Effects of small-grit grinding and glazing on mechanical behaviors and ageing resistance of a super-translucent dental zirconia

Boron-containing coating yields enhanced antimicrobial and mechanical effects on translucent zirconia

OBJECTIVES

To evaluate the mechanical and antimicrobial properties of boron-containing coating on translucent zirconia (5Y-PSZ).

METHODS

5Y-PSZ discs (Control) were coated with a glaze (Glaze), silver- (AgCoat), or boron-containing (BCoat) glasses. The coatings' antimicrobial potential was characterized using S. mutans biofilms after 48 h via viable colony-forming units (CFU), metabolic activity (CV) assays, and quantification of extracellular polysaccharide matrix (EPS). Biofilm architectures were imaged under scanning electron and confocal laser scanning microscopies (SEM and CLSM). The cytocompatibility was determined at 24 h via WST-1 and LIVE&DEAD assays using periodontal ligament stem cells (PDLSCs). The coatings' effects on properties were characterized by Vickers hardness, biaxial bending tests, and fractography analysis. Statistical analyses were performed via one-way ANOVA, Tukey's tests, Weibull analysis, and Pearson's correlation analysis.

RESULTS

BCoat significantly decreased biofilm formation, having the lowest CFU and metabolic activity compared with the other groups. BCoat and AgCoat presented the lowest EPS, followed by Glaze and Control. SEM and CLSM images revealed that the biofilms on BCoat were thin and sparse, with lower biovolume. In contrast, the other groups yielded robust biofilms with higher biovolume. The cytocompatibility was similar in all groups. BCoat, AgCoat, and Glaze also presented similar hardness and were significantly lower than Control. BCoat had the highest flexural strength, characteristic strength and Weibull parameters (σF: 625 MPa; σ0: 620 MPa; m = 11.5), followed by AgCoat (σF: 464 MPa; σ0: 478 MPa; m = 5.3).

SIGNIFICANCE

BCoat is a cytocompatible coating with promising antimicrobial properties that can improve the mechanical properties and reliability of 5Y-PSZ.

Should finishing, polishing or glazing be performed after grinding YSZ ceramics? A systematic review and meta-analysis

The present systematic review and meta-analysis aimed to assess the characteristics and consequences of post-processing methods after grinding procedures in YSZ ceramics on its surface roughness and flexural strength. The protocol of this review was made prospectively and is available online in the PROSPERO database (link). Literature searches on PubMed/MEDLINE, EMBASE, Lilacs, Web of Science and Scopus were conducted on December 2022 to select in vitro studies written in English, without publishing-date restrictions, that considered surface characteristics and mechanical properties of YSZ ceramics submitted to grinding and subsequent post-processing surface treatments as an attempt to revert the effect induced by grinding. Two authors independently selected the studies, extracted the data and assessed the risk of bias. Mean differences (Rev-Man 5.1, random effects model, α= 0.05) were obtained by comparing flexural strength and surface roughness values of ground surfaces with at least one post-processing surface treatment (global analysis). Subgroup analyses were performed considering the most prevalent categories of post-processing methods. A total of 33 (out of 4032) studies were eligible and included in the analysis. In the global analysis, ground surfaces showed higher flexural strength than when post-processing methodologies were employed (p< 0.0001). The subgroup analysis showed that only polishing was able to enhance the flexural strength after grinding (p= 0.001); however, when other protocols were used, the ground surface was always superior in terms of flexural strength (p< 0.0001). Post-processing techniques in both the global and sub-group analyses were able to reduce the surface roughness after grinding in YSZ ceramics (p< 0.00001). High heterogeneity was found in all the meta-analyses. Concerning the risk of bias analysis, the included studies had mixed scores for the considered factors. In conclusion, in terms of improving flexural strength and restoring surface roughness after grinding, polishing protocols can be considered the best indication as post-processing treatment after YSZ ceramics adjustments/grinding.

Surface Characteristics of High Translucent Multilayered Dental Zirconia Related to Aging

(1) Background: The purpose of this study was to evaluate the differences in terms of surface characteristics (roughness, topography, microhardness) among layers for multi-layered high translucent and super-high translucent zirconia and the influence of finishing and aging on surface characteristics and microstructure. (2) Methods: Three types of translucent multilayer zirconia were evaluated: STML (4Y-TZP); IPS e.maxZirCAD CEREC/in Lab MT Multi (4Y-TZP + 5Y-TZP); CeramillZolidfx ML (5Y-TZP). Ninety-six plate-shaped samples (32 for a material), 16 mm × 14 mm × 1 mm size, were cut with a precision disc, polished on both sides with sand papers and sintered respecting the manufacturer’s protocol. Half of the specimens (16) were finished by polishing and the other half by glazing and then equally divided into one control group and one group subject to aging by autoclaving (1 h, 134 °C, 0.2 MPa), resulting in four groups of eight samples, for each zirconia. The specimens were evaluated in three areas: cervical, medium, incisal-of each glazed or polished surface, before and after aging. Tests were performed to determine the surface roughness using a profilometer; the surface topography by an atomic force microscope (AFM) and a scanning electron microscope (SEM). Microhardness was recorded using a microhardness tester. Statistical analyses were performed using two-way ANOVA test, unpaired sample t-Test, paired sample t-Test (α = 0.05) and Pearson’s correlation. (3) Results: Before and after autoclaving, for glazed samples significance (p < 0.05) higher surface roughness, respectively lower microhardness in comparison with the polished group was assessed. No significant differences (p > 0.05) were reported between the three areas, on glazed or polished surfaces of a material. Although, after aging an increase in surface roughness was observed both on glazed and polished samples, statistical differences were found for STML (p < 0.05). No significant differences (p> 0.05) concerning microhardness among the same areas, on glazed and polished surfaces, recorded before and after aging, except CeramillZolidfx ML glazed samples. (4) Conclusions: For tested zirconia materials no significant differences among layers were registered regarding surface characteristics. Surface treatment (glazing or polishing) has a significant impact on surface roughness and microhardness. Both before and after aging, the surface roughness values for the glazed samples were higher than for those polished. The super translucent 4Y-TZP material was more affected by aging compared to the super-high translucent 5Y-TZP material. The combined material revealed similarities for each layer corresponding to the microstructure.

The effect of nonthermal argon plasma surface treatment on the fracture resistance of monolithic zirconia restorations containing tetragonal and cubic grains

PURPOSE

The aim of this study was to investigate the effect of nonthermal argon plasma (NP) surface treatment on the fracture resistance of monolithic zirconia restorations with different microstructures.

METHODS

Twenty restorations were prepared from each of two tetragonal and two cubic zirconia materials (80 restorations in total). The restorations were then divided into two subgroups (n = 10) for each material according to the surface treatment applied: air abrasion or NP. The surface topography of the treated groups was examined using a scanning electron microscope. All restorations were fixed to metal dies with resin cement, subjected to thermal cycling, and then underwent fracture resistance testing with a universal testing device. Two-way ANOVA and Bonferroni tests were used for statistical analysis of the data (α = 0.05).

RESULTS

The type of surface treatment and the type of zirconia material were shown to significantly affect the fracture resistance of the restorations. The air-abraded groups showed significantly higher fracture resistance (N) than the NP groups (P < 0.001).

CONCLUSION

The results of this study suggest that air abrasion surface treatment has a more favorable effect on the fracture resistance of tetragonal and cubic zirconia restorations than NP surface treatment.

Effect of air-abrasion at pre- and/or post-sintered stage and hydrothermal aging on surface roughness, phase transformation, and flexural strength of multilayered monolithic zirconia

This study aimed to evaluate the effect of air-abrasion/sintering order and autoclave aging on the surface roughness (Ra), phase transformation, and biaxial flexural strength (BFS) of monolithic zirconia. A total of 104 monolithic zirconia specimens (Katana ML) were divided into eight groups according to airborne-particle abrasion protocols and hydrothermal aging: control (non-aged: C-, aged: C+), air-abrasion before sintering (BS-, BS+), air-abrasion after sintering (AS-, AS+), and air-abrasion before and after sintering (BAS-, BAS+). A steam autoclave was used for accelerated aging, and Ra values were measured with a surface profilometer. All specimens were analyzed by X-ray diffraction to determine any phase transformation on the zirconia surface. BFS was measured by using the piston-on-three-balls method. Scanning electron microscopy and atomic force microscopy were performed on one specimen per group. BS and BAS groups showed higher Ra values compared with groups C and AS. The aging process significantly increased the monoclinic phase content of all specimens. Lower monoclinic levels were found in AS+ and BAS+ compared with other aged groups. The AS groups exhibited higher flexural strength values relative to control groups, whereas BS groups exhibited significantly lower flexural strength values (p < .05). There was no reduction in flexural strength by using the BAS protocol. Air-abrasion of zirconia at the pre-sintered stage only is not recommended in clinical use because of the remarkable decrease in flexural strength.

Fracture resistance and marginal fit of the zirconia crowns with varied occlusal thickness

PURPOSE

The present study aimed to evaluate the clinical applicability of monolithic zirconia (MZ) crowns of different thickness via determination of fracture resistance and marginal fit.

MATERIALS AND METHODS

MZ crowns with 0.5, 0.8, 1.0, and 1.5 mm thickness and porcelain fused to metal (PFM) crowns were prepared, ten crowns in each group. Marginal gaps of the crowns were measured. All crowns were aged with thermal cycling (5 - 55℃/10000 cycle) and chewing simulator (50 N/1 Hz/lateral movement: 2 mm, mouth opening: 2 mm/240000 cycles). After aging, fracture resistance of crowns was determined. Statistical analysis was performed with one-way ANOVA and Tukey's HDS post hoc test.

RESULTS

Fracture loads were higher in the PFM and 1 mm MZ crowns compared to 0.5 mm and 0.8 mm crowns. 1.5 mm MZ crowns were not broken even with the highest force applied (10 kN). All marginal gap values were below 86 µm even in the PFM crowns, and PFM crowns had a higher marginal gap than the MZ crowns.

CONCLUSION

The monolithic zirconia exhibited high fracture resistance and good marginal fit even with the 0.5 mm thickness, which might be used with reduced occlusal thickness and be beneficial in challengingly narrow interocclusal space.

Surface Characterization and Optical Properties of Reinforced Dental Glass-Ceramics Related to Artificial Aging

The development of various dental glass-ceramic materials and the evolution of novel processing technologies lead to an essential change in the clinical and technical workflow. The long-term success of a dental restoration treatment is defined by its durability, which is directly influenced by the oral environment. This study's purpose was to evaluate the artificial aging behavior of nanostructured, respective microstructured ceramics related to surface topography, roughness, and optical properties. Six monolithic restoration materials were selected: milled lithium disilicate glass-ceramic (LDS-M) MT (medium translucency), hot-pressed lithium disilicate glass-ceramic (LDS-P) MT and HT (high translucency), milled zirconia-reinforced lithium silicate ceramic (ZLS-M) MT and hot-pressed zirconia-reinforced lithium silicate ceramic (ZLS-P) MT and HT, resulting n = 96 surfaces. All the samples were artificially aged by thermal cycling, and all investigations were made before and after thermal cycling. In terms of optical properties, differences recorded between ZLS and LDS ceramics are not significant. Thermal cycling increases the translucency of ZLS and LDS glass-ceramic materials significantly, with the most harmful effect on the pressed and polished samples. Micro- and nano roughness are significantly influenced by in vitro aging and a negative correlation was recorded. Glazed samples are characterized by significant rougher surfaces for all types of materials. On nanolevel, ZLS materials are significantly smoothed by thermal cycling.

Effects of low-temperature degradation on the surface roughness of yttria-stabilized tetragonal zirconia polycrystal ceramics: A systematic review and meta-analysis

STATEMENT OF PROBLEM

A wide range of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics have been applied for dental restorations. However, whether hydrothermal aging affects the surface roughness of Y-TZP is unknown.

PURPOSE

The purpose of this systematic review and meta-analysis was to evaluate the effects of low-temperature degradation (LTD) on the surface roughness of Y-TZP ceramics.

MATERIAL AND METHODS

This report follows the Preferred Reporting Items for Systematic Reviews and Qualitative Analyses statement. The literature search was conducted with Medline through the PubMed, Web of Science, and Cochrane Library with no publication year limits. The screening and quality assessment were performed by 2 independent reviewers. The studies comparing the surface roughness of Y-TZP ceramics after LTD by using steam autoclave aging were included in the meta-analysis. Meta-analyses were conducted with a random-effects model (α=.05) by using Review Manager Software (Cochrane Collaboration).

RESULTS

Of the 203 potentially relevant studies, 32 full texts were assessed for eligibility. A total of 17 articles were included in the systematic review, and 15 were included in the qualitative analyses. The results showed no significant difference in the arithmetic average height (R_a) values between the nonaged and aged Y-TZP (P=.670; mean difference=0.01; 95% confidence interval=-0.03 to 0.05). Subgroup analyses revealed that the aging duration (P=.003) and specimen preparation (P=.010) contributed significantly to the changes in the surface roughness of the Y-TZP ceramics.

CONCLUSIONS

Although LTD was found to have no significant effects on the surface roughness of Y-TZP ceramics, the effects of LTD depended on the duration of the steam autoclave process and the specimen preparation.

Effect of finishing/polishing techniques and low temperature degradation on the surface topography, phase transformation and flexural strength of ultra-translucent ZrO2 ceramic

OBJECTIVE

To investigate the effect of different surface finishing and polishing regimes and low temperature degradation on flexural strength, phase transformation and surface topography of ultra-translucent ZrO₂ ceramic.

METHODS

300 (n=15/group) of conventional zirconia (Z: Ice Zirkon Transluzent) and ultra-translucent zirconia (UT: Prettau Anterior) bar-specimens were made and divided according to the "Finishing/Polishing" - (C - Control, B - diamond rubber polishers, P - adjusting with burs, PB - adjusting with burs+diamond polishers, PG - adjusting with burs+glaze), "Low temperature Degradation (LTD)" (with or without a treatment at 127°C, 1.7bar/24h). Then, a 3-point mini flexural test was performed in a universal testing machine (1mm/min, 500kgf load cell). SEM, EDS, XDR, AFM, optical profilometry and Weibull analysis were performed. Data were analyzed by 3-way ANOVA and Tukey's post-test (5%).

RESULTS

Groups ZPB_D (1670±253MPa), ZB_D (1664±217MPa), and ZB (1655±3678MPa) showed significantly higher flexural strength than the UTPG group (372±56MPa). The Weibull modulus was significantly higher for the ZP_D group compared to the UB, UC_D, UP_D and UPB_D, while UTB, UTC_D and UTP_D had the lowest value. Monoclinic phases were observed only in the conventional zirconia groups and were more evident after LTD. Diamond rubber polishers presented less roughness for both zirconias.

SIGNIFICANCE

The use of diamond rubber polishers is the most suitable finishing/polishing method for zirconia ceramic restorations and that final glazing reduces the fracture resistance of these materials.

Does the bond strength of highly translucent zirconia show a different dependence on the airborne-particle abrasion parameters in comparison to conventional zirconia?

PURPOSE

To compare the effects of airborne-particle abrasion protocols on the surface morphology, the phase transformation and the resin bond strength of highly translucent zirconia (M) and conventional zirconia (Z).

METHODS

Thirteen groups (N = 12) of Z and M specimens were prepared. Except for the control group, the specimens were sandblasted with conditions involving different grit sizes (50 μm or 110 μm), treatment times (10 s or 20 s) and pressures (0.1 MPa, 0.3 MPa or 0.6 MPa). The surface morphology was analyzed using scanning electron microscope (SEM) and the phase analysis was conducted with X-ray diffraction (XRD). The Ra and the shear bond strength (SBS) were measured and statistically analyzed, and the failure mode was determined by optical microscope.

RESULTS

The surface morphologies were strongly dependent on treatment conditions. Larger particle size and higher pressure resulted in higher Ra for both materials. Longer blasting time resulted in higher Ra for Z but not M. Overall, the SBS increased with increasing Ra; the highest average SBS was achieved by M and exceeded 18 MPa. The monoclinic transformation was not found in any treatment for M, but was found in Z.

CONCLUSIONS

Z and M showed different dependence on the airborne-particle abrasion parameters in terms of Ra, SBS and phase transformation. The conditions for maximizing SBS included a 110 μm particle size and 20 s treatment for both, with pressures of 0.3 MPa and 0.6 MPa for the M and Z, respectively.

Graded Ultra-Translucent Zirconia (5Y-PSZ) for Strength and Functionalities

Ultra-translucent zirconias are drawing immense attention due to their fascinating esthetic appearance. However, the high translucency came at the expense of diminishing strength along with the reduced ability of transformation toughening due to the increased cubic zirconia content. We aim to address these issues by infiltrating glass on the surface of an ultra-translucent zirconia (5Y-PSZ). Glasses of different shades can be used and the resulting graded glass/zirconia layer is expected to improve the material's flexural strength without compromising its esthetics. We also aim to elucidate how clinically relevant surface treatments-namely, air abrasion, glazing, or polishing-affect the fracture resistance of these zirconias with a high cubic content. All surface treatments were performed on bar-shaped (2 × 3 × 25 mm³) and plate-shaped (12 × 12 × 1 mm³) specimens, which were then subjected to a 4-point bending test and translucency measurements, respectively. 5Y-PSZ proved to be significantly more translucent than 3Y-TZP but also much weaker. Our hypothesis was accepted, as the strength of the glass-infiltrated ultra-translucent 5Y-PSZ (582 ± 20 MPa) is over 70% higher than its uninfiltrated counterpart (324 ± 57 MPa). Its strength is also over 25% higher than the highly polished 5Y-PSZ (467 ± 38 MPa). In addition, the translucency of 5Y-PSZ (translucency parameter [ TP] = 34, contrast ratio [ CR] = 0.31) is not affected by glass infiltration ( TP = 34, CR = 0.32) when the residual surface glass is removed by gentle polishing using 6- and then 3-µm diamond grits. Finally, both air abrasion and the presence of a glaze layer on the tensile surface decreased flexural strength significantly, being 274 ± 55 and 211 ± 21 MPa, respectively. With a combined high strength and translucency, the newly developed glass-infiltrated 5Y-PSZ may be considered a suitable material for next-generation, damage-resistant, and esthetic dental restorations.