Effects of Pretreatment, Specimen Thickness, and Artificial Aging on Biaxial Flexural Strength of Two Types of Y-TZP Ceramics

The Effect of Various Lasers on the Bond Strength Between Orthodontic Brackets and Dental Ceramics: A Systematic Review and Meta-Analysis

Background/objective: This systematic review and meta-analysis aimed to assess how laser conditioning affected brackets bonded to dental ceramics' shear bond strength (SBS). Materials and methods: The study was conducted by searching Pubmed/Medline, Scopus, Embase, Web of Science, the Cochrane Library, and Google Scholar up to September 14, 2022. In addition, the reference lists of the relevant articles were checked manually. Articles that compared SBS of laser-treated feldspathic, lithium disilicate, or zirconia surfaces with other standard techniques for bonding metal or ceramic orthodontic brackets were considered. Using a random-effects model, data pooling was carried out as the weighted mean difference (WMD). Results: This study initially contained 1717 reports, and following review, 32 articles were deemed suitable for our meta-analysis. The pooling results showed that the treatments with lasers such as "Er:YAG" [WMD = -1.12 MPa; 95% confidence interval (CI): -1.93 to -0.31], "Er:YAG + Silane" (WMD = -3.08 MPa; 95% CI: -4.77 to -1.40), and "Nd: YAG + Silane" (WMD = -2.58 MPa; 95% CI: -3.76 to -1.40) had statistically significant lower adhesion values compared with controls. Contrarily, "Ti:Sapphire femtosecond" demonstrated significantly higher bonding values (WMD = 0.94 MPa; 95% CI: 0.29-1.60). In contrast, other interventions obtained no statistically significant difference in SBS. Conclusions: Most of the laser groups showed results comparable with those of conventional approaches. Although more research is necessary for definitive conclusions, laser treatment may be an effective option for treating the surfaces of ceramic materials.

Thickness and yttria percentage influences the fracture resistance of laminate veneer zirconia restorations

OBJECTIVES

Mechanical properties are cardinal for the long-term clinical success of laminate veneer restorations but the selection of new restorative materials should ideally be based on clinical evidence, therefore, in vitro testing of dental materials is a good alternative to evaluate their properties and understand their behavior so this study aimed to compare and evaluate the effect of two different thicknesses and yttria percentage on the fracture resistance of laminate veneer zirconia restorations.

MATERIALS AND METHODS

Forty laminate veneer restoration prepared from partial sintering zirconia of 3Y (yttria), 5Y (yttria), combined 3Y&5Y (yttria), and lithium disilicate. Specimens were assigned into four main groups according to their percentage of yttria content (n = 10) and subgrouped into two thicknesses (0.5 mm thickness and 0.3 mm thickness) (n = 5) as follows: Group I, II, III, and IV (Group I for lithium disilicate (control), Group II for 3Y zirconia, Group III for 5Y zirconia, and Group IV for combined 3Y&5Y zirconia), each of them subdivided according to their thickness into two subgroups (n = 5 for each one) and resistance to fracture for each restoration was evaluated using a universal testing machine. Data were analyzed using a one-way analysis of variance and Duncan's tests at a 5% level of significance.

RESULTS

The thickness of laminate veneer restoration significantly affects the fracture resistance value of all type of laminate veneers restorations (fracture resistance mean value was highest for 0.5 mm thickness and lower for 0.3 mm thickness restorations) and yttria percentage significantly affect fracture resistance value of zirconia laminate veneer restorations (fracture resistance mean value was highest for 0.5 mm thickness of 3Y zirconia [865 N] and combined 3Y&5Y zirconia [846 N]).

CONCLUSIONS

Reducing the thickness of laminate zirconia veneer restorations to 0.3 mm reduces its fracture resistance and increasing yttria percentage had an adverse effect on fracture resistance of zirconia laminate veneer restorations.

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.

A new technique for incorporation of TiO2 nanotubes on a pre-sintered Y-TZP and its effect on bond strength as compared to conventional air-borne particle abrasion and silicatization TiO2 nanotubes application on pre-sintered Y-TZP

OBJECTIVE

This study evaluated the microshear bond strength of a resin cement to Y-TZP after different methods of TiO₂ nanotubes (nTiO₂) incorporation on pre-sintered Y-TZP surfaces.

METHODS

nTiO₂ were synthesized and incorporated on Y-TZP slices as follows (n = 15): 1) nTiO₂ mixed with isopropyl alcohol/manual application (MAl); 2) nTiO₂ mixed with acetone/manual application (MAc); 3) nTiO₂ mixed with isopropyl alcohol/high-pressure vacuum application (HPVAl); 4) nTiO₂ mixed with acetone/high-pressure vacuum application (HPVAc). As controls, surfaces were sandblasted with Al₂O₃ (OX) or Rocatec silicatization (ROC). All ceramics were sintered after nTiO₂ incorporation. Surface treatments of OX and ROC were made after sintering. Surfaces were characterized by confocal laser microscopy, scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Resin composite cylinders (1.40 mm diameter and 1 mm height) were cemented with a resin cement, stored in water at 37 °C for 24 h and thermocycled for 10 000 cycles before microshear bond strength evaluation. Data were analyzed with one-way ANOVA and Games-Howell (α = 0.05), and fracture analysis was performed using a stereomicroscope.

RESULTS

EDS confirmed the presence of TiO₂ on treated Y-TZP. The confocal analysis showed higher roughness for HPVAc and OX. There were significant differences between surface treatments (p < 0.001). HPVAl (22.96 ± 10.3), OX (34.16 ± 7.9) and ROC (27.71 ± 9.4) showed higher microshear bond strengths and were statistically similar (p > 0.05). MAC showed intermediary values, and HPVAc and MAl presented decreased bond strength, with a high percentage of premature debonding.

CONCLUSION

High-pressure vacuum application of nTiO₂ mixed with isopropyl alcohol was able to produce bond strength values compared to conventional air abrasion and Rocatec silicatization.

SIGNIFICANCE

The infiltration of TiO₂ nanostructures on the pre-sintered Y-TZP is an interesting approach that can improve bond strength without the need of sandblasting methods.

Effect of different surface treatments on surface roughness, phase transformation, and biaxial flexural strength of dental zirconia

Background. Interfacial failures at the cement‒restoration interface highlights the importance of effective surface treatment with no adverse effect on the zirconia’s mechanical properties. This study aimed to determine the effect of different surface treatments on dental graded zirconia’s surface roughness and certain mechanical properties.

Methods. Forty sintered zirconia specimens were randomly divided into four groups (n=10): control (no surface treatment), sandblasting (SA), grinding with diamond bur (GB), and Er,Cr:YSGG laser (LS). Following surface treatment, the surface roughness and surface topography of the specimens were examined. X-ray diffraction (XRD) was conducted. In addition, the biaxial flexural strengths of specimens were evaluated. The data were analyzed using one-way analysis of variance (ANOVA) and post hoc Tukey tests; the Pearson correlation coefficient was calculated between either volumetric percentage of monoclinic phase or roughness and flexural strength of specimens (α=0.05).

Results. The GB group exhibited significantly greater surface roughness compared to the other groups (P < 0.005). The LS and control groups exhibited a significantly lower volumetric percentage of the monoclinic phase (P < 0.001) than the GB and SA treatments. The SA group exhibited significantly higher flexural strength than the control (P = 0.02) and GB groups (P < 0.01). Furthermore, the Weibull analysis for the LS showed higher reliability for the flexural strength than other treatments.

Conclusion. Er,Cr:YSGG laser treatment, with the lowest extent of phase transformation and reliable flexural strength, can be a promising choice for surface treatment of zirconia.