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Gao Y, Ding Q, Li W, Gu R, Zhang P, Zhang L. Role and Mechanism of a Micro-/Nano-Structured Porous Zirconia Surface in Regulating the Biological Behavior of Bone Marrow Mesenchymal Stem Cells. ACS APPLIED MATERIALS & INTERFACES 2023. [PMID: 36913521 DOI: 10.1021/acsami.2c22736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Zirconia as a promising dental implant material has attracted much attention in recent years. Improving the bone binding ability of zirconia is critical for clinical applications. Here, we established a distinct micro-/nano-structured porous zirconia through dry-pressing with addition of pore-forming agents followed by hydrofluoric acid etching (POROHF). Porous zirconia without hydrofluoric acid treatment (PORO), sandblasting plus acid-etching zirconia, and sintering zirconia surface were applied as controls. After human bone marrow mesenchymal stem cells (hBMSCs) were seeded on these four groups of zirconia specimens, we observed the highest cell affinity and extension on POROHF. In addition, the POROHF surface displayed an improved osteogenic phenotype in contrast to the other groups. Moreover, the POROHF surface facilitated angiogenesis of hBMSCs, as confirmed by optimal stimulation of vascular endothelial growth factor B and angiopoietin 1 (ANGPT1) expression. Most importantly, the POROHF group demonstrated the most obvious bone matrix development in vivo. To investigate further the underlying mechanism, RNA sequencing was employed and critical target genes modulated by POROHF were identified. Taken together, this study established an innovative micro-/nano-structured porous zirconia surface that significantly promoted osteogenesis and investigated the potential underlying mechanism. Our present work will improve the osseointegration of zirconia implants and help further clinical applications.
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Affiliation(s)
- Yuan Gao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22, Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Qian Ding
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22, Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Wenjin Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22, Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Ranli Gu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22, Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Ping Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22, Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
| | - Lei Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, No.22, Zhongguancun South Avenue, Haidian District, Beijing 100081, PR China
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Li W, Ding Q, Sun F, Liu B, Yuan F, Zhang L, Bao R, Gu J, Lin Y. Fatigue behavior of zirconia with microgrooved surfaces produced using femtosecond laser. Lasers Med Sci 2023; 38:33. [PMID: 36598586 DOI: 10.1007/s10103-022-03679-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 11/19/2022] [Indexed: 01/05/2023]
Abstract
Femtosecond laser is a promising surface treatment tool for zirconia implant. In this study, the fatigue behavior of zirconia specimens with microgrooved surfaces formed by femtosecond laser is reported. One hundred sixty CAD/CAM zirconia bars (20 mm × 4 mm × 1.4 mm) were evenly divided into four groups with different surface: as sintered; sandblasted with 110 μm Al2O3; femtosecond laser produced microgrooves having 50 μm width, 30 μm depth, and 100 μm pitch; microgrooves having 30 μm width, 20 μm depth, and 60 μm pitch. The femtosecond laser formed micro/nanostructured microgrooves with precise size on zirconia surfaces. XRD analysis indicated that microgrooved surface showed no obvious tetragonal-to-monoclinic phase transformation. The fatigue strength of sandblasted specimens (728 MPa) was significantly higher than that of as sintered specimens (570 MPa). However, the fatigue strength of specimens with microgrooved surface decreased to about 360-380 MPa. The results suggest femtosecond laser is an effective technique to regulate the surface microtopography of zirconia, while further investigations are needed to improve its fatigue behavior.
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Affiliation(s)
- Wenjin Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Qian Ding
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China
| | - Fengbo Sun
- School of Materials Science and Engineering, Tsinghua University, 100084, Beijing, China
| | - Binchao Liu
- School of Aeronautic Science and Engineering, Beihang University, 100191, Beijing, China
| | - Fusong Yuan
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Digital Dentistry, Ministry of Health, Beijing, 100081, China
| | - Lei Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, 100081, China.
| | - Rui Bao
- School of Aeronautic Science and Engineering, Beihang University, 100191, Beijing, China
| | - Jinghua Gu
- School of Materials Science and Engineering, Beihang University, Beijing, 100191, China
| | - Yuanhua Lin
- School of Materials Science and Engineering, Tsinghua University, 100084, Beijing, China
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Yu MK, Oh EJ, Lim MJ, Lee KW. Change of phase transformation and bond strength of Y-TZP with various hydrofluoric acid etching. Restor Dent Endod 2021; 46:e54. [PMID: 34909418 PMCID: PMC8636086 DOI: 10.5395/rde.2021.46.e54] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/18/2021] [Accepted: 09/01/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives The purpose of this study was to quantify phase transformation after hydrofluoric acid (HF) etching at various concentrations on the surface of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), and to evaluate changes in bonding strength before and after thermal cycling. Materials and Methods A group whose Y-TZP surface was treated with tribochemical silica abrasion (TS) was used as the control. Y-TZP specimens from each experimental group were etched with 5%, 10%, 20%, and 40% HF solutions at room temperature for 10 minutes. First, to quantify the phase transformation, Y-TZP specimens (n = 5) treated with TS, 5%, 10%, 20% and 40% HF solutions were subjected to X-ray diffraction. Second, to evaluate the change in bond strength before and after thermal cycling, zirconia primer and MDP-containing resin cement were sequentially applied to the Y-TZP specimen. After 5,000 thermal cycles for half of the Y-TZP specimens, shear bond strength was measured for all experimental groups (n = 10). Results The monoclinic phase content in the 40% HF-treated group was higher than that of the 5%, 10%, and 20% HF-treated groups, but lower than that of TS-treated group (p < 0.05). The 40% HF-treated group showed significantly higher bonding strength than the TS, 5%, and 10% HF-treated groups, even after thermal cycling (p < 0.05). Conclusions Through this experiment, the group treated with SiO2 containing air-borne abrasion on the Y-TZP surface showed higher phase transformation and higher reduction in bonding strength after thermal cycling compared to the group treated with high concentration HF.
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Affiliation(s)
- Mi-Kyung Yu
- Department of Conservative Dentistry, Jeonbuk National University School of Dentistry, Jeonju, Korea.,Research Institute of Clinical Medicine Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
| | - Eun-Jin Oh
- Department of Conservative Dentistry, Jeonbuk National University School of Dentistry, Jeonju, Korea
| | - Myung-Jin Lim
- Department of Conservative Dentistry, Jeonbuk National University School of Dentistry, Jeonju, Korea
| | - Kwang-Won Lee
- Department of Conservative Dentistry, Jeonbuk National University School of Dentistry, Jeonju, Korea.,Research Institute of Clinical Medicine Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Korea
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李 文, 丁 茜, 原 福, 孙 丰, 郑 剑, 鲍 蕊, 张 磊. [Effects of femtosecond laser treatment on surface characteristics and flexural strength of zirconia]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2021; 53:770-775. [PMID: 34393243 PMCID: PMC8365050 DOI: 10.19723/j.issn.1671-167x.2021.04.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the effects of femtosecond laser treated microgrooved surface on microscopic topography, phase transformation, and three-points flexural strength of zirconia, and to provide reference for surface microstructure optimization of zirconia implant. METHODS According to different surface treatment methods, 57 computer aided design/computer aided manufacture (CAD/CAM) zirconia bars (20.0 mm×4.0 mm×1.4 mm) were evenly divided into three groups: sintered group, no treatment after sintering, taken as control; sandblasted group, sandblasted with 110 μm aluminium oxide (Al2O3) after sintering; microgrooved group, femtosecond laser fabricated microgrooves with 50 μm width, 30 μm depth, and 100 μm pitch. Surface microscopic topography was observed with scanning electron microscope (SEM) and 3D laser microscope. Further, surface roughness in each group and microgroove size were measured. Crystal phase was analyzed with X-ray diffraction. Specimens were subjected to three- points flexural strength test, and Weibull distribution was used to analyze their strength characteristics. RESULTS SEM showed that sintered surface was flat with clear grain structure; sandblasted surface exihibited bumps and holes with sharp margins and irregular shape; microgrooves were regularly aligned without evident defect, and nano-scale particles were observed on the surface inside of the microgrooves. Ra value of microgrooved group [(9.42±0.28)] μm was significantly higher than that of sandblasted group [(1.04±0.03) μm] and sintered group [(0.60±0.04) μm], and there was statistical difference between sandblasted group and sintered group (P < 0.001). The microgroove size was precise with (49.75±1.24) μm width, (30.85±1.02) μm depth, and (100.58±1.94) μm pitch. Crystal phase analysis showed that monoclinic volume fraction of sandblasted group (18.17%) was much higher than that of sintered group (1.55%), while microgrooved group (2.21%) was similar with sintered group. The flexural strength of sandblasted group (986.22±163.25) MPa had no statistical difference with that of sintered group (946.46±134.15) MPa (P=0.847), but the strength in microgrooved group (547.92±30.89) MPa dropped significantly compared with the other two groups (P < 0.001). Weibull modulus of sintered, sandblasted, microgrooved groups were 7.89, 6.98, and 23.46, respectively. CONCLUSION Femtosecond laser was able to form micro/nanostructured microgrooves on zirconia surface, which deleteriously affected the flexural strength of zirconia.
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Affiliation(s)
- 文锦 李
- 北京大学口腔医学院·口腔医院,修复科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - 茜 丁
- 北京大学口腔医学院·口腔医院,修复科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - 福松 原
- 北京大学口腔医学院·口腔医院,口腔医学数字化研究中心 口腔数字医学北京市重点实验室 国家卫生健康委口腔医学计算机应用工程技术研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - 丰博 孙
- 清华大学材料学院,北京 100084School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - 剑桥 郑
- 北京大学口腔医学院·口腔医院,口腔医学数字化研究中心 口腔数字医学北京市重点实验室 国家卫生健康委口腔医学计算机应用工程技术研究中心,北京 100081Center for Digital Dentistry, Peking University School and Hospital of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Beijing 100081, China
| | - 蕊 鲍
- 北京航空航天大学航空科学与工程学院,北京 100191School of Aeronautic Science and Engineering, Beihang University, Beijing 100191, China
| | - 磊 张
- 北京大学口腔医学院·口腔医院,修复科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室,北京 100081Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
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Kim JE, Kwon YC, Kim S, Park YB, Shim JS, Moon HS. Effect of Acid Mixtures on Surface Properties and Biaxial Flexural Strength of As-Sintered and Air-Abraded Zirconia. MATERIALS 2021; 14:ma14092359. [PMID: 34062894 PMCID: PMC8125152 DOI: 10.3390/ma14092359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 11/17/2022]
Abstract
The aim of this work was to evaluate the effects of application time of an acid mixture solution on the surface roughness, phase transformation, and biaxial flexural strength of 3Y-TZP after sintering or air abrasion. For the biaxial flexural strength measurement, 220 3Y-TZP disk-shaped specimens were prepared after as-sintering or air abrasion. The etching solution comprised a mixture of hydrofluoric acid, sulfuric acid, hydrogen peroxide, methyl alcohol, and purified water. The samples were divided into 11 subgroups according to the etching times (Control, 1, 2, 3, 5, 8, 10, 12, 15, 20, and 30 min). The results showed that acid treatment on both as-sintered and air-abraded 3Y-TZP surfaces increased the surface roughness. However, it had no significant effects on the monoclinic phase or flexural strength of as-sintered zirconia. The monoclinic phase and flexural strength of air-abraded zirconia increased sharply after air abrasion; however, they gradually decreased after acid treatment, to a similar level to the case of the untreated surface. Surface treatment with acid mixture increased the roughness, but the lack of increase of monoclinic phase is thought to be because the loose monoclinic particles remaining on the surface were removed through the etching process.
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Affiliation(s)
- Jong-Eun Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
| | - Yong-Chan Kwon
- CLF Dental Laboratory, 227 Moraenae-ro, Seodaemun Gu, Seoul 03695, Korea;
| | - Sunjai Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
| | - Young-Bum Park
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
| | - June-Sung Shim
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
| | - Hong-Seok Moon
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-Ro, SeodaemunGu, Seoul 03722, Korea; (J.-E.K.); (S.K.); (Y.-B.P.); (J.-S.S.)
- Correspondence: ; Tel.: +82-2-2228-3155
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Influence of surface treatments and cyclic fatigue on subsurface defects and mechanical properties of zirconia frameworks. Dent Mater 2021; 37:905-913. [PMID: 33691991 DOI: 10.1016/j.dental.2021.02.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/16/2021] [Accepted: 02/24/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate the effect of laser fused and air abraded fluorapatite particles on flexural strength σf and fracture toughness (KIC) of Yttria tetragonal zirconia polycrystal (Y-TZP). METHODS 160 polished Y-TZP bars received one of the following surface treatments: airborne particle abrasion (APA) with fluorapatite glass-ceramics (FGC), APA with tribochemical silica-coated alumina (CoJet), laser fused FGC using Nd:YAG Laser (FGC + Laser), while as-sintered polished specimens served as control. Initial flexural strength σfI was measured to half of the specimens, while the rest underwent cyclic fatigue (1,000,000 cycle of 15N load and 3 s contact time) followed by measuring residual flexural strength σfR. Fractographic analysis was performed and KIC was calculated. The effect of surface treatment and fatigue on flexural strength was statistically analysed using 2-way ANOVA (α = 0.05). Weibull probability was measured to assess the reliability of flexural strength. RESULTS The highest σf before or after the fatigue was reported for the control group while the lowest was for FGC + Laser group. Cyclic fatigue significantly decreased the flexural strength of all groups except for FGC + Laser group. There was no significant difference between the KIC between the control and FGC groups, however, a significant reduction of KIC was found in the CoJet group, while FGC + Laser reported the significant lowest value compared to all groups (P = 0.00). SIGNIFICANCE Fluorapatite glass-ceramic powder offers a promising alternative for particle abrasion of zirconia-based frameworks.
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Rohr N, Zeller B, Matthisson L, Fischer J. Surface structuring of zirconia to increase fibroblast viability. Dent Mater 2020; 36:779-786. [PMID: 32354484 DOI: 10.1016/j.dental.2020.03.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 03/19/2020] [Accepted: 03/26/2020] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The neck area of zirconia implants or abutments is currently either machined, polished and in some cases additionally heat-treated. The aim of the present study was to determine how the surface topography and crystalline structure of zirconia affects the viability of human gingival fibroblasts (HGF-1). METHODS Zirconia discs with a diameter of 13mm were either polished [Zp], polished and heat-treated [Zpt], machined [Zm], machined and heat-treated [Zmt] or sandblasted, etched and heat-treated [Z14] which is the surface topography of the endosseous part of a zirconia implant. The specimen surfaces were analyzed using scanning electron microscopy (SEM), characterized in terms of monoclinic to tetragonal phase ratio, storage effect on wettability and roughness. The viability and morphology of HGF-1 cells was then tested on all surfaces after 24h. RESULTS The effect of the heat-treatment was visualized for the polished specimens with SEM. Contact angle of water was significantly decreased after 2 weeks air storage of the zirconia. Cell viability was significantly higher on smooth surfaces (Zpt, Zm, Zmt) when compared to Z14. HGF-1 cells spread very flat and attached tightly to the smoother surfaces Zp, Zpt, Zm and Zmt while on Z14, cells did not fully extend into the etched morphology of zirconia and stretched over longer distances. SIGNIFICANCE For the structuring of the neck part of zirconia implants or abutments, a smooth surface with exposed grains might be suggested as the optimal substrate for human gingival fibroblasts. The wettability with water of zirconia decreases with prolonged air storage.
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Affiliation(s)
- Nadja Rohr
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
| | - Barbara Zeller
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Lea Matthisson
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Jens Fischer
- Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
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Bethke A, Pieralli S, Kohal RJ, Burkhardt F, von Stein-Lausnitz M, Vach K, Spies BC. Fracture Resistance of Zirconia Oral Implants In Vitro: A Systematic Review and Meta-Analysis. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E562. [PMID: 31991565 PMCID: PMC7040771 DOI: 10.3390/ma13030562] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/15/2020] [Accepted: 01/21/2020] [Indexed: 12/27/2022]
Abstract
Various protocols are available to preclinically assess the fracture resistance of zirconia oral implants. The objective of the present review was to determine the impact of different treatments (dynamic loading, hydrothermal aging) and implant features (e.g., material, design or manufacturing) on the fracture resistance of zirconia implants. An electronic screening of two databases (MEDLINE/Pubmed, Embase) was performed. Investigations including > 5 screw-shaped implants providing information to calculate the bending moment at the time point of static loading to fracture were considered. Data was extracted and meta-analyses were conducted using multilevel mixed-effects generalized linear models (GLMs). The Šidák method was used to correct for multiple testing. The initial search resulted in 1864 articles, and finally 19 investigations loading 731 zirconia implants to fracture were analyzed. In general, fracture resistance was affected by the implant design (1-piece > 2-piece, p = 0.004), material (alumina-toughened zirconia/ATZ > yttria-stabilized tetragonal zirconia polycrystal/Y-TZP, p = 0.002) and abutment preparation (untouched > modified/grinded, p < 0.001). In case of 2-piece implants, the amount of dynamic loading cycles prior to static loading (p < 0.001) or anatomical crown supply (p < 0.001) negatively affected the outcome. No impact was found for hydrothermal aging. Heterogeneous findings of the present review highlight the importance of thoroughly and individually evaluating the fracture resistance of every zirconia implant system prior to market release.
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Affiliation(s)
- Annalena Bethke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Felix Burkhardt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Manja von Stein-Lausnitz
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany;
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
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Load-Bearing Capacity of Zirconia Crowns Screwed to Multi-Unit Abutments with and without a Titanium Base: An In Vitro Pilot Study. MATERIALS 2019; 12:ma12193056. [PMID: 31547045 PMCID: PMC6803877 DOI: 10.3390/ma12193056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/13/2019] [Accepted: 09/17/2019] [Indexed: 12/31/2022]
Abstract
The static and dynamic load-bearing capacities and failure modes of zirconia crowns screwed to multi-unit abutments (MUAs) with and without a titanium base (T-base) were determined. Thirty-six monolithic zirconia crowns screwed to straight MUAs torqued to laboratory analogs (30 Ncm) were assigned to two groups (n = 18). In group A, the zirconia crowns were screwed directly to the MUAs; in group B, the zirconia crowns were cemented to the T-base and screwed to the MUAs. All specimens were aged in 100% humidity (37 °C) for one month and subjected to thermocycling (20,000 cycles). Afterwards, the specimens underwent static and dynamic loading tests following ISO 14801. The failure modes were evaluated by stereomicroscopy (20×). There was an unequivocally similar trend in the S-N plots of both specimen groups. The load at which the specimens survived 5,000,000 cycles was 250 N for both groups. Group A failed mainly within the metal, and zirconia failure occurred only at a high loading force. Group B exhibited failure within the metal mostly in conjunction with adhesive failure between the zirconia and T-base. Zirconia restoration screwed directly to an MUA is a viable option, but further studies with larger sample sizes are warranted.
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