Effect of surface treatments on the shear bond strength of luting cements to Y-TZP ceramic

Effect of non-thermal plasma treatment and resin cements on the bond strength of zirconia ceramics with different yttria concentrations

OBJECTIVES

To investigate the effect of different surface treatments and resin cements on the shear bond strength of zirconia ceramics with different yttria concentrations.

METHODS

Zirconia blocks characterized by different yttria concentrations [Vita YZ HT (HT), Vita YZ ST (ST) and Vita YZ XT (XT)] were used to prepare disc-shaped specimens (n=252). Specimens prepared to investigate shear bond strength (SBS), water contact angle and surface roughness (Ra) were divided into four subgroups; control (C), sandblasting (S), sandblasting + nonthermal plasma treatment (SNTP) and nonthermal plasma treatment (NTP). For SBS testing, specimens were further divided into two groups (n=108) according to the luting cement used [Panavia F2.0 (P) and Rely X U200 (R)]. The water contact angles were determined by sessile drop technique and Ra was analyzed with optical profilometer. SBS tests were performed in a universal testing machine at a crosshead speed of 0.5 mm/min. The data sets were statistically analyzed with two and three-way ANOVAs followed by post-hoc comparisons (α=0.05).

RESULTS

The water contact angle and Ra data were significantly affected by surface treatments. The mean Ra values of ST and XT were significantly lower than HT for the surface treatment groups of C and NTP. The SBS values were significantly different among the groups subjected to different surface treatments. The mean SBS values of surface treatment groups (S, SNTP and NTP) when cemented with R were significantly higher than the groups of C (p<0.05).

CONCLUSIONS

For the tested zirconia ceramics with different yttria concentrations, non-thermal plasma activation helps to improve SBS and is a promising tool in practical use.

Shear bond strength between standard or modified zirconia surfaces and two resin cements incorporating or not 10-MDP in their matrix

OBJECTIVE

This study aimed first to compare the shear bond strength between zirconia samples luted to enamel with a 10-MDP- containing resin cement (Panavia F2.0, Kuraray, Japan) and those luted with a resin cement using a separated 10-MDP monomer-containing bottle (Panavia V5, Kuraray, Japan). The second objective was to evaluate the bond stability after 150 days of aging in water, between enamel and zirconia ceramic surface enhanced with a glass-ceramic coating.

MATERIALS AND METHODS

80 specimens composed of ceramic cylinders and enamel disks were obtained, within eight experimental groups (n = 10). 60 zirconia cylinders (Katana STML zirconia, Kuraray, Japan) were assigned to 3 groups according to their surface treatment: milled/sintered surface (ZRCT), tribochemical silica-coating (Cojet™ Sand, 3 M ESPE, Seefeld, Germany) (ZRTC), and glass-ceramic coating (IPS e.max Zirpress) (ZRZP). 20 cylinders of lithium disilicate had a milled surface (IPS e.max CAD, Ivoclar-Vivadent, Schaan, Liechtenstein) (ECAD). The cylinders of each group were further divided into two subgroups according to the resin cement used: Panavia F2.0 (-PF) and Panavia V5 (-PV). All specimens were stored in distilled water for 150 days before shear bond strength (SBS) tests. The fracture mode was analyzed, and data were statistically computed (two-way ANOVA, post hoc Tukey test, p < 0.05, SPSS, IBM, v26).

RESULTS

The ECAD-PF group recorded the highest SBS values (31.75 ± 2.2), and the ZRCT-PF group recorded the lowest values (5.59 ± 1.1). The two-way ANOVA test showed that ceramic surface treatment had a statistically significant effect on SBS (F (3,72) = 38.95, p < 0.001) while the type of ARC did not (F (1,72) = 2.40, p = 0.126). Tukey's post hoc test revealed no statistical difference between the ZRZP and the ZRTC or ECAD groups.

CONCLUSION

Within the limitations of this study, the PV resin achieved similar shear bond strength results between tribocoated zirconia and enamel compared to the one for glass-ceramic and enamel. Furthermore, a long-term durable bond, similar to the glass-ceramic one, was achieved with the heat pressed ceramic coated specimens. Thus, this new surface treatment could be recommended for anterior cantilever bridges for its fracture resistance and bonding ability.

Comparison of the clinical outcomes of resin-modified glass ionomer and self-adhesive resin cementations for full-coverage zirconia restorations

OBJECTIVES

Both resin-modified glass ionomer cement (RMGIC) and self-adhesive resin cement (SAC) may be suitable for cementation of full-coverage zirconia restorations. This retrospective study aimed to investigate the clinical outcomes of zirconia-based restorations cemented with RMGIC and compare them with those cemented with SAC.

METHODS

Cases of full-coverage zirconia-based restorations cemented with either RMGIC or SAC between March 2016 and February 2019 were evaluated in this study. The clinical outcomes of the restorations were analyzed according to the type of cement used. In addition, cumulative success and survival rates were evaluated according to the cement and abutment types. Non-inferiority, Kaplan-Meier, and Cox hazard tests were conducted (α=.05).

RESULTS

A total of 288 full-coverage zirconia-based restorations (natural teeth, 157; implant restorations, 131) were analyzed. Loss of retention occurred in only one case; a single-unit implant crown cemented with RMGIC, which decemented 4.25 years post-restoration. RMGIC was non-inferior to SAC in terms of loss of retention (<5%). For single-unit natural tooth restorations, the four-year success rates in the RMGIC and SAC groups were 100% and 95.65%, respectively (p=.122). For single-unit implant restorations, the four-year success rates in the RMGIC and SAC groups were 95.66% and 100%, respectively (p=.365). The hazard ratios of all the predictor variables, including cement type, were not significant (p>.05).

CONCLUSIONS

Cementation of full-coverage zirconia restorations of both natural teeth and implants using RMGIC and SAC yields satisfactory clinical outcomes. Furthermore, RMGIC is non-inferior to SAC in terms of cementation success.

CLINICAL SIGNIFICANCE

Cementation with RMGIC or SAC for full-coverage zirconia restorations has favorable clinical outcomes in both natural teeth and implants. Both RMGIC and SAC have advantages in the cementation of full-coverage zirconia restorations to abutments with favorable geometries.

Comparative Analysis of Three Surface Treatments on the Bond Strength of Zirconia to Resin-luting Agents: An In Vitro Study

AIM

To study the impact of three different surface treatments namely sandblasting, silane-coupling agent, and laser on the retention of zirconia prosthesis and bond strength of zirconia to a resin-luting agent.

MATERIALS AND METHODS

Sixty zirconia crowns were fabricated and were divided into four groups of 15 samples each on the basis of surface treatments. A control group with no surface treatment (group A), laser-treated (group B), treatment with silane-coupling agent (group C), and sandblasting with aluminium oxide (Al₂O₃) particles (group D). Testing was then carried out using a universal testing machine (0.5 mm/min crosshead speed). At a point where the crown got separated from the tooth, the reading in kilogram force (kgF) was recorded. The data were collected and analyzed statistically.

RESULTS

Group D produced the highest mean bond strength (17.5233 kgF) followed by group B (10.0067 kgF), group C (8.6907 kgF), and group A (3.3773 kgF). One-way ANOVA test showed a p-value more than 0.05, concluding no significant difference among the groups. Tukey's HSD post hoc test gave the p-value corresponding to the F-statistic of one-way ANOVA lower than 0.01 when intergroup comparison was done confirming a significant difference among the groups.

CONCLUSION

The bond strength significantly increased in the samples treated by sandblasting compared with those treated with laser and silane-coupling agents.

CLINICAL SIGNIFICANCE

The success of a zirconia prosthesis lies on its bonding with the tooth structure. Bond failure leads to loss of function and hence ends up in failure. Selection of the proper surface treatment will not only improve the bond strength but also amplify the retention of zirconia-based prosthesis, thereby reducing the failure of the final prosthesis. It also improves the longevity of the prosthesis and restores the lost function which is the basic clinical aim of a prosthodontic treatment.

Adhesive Cementation of Zirconia Based Ceramics-Surface Modification Methods Literature Review

Introduction: The conditioning procedures for glass-based ceramic restorations before adhesive cementation are generally recognized. In the case of polycrystalline ceramics, which include zirconium oxide, there is still no standardized protocol. The aim of this work was to present conditioning methods of the cementation surface of zirconium oxide fixed dentures. The new generation high translucency zirconia has been also considered. Material and method: The following keywords for the PUBMED and EMBASE databases were used: zirconium oxide, zirconium oxide with increased translucency, bond strength, bending strength, surface treatment. The inclusion criteria were original papers in English published between 2015–2021. Results: Out of 1537 publications, 53 articles were selected for the study, covering methods of conditioning zirconium ceramics, including new materials with increased translucency. These procedures were divided into 5 main groups. Summary: Due to the widespread use of zirconia ceramics and the introduction of new zirconia-based materials, the use of a predictable and standardized cementation protocol is one of the most important factors contributing to the long-term clinical success of prosthetic restorations. Therefore, the research showed differences in the properties of the covered materials after conditioning. It suggests the need to create separate conditioning protocols for highly translucent and traditional zirconia.

Is the Er:YAG laser affect the surface characteristics and bond strength of Y-TZP?

This study evaluated the surface characteristics and bond strength of Y-TZP treated with Er:YAG laser at different focal distances. 120 Y-TZP blocks were divided into five groups (n=24), according to the surface treatment: no treatment (C-); sandblasting with silica-coated aluminum oxide particles (C+); and Er:YAG laser application at focal distances of 1mm (Er:YAG-1), 4mm (Er:YAG-4), and 7mm (Er:YAG-7). Surface characteristics were analyzed using Vickers microhardness, confocal laser microscope, scanning electron microscopy (SEM), and X-ray diffractometer (XRD). For the bond strength test, 100 Y-TZP blocks were subdivided into two subgroups (n=10), according to the resin cement used: with (MDP+) or without 10-methacryloyloxydecyl dihydrogen phosphate (MDP-). The Vickers microhardness and surface roughness were analyzed by one-way ANOVA and bond strength by two-way ANOVA and Tukey's test for both (α=0.05). Vickers microhardness differences were not observed between the groups (p>0.05); C+ showed higher surface roughness values. SEM images showed micromorphological differences between the groups. The XRD data detected tetragonal crystals for C- and, for the other groups, tetragonal and monoclinic peaks. For bond strength, no statistically difference significance were observed among the cements with or without MDP (p>0.05) but showed significant difference between the surface treatments (C+ > C- = Er:YAG1 > Er:YAG4 = Er:YAG7) (p<0.05). Suggested that the Er:YAG laser cannot replace conventional treatment with aluminum oxide particles and the presence of MDP in the resin cement had no influence on the bond strength.

Bonding properties of third-generation zirconia CAD-CAM blocks for monolithic restorations to composite and resin-modified glass-ionomer cements

PURPOSE

To compare the interfacial fracture toughness (IFT) of two MDP-based composite cements and a resin-modified glass-ionomer cement (RMGIC) with third-generation zirconia CAD-CAM restorations using two different airborne-particle abrasion (AB) pressures.

METHODS

Blocks were cut into prisms (n=60), split and sintered to the desired equilateral half prisms. Half-prisms were divided into two groups for AB at 0.5 or 2.5 bar with 50 µm Al₂O₃ particles. Each group was then further divided into 3 subgroups, and half-prisms were bonded to their counterparts with Panavia V5 (V5), Panavia Self Adhesive Cement Plus (SA), or RMGIC Fuji Plus (n=10/group). The IFT was determined using the Notchless Triangular Prism test in a water bath at 36°C after thermocycling (10,000 cycles). Surface roughness and SEM analyses were performed for representative zirconia samples after AB, and composite cements were tested for flexural strength and wettability.

RESULTS

SA (2.5 bar) showed a significantly higher IFT. The 3 other groups with SA and V5 showed no significant difference in their IFT values regardless of the AB pressure (1-way ANOVA). Weibull analysis of SA was higher than V5. All RMGIC samples debonded while thermocycling, and were, therefore, not included in the statistical analysis. Surface roughness increased with increasing AB pressure, and both cements showed similar flexural strength values and good wettability.

CONCLUSION

Contrary to RMGIC, composite cements show high performance with zirconia after AB. Increasing AB pressure enhances the micromechanical retention of composite cement. Future perspectives should include study of the effect of AB pressure on zirconia surface properties.

Bond strength of zirconia- or polymer-based copings cemented on implant-supported titanium bases - an in vitro study

Purpose

To evaluate the bond strength between polymer-based copings and zirconia copings as positive control, cemented on implant-supported titanium bases with different adhesive cement systems. Moreover, to evaluate if airborne-particle abrasion of polymethylmetacrylate (PMMA) would enhance the bond strength.

Methods

Four groups of different materials were used to fabricate the copings, 30 in each group: airborne-particle abraded milled zirconia (TAZirconia, control group), milled PMMA (TPMMA), airborne-particle abraded milled PMMA (TAPMMA) and 3 D-printed micro filled hybrid resin (TAMFH). Each group of copings was cemented on titanium bases by three different adhesive cement systems, 10 each: Multilink Hybrid Abutment, Panavia V5, RelyX Ultimate. The specimens were stored dry at room temperature for 24 h, subjected to thermocycling for 5000 cycles followed by evaluating the bond strength by tensile strength test.

Results

TPMMA and TAPMMA cemented with Multilink Hybrid Abutment showed statistically significant lower bond strength in comparison to TAZirconia and TAMFH. No difference was observed between the latter two. TPMMA, TAPMMA and TAMFH had a statistically significant lower bond strength compared to the control group when cemented with Panavia V5. TPMMA and TAPMMA cemented with Rely X Ultimate showed statistically significant lower bond strength in comparison to the control group.

Conclusion

Almost all experimental groups, except 3 D-printed MFH, performed inferior than the positive control group where the highest bond strength was reported for the cementation of zirconia copings cemented with Panavia V5 or Rely X Ultimate. Airborne-particle abrasion did not improve the bond strength of the PMMA, except when Multilink Hybrid Abutment was used.

Effect of grain size of dental zirconia on shear bond strength of composite resin cement

The effect of grain size of dental zirconia on the shear bond strength of composite resin cement was newly studied. Disc-shaped dental zirconia with small (sample S) and large (sample L) grains were made by sintering of pre-sintered dental zirconia at 1450°C for 0.5 h and 40 h, respectively. After the sintering, the average grain size of sample S was 1.37 ± 0.15 µm, while that of sample L was 3.74 ± 0.50 µm. The sintered discs were successively polished with different grades of diamond and alumina slurries. The interfacial free energies were 63.5 ± 4.2 dyne/cm for sample S and 52.1 ± 5.5 dyne/cm for sample L. Stainless steel cylinders, previously sandblasted with 50 µm alumina powder, were bonded to the zirconia discs using composite resin cement. Next, samples were kept in an oven for 7 d at 36.5°C. The shear bond strength of sample S was 23.0 ± 4.5 MPa while that of sample L was 17.5 ± 4.6 MPa. After the fracture, the areal % values of composite resin cement remaining on the zirconia surfaces were 89.7 ± 5.9% for sample S and 61.6 ± 5.5% for sample L. The results suggest that grain size reduction has a potential to enhance the degree of bonding between a composite resin cement and a dental zirconia due to the increase of interfacial free energy.

Influence of Sandblasting Particle Size and Pressure on Resin Bonding Durability to Zirconia: A Residual Stress Study

The influence of residual stress induced by sandblasting the zirconia ceramic surface on the resin bonding to the ceramic is still unclear. The effect of four different sandblasting conditions (with 50 and 110 μm alumina at pressures of 0.2 and 0.4 MPa) on the bonding of adhesive resin cement (Panavia F 2.0) to zirconia (Cercon^® ht) was investigated in terms of residual stress. The surface roughness and water contact angle of the zirconia surfaces were measured. The tetragonal-to-monoclinic (t-m) phase transformation and residual stresses (sin²ψ method) were studied by X-ray diffraction. The resin-bonded zirconia specimens were subjected to shear bond strength (SBS) tests before and after thermocycling (10,000 and 30,000 cycles) (n = 10). As the particle size and pressure increased, the roughness gradually and significantly increased (p = 0.023). However, there were no significant differences in roughness-corrected contact angle among all the sandblasted groups (p > 0.05). As the particle size and pressure increased, the m-phase/(t-phase + m-phase) ratios and compressive residual stresses gradually increased. After thermocycling, there were no significant differences in SBS among the sandblasted zirconia groups (p > 0.05). In conclusion, increased surface roughness and residual stress do not directly affect the resin bonding durability.

The effect of repeated surface treatment of zirconia on its bond strength to resin cement

PURPOSE

The aim of this study is to evaluate the influence of repeated surface treatments on wettability and surface roughness for zirconia surface and bond strength of zirconia-based ceramics to resin cement.

MATERIALS AND METHODS

Seventy blocks (10 × 10 × 3 mm) of zirconia-based ceramics were fabricated and divided into two groups according to the surface treatments: (A) 110 µm Al₂O₃ airborne-particle abrasion and (R) 110 µm silica modified Al₂O₃ airborne-particle abrasion. At stage 2, each group was subdivided into 5 groups according to the surface retreatments: (a) 110 µm Al₂O₃ airborne-particle abrasion, (r) 110 µm silica modified Al₂O₃ airborne-particle abrasion, (D) diamond bur, (Da) diamond bur + 110 µm Al₂O₃ airborne-particle abrasion, and (Dr) diamond bur + 110 µm silica modified Al₂O₃ airborne-particle abrasion. Cylinders of self-adhesive resin cement were cemented onto each treated ceramic surface and subjected to micro-shear bond strength test. Additional specimens were prepared for roughness and wettability analyses. The data were subjected to t-test and One-way ANOVA followed by Tukey's post hoc test (α=.05).

RESULTS

At stage 1, group R presented higher bond strength values than group A (P=.000). There was a statistically significant increase of bond strength at stage 2 for group A (P=.003). The diamond bur influenced the surface roughness, increasing the values (P=.023). Group R provided better wettability. Regardless of the applied surface treatment, most of failures were adhesive.

CONCLUSION

The combination of application and reapplication of Rocatec Plus showed the best results of bond strength. Surface retreatment and recementation might be an indicated clinical strategy.

Investigating the shear bond strength of five resin-based luting agents to zirconia ceramics

The present study investigated the bond strength and aging resistance performance of five resin-based luting agents to zirconia. A total of 100 large blocks (10.0 mm × 10.0 mm × 2.5 mm) and 100 small blocks (4.0 mm × 4.0 mm × 2.5 mm) of zirconia were airborne-particle abraded and randomly divided into five groups: (RelyX Ultimate [RUl]; Panavia F [PF]; Clearfil SA Luting [SAC]; Multilink Speed [MS]; and RelyX Unicem [RUn]). The small blocks were bonded to the large blocks using the resin-based luting agents. Shear bond strengths (SBS) and failure mode were determined before and after 5,000 thermocycles. After being stored in water for 24 h, the SBS were MS > PF > RUl > SAC > RUn (P < 0.05). After 5,000 thermocycles, the SBS were MS > SAC ≈ RUl > PF ≈ RUn (P < 0.05); the SBS of the PF, MS, and RUn groups were lower than that before 5,000 thermocycles (P < 0.01). Adhesive failure, cohesive failure, or mixed failure occurred in the specimens. In general, Clearfil SA Luting, a self-adhesive resin-based luting agent containing 10-methacryloxy decyl diphosphate, had good initial and durable SBS to zirconia and was a better adhesive.

Adhesion to Zirconia: A Systematic Review of Current Conditioning Methods and Bonding Materials

Background. Reliable bonding between resin composite cements and high strength ceramics is difficult to achieve because of their chemical inertness and lack of silica content that makes etching impossible. The purpose of this review is to classify and analyze the existing methods and materials suggested to improve the adhesion of zirconia to dental substrate by using composite resins, in order to explore current trends in surface conditioning methods with predictable results. Methods. The current literature, examining the bond strength of zirconia ceramics, and including in vitro studies, clinical studies, and a systematic review, was analyzed. The research in the literature was carried out using PubMed and Cochrane Library databases, only papers in English, published online from 2013 to 2018. The following keywords and their combinations were used: Zirconia, 3Y-TZP, Adhesion, Adhesive cementation, Bonding, Resin, Composite resin, Composite material, Dentin, Enamel. Results. Research, in PubMed and Cochrane Library databases, provided 390 titles with abstracts. From these, a total of 93 publications were chosen for analysis. After a full text evaluation, seven articles were discarded. Therefore, the final sample was 86, including in vitro, clinical studies, and one systematic review. Various adhesive techniques with different testing methods were examined. Conclusions. Airborne-particle abrasion and tribo-chemical silica coating are the pre-treatment methods with more evidence in the literature. Increased adhesion could be expected after physico-chemical conditioning of zirconia. Surface contamination has a negative effect on adhesion. There is no evidence to support a universal adhesion protocol.

Adhesion behavior of conventional and high-translucent zirconia: Effect of surface conditioning methods and aging using an experimental methodology

OBJECTIVE

Evaluate the adhesive behavior of conventional and high-translucent zirconia after surface conditioning and hydrothermal aging.

MATERIALS AND METHODS

Conventional (ZrC) and high-translucent zirconia (ZrT) specimens were divided into six groups: without surface treatment (ZrC and ZrT), air-borne particle abrasion with 50-μm Al₂ O₃ sized particles (ZrC-AO and ZrT-AO), and tribochemical treatment with 30-μm silica modified Al₂ O₃ sized particles (ZrC-T and ZrT-T). Zirconia specimens were treated using an MDP-containing universal adhesive and bonded to two resins blocks with an adhesive luting cement. Microbar specimens with cross-sectioned areas of 1 mm² were achieved. Half of the microbars were subjected to hydrothermal aging. Bond strength was evaluated by microtensile bond strength test and statistically evaluated by the Weibull analysis.

RESULTS

Roughness of the ZrC-AO and ZrT-AO groups were statistically higher. Bond strength analysis revealed higher bond strength for ZrC-AO and ZrC-T groups compared to ZrT-AO and ZrT-T, respectively. Mixed failure was the most frequent for the mechanically treated groups, while no cohesive failures were obtained.

CONCLUSION

Lower values of bond strength were obtained for the mechanically treated high-translucent zirconia groups when compared to their conventional zirconia counterparts. Mechanical surface treatment significantly improved the bond strength to conventional and high-translucent zirconia.

CLINICAL SIGNIFICANCE

Mechanical surface treatment (air-borne particle abrasion or tribochemical treatment) associated with the use of universal adhesives containing MDP could provide a durable bonding to conventional and high-translucent zirconia.

Effect of airborne-particle abrasion and, acid and alkaline treatments on shear bond strength of dental zirconia

The surface roughness, morphology and shear bond strength (SBS) of dental zirconia using three different surface treatment techniques were evaluated. Three groups of sintered zirconia blocks were treated as follow, 1) Airborne-particle abrasion (APA) group (G1-APA), 50-µm Al₂O₃; 2) APA and 9% hydrofluoric acid etching (G2-HF); 3) APA and Sodium Hydroxide (G3-NaOH). The specimens were evaluated for roughness [atomic force microscope (AFM)], morphology [Scanning Electron Microscope (SEM)] and for SBS in the universal testing machine. The AFM revealed changes in the roughness after the surface treatments, however there was not Ra difference between groups, SEM analysis revealed changes in surface morphology for all surface treated specimens. For SBS, significant difference was found between G1-APA=8.4±2.7 MPa and G2-HF=3.3±0.6 MPa (p<0.05) and G2-HF and G3-NaOH=9.0±3.0 MPa (p<0.05). The main fracture mode was mixed failure (63%) for G1-APA and G3-NaOH groups. G2-HF showed 100% adhesive failure. SBS was improved with NaOH, however application of HF significantly decreased SBS.

Effect of occlusal groove on abutment, crown thickness, and cement-type on fracture load of monolithic zirconia crowns

The aim of this study was to investigate the effects of occlusal form of abutment, occlusal thickness of monolithic zirconia crowns (MZC), and cement type on the fracture load of MZC. Abutments were prepared with 2 types of occlusal forms: groove-type and flat-type. These were designed so that thickness at the central fissure region of MZC was 0.3, 0.5, or 0.7 mm. Glass ionomer cement and resin cement were used to lute MZC to their corresponding abutment. Fracture load was determined using a universal testing machine. As a result, groove-type abutment had lower fracture load compared to flat-type abutment; however, the decline in strength was smaller when resin cement was used. Additionally, specimens with larger occlusal thickness had greater fracture load regardless of groove or cement-type. The fracture of MZC occurred on the central fissure region of MZC except for 0.7 mm groove-type MZC luted with resin cement.

Structural and Morphological Evaluation of Presintered Zirconia following Different Surface Treatments

AIM

The aim of this study was to evaluate the effect of different surface treatments on roughness, grain size, and phase transformation of presintered zirconia.

MATERIALS AND METHODS

Surface treatments included airborne particle abrasion (APA) before and after sintering with different particles shape, size, and pressure (50 μm Al₂O₃, 50 μm glass beads, and ceramic powder). Thirty-five square-shaped presin-tered yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic slabs (Zenostar ZR bridge, Wieland) were prepared (4 mm height × 10 mm width × 10 mm length) and polished with silicon carbide grit papers #800, 1000, 1200, 1500, and 2000 to ensure identical initial roughness. Specimens were divided into five groups according to surface treatment: group I (control): no surface treatment; group II: APA 50 μm Al₂O₃ after sintering; group III: APA 50 μm Al₂O₃ particles before sintering; group IV: APA 50 μm glass bead particles before sintering; and group V: APA ceramic powder before sintering. Specimens were analyzed using scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray diffraction (XRD) analyses, and tested for shear bond strength (SBS). Data were statistically analyzed using one-way analysis of variance (ANOVA) followed by post hoc tests for multiple comparisons Tukey's test (a > 0.05).

RESULTS

Air abrasion before sintering significantly increased the surface roughness when compared with groups I and III. The highest tetragonal to monoclinic (t-m) phase transformation (0.07%) was observed in group III, and a reverse transformation was observed in presintered groups (0.01%). Regarding bond strength, there was a significant difference between APA procedures pre- and postsintering.

CONCLUSION

Air abrasion before sintering is a valuable method for increasing surface roughness and SBS. The abrasive particles' size and type used before sintering had a little effect on phase transformation.

CLINICAL SIGNIFICANCE

Air abrasion before sintering could be supposed to be an alternative surface treatment method to air abrasion after sintering.

Influence of Particle and Air-Abrasion Moment on Y-TZP Surface Characterization and Bond Strength

PURPOSE

To evaluate the influence of particle and air-abrasion on the surface characterization and shear bond strength (SBS) of a Y-TZP ceramic with a resin cement.

MATERIALS AND METHODS

Y-TZP specimens were air-abraded with 50 μm alumina particles; 120 μm alumina particles; 30 μm silica-coated alumina particles (Rocatec Soft); 110 μm silica-coated alumina particles (Rocatec Plus). Air-abrasion was performed before (BS); after (AS); before and after (BAS) zirconia sintering. Surface characterization included roughness (n = 10), wettability (n = 10), morphology (n = 2), and elemental composition (n = 2). For SBS (n = 11), composite resin discs were bonded to the air-abraded and silane-treated zirconia surface, with the resin cement RelyX ARC. Failure mode was determined. Roughness, wettability, and SBS data were analyzed by two-way ANOVA with pairwise interaction and Tukey's test (α = 0.05).

RESULTS

Air-abrasion performed with coarser particles at BS and BAS moments provided the highest roughness values, while the lowest roughness values were observed with particles combined with AS moment (p < 0.01). Rocatec Plus provided lower contact angle than the 120 μm alumina particles (p = 0.013), and BAS exhibited lower contact angle than BS (p = 0.002). The combinations 120 μm/BS and the silica-coated alumina particles/AS and /BAS showed the highest SBS (p < 0.05). The combination of each particle/BAS was statistically similar to the same particle/AS. Failure mode was 100% adhesive for all groups. The interaction particle size/air-abrasion moment determined the morphological pattern. Silicon was observed only in the Rocatec groups.

CONCLUSIONS

Roughness was influenced by the particle size and was higher when the zirconia was air-abraded in its green stage. The particle composition played an important role in the wettability and both studied air-abrasion moments provided similar wettability than the one in which air-abrasion is usually performed. The highest SBS values were observed in the three moments, by using certain particles for each moment.

Shear Bond Strength of Al₂O₃ Sandblasted Y-TZP Ceramic to the Orthodontic Metal Bracket

As the proportion of adult orthodontic treatment increases, mainly for aesthetic reasons, orthodontic brackets are directly attached to yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) restorations. This, study analyzed the shear bond strength (SBS) between various surface treated Y-TZP and orthodontic metal brackets. The Y-TZP specimens were conditioned by 110 μm Al₂O₃ sandblasting, or sandblasting followed by coating with one of the primers (silane, MDP, or an MDP-containing silane primer). After surface treatment, the orthodontic metal bracket was bonded to the specimen using a resin cement, and then 24 h storage in water and thermal cycling (5000 cycles, 5-55 °C), SBS was measured. Surface roughness was analyzed for surface morphology, and X-ray photoelectron spectroscopy (XPS) was employed for characterization of the chemical bond between the Y-TZP and the MDP-based primers (MDP, MDP containing silane primer). It was found that after surface treatment, the surface roughness of all groups increased. The groups treated with 110 μm Al₂O₃ sandblasting and MDP, or MDP-containing silane primer showed the highest SBS values, at 11.92 ± 1.51 MPa and 13.36 ± 2.31 MPa, respectively. The SBS values significantly decreased in all the groups after thermal cycling. Results from XPS analysis demonstrated the presence of chemical bonds between Y-TZP and MDP. Thus, the application of MDP-based primers after Al₂O₃ sandblasting enhances the resin bond strength between Y-TZP and the orthodontic metal bracket. However, bonding durability of all the surface-treated groups decreased after thermal cycling.

Surface analysis and shear bond strength of zirconia on resin cements after non-thermal plasma treatment and/or primer application for metallic alloys

There is no established protocol for bonding zirconia (Y-TZP) with resin cements. Non-thermal plasma (NTP) may be an alternative for the clinical problems related to adhesion. The purpose of the present study was to characterize the surface of Y-TZP exposed to methane (CH₄) NTP or coated with a layer of primer for metal alloys and the association between the two methods and to evaluate the effect of NTP treatment on bond strength between Y-TZP and two resin cements. A total of 235 Y-TZP discs (8×2mm) were distributed into five groups: Co (no surface treatment), Pr (primer), NTP (methane plasma), Pr+NTP and NTP+Pr. The effect of the treatment type on the surface free energy, morphology, topography and chemical composition of the Y-TZP discs was investigated. The discs were cemented to composite resin substrates using Panavia F2.0 or RelyX U200. Shear bond strength (n=10) analyses were performed (1mm/min) before and after thermocycling (5-55°C, 2000cycles) on the bonded specimens. The data were analyzed with one and three-way ANOVAs and Bonferroni tests (α=0.05). NTP reduced the surface energy and roughness of the Y-TZP discs. SEM-EDS and XPS analyses showed the presence of the organic thin film, which significantly improved the bond strength results when Rely X U200 was used, whereas the primer treatment was more effective with Panavia F2.0. Thermocycling significantly reduced the bond strength results of the NTP and Pr+NTP groups cemented with Rely X U200 and the Pr and NTP+Pr groups cemented with Panavia F2.0. Nonthermal plasma improves the bond strength between Rely X U200 and Y-TZP and also seems to have water-resistant behavior, whereas Panavia F2.0 showed better results when associated with primer.

Zirconia as a Dental Biomaterial

Ceramics are very important in the science of dental biomaterials. Among all dental ceramics, zirconia is in evidence as a dental biomaterial and it is the material of choice in contemporary restorative dentistry. Zirconia has been applied as structural material for dental bridges, crowns, inserts, and implants, mostly because of its biocompatibility, high fracture toughness, and radiopacity. However, the clinical success of restorative dentistry has to consider the adhesion to different substrates, which has offered a great challenge to dental zirconia research and development. This study characterizes zirconia as a dental biomaterial, presenting the current consensus and challenges to its dental applications.