Volume loss was calculated (Inspect Software, GOM), and statistically analyzed (SPSS Statistics 24, IBM). RESULTS Volume loss of the natural antagonists decreased in the following order: 106-µm-grit diamond-finished zirconia (4.6 ± 2.5 mm3), glazed 106-µm-grit diamond-finished zirconia (3.8 ± 1.1 mm3), glazed as-sintered zirconia (3.5 ± 0.9 mm3), 46-µm-grit diamond-finished zirconia (1.7 ± 0.6 mm3), control (1.6 ± 0.7 mm3), glazed polished zirconia (1.4 ± 0.5 mm3), and solely polishing (0.4 ± 0.2 mm3). Even when polishing the surfaces before glazing, volume loss was not mitigated to the same extent as after polishing alone. CONCLUSIONS The zirconia surface condition beneath the glazing influences antagonist wear. Although polishing before glazing resulted in acceptable levels of antagonist wear, this approach did not yield as favorable results as polishing alone. CLINICAL RELEVANCE For operators favoring glazing, pre-polishing the zirconia surface could be advantageous to reduce wear.
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Affiliation(s)
- René Steiner
- Department of Prosthetic Dentistry, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Shawn Scott
- Private Dental Practice, Oberndorferstraße 39, 6322, Kirchbichl, Austria
| | - Vera Wiesmüller
- Department of Conservative Dentistry and Periodontology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Ulrike Lepperdinger
- Department of Conservative Dentistry and Periodontology, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Otto Steinmassl
- Private Dental Practice, Kaiser-Josef Straße 13, 6020, Innsbruck, Austria
| | - Dagmar Schnabl
- Department of Prosthetic Dentistry, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Sebastian Schwindling
- Department of Prosthetic Dentistry, Medical University Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
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Lassila L, Novotny R, Säilynoja E, Vallittu PK, Garoushi S. Wear behavior at margins of direct composite with CAD/CAM composite and enamel. Clin Oral Investig 2023; 27:2419-2426. [PMID: 36746817 PMCID: PMC10159970 DOI: 10.1007/s00784-023-04883-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/26/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aim was to investigate the two-body wear at the marginal area between direct filling composites and substrate of CAD/CAM composites or enamel. MATERIALS AND METHODS Flat specimens were prepared from CAD/CAM composites (CERASMART 270 and SFRC CAD) and bovine enamel. A box-shaped cavity cut into CAD/CAM composites and enamel surfaces was made. The prepared cavity in CAD/CAM composites was treated with a primer, while in enamel, the cavity was treated with an adhesive. Three conventional composites (Universal Injectable, G-aenial A'Chord, and Filtek Bulk Fill) and one short fiber composite (everX Flow) were placed and cured in the prepared cavities. A two-body wear test was conducted with 15,000 chewing cycles using a dual-axis chewing simulator. The specimens (n = 5/per group) were positioned to produce wear (load = 20 N) across the marginal area between filling composites and substrates. The wear depth was analyzed using a 3D optical profilometer. SEM was used to evaluate the wear behavior and margins between the filling and substrate materials. RESULTS All composites used displayed different wear behavior (20-39 µm) (p < 0.05). The highest wear values were recorded for A'Chord and Filtek, while the lowest values were for Injectable and CERASMART 270. The data analysis showed that the wear behavior of substrate materials depends on the filling materials used at margins (p < 0.05). The marginal breakdown was seen only between bovine enamel and filling composites. CONCLUSIONS The use of the two-body wear simulation method revealed important information about the behavior of the filling composites at the marginal area with CAD/CAM composites or bovine enamel substrates. CLINICAL RELEVANCE The marginal breakdown related to the material combination at the bonding region.
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Affiliation(s)
- Lippo Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| | - Rudolf Novotny
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| | - Eija Säilynoja
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Research Development and Production Department, Stick Tech Ltd-Member of GC Group, Turku, Finland
| | - Pekka K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- City of Turku Welfare Division, Oral Health Care, Turku, Finland
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
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