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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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Aydin N, Uslu Kavrama F, Kocak EF. Effect of thickness on the translucency of machinable and printable ceramic-glass polymer materials. J Dent 2024; 147:105129. [PMID: 38878814 DOI: 10.1016/j.jdent.2024.105129] [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: 11/27/2023] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVES To assess the translucency of machinable and printable ceramic-glass polymer materials with different thicknesses. METHODS Five ceramic-glass polymer materials were tested: one 3D-printable material, Permanent Crown resin (3D), two machinable materials available at low translucency (LT) and high translucency (HT) levels, VITA Enamic (VE) HT/LT, and Cerasmart 270 (CS) HT/LT. A total of 100 specimens were produced across 10 subgroups (n = 10) with thicknesses of 1 mm and 1.5 mm. The colour coordinates of the specimens were measured against black and white backgrounds using a spectrophotometer. Translucency was quantified using the Relative Translucency Parameter (RTP), calculated via the CIEDE2000 formula. A two-way ANOVA followed by post-hoc tests with Bonferroni correction (α = 0.05) was used for statistical analysis. RESULTS The RTP for both thicknesses were ranked as follows: CSHT > VEHT > CSLT > 3D > VELT. The RTP of the 3D was lower than that of the HT machinable materials (CSHT and VEHT) for both thicknesses (p < 0.05). No significant difference was observed between the RTP of 3D and CSLT at 1.5 mm (p = 1.000); however, at 1 mm, the RTP of the 3D was lower than that of the CSLT (p < 0.05). Notably, the 3D showed the least translucency difference with a 0.5 mm increase in thickness. CONCLUSIONS Printable ceramic-glass polymer materials demonstrated lower translucency than HT machinable ceramic-glass polymer materials. Both the thickness and type significantly influenced the translucency of the LT machinable counterparts compared to the printable ceramic-glass polymer material. CLINICAL SIGNIFICANCE Printable ceramic-glass polymer resins may be a suitable option for minimally invasive procedures, especially when attempting to mask undesirable-coloured abutments. When selecting HT machinable ceramic-glass polymers, clinicians should pay greater attention to the abutment colour and thickness of the restorative material.
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Affiliation(s)
- Nazli Aydin
- Cukurova University, Faculty of Dentistry, Department of Prosthodontics, Adana, Turkey; The Abdi Sutcu Vocational School of Health Services, Cukurova University, Balcali, Adana, Turkey.
| | | | - Elif Figen Kocak
- Dokuz Eylul University, Faculty of Dentistry, Department of Prosthodontics, Izmir, Turkey
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Zhu Z, Huang X, Lyu J, Yang X, Tan J, Liu X. Optical properties of monolithic zirconia fabricated with nanoparticle jetting. J Prosthet Dent 2024:S0022-3913(24)00346-9. [PMID: 38796354 DOI: 10.1016/j.prosdent.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 05/03/2024] [Accepted: 05/07/2024] [Indexed: 05/28/2024]
Abstract
STATEMENT OF PROBLEM Excellent optical properties are essential for esthetic dental materials. However, the translucency and color masking ability of zirconia fabricated with nanoparticle jetting (NPJ), a type of printed zirconia, are unknown. PURPOSE The purpose of this in vitro study was to evaluate the translucency and color masking ability of zirconia fabricated using NPJ. MATERIAL AND METHODS A total of 90 specimens with thicknesses of 1.5, 1.0, and 0.5 mm were fabricated using high translucent milled zirconia (HT), low translucent milled zirconia (LT), and NPJ. CIELab values (L*, a*, and b*) of the specimens over 7 backgrounds, black, white, VitaB1, VitaA2, VitaA4, gold alloy (Au), and titanium (Ti), were obtained using a spectral radiometer. The relative translucency parameter (RTP) and color difference (∆E) of specimens over VitaB1, VitaA4, Au, and Ti were determined using VitaA2 as the control with the CIEDE2000 color difference equation. The normality of the data distribution was determined using the Shapiro-Wilk test. Differences among groups were analyzed using 2-way analysis of variance and the Student-Newman-Keuls (SNK) post hoc test (α=.05). The ∆E of specimens was analyzed according to perceptibility (∆E=0.8) and acceptability (∆E=1.8) thresholds using the 1 sample t test. The correlation between RTP and ∆E and RTP/∆E and thickness was examined using the Pearson correlation analysis. RESULTS Statistically significant differences were observed in translucency and color masking ability among HT, LT, and NPJ (P<.05). The RTP value was the lowest for zirconia fabricated with NPJ (P<.001) and highest for HT (P<.001). Monolithic zirconia fabricated with NPJ had lower ∆E values than those of HT and LT for the same thickness and background (P<.05). A positive correlation was found in RTP and ∆E (P<.001). A negative correlation was observed in RTP and thickness (P<.001) and ∆E and thickness across a constant background (P<.001). CONCLUSIONS Zirconia fabricated with NPJ was less translucent and had a greater color masking ability for discolored backgrounds than HT and LT.
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Affiliation(s)
- Zhiyao Zhu
- Graduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Xinyue Huang
- Graduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Jizhe Lyu
- Graduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Xu Yang
- Clinical Associate Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Jianguo Tan
- Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Xiaoqiang Liu
- Clinical Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China.
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Stevens CD, Renné WG, Vág J. Translucency of chairside monolithic zirconias using different sintering ovens: An in vitro investigation. J Dent 2024; 142:104839. [PMID: 38216029 DOI: 10.1016/j.jdent.2024.104839] [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: 11/30/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE To evaluate the translucency of several monolithic zirconias (MZ) processed in various sintering ovens designed for single-visit, chairside use. METHODS Discs (n = 40) from zirconia blocks were fabricated for each MZ at manufacturer-recommended minimal thicknesses, as provided in each material's instructions for use: IPS e.max ZirCAD LT (ZLT); CEREC Zirconia+ (CZ+); 3M Chairside (3M); KATANA Zirconia (KT). Groups (n = 10) were sintered following manufacturer instructions for each oven: CEREC SpeedFire, Ivoclar CS4, Ivoclar CS6, and Ivoclar S2 (laboratory furnace control). Specimens were highly polished on one side and glazed on the other. Each side was measured with a spectrophotometer against white and black backgrounds to determine translucency parameter (TP) and contrast ratio (CR) values. Results for TP and CR for each material and oven combination were compared with a linear mixed model. Oven precision was evaluated using the Kruskall-Wallis test. RESULTS Glazed specimens were more translucent than polished ones (p < 0.001). ZLT and CZ+ were more translucent than 3M and KT regardless of the sintering oven (p < 0.01). Several oven/material combinations reached or exceeded the S2 oven TP: CS4 with CZ+ and 3M; CS6 with ZLT and KT (p < 0.01). SpeedFire was significantly less precise (p < 0.05) and produced lower TP values for ZLT, CZ+, and KT (p < 0.01). Results for TP and CR were highly correlated. CONCLUSIONS MZ surface finish, material thickness, and oven used all had a significant effect on translucency. Some chairside-oriented solutions produced results with translucency equal to conventionally processed zirconia. CLINICAL SIGNIFICANCE The translucency of a ceramic restoration is an important factor in determining its esthetics. Clinicians desiring the most esthetic outcomes with monolithic zirconia should be aware of the significant effects that surface finishing, material thickness, and the sintering oven used can have on restoration translucency.
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Affiliation(s)
| | | | - János Vág
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary.
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Yang J, Hao Z, Xu J, Wang J, Jiang X. Fusion machine learning model predicts CAD-CAM ceramic colors and the corresponding minimal thicknesses over various clinical backgrounds. Dent Mater 2024; 40:285-296. [PMID: 37996303 DOI: 10.1016/j.dental.2023.11.013] [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: 06/28/2023] [Revised: 11/13/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES This study has developed and optimized a machine learning model to accurately predict the final colors of CAD-CAM ceramics and determine their required minimum thicknesses to cover different clinical backgrounds. METHODS A total of 120 ceramic specimens (2 mm, 1 mm and 0.5 mm thickness; n = 10) of four CAD-CAM ceramics - IPS e.max, IPS ZirCAD, Upcera Li CAD and Upcera TT CAD - were studied. The CIELab coordinates (L*, a* and b*) of each specimen were obtained over seven different clinical backgrounds (A1, A2, A3.5, ND2, ND7, cobalt-chromium alloy (CC) and medium precious alloy (MPA)) using a digital spectrophotometer. The color difference (ΔE) and lightness difference (ΔL) results were submitted to 39 different models. The prediction results from the top-performing models were used to develop a fusion model via the Stacking integrated learning method for best-fitting prediction. The SHapley Additive exPlanation (SHAP) was performed to interpret the feature importance. RESULTS The fusion model, which combined the ExtraTreesRegressor (ET) and XGBRegressor (XGB) models, demonstrated minimal prediction errors (R2 = 0.9) in the external testing sets. Among the investigated variables, thickness and background colors (CC and MPA) majorly influenced the final color of restoration. To achieve perfect aesthetic restoration (ΔE<2.6), at least 1.9 mm IPS ZirCAD or 1.6 mm Upcera TT CAD were required to cover the CC background, while two tested glass-ceramics did not meet the requirements even with thicknesses over 2 mm. SIGNIFICANCE The fusion model provided a promising tool for automate decision-making in material selection with minimal thickness over various clinical background.
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Affiliation(s)
- Jiawei Yang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Zezhou Hao
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Jiani Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Jie Wang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China.
| | - Xinquan Jiang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China.
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