Effect of Various Lasers on the Bond Strength of Two Zirconia Ceramics

Comparison of the effects of laser systems and cold atmospheric plasma on the surface roughness and shear bond strength of flexible hybrid ceramics

The aim of this study was to compare the effects of laser systems and cold atmospheric plasma (CAP) on the surface roughness (Ra) and shear bond strength (SBS) of flexible hybrid ceramics (FHCs). Eighty FHC samples were divided into 5 groups to be subjected to surface treatments (hydrofluoric acid (HFA), HFA + 5 W Er: YAG laser (HFA + 5WE), HFA + 3 W Er: YAG laser (HFA + 3WE), HFA + ultrafast fiber laser (HFA + FL), and CAP). The Er: YAG laser (AT Fidelis Plus III, Fotona, Slovenia) was operated with a 0.9 mm diameter tip, delivering 250 mJ and 150 mJ per pulse, with output powers of 5 W and 3 W, and fluences of 23,623 J/cm² and 14,157 J/cm², respectively, at a frequency of 20 Hz and a pulse duration of 600 µs for 30 s. The FL (FiberLAST Inc., Turkey) was applied with a 7 mm spot size, 1 mJ pulse energy, 20 W output power, 100 kHz repetition rate, ultrashort pulse length (100 ns), and the fluence of 1,820 J/cm² for 7 s. The CAP (PiezoBrush PZ3, Relyon Plasma, Germany) applied to the surfaces for 80 s at a treatment speed of 5 cm2/s and 100% plasma power. After the Ra values were measured, each group was divided into 2 subgroups to be cemented with total-etch (TE) and self-adhesive (SA) resin cements. The SBS of all the samples was measured. One sample was randomly selected from each group, and the fractured surfaces were examined by SEM analysis. The significance level was at P < 0.05. HFA + FL had the highest Ra values, and there was no significant difference between HFA + FL and HFA + 5WE (P > 0.05). There was no difference in Ra between CAP and HFA (P > 0.05). The highest SBS values were observed for the samples cemented with TE after HFA + FL. The difference between the SBS values of the groups cemented with TE after CAP, HFA + 5WE, HFA + 3WE, and HFA + FL was not significant (P < 0.05). The use of FL may be a promising method to improve SBS without causing thermal damage when using TE or SA cements. CAP can be recommended as a practical and safe treatment with SA cement because it is suitable for chairside use with a handheld device and does not change the physical properties of the material.

Effect of femtosecond laser induced surface patterns on the flexural strength of monolithic zirconia

To investigate how patterns generated by femtosecond (fs) laser and femtosecond laser power affect the surface roughness (Ra) and biaxial flexural strength (BFS) of monolithic zirconia. Eighty disk-shaped zirconia specimens were divided into eight subgroups (n = 10): Control (C), airborne-particle abrasion (APA), 400 mW fs laser (spiral [SP(400)], square [SQ(400)], circular [CI(400)]), and 700 mW fs laser ([SP(700)], [SQ(700)], [CI(700)]). Ra values were calculated by using a surface profilometer. One additional specimen per group was analyzed with scanning electron microscopy and x-ray diffractometry. BFS values were obtained by using the piston-on-3-ball test. One-way ANOVA and either Tukey's HSD (BFS) or Tamhane's T2 (Ra) tests were used to evaluate data (α = 0.05). Regardless of the pattern and power, fs laser groups had higher Ra than C and APA, while SP groups had lower Ra than CI and SQ groups (p ≤ 0.004). For each pattern, Ra increased with higher laser power (p < 0.001), while the laser power did not affect the BFS (p ≥ 0.793). CI and SQ groups had lower BFS than the other groups (p ≤ 0.040), whereas SP groups had similar BFS to C and APA (p ≥ 0.430). Fs laser microstructuring with spiral surface pattern increased the Ra without jeopardizing the BFS of zirconia. Thus, this treatment might be an option to roughen tested zirconia.

The Effect of Femtosecond Laser Surface Patterns on the Effectiveness of Resin Composite to Zirconia Bonding

This laboratory study aimed to evaluate the effect of different surface patterns using femtosecond laser treatment on the enclosed mold shear bond strength (EM-SBS) of resin composite to zirconia (ZrO2) surfaces and to contrast it with the widely used tribochemical silica coating (TBC) surface conditioning method. A set of fifteen rectangular ZrO2 blocks were randomly divided into five groups according to surface pretreatment: Control G0-no treatment; G1-TBC with silane application; G2-femtosecond laser irradiation with horizontal lines 30 µm apart; G3-femtosecond laser irradiation with horizontal lines 15 µm apart; and G4-femtosecond laser irradiation with cross lines 30 µm apart. The pretreated surfaces were characterized by a surface profilometer, tensiometer and scanning electron microscope. The EM-SBS of resin composite stubs to ZrO2 was measured followed by fractographic analysis. The surface roughness and water contact angle were observed to be statistically higher among the femtosecond laser groups compared to the TBC and control groups. The G4 group exhibited the highest EM-SBS among all the groups, irrespective of the ageing conditions used. At the end of 5000 thermocycles, G4 exhibited EM-SBS of 14.05 ± 4.21 MPa compared to 13.80 ± 3.01 MPa in G1 and 5.47 ± 0.97 MPa in G0. The two-way ANOVA revealed a significant effect of both study groups and ageing conditions on the EM-SBS (p < 0.001). Utilization of femtosecond laser technology holds promise as a potential and alternative mechanical retention approach for enhancing the bonding strength of the resin composite to ZrO2.

In vitro comparative study between adhesion forces obtained on zirconia ceramic micromechanically treated with femtosecond laser (1027 nm), carbon dioxide laser (10,600 nm), and aluminum-oxide particles

Conventional surface roughening treatments used for silica-based ceramics in order to improve subsequent adhesion become unreliable for zirconia ceramics. Laser conditioning can be a good alternative. The purpose of this in vitro study was to compare conventional (macro) shear bond strength (SBS) values obtained between resin composite and zirconium oxide ceramic samples grouped according to different micromechanical treatments received, and examine differences in surface roughness. One-hundred and fifty disks of sintered zirconia were randomly divided into 5 groups and roughened as follows: (1) Group NOT, no surface treatment; (2) Group APA, abraded with 50-μm aluminum-oxide (Al2O3) particles; (3) Group TBS, abraded with 30-μm aluminum-oxide particles covered with silica; (4) Group CO2, irradiated with a CO2 laser which emitted in continuous wave mode at 3 W of power; and (5) Group FEM, irradiated with a pulsed femtosecond laser, with an incident energy of 10 μJ, a frequency of 1000 Hz, and a fluence of 1.3 kJ/cm2. All surfaces were treated with a MDP-containing adhesive/silane coupling agent mixture upon which were prepared and light polymerized composite resin cylinders. Shear bond strength was measured and samples were observed by scanning electron microscopy (SEM). Statistically significant differences (p < 0.05) were found among all groups, except between CO2 and FEM, which showed the highest adhesion values (15.12 ± 2.35 MPa and 16.03 ± 2.73 MPa). SEM revealed differences in surface patterns. CO2 laser irradiation can be an alternative to sandblasting, although it could also weaken the ceramic. Suitable surface patterns on zirconia ceramics can be obtained with ultrashort pulsed radiation emitted by a pulsed femtosecond laser.

Ultrashort pulse laser patterning of zirconia (3Y-TZP) for enhanced adhesion to resin-matrix cements used in dentistry: An integrative review

Surface modification of yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) using lasers for adhesion enhancement with resin-matrix cement has been increasingly explored. However, Y-TZP is chemically inert and non-reactive, demanding surface modification using alternative approaches to enhance its bond strength to resin-matrix cements. The main aim of this study was to conduct an integrative review on the influence of ultrashort pulse laser patterning of zirconia (3Y-TZP) for enhanced bonding to resin-matrix cements. An electronic search was performed on web of science, SCOPUS, Pubmed/Medline, Google Scholar and EMBASE using a combination of the following search items: zirconia, 3Y-TZP, surface modification, laser surface treatment, AND laser, ultrashortpulse laser, bonding, adhesion, and resin cement. Articles published in the English language, up to January 2022, were included regarding the influence of surface patterning on bond strength of Y-TZP to resin-matrix cements. Out of the 12 studies selected for the present review 10 studies assessed femtosecond lasers while 2 studies assessed picosecond lasers. Ultrashort pulsed laser surface patterning successfully produced different surface morphological aspects without damaging the bulk properties of zirconia. Contrarily, defects such as micro-cracks occurs after surface modification using traditional methods such as grit-blasting or long-pulsed laser patterning. Ultrashort pulsed laser surface patterning increase bond strength of zirconia to resin-matrix cements and therefore such alternative physical method should be considered in dentistry. Also, surface defects were avoided using ultrashort pulsed laser surface patterning, which become the major advantage when compared with traditional physical methods or long pulse laser patterning.

LASER as a tool for surface modification of dental biomaterials: A review

In recent years, the application of lasers for modifying the surface topography of dental biomaterials has received increased attention. This review paper aims to provide an overview of the current status on the utilization of lasers as a potential tool for surface modification of dental biomaterials such as implants, ceramics, and other materials used for restorative purposes. A literature search was done for articles related to the use of lasers for surface modification of dental biomaterials in English language published between October 2000 and March 2023 in Scopus, Pubmed and web of science, and relevant articles were reviewed. Lasers have been mainly used for surface modification of implant materials (71%), especially titanium and its alloys, to promote osseointegration. In recent years, laser texturing has also emerged as a promising technique to reduce bacterial adhesion on titanium implant surfaces. Currently, lasers are being widely used for surface modifications to improve osseointegration and reduce peri-implant inflammation of ceramic implants and to enhance the retention of ceramic restorations to the tooth. The studies considered in this review seem to suggest laser texturing to be more proficient than the conventional methods of surface modification. Lasers can alter the surface characteristics of dental biomaterials by creating innovative surface patterns without significantly affecting their bulk properties. With advances in laser technology and availability of newer wavelengths and modes, laser as a tool for surface modification of dental biomaterials is a promising field, with excellent potential for future research.

Repair bond strength of different CAD-CAM ceramics after various surface treatments combined with laser irradiation

The aim of this study was to evaluate the effect of different surface treatments combined with laser irradiation on the shear bond strength of different CAD-CAM ceramics to composite resin. A total of hundred forty-seven ceramic specimens with thicknesses of 2.5 mm were prepared from three different CAD-CAM ceramics (an yttrium oxide partially stabilized tetragonal zirconia polycrystal (Y-TZP); a zirconia-reinforced lithium silicate glass ceramic (ZLS); and a lithium disilicate-strengthened lithium aluminosilicate glass ceramic (LD-LAS)) and subjected to seven groups of treatment (n = 7): (1) control (no treatment), (2) Er:YAG laser irradiation, (3) Nd:YAG laser irradiation, (4) etching with hydrofluoric acid (HFA), (5) Er:YAG + HFA, (6) Nd:YAG + HFA, and (7) sandblasting. After surface treatment procedures, a ceramic primer (Clearfil Ceramic Primer Plus, Kuraray, Japan) was applied to the ceramics. Bonding agent (Single Bond Universal Adhesive, 3 M ESPE, USA) was then applied, and the composite resin (Estelite Sigma Quick, Kuraray, Japan) was layered on the ceramic surfaces. The shear bond strength test was performed using a universal testing machine at a load of 0.5 mm/min. Data were analyzed by 2-way analysis of variance (ANOVA), and the Bonferroni correction was used for pairwise comparisons (α = 0.05). Compared to the bond strength of the control group, irradiation by Er:YAG and Nd:YAG lasers alone improved the bond strength of the composite resin to the Y-TZP (P < 0.001) but did not change the bond strength of composite resin to the ZLS and LD-LAS (P > 0.05). Compared to the bond strength of the control group, etching with HFA alone increased the bond strength of the composite resin to the ZLS and LD-LAS (P < 0.001) but did not affect the bond strength of the composite resin to the Y-TZP (P > 0.05). The highest bond strength of ZLS was obtained using HFA + Er:YAG, and the highest bond strength for LD-LAS was obtained using HFA + Nd:YAG. It was concluded that Er:YAG and Nd:YAG laser treatments presented the highest repair bond strength between the composite resin and Y-TZP ceramics. Er:YAG and Nd:YAG laser treatments in conjuction with HFA presented the highest repair bond strength between the composite resin and the glassy ceramics, ZLS, and LD + LAS.

Effect of Hydroxyapatite Coating in Combination with Physical Modifications on Microshear Bond Strength of Zirconia to Resin Cement

Background

Zirconia has been used as a reliable core material in dental restorations for years; however, its bonding to resin cement is a matter of challenge. Physical, chemical, and combinations of these techniques have been investigated to boost the properties of zirconia surface bonding. The objective of this work was to evaluate the effect of hydroxyapatite coating as a chemical therapy in combination with physical modifications on the microshear bond strength of the resin cement over zirconia.

Methods

In the present research, 60 sintered zirconia blocks (4 × 4 × 4 mm) were randomized into four groups of 15, including Al2O3 particle abrasion (group 1), HA coating (group 2), Al2O3 particle abrasion + HA coating (group 3), and Er, Cr: YSGG laser irradiation + HA coating (group 4). The microshear bond strength was determined by bonding the blocks to the resin cement.

Results

The bond strengths (mean ± standard deviation) of modified zirconia surfaces were 16.93 ± 4.94 MPa, 16.14 ± 5.4 MPa, 19.4 ± 5.27 MPa, and 16.21 ± 3.7 MPa in groups 1-4, respectively. Test results of the ANOVA test revealed no significant difference regarding the bond strength values of zirconia surfaces to the resin cement between the studied preparation modalities (p > 0.05).

Conclusion

Observations from the present study showed that HA coating can be as effective as the air-borne particle abrasion technique in improving bond strength to zirconia surfaces. Moreover, sandblasting by an aluminum oxide or Er, Cr: YSGG laser irradiation prior to HA coating of zirconia showed no significant effect on the reinforcement of bond strength values when compared to HA coating alone. The clinic hydroxyapatite coating alone or in combination with physical treatments improves the bond strength of zirconia to resin cement.

Effect of Ti: Sapphire and Nd: YAG Lasers on Shear Bond Strength at the Zirconia - Veneering Ceramic Juncture

Introduction: This study was conducted to assess the impact of nanosecond and femtosecond lasers on shear bond strength at the zirconia - veneering ceramic juncture. Materials and Methods: The first 60 samples of partially sintered zirconia cylindrical discs measuring 7 mm diameter and 4 mm height were milled and sintered. Then they were randomly divided into three groups namely group C (control, n=10), group N (Nd: YAG laser, n=10), and group T (Ti: sapphire laser n=40) which was further divided based on the duration of laser irradiation, into 4 subgroups (n=10 each) which were 30 seconds, 1 minute, 2 minutes and 3 minutes. Surface treatment was done on sintered zirconia discs based on the group. Following the treatment, the discs were ultrasonically cleaned followed by liner application (IPS Emax Zirliner, Ivoclar-Vivadent) and veneer ceramic layering (IPS e.max Ceram, Ivoclar-Vivadent) of 1.5 mm height. Each sample underwent shear stress in the universal test machine on the mounting jig, and bond strength was evaluated. Data were assessed using ANOVA followed by Tukey’s post hoc multiple comparison analyses. Results: According to one-way ANOVA, there was a significant difference in shear bond strength between the groups. Tukey’s post hoc pair wise comparison test showed a significant difference (P value=0.001) in shear bond strength of all pairs except group C and group N. The results of repeated measures, ANOVA (related and dependent groups) and Tukey’s multiple pair wise comparison test showed that there was a significant difference (P value=0.001) in shear bond strength at 30 seconds and all other groups. Conclusion: Ti: sapphire laser irradiation for 30 seconds can be used as potential surface treatment to increase shear bond strength at the zirconia-veneering ceramic juncture.

Evaluation of Surface Roughness of a Ni-Cr Alloy Treated With the Nd/YAG Laser and the Sandblast Technique

Introduction: This study was to assess the effect of various output parameters of laser treatment on roughening the surface of a commercial nickel-chromium (Ni-Cr) alloy as compared to the sandblasting technique. Materials and Methods: Ninety-six disk-shaped (5 mm diameter and 2 mm thickness) specimens in total were made of a nickel-chromium alloy by using the lost-wax technique. Air-abrasion surface treatment was used for sixteen specimens. Specimens were divided into six groups; one of them was sandblasted and the rest were irradiated by different Nd:YAG laser output parameters as follows: Group A: energy: 122 mJ, frequency: 20 Hz, irradiation duration: 20 seconds, spot size: 1.5 mm; Group B: energy: 122 mJ, frequency: 20 Hz, irradiation duration: 20 seconds, spot size: 3.5 mm; Group C: energy: 122 mJ, frequency: 10 Hz, irradiation duration: 20 seconds, spot size: 3.5 mm; Group D: energy: 102 mJ, frequency: 10 Hz, irradiation duration: 20 seconds, spot size: 3 mm; Group E: energy: 102 mJ, frequency: 20 Hz, irradiation duration: 20 seconds, spot size: 3 mm. The surface roughness of all surface-treated specimens was evaluated by using a profilometer, and their average roughness (Ra) was calculated. The average value of each group was analyzed by t test and one-way ANOVA (SPSS 17). Results: Significant differences (P<0.05) were observed between the study groups. The highest Ra was achieved for the sandblasted group. The Ra value in group C was the highest value among the laser-etched groups. Conclusion: Based on the results, Nd:YAG laser irradiation increases surface roughness, but it is not as efficient as the sandblasting method as a gold standard.

The Use of Lasers in Dental Materials: A Review

Lasers have been well integrated in clinical dentistry for the last two decades, providing clinical alternatives in the management of both soft and hard tissues with an expanding use in the field of dental materials. One of their main advantages is that they can deliver very low to very high concentrated power at an exact point on any substrate by all possible means. The aim of this review is to thoroughly analyze the use of lasers in the processing of dental materials and to enlighten the new trends in laser technology focused on dental material management. New approaches for the elaboration of dental materials that require high energy levels and delicate processing, such as metals, ceramics, and resins are provided, while time consuming laboratory procedures, such as cutting restorative materials, welding, and sintering are facilitated. In addition, surface characteristics of titanium alloys and high strength ceramics can be altered. Finally, the potential of lasers to increase the adhesion of zirconia ceramics to different substrates has been tested for all laser devices, including a new ultrafast generation of lasers.

Effects of laser modalities on shear bond strengths of composite superstructure to zirconia and PEEK infrastructures: an in vitro study

In the last decade, demand for metal-free esthetic restorations has grown considerably due to the development of materials to fulfill the need for an esthetic prosthesis. We examined the effects of erbium-doped yttrium aluminum garnet (Er:YAG), neodymium-doped yttrium aluminum garnet (Nd:YAG), and potassium titanyl phosphate (KTP) laser applications on the shear bond strength (SBS) of nanohybrid composite superstructures to zirconia and PEEK infrastructures. Zirconia and PEEK specimens were prepared with CAD/CAM technology in accordance with ISO 11405 standards. The disc-shaped samples were randomly separated into four groups (n = 8) according to applied laser type: no treatment and Er:YAG, Nd:YAG, and KTP lasers. Nanohybrid composite resin was applied as a veneering material to each infrastructure. After surface treatment of infrastructures by the lasers, the SBS test was carried out to determine the bonding of infrastructures, which were also examined with a stereomicroscope. The SBS were significantly higher in the PEEK specimens treated with the studied lasers. Nd:YAG laser was the most effective method, followed by Er:YAG laser and KTP laser. The lowest SBS value was obtained in the no-treatment group. Stereomicroscopically, the studied lasers produced different irregularities on the infrastructures. PEEK as a framework provides meaningfully higher bonding strength to composite resins compared to zirconia. Nd:YAG, Er:YAG, and KTP, in descending order, are efficacious in increasing the attachment of studied structures.

Nanosecond pulsed fiber laser irradiation for enhanced zirconia crown adhesion: Morphological, chemical, thermal and mechanical analysis

The increasing demand for aesthetics, together with advancements in technology, have contributed to the rise in popularity of all-ceramic restorations. In the last two decades, the continuous progression in ceramic materials science for dental applications has permitted the fabrication of high-strength materials. Amongst these, zirconia-based ceramics have improved in terms of fracture resistance and long-term viability in comparison with other silica-based materials. Unfortunately, while bonding of resin cement-silica ceramics can be strengthened through creation of a porous surface by applying hydrofluoric acid (5%-9.5%) and a subsequent silane coupling agent, the glass-free polycrystalline microstructure of zirconia ceramics does not allow such a reaction. The aim of the present in vitro study was to observe the effect of 1070 nm fiber nanosecond pulse laser irradiation on zirconia samples through morphological analysis (profilometry, SEM), thermal recording with Fiber Bragg Gratings (FBGs), elemental composition analysis (EDX) and bond strength testing (mechanical tests) in order to evaluate the possible advantages of this kind of treatment on zirconia surfaces, as well as to show the potential side effects and changes in chemical composition. Despite laser irradiation with a 1070 nm wavelength fiber laser and correct process parameters demonstrating suitable outcomes in terms of improved surface roughness and minimal thermal damage, comparison between irradiated and unirradiated samples did not exhibit statistically significant differences in terms of bonding strength.

Laser surface texturing of zirconia-based ceramics for dental applications: A review

Laser surface texturing is widely explored for modifying the surface topography of various materials and thereby tuning their optical, tribological, biological, and other surface properties. In dentistry, improved osseointegration has been observed with laser textured titanium dental implants in clinical trials. Due to several limitations of titanium materials, dental implants made of zirconia-based ceramics are now considered as one of the best alternatives. Laser surface texturing of zirconia dental implants is therefore attracting increasing attention. However, due to the brittle nature of zirconia, as well as the metastable tetragonal ZrO₂ phase, laser texturing in the case of zirconia is more challenging than in the case of titanium. Understanding these challenges requires different fields of expertise, including laser engineering, materials science, and dentistry. Even though much progress was made within each field of expertise, a comprehensive analysis of all the related factors is still missing. This review paper provides thus an overview of the common challenges and current status on the use of lasers for surface texturing of zirconia-based ceramics for dental applications, including texturing of zirconia implants for improving osseointegration, texturing of zirconia abutments for reducing peri-implant inflammation, and texturing of zirconia restorations for improving restoration retention by bonding.

Effect of Different Nd:YAG Laser Power Outputs on Bond Strength of Resin Cement to Zirconia in Comparison to Sandblasting

Introduction: This study investigated the effect of various laser powers on the shear bond strength (SBS) of resin cement to the zirconia surface. Methods: Seventy-five zirconia disks were prepared and assigned to five groups including no surface treatment (control group), sandblasting with 50 µ Al₂ O₃ particles (second group), and Nd:YAG laser treatments with 2 W, 2.5 W and 3 W powers respectively (third, fourth and fifth groups). Afterwards, composite resin cylinders were cemented on zirconia disks using dual-curing resin cement. Before thermocycling (2000 cycles, 5-55°C), all samples were placed in distilled water at 37°C for 24 hours. Using a universal testing machine at the crosshead speed of 0.5 mm/min, the SBS was examined. Also, using a stereomicroscope, the failure type was determined. Data analyses were performed using Welch and Games-Howell tests (P < 0.05). Results: The mean bond strength difference between the control group and the other groups was significant. The respective bond strength from the highest to the lowest was observed in the sandblast group, the laser group with 2.5 W power, the laser group with 3 W power, the laser group with 2 W power, and finally the control group. However, no significant difference was observed between different laser groups (P < 0.05). Also, there was no significant difference between the sandblast and laser groups with 2.5 W and 3 W power (P < 0.05). Most of the failures in the sandblasting and laser groups with powers of 2.5 W and 3 W were mixed, but in the control and 2 W laser groups, most of the failures were of adhesive nature. Conclusion: The highest bond strength was achieved by sandblasting with Al₂ O₃ particles and then using an Nd: YAG laser with a power of 2.5 W.

Novel Femto Laser Patterning of High Translucent Zirconia as an Alternative to Conventional Particle Abrasion

Background: currently applied surface treatments for zirconia bonding may create undesired microcracks and surface flaws. The aim of the present study was to evaluate the efficacy of alternative surface treatments on the shear bond strength of high translucency zirconia to 10-Methacryloyloxydecyl dihydrogen phosphate (MDP)-containing resin-based cement. Methods: fifty disk-shaped specimens (10 mm × 5 mm) were fabricated from a commercial yttria-stabilized zirconia with 5 mole% yttrium oxide tetragonal zirconia polycrystal (5Y-TZP), and underwent air-abrasion with alumina particles (50 μm-AL50 and 90 μm-AL90), glass beads (GB 10–60 μm), and ablation with femtosecond laser (FEMTO). Shear bond strength was evaluated with a universal testing machine under a crosshead speed of 0.5 mm/min until fracture. Fracture type was evaluated with an optical stereomicroscope. Differences among groups were evaluated by one-way ANOVA and Bonferroni pairwise comparison tests (p < 0.05). Results: the highest shear bond strength values were presented by the laser treated group (23.97 ± 3.7 MPa). No statistically significant differences were found among the Cl, Al50, Al90 and FEMTO groups. The lowest mean value was presented by the glass-beads treated group (11.93 ± 2.88 MPa) which was significantly lower compared to all other groups (p < 0.001). Conclusions: under the limitations of this in vitro study, femtosecond laser treatment of High-translucent monolithic zirconia (HTZ) ceramics is a promising alternative method for the mechanical retention of resin cements.

Combined application of femtosecond laser and air-abrasion protocols to monolithic zirconia at different sintering stages: Effects on surface roughness and resin bond strength

This study aimed to investigate the effects of femtosecond laser (Fs) and/or air-abrasion protocols on surface roughness (Ra) of zirconia and resin bond strength. Eighty zirconia samples were randomly divided into eight subgroups according to surface treatment protocols: Control (C), Air-abrasion before sintering (ABS), Air-abrasion after sintering (AAS), Air-abrasion before and after sintering (ABS + AAS), Fs laser before sintering (FBS), Fs laser before sintering + air-abrasion after sintering (FBS + AAS), Fs laser after sintering (FAS), and Fs laser after sintering + air-abrasion after sintering (FAS + AAS). Measurements of Ra values were obtained using a surface profilometer. Surface morphological properties were evaluated with scanning electron microscopy (SEM), and crystallographic changes were examined by X-Ray diffractometry (XRD). Self-adhesive resin cement was bonded to zirconia samples, and shear bond strength (SBS) tests were performed. The data were statistically analyzed by one-way ANOVA, followed by Tamhane tests. The control group displayed the lowest Ra and SBS values among all groups. The highest Ra and SBS values were found in the FBS and FBS + AAS groups. Air-abrasion applied before sintering significantly increased the Ra of specimens. FAS, FAS + AAS, and ABS + AAS groups exhibited higher SBS values than AAS and ABS (p < .05). Air-abrasion applied after Fs laser did not produce any significant change in the Ra and SBS compared to Fs laser alone (p > .05). Femtosecond laser application may be a promising method to enhance the surface roughness of zirconia and improve resin bond strength. Air-abrasion at pre- and post-sintered stages may also be a viable surface treatment option.

Effect of Fiber Laser Irradiation on the Shear Bond Strength between Acrylic Resin and Titanium

OBJECTIVES

The aim of this study is to investigate the shear bond strength of an acrylic resin to titanium after different surface treatment methods.

MATERIAL AND METHODS

A total of seventy-two disc-shaped specimens (10 mm × 10 mm × 2 mm) were prepared from titanium alloy. The specimens were randomly allocated to six equal groups: Group S (sandblasting), Group MP (metal primer), Group 10W (fiber laser 10 W), Group 20W (fiber laser 20 W), Group 10WMP (fiber laser 10 W+metal primer), and Group 20WMP (fiber laser 20 W+metal primer). All of the specimens were thermocycled up to 5000 cycles. After thermal cycling, a shear bond strength test was conducted. The shear bond strength data were analyzed with one-way ANOVA and Tukey's post hoc pairwise comparisons (p < 0.05).

RESULTS

While the highest values were determined in Group MP, the lowest values were observed in Group S. Additionally, Group MP exhibited significantly higher shear bond strength values than any of the other groups (p < 0.05) except Group 10WMP. Similar results were observed between Group MP and Group 10WMP (p > 0.05). The groups in which a metal primer was applied (Group MP, 10WMP, and 20WMP) showed significantly higher values than Group S. The shear bond strength values of Group 10W and Group 20W were similar.

CONCLUSIONS

The application of a metal primer significantly improved the bond strength of acrylic resin to titanium. Fiber laser application may be an alternative method to sandblasting for improving the bond strength of acrylic resin to titanium.

Surface Characterization and Cell Adhesion of Different Zirconia Treatments: An in vitro Study

AIM

The aim of this study was to characterize the surface of zirconia subjected to different treatments and evaluate its effect on cell adhesion and proliferation.

MATERIALS AND METHODS

A total of 80 zirconia disks were divided into four groups (n = 20) according to the surface treatments used: group I: as-sintered (AS), no surface treatment applied; group II: abrasion treatment applied using Rocatec (ROC; 3M ESPE) system with silica-coated alumina powder of grit size 110 μm; group III: erbium, chromium:yttrium, scandium, gallium, garnet (Er, Cr:YSGG) laser (LAS; BIOLASE) was used at a frequency of 20 Hz and output power of 3 W; and group IV: specimens were subjected to the selective infiltration etching (SIE) technique. Surface characterization was evaluated for the different groups (roughness, hardness, and morphology), and cell behavior (adhesion and proliferation) was tested (a = 0.05).

RESULTS

The ROC group reported a significant increase in surface roughness (2.201 ± 0.352) and Vickers hardness (1758 ± 16.6) compared with the other surface treatments. The SIE surface-treated group reported a significantly higher number of cells (64.5 ± 2.6 and 53.5 ± 2.2 respectively) compared with the other surface-treated groups.

CONCLUSION

The SIE is a promising surface treatment for zirconia that significantly enhances cell adhesion and osseointegration.

CLINICAL SIGNIFICANCE

The SIE treatment of zirconia implants may help in a faster and better osseointegration.

The effects of lasers on bond strength to ceramic materials: A systematic review and meta-analysis

Lasers have recently been introduced as an alternative means of conditioning dental ceramic surfaces in order to enhance their adhesive strength to cements and other materials. The present systematic review and meta-analysis aimed to review and quantitatively analyze the available literature in order to determine which bond protocols and laser types are the most effective.

A search was conducted in the Pubmed, Embase and Scopus databases for papers published up to April 2017. PRISMA guidelines for systematic review and meta-analysis were followed.

Fifty-two papers were eligible for inclusion in the review. Twenty-five studies were synthesized quantitatively. Lasers were found to increase bond strength of ceramic surfaces to resin cements and composites when compared with control specimens (p-value < 0.01), whereas no significant differences were found in comparison with air-particle abraded surfaces.

High variability can be observed in adhesion values between different analyses, pointing to a need to standardize study protocols and to determine the optimal parameters for each laser type.

Evaluation of Different Types of Lasers in Surface Conditioning of Porcelains: A Review Article

To achieve proper bond strength for porcelains, adequate surface roughness is essential, which is traditionally gained by sandblasting or acid etching with hydrofluoric (HF) acid. Nowadays with the development of laser systems, serious efforts were made to apply this new instrument for surface etching of porcelains due to easy usage, safety, and more efficiency. There are different kinds of lasers and porcelains, so choosing the ones which will be good match for each other is crucial. Besides that, changing the irradiation setting can be beneficial as well. This article reviewed 33 related studies and summarized results of etching accomplished by Nd:YAG, Er:YAG, Er,Cr:YSGG and CO2 lasers on different types of porcelains considering different laser settings and evaluation methods to bring a comprehensive insight.

The Effect of Femtosecond Laser Treatment on the Effectiveness of Resin-Zirconia Adhesive: An In Vitro Study

Introduction: When aesthetics is compromised, dental ceramics are excellent materials for dental restorations; owing to their optical properties and biocompatibility, zirconia ceramics are particularly interesting. Self-adhesive resin cements are the most suitable for bonding to zirconia ceramics, but traditional adhesive chemistry is ineffective and surface treatments are required to improve the adhesive bonding between resin and zirconia. The aim of this study was to evaluate the effect of femtosecond laser treatment on the shear bond strength (SBS) of self-adhesive resin cement on zirconia surfaces and to contrast it with other different surface conditioning methods. Methods: Sixty square-shaped zirconia samples were divided randomly into four groups (n = 15) according to their surface conditioning method: the NT group - no surface treatment; the APA25 group - airborne abrasion with 25 μm alumina particles; the TSC group - tribochemical silica coating, and the FS group - femtosecond laser irradiation (800 nm, 4 mJ, 40 fs/pulse, 1 kHz). Self-adhesive resin cements were bonded at the centre of samples, and after 72 hours, they were tested for SBS with a universal testing machine at a crosshead speed of 0.5 mm/min, until fracture. Five zirconia surfaces for each group were subjected to a surface morphology analysis by scanning electron microscopy (SEM). The failure modes were noted and a third of the specimens were prepared to morphological analysis. Results: The NT group showed lower SBS values than the other groups. Femtosecond laser treatment demonstrated higher values than the control and APA25 groups and similar values to those of the TSC group. In the APA25 group, the surface conditioning method had values close to those of the TSC group, but lower than those obtained with femtosecond laser treatment. Conclusion: The treatment of zirconia with femtosecond laser irradiation created a consistent and profound surface roughness, improving the adhesive effectiveness of the zirconia-resin interface.

Effects of Laser Treatment on the Bond Strength of Differently Sintered Zirconia Ceramics

OBJECTIVE

The purpose of this study was to investigate the effects of carbon dioxide (CO2) and Erbium-doped yttrium aluminum garnet (Er:YAG) laser irradiations on the shear bond strength (SBS) of differently sintered zirconia ceramics to resin cement.

MATERIALS AND METHODS

Eighty zirconia specimens were prepared, sintered in two different periods (short = Ss, long = Ls), and divided into four treatment groups (n = 10 each). These groups were (a) untreated (control), (b) Er:YAG laser irradiated with 6 W power for 5 sec, (c) CO2 laser with 2 W power for 10 sec, (d) CO2 laser with 4 W power for 10 sec. Scanning electron microscope (SEM) images were recorded for each of the eight groups. Eighty composite resin discs (3 × 3 mm) were fabricated and cemented with an adhesive resin cement to ceramic specimens. The SBS test was performed after specimens were stored in water for 24 h by an universal testing machine at a crosshead speed of 1 mm/min. Data were statistically analyzed with two way analysis of variance (ANOVA) and Tukey honest significant difference (HSD) test (α = 0.05).

RESULTS

According to the ANOVA, the sintering time, surface treatments and their interaction were statistically significant (p < 0.05). Although each of the laser-irradiated groups were significantly higher than the control groups, there was no statistically significant difference among them (p > 0.05).

CONCLUSIONS

Variation in sintering time from 2.5 to 5.0 h may have influenced the SBS of Yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) ceramics. Although CO2 and Er:YAG laser irradiation techniques may increase the SBS values of both tested zirconia ceramics, they are recommended for clinicians as an alternative pretreatment method.

Effect of Different Surface Treatments on the Bond Strength of Lithium Disilicate Ceramic to the Zirconia Core

OBJECTIVE

The aim of this study was to evaluate the effect of different surface treatments [sandblasting, Erbium:Yttrium-Aluminium-Garnet (Er:YAG), and femtosecond lasers] on the shear bond strength (SBS) of the CAD-on technique.

BACKGROUND DATA

Although demand for all-ceramic restorations has increased, chipping remains one of the major problems for zirconia-based restorations.

MATERIALS AND METHODS

Forty yttrium-stabilized tetragonal zirconia polycrystalline (Y-TZP) zirconia plates (IPS e.max ZirCAD, Ivoclar Vivadent) were cut, sintered (12.4 × 11.4 × 3 mm) and divided into four groups according to the surface treatments (n = 10): a control group with no surface treatment (Group C), sandblasting with 50 μm Al2O3 (Group S), Er:YAG laser irradiation (Group E), and femtosecond laser irradiation (Group F). Also, 40 cylindrical (5 mm diameter, 2 mm height) lithium disilicate (IPS e.max CAD) veneer ceramics were cut and fused to all zirconia cores by a glass-fusion ceramic and crystallized according to the CAD-on technique. Specimens were subjected to shear force using a universal testing machine. The load was applied at a crosshead speed of 0.5 mm/min until failure. Mean SBS (MPa) were analyzed with one way ANOVA (p < 0.05). The failed specimens were examined under a stereomicroscope at ×20 to classify the mode of failure.

RESULTS

The highest SBS was observed in Group F (36 ± 3.31 MPa), followed by Group S (33.03 ± 5.05 MPa), and Group C (32.52 ± 10.15 MPa). The lowest SBS was observed in Group E (31.02 ± 4.96 MPa), but no significant differences were found between the control and surface treated groups (p = 0.377). All the specimens showed a mixed type of failure.

CONCLUSIONS

Femtosecond laser application increased the bond strength between zirconia-veneer specimens. However, the novel CAD-on technique with no surface treatment also showed high bonding strength. Thus, this technique could prevent ceramic chipping without additional surface treatments.