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Campos TMB, Dos Santos C, Alves LMM, Benalcazar-Jalkh EB, Strazzi-Sahyon HB, Bergamo ETP, Tebcherani SM, Witek L, Coelho PG, Yamaguchi S, Thim GP, Bonfante EA. Minimally processed recycled yttria-stabilized tetragonal zirconia for dental applications: Effect of sintering temperature on glass infiltration. J Mech Behav Biomed Mater 2024; 150:106311. [PMID: 38128470 DOI: 10.1016/j.jmbbm.2023.106311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023]
Abstract
This study aimed to develop a recycling process for the remnants of milled 3Y-TZP and enhance their properties using glass infiltration. 3Y-TZP powder was gathered from the vacuum system of CAD-CAM milling equipment, calcined and sieved (x < 75 μm). One hundred twenty discs were fabricated and pre-sintered at 1000 °C/h. These specimens were then divided into four groups, categorized by glass infiltration (non-infiltrated [Zr] or glass-infiltrated [Zr-G]) and sintering temperature (1450 °C [Zr-1450] or 1550 °C [Zr-1550]/2h). After sintering, the specimens were characterized by X-Ray Diffraction (XRD), relative density measurement, and scanning electron microscopy and energy dispersive spectroscopy (SEM-EDS). The biaxial flexural strength test was performed according to the ISO 6872 and followed by fractographic analysis. Subsequent results were analyzed using Weibull statistics. Relative density values of the sintered specimens from Zr-1450 and Zr-1550 groups were 86.7 ± 1.5% and 92.2 ± 1.7%, respectively. Particle size distribution revealed particles within the range of 0.1-100 μm. XRD analysis highlighted the presence of the ZrO2-tetragonal in both the Zr-1450 and Zr-1550 groups. Glass infiltration, however, led to the formation of the ZrO2-monoclinic of 9.84% (Zr-1450-G) and 18.34% (Zr-1550-G). SEM micrographs demonstrated similar microstructural characteristics for Zr-1450 and Zr-1550, whereas the glass-infiltrated groups exhibited comparable infiltration patterns. The highest characteristic strength was observed in the glass-infiltrated groups. Fractographic analyses suggested that fracture origins were related to defects on the tensile side, which propagated to the compression side of the samples. Both the sintering temperature and glass infiltration significantly influenced the mechanical properties of the 3Y-TZP recycled.
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Affiliation(s)
- Tiago Moreira Bastos Campos
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Claudinei Dos Santos
- Faculty of Technology, University of Rio de Janeiro State (UERJ - FAT), Resende, RJ, Brazil
| | - Larissa Marcia Martins Alves
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil.
| | - Ernesto B Benalcazar-Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | | | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil; Biomaterials Division, New York University College of Dentistry, New York, NY, USA
| | - Sérgio Mazurek Tebcherani
- Department of Production Engineering, Federal University of Technology, Paraná, Ponta Grossa, PR, Brazil
| | - Lukasz Witek
- Biomaterials Division, New York University College of Dentistry, New York, NY, USA; Department of Biomedical Engineering, NYU Tandon School of Engineering, New York University, Brooklyn, NY, USA
| | - Paulo G Coelho
- Division of Plastic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Satoshi Yamaguchi
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Gilmar P Thim
- Department of Physics, Aeronautics Technological Institute, São José Dos Campos, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
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Martakoush-Saleh S, Salgado-Peralvo AO, Peña-Cardelles JF, Kewalramani N, Gallucci GO. Evaluating the clinical behavior of veneered zirconia in comparison with monolithic zirconia complete arch implant-supported prostheses: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00497-3. [PMID: 37696747 DOI: 10.1016/j.prosdent.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 09/13/2023]
Abstract
STATEMENT OF PROBLEM Because the use of zirconia in dentistry is relatively new, the number of published studies on the subject is scarce, even though material selection is an important factor in clinical performance. Therefore, a systematic assessment of the impact of the prosthetic material, framework design, veneering material, and manufacturing process is required. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the survival and success rates of feldspathic porcelain veneered zirconia (VZir) in comparison with monolithic zirconia (MZir) complete arch implant-supported prostheses (CAISPs). A secondary objective was to assess the influence of the type of loading, the presence or absence of a cantilever, the type of zirconia used, the location, and the opposing arch on complications rates and patient satisfaction. MATERIAL AND METHODS An electronic search of the MEDLINE database (via PubMed), Scopus, Science Direct, Cochrane Library, and OpenGrey was carried out. The criteria described in the preferred reporting items for systematic reviews and meta-analyses statement were used. The search was restricted from January 2000 to January 2022. RESULTS The systematic search resulted in 20 articles that met the established criteria. In total, 751 patients (VZir=302; MZir=449) with 3038 CAISPs (VZir=368; MZir=2670) were analyzed. Higher prosthetic survival and success rates were found in MZir compared with VZir CAISPs (100% and 95.45%, respectively). The meta-analysis found significantly fewer complications related to MZir (9.4% [4.8%-14.1%]) compared with VZir (33.7% [17.5%-49.9%]). CONCLUSIONS Based on the findings of this systematic review, MZir CAISPs had higher survival and success rates than VZir CAISPs, with significantly fewer prosthetic complications. The influence of factors such as the type of functional loading, the presence of a cantilever, the material used in the prosthodontic workflow, the location of the CAISP, and the type of antagonist arch on the performance of Zir CAISPs remains unclear.
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Affiliation(s)
- Sara Martakoush-Saleh
- Postgraduate student, Department of Dental Clinical Specialties, Complutense University of Madrid, Spain
| | - Angel-Orión Salgado-Peralvo
- Professor, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University of Madrid, Spain.
| | - Juan-Francisco Peña-Cardelles
- Professor, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Naresh Kewalramani
- Professor, Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, Madrid, Spain
| | - German O Gallucci
- Professor and Department Chair, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
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Alenezi A, Aloqayli S. Technical complications with tooth-supported fixed dental prostheses (FDPs) of different span lengths: an up to 15-year retrospective study. BMC Oral Health 2023; 23:393. [PMID: 37316922 DOI: 10.1186/s12903-023-03121-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/08/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUNDS Long-span dental bridges may cause excessive load on abutment teeth and the periodontal area, which may lead to bridge fractures or periodontal problems. However, some reports have revealed that short- and long-span bridges can provide a similar prognosis. This clinical study aimed to investigate the technical complications associated with fixed dental prostheses (FDPs) of different span lengths. METHODS All patients with previously cemented FDPs were clinically examined during their follow-up visits. Several data related to FDPs were registered, such as design, material type, location, and type of complication. The main clinical factors analyzed were technical complications. Life table survival analyses were performed to calculate the cumulative survival rate of FDPs when technical complications were detected. RESULTS The study examined 229 patients with a total number of 258 prostheses and an average of 98 months of follow-up. Seventy-four prostheses suffered from technical complications, and the most common complication was ceramic fracture or chipping (n = 66), while loss of retention occurred in 11 prostheses. The long-term evaluation of long-span prostheses revealed a significantly higher technical complication rate compared to short-span prostheses (P = ,003). The cumulative survival rate for short-span FDPs was 91% in year 5, 68% in year 10, and 34% in year 15. For long-span FDPs, the cumulative survival rate was 85% in year 5, 50% in year 10, and 18% in year 15. CONCLUSION Long-span prostheses (5 units or more) can be associated with a higher technical complication rate compared to short-span prostheses after long-term evaluation.
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Affiliation(s)
- Ali Alenezi
- Department of Prosthodontics, College of Dentistry, Qassim University, P.O. Box 6700, Buraydah, Saudi Arabia.
| | - Sarah Aloqayli
- Intern, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
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Elraggal A, Aboushelib M, Abdel Raheem IM, Afifi RR. Effect of surface treatments on biaxial flexural strength, fatigue resistance, and fracture toughness of high versus low translucency zirconia. BMC Oral Health 2022; 22:412. [PMID: 36123676 PMCID: PMC9487058 DOI: 10.1186/s12903-022-02431-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/05/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mechanical surface treatments can deteriorate the mechanical properties of zirconia. This study evaluated and compared the biaxial flexural strength, fracture toughness, and fatigue resistance of high translucency (HT) to low translucency (LT) zirconia after various mechanical surface treatments. METHODS Four hundred eighty zirconia discs were prepared by milling and sintering two HT (Katana and BruxZir) and LT (Cercon and Lava) zirconia blocks at targeted dimensions of 12 mm diameter × 1.2 mm thickness. Sintered zirconia discs received one of the following surface treatments: low-pressure airborne particle abrasion (APA) using 50 µm alumina particles, grinding using 400 grit silicon carbide paper, while as-sintered specimens served as control. Internal structure and surface roughness were evaluated by scanning electron microscope (SEM) and a non-contact laser profilometer, respectively. Half of the discs were tested for initial biaxial flexural strength, while the rest was subjected to 106 cyclic fatigue loadings, followed by measuring the residual biaxial flexural strength. Fractured surfaces were examined for critical size defects (c) using SEM to calculate the fracture toughness (KIC). The effect of surface treatments, zirconia type, and cyclic fatigue on the biaxial flexural strength was statistically analyzed using three-way analysis of variance (ANOVA) and Tukey HSD post hoc tests (α = 0.05). Weibull analysis was done to evaluate the reliability of the flexural strength for different materials. RESULTS The initial biaxial flexural strength of LT zirconia was significantly higher (p < 0.001) than that of HT zirconia in all groups. While low APA significantly increased the biaxial flexural strength of LT zirconia, no significant change was observed for HT zirconia except for Katana. Surface grinding and cyclic fatigue significantly reduced the flexural strength of all groups. High translucency zirconia reported higher fracture toughness, yet with lower Weibull moduli, compared to LT zirconia. CONCLUSION LT zirconia has higher biaxial flexural strength, yet with lower fracture toughness and fatigue resistance, compared to HT zirconia. Low-pressure APA has significantly increased the biaxial flexural strength in all zirconia groups except BruxZir. Grinding was deteriorating to biaxial flexural strength and fracture toughness in all zirconia types. Cyclic fatigue has significantly decreased the biaxial flexural strength and reliability of HT and LT zirconia.
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Affiliation(s)
- Alaaeldin Elraggal
- Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Moustafa Aboushelib
- grid.7155.60000 0001 2260 6941Dental Biomaterials Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Islam M. Abdel Raheem
- grid.7155.60000 0001 2260 6941Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Rania R. Afifi
- grid.7155.60000 0001 2260 6941Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Nakamura K, Tarkeshi A, Niklasson A, Shishido S, Svanborg P, Barkarmo S, Örtengren U. Influence of crystalline phase transformation induced by airborne-particle abrasion and low-temperature degradation on mechanical properties of dental zirconia ceramics stabilized with over 5 mol% yttria. J Mech Behav Biomed Mater 2021; 125:104890. [PMID: 34673358 DOI: 10.1016/j.jmbbm.2021.104890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/05/2021] [Accepted: 10/10/2021] [Indexed: 11/30/2022]
Abstract
Monolithic dental prostheses fabricated from 5 mol% yttria-stabilized zirconia (5YZ) have been developed to improve the translucency of conventional 3 mol% yttria-stabilized zirconia. In this study, we aimed to evaluate the influence of airborne-particle abrasion (APA) and low-temperature degradation (LTD) on the mechanical properties of 5YZ in association with the crystalline phase transformation. In total, 120 disc-shaped specimens of two brands of 5YZ (Lava Esthetic and Katana UTML) were prepared. The specimens were divided into four groups (n = 15 for each group): (i) control, (ii) APA, (iii) LTD, and (iv) APA + LTD groups. APA was performed with 50 μm alumina particles, and LTD was induced by autoclaving at 134 °C for 50 h. The biaxial flexural strength of the specimens was assessed using a piston-on-three-ball test according to ISO 6872:2015, and Vickers hardness was determined using a microhardness tester. The crystalline phase was analyzed by the Rietveld refinement of X-ray diffraction patterns. APA significantly increased the flexural strength of the Lava Esthetic specimens, whereas LTD hardly affected the strength of both materials. APA and APA + LTD significantly increased the Vickers hardness of both materials. According to Rietveld analysis, the pseudocubic phase was predominant in both materials, i.e., 66 mass% and 81 mass% in the Lava Esthetic and Katana UTML specimens, respectively. APA induced the rhombohedral phase at approximately 37 mass% in both materials, while LTD induced the monoclinic phase at 2.8 mass% in the Lava Esthetic specimens and 0.9 mass% in the Katana UTML specimens. APA + LTD weakly affected the amount of the rhombohedral phase but slightly increased the amount of the monoclinic phase. These findings suggest that APA may improve the mechanical properties of 5YZ, particularly hardness, via the generation of the rhombohedral phase. In contrast, the influence of LTD on the mechanical and microstructural properties of 5YZ was limited.
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Affiliation(s)
- Keisuke Nakamura
- Department of Advanced Free Radical Science, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980 8575, Japan.
| | - Aria Tarkeshi
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Gothenburg, Sweden
| | - Alexander Niklasson
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Gothenburg, Sweden
| | - Shunichi Shishido
- Department of Advanced Free Radical Science, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai, 980 8575, Japan
| | - Per Svanborg
- Department of Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Gothenburg, Sweden
| | - Sargon Barkarmo
- Department of Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Gothenburg, Sweden
| | - Ulf Örtengren
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30, Gothenburg, Sweden
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Nejatidanesh F, Abbasi M, Savabi G, Bonakdarchian M, Atash R, Savabi O. Five year clinical outcomes of metal ceramic and zirconia-based implant-supported dental prostheses: A retrospective study. J Dent 2020; 100:103420. [PMID: 32598899 DOI: 10.1016/j.jdent.2020.103420] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/23/2020] [Accepted: 06/25/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVES The implant-supported restorations can be made of all-ceramic materials. The purpose of this study was to compare five year clinical outcomes of zirconia-based and metal ceramic implant-supported fixed dental prostheses (FDPs). METHODS In this study, 114 posterior implant-supported FDPs including zirconia-based (52) or metal ceramic (62) restorations were made for 114 patients with a mean age of 59 ± 8.4 years and evaluated in a 5 year follow up. The modified California Dental Association (CDA) guidelines were used to assess the quality of the restorations. The soft tissue status was evaluated using gingival and plaque indices, probing depth and bleeding on probing. Additionally, the bone loss around implants was assessed by parallel priapical radiographs. The visual analogue scale was used regarding patients' satisfaction. The data analysis were performed by Kaplan-Meier, log rank test, Cox regression, Mann-Whitney U and Student's t-test. (α = 0.05). RESULTS Five year Kaplan-Meier survival rate of the zirconia-based and metal ceramic FDPs were 98.1 % and 100 % respectively with no significant difference (P = 0.12). The success rates were 81.6 % for zirconia-based and 81.0 % for metal ceramic restorations (P = 0.85). The CDA rating of both studied groups was not significantly different except the marginal gap which was better in zirconia-based FDPs (P < 0.001). Fracture of veneering ceramics occurred in 2.7 % of metal ceramic and 6.4 % of zirconia-based FDPs, which were not considered as failure. Soft tissue status was not affected by the type of restorations except for plaque index which was more favorable for zirconia-based FDPs (P < 0.001). No significant difference was found between marginal bone loss of the two groups (P = 0.30 mesial, P = 0.46 distal). CONCLUSIONS Zirconia-based and metal ceramic FDPs showed similar promising clinical performance in the 5-year follow-up. CLINICAL SIGNIFICANCE Zirconia-based implant-supported FDPs might be a successful restorative method with acceptable survival rate and patient's satisfaction.
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Affiliation(s)
- Farahnaz Nejatidanesh
- Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahsa Abbasi
- School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Ghazal Savabi
- Dental Materials Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Bonakdarchian
- Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Atash
- Department of Stomatology and Dentistry, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Omid Savabi
- Dental Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
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Benalcazar Jalkh EB, Monteiro KN, Cesar PF, Genova LA, Bergamo ETP, Lopes ACDO, Lima E, Lisboa-Filho PN, Campos TMB, Witek L, Coelho PG, Borges AFS, Bonfante EA. Aging resistant ZTA composite for dental applications: Microstructural, optical and mechanical characterization. Dent Mater 2020; 36:1190-1200. [PMID: 32561117 DOI: 10.1016/j.dental.2020.05.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 05/03/2020] [Accepted: 05/24/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To synthesize a zirconia toughened alumina (ZTA) composite with 70% alumina reinforced by 30% zirconia for dental applications and to characterize its microstructure and optical properties for comparison with the isolated counterpart materials and a first-generation 3Y-TZP. METHODS Disc-shaped specimens were divided in four groups (n = 70/material): (1) 3YSB-E (first generation 3Y-TZP), (2) Zpex (second generation 3Y-TZP), (3) alumina, and (4) ZTA-Zpex 70/30. After synthesis, ceramic powders were pressed, and green-body samples sintered following a predetermined protocol. Specimens were polished to obtain a mirror surface finish. Apparent density was measured by Archimedes principle. X-ray diffraction (XRD) and scanning electron microscope (SEM) were used to characterize the crystalline content and microstructure. Reflectance tests were performed to determine the contrast-ratio (CR) and translucency-parameter (TP). Mechanical properties were assessed by biaxial flexural strength (BFS) test. All analyses were conducted before and after artificial aging (20 h, 134 °C, 2.2 bar). Optical parameters were evaluated through repeated-measures analysis of variance and Tukey tests (p < 0.05). BFS data were analyzed using Weibull statistics (95% CI). RESULTS High density values (95-99%) were found for all ceramic materials and SEM images exhibited a dense microstructure. While XRD patterns revealed the preservation of crystalline content in the ZTA composite, an increase in the monoclinic peak was observed for pure zirconias after aging. Significantly higher CR and lower TP values were observed for the ZTA composite, followed by alumina, 3YSB-E, and Zpex. The highest characteristic stress was recorded for 3YSB-E, followed by intermediate values between ZTA and Zpex, and the lowest for alumina. Aging affected the optical and mechanical properties of both zirconias, while remained stable for ZTA composite and alumina. SIGNIFICANCE The synthesis of experimental 70-30% ZTA composite was successful and its relevance for dental applications relies on its higher masking ability, aging resistance, and strength similar to zirconia.
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Affiliation(s)
- Ernesto Byron Benalcazar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil; Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA.
| | - Kelli Nunes Monteiro
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, SP, Brazil
| | - Paulo Francisco Cesar
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, SP, Brazil
| | | | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | | | - Erick Lima
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, SP, Brazil
| | | | | | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Biomedical Engineering, New York University, Tandon School of Engineering, Brooklyn, NY, USA
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, NY, USA; Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, New York, NY, USA
| | - Ana Flavia Sanches Borges
- Department of Operative Dentistry, Endodontics and Dental Materials, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
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8
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Hampe R, Theelke B, Lümkemann N, Stawarczyk B. Impact of artificial aging by thermocycling on edge chipping resistance and Martens hardness of different dental CAD-CAM restorative materials. J Prosthet Dent 2020; 125:326-333. [PMID: 32115219 DOI: 10.1016/j.prosdent.2019.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 12/30/2019] [Accepted: 12/31/2019] [Indexed: 11/28/2022]
Abstract
STATEMENT OF PROBLEM The selection of an appropriate restorative material based on fracture behavior is important for the marginal integrity of a dental restoration. For computer-aided design and computer-aided manufacturing (CAD-CAM) restorative materials, information regarding their edge chipping resistance is scarce. PURPOSE The purpose of this in vitro study was to determine the edge chipping resistance (ECR) and Martens hardness (HM) of 6 different dental CAD-CAM restorative materials before and after thermocycling. MATERIAL AND METHODS Four composite resin materials including Brilliant Crios; Cerasmart, an experimental material; Lava Ultimate, a polymer-infiltrated ceramic-network (PICN) material (VITA Enamic), and a glass-ceramic control (IPS Empress CAD) were tested. The specimens were tested before and after thermocycling (30 000 times, 5 °C/55 °C). The ECR was measured for each material (n=25) and related to the point of loading and to the maximum chipping depth. HM was determined for each material (n=25). The Kruskal-Wallis and Mann-Whitney U tests were used to compare materials (α=.05). The impact of thermocycling was analyzed by using the Wilcoxon test (α=.05). The correlations between all parameters were calculated by using the Spearman-Rho test (α=.05). For fractographic analysis of chip patterns, chipped surfaces were analyzed by laser scanning microscopy. RESULTS For ECR and HM, the materials showed different values. ECRmd and ECRpl showed a positive correlation, but both showed a negative correlation to HM. The materials showed a different chip size (P<.001). Chip patterns revealed brittle material behavior in all cases. CONCLUSIONS All tested CAD-CAM materials behaved as brittle materials, but HM and ECR differed among the materials. The control glass-ceramic material showed the highest values for HM, followed by the PICN material. ECR values revealed the opposite order of materials, with the highest for composite resins. Artificial aging by thermocycling affected all dental CAD-CAM restorative materials. Especially for composite resin materials, ECR changed after aging.
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Affiliation(s)
- Rüdiger Hampe
- Research Fellow, Dental Material Unit, Department of Prosthodontics, Ludwig-Maximilians University, Munich, Germany.
| | - Björn Theelke
- Doctoral student, School of Metallurgy and Materials, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Nina Lümkemann
- Research Fellow, Dental Material Unit, Department of Prosthodontics, Ludwig-Maximilians University, Munich, Germany
| | - Bogna Stawarczyk
- Scientific Head, Dental Material Unit, Department of Prosthodontics, Ludwig-Maximilians University, Munich, Germany
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Esquivel-Upshaw JF, Mecholsky JJ, Clark AE, Jenkins R, Hsu SM, Neal D, Ren F. Factors influencing the survival of implant-supported ceramic-ceramic prostheses: A randomized, controlled clinical trial. J Dent 2020; 103S:100017. [PMID: 34059304 PMCID: PMC9993352 DOI: 10.1016/j.jjodo.2020.100017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 02/29/2020] [Accepted: 04/08/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The goals of this research are: (1) to determine the clinical survival of ceramic-ceramic 3-unit implant supported fixed dental prostheses (FDPs) compared with control metal-ceramic and; (2) to analyze the effects of design parameters such as connector height, radius of curvature of gingival embrasure, and occlusal veneer thickness. MATERIALS AND METHODS This randomized, controlled clinical trial enrolled 96 participants with 129 3-unit implant-supported FDPs. Participants were randomized to receive different design combinations to include FDP material, thickness of occlusal veneer ceramic, radius of curvature of gingival embrasure and connector height. Participants were recalled for 6 months, 1year and yearly thereafter for the next 5 years. FDPs were examined for evidence of fracture and radiographs were made to assess viability of implants. Fractographic analyses and Kaplan Meier survival analysis was used to analyze the data. RESULTS 27 FDPs, representing 21%, exhibited chipping fractures of the veneer during the 5-year observation period. There was no statistically significant effect of type of material, veneer thickness, radius of curvature of gingival embrasure and connector height on occurrence of fracture. Fractographic and occlusal analyses reveal that fractures originated from the occlusal surface and that occlusion was the most important factor in determining survival. Stresses calculated at failure demonstrated lower values compared with in vitro data. CONCLUSION Implant-supported ceramic-ceramic prosthesis is a viable alternative to metal-ceramic. Survival analysis for both materials were comparable and design parameters employed in this study did not affect survival as long as zirconia was used as the core material.
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Affiliation(s)
- J F Esquivel-Upshaw
- Division of Prosthodontics, Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, FL, United States.
| | - J J Mecholsky
- Department of Materials Science and Engineering, University of Florida Herbert Wertheim College of Engineering, Gainesville, FL, United States
| | - A E Clark
- Division of Prosthodontics, Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, FL, United States
| | - R Jenkins
- Dental Clinical Research Unit, University of Florida College of Dentistry Office of Research, Gainesville, FL, United States
| | - S M Hsu
- Division of Prosthodontics, Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, FL, United States
| | - D Neal
- Department of Neurosurgery, University of Florida College of Medicine, Gainesville, FL, United States
| | - F Ren
- Department of Chemical Engineering, University of Florida Herbert Wertheim College of Engineering, Gainesville, FL, United States
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Aung SSMP, Takagaki T, Lyann SK, Ikeda M, Inokoshi M, Sadr A, Nikaido T, Tagami J. Effects of alumina-blasting pressure on the bonding to super/ultra-translucent zirconia. Dent Mater 2019; 35:730-739. [PMID: 30826073 DOI: 10.1016/j.dental.2019.02.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/13/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Translucent zirconia has brought the advantages such as less tooth preparation, biological compatibility, high strength, good mechanical properties, and less antagonist wear. This study's aim was to elucidate how clinically relevant surface treatments; alumina-abrasion and priming effect on bond strength of Y-PSZ in three different translucency grades after long-term water storage. MATERIALS AND METHODS Three highly translucent Y-PSZ grades were ground flat with #600-grit SiC paper. Four different surface treatments (untreated, alumina blasting at 0.1 MPa or 0.2 MPa or 0.4 MPa) and two resin cements (PANAVIA V5 and PANAVIA SA CEMENT PLUS AUTOMIX) were tested. The bonded specimens were stored in water for 1 day, 30 days and 150 days and tensile bond strength (TBS) were measured with universal testing machine at a crosshead speed of 2 mm/min (n=10). The surface roughness (Sa) measurement and surface morphology analysis without alumina-blasting pressure (untreated) and with alumina-blasting pressures (0.1 MPa, 0.2 MPa and 0.4 MPa) for three different zirconia grades were evaluated with 3D-Laser Scanning Confocal Microscope. RESULTS Different alumina-blasting pressures and different storage periods affected the bonding of resin cement to translucent zirconia. The Weibull moduli increased in some groups after 150 days storage. After 1 day and 30 days storage, 0.4 MPa alumina-blasting pressure provided superior bond strength, however, after 150 days, 0.2 MPa gave reliable and stable bond strength. SIGNIFICANCE Alumina-blasting pressure of 0.2 MPa was the most effective for reliable and durable bonding performance to translucent zirconia after long-term water storage.
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Affiliation(s)
- San San May Phyo Aung
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Tomohiro Takagaki
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
| | - Sai Kham Lyann
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Masaomi Ikeda
- Department of Oral Prosthetic Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
| | - Masanao Inokoshi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Alireza Sadr
- Biomimetics Biomaterials Biophotonics & Technology Laboratory, Department of Restorative Dentistry, University of Washington School of Dentistry, 1959 NE Pacific St. Box 357456, Seatle, WA, 98195-7456, USA
| | - Toru Nikaido
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; Department of Operative Dentistry, Division of Oral Functional Science and Rehabilitation, School of Dentistry, Asahi University, Hozumi 1851, Mizuho, Gifu 501-0296, Japan
| | - Junji Tagami
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
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11
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Øilo M, Arola D. Fractographic analyses of failed one-piece zirconia implant restorations. Dent Mater 2018; 34:922-931. [PMID: 29673708 DOI: 10.1016/j.dental.2018.03.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 10/19/2017] [Accepted: 03/23/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Promising results of initial clinical trials with yttria-stabilized zirconia have led to more extensive use of zirconia in dental implant superstructures. The applications have extended to abutments and complex individually designed crown-abutment one-piece structures. Little is known about their clinical success and the primary cause of failures. PURPOSE The aim of this study was to identify the cause of fracture of retrieved implant-retained one-piece prostheses that failed during clinical use. METHODS Nine fractured restorations were analyzed with fractographic methods and their fracture origins were identified. RESULTS All but two of the fractures originated in an area of tight contact between the implant or titanium screw and the abutment base. Results of the evaluation showed that zirconia-based implant restorations with very thin walls in the region connecting the prosthesis to the implant are vulnerable to damage from the screw retaining process and fracture from non-axial loads. Two restorations failed due to veneer fractures. SIGNIFICANCE The findings suggest that large crowns on narrow implants or implants with internal fixation should preferably not be made with zirconia abutments, or that a new design approach should be considered.
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Affiliation(s)
- Marit Øilo
- Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway; Department of Materials Science and Engineering, University of Washington Seattle, WA, USA.
| | - Dwayne Arola
- Department of Materials Science and Engineering, University of Washington Seattle, WA, USA; Departments of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA; Departments of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA
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12
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Wong CKK, Narvekar U, Petridis H. Prosthodontic Complications of Metal-Ceramic and All-Ceramic, Complete-Arch Fixed Implant Prostheses with Minimum 5 Years Mean Follow-Up Period. A Systematic Review and Meta-Analysis. J Prosthodont 2018; 28:e722-e735. [DOI: 10.1111/jopr.12797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 10/17/2022] Open
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13
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Cheng CW, Chien CH, Chen CJ, Papaspyridakos P. Randomized Controlled Clinical Trial to Compare Posterior Implant-Supported Modified Monolithic Zirconia and Metal-Ceramic Single Crowns: One-Year Results. J Prosthodont 2018. [PMID: 29528175 DOI: 10.1111/jopr.12767] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The purpose of this randomized controlled clinical trial was to investigate the prosthetic outcomes of posterior implant-supported single crowns (SCs) with a modified monolithic zirconia or metal-ceramic design at 1 year of loading. MATERIALS AND METHODS Forty participants with 73 dental implants in need of at least 1 maxillary or mandibular posterior implant-supported SC were consecutively selected for this study. The included participants were randomly divided into modified monolithic zirconia (MMZ) and metal-ceramic (MC) groups. The implant-supported SCs were examined after 1 year for survival and technical complications. Descriptive statistics were used to illustrate the data, and the association associated risks of complications were estimated using the logistic regression model with Firth's approach for rare outcome (α = 0.05). RESULTS During the observation period, 2 participants in the MC group were lost to follow-up. A total of 38 participants with 70 posterior implant-supported SCs (36 and 34 SCs in the MMZ and MC groups respectively) completed the 1-year follow-up examination. One implant failed in the MMZ group. The 1-year survival rates for implants and crowns were both 97.2% in the MMZ group. The survival rates for implants and crowns were both 100% in the MC group. One screw loosening event was observed in one screw-retained SC in the MMZ group; however, 8 complication events occurred in 7 SCs in the MC group. Therefore, the complication-free rates were 97.1% and 79.4% in the MMZ and MC SCs respectively. The most common complication in the MC group was screw loosening (14.7%), followed by loss of retention (5.9%), and ceramic fracture (2.9%). Significantly more technical complications were observed in the MC SCs than MMZ SCs (p = 0.0432). CONCLUSION The modified monolithic zirconia design applied to the posterior implant-supported SCs had a significantly lower technical complication rate than did the metal-ceramic one.
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Affiliation(s)
- Chih-Wen Cheng
- Division of Prosthodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Chia-Hui Chien
- Division of Prosthodontics, Department of Dentistry, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chun-Jung Chen
- Division of Periodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Panos Papaspyridakos
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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14
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Survival of 2039 complete arch fixed implant-supported zirconia prostheses: A retrospective study. J Prosthet Dent 2018; 119:220-224. [DOI: 10.1016/j.prosdent.2017.05.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/06/2017] [Accepted: 05/08/2017] [Indexed: 12/12/2022]
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15
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Abstract
Zirconias, the strongest of the dental ceramics, are increasingly being fabricated in monolithic form for a range of clinical applications. Y-TZP (yttria-stabilized tetragonal zirconia polycrystal) is the most widely used variant. However, current Y-TZP ceramics on the market lack the aesthetics of competitive glass-ceramics and are therefore somewhat restricted in the anterior region. This article reviews the progressive development of currently available and next-generation zirconias, representing a concerted drive toward greater translucency while preserving adequate strength and toughness. Limitations of efforts directed toward this end are examined, such as reducing the content of light-scattering alumina sintering aid or incorporating a component of optically isotropic cubic phase into the tetragonal structure. The latest fabrication routes based on refined starting powders and dopants, with innovative sintering protocols and associated surface treatments, are described. The need to understand the several, often complex, mechanisms of long-term failure in relation to routine laboratory test data is presented as a vital step in bridging the gaps among material scientist, dental manufacturer, and clinical provider.
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Affiliation(s)
- Y Zhang
- 1 Department of Biomaterials and Biomimetics, College of Dentistry, New York University, New York, NY, USA
| | - B R Lawn
- 2 Materials Measurement Laboratory, National Institute of Standards and Technology, Gaithersburg, MD, USA
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16
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Abstract
A survey of the development of dental ceramics is presented to provide a better understanding of the rationale behind the development and clinical indications of each class of ceramic material. Knowledge of the composition, microstructure, and properties of a material is critical for selecting the right material for specific applications. The key to successful ceramic restorations rests on material selection, manufacturing technique, and restoration design, including the balancing of several factors such as residual stresses, tooth contact conditions, tooth size and shape, elastic modulus of the adhesives and tooth structure, and surface state.
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Affiliation(s)
- Yu Zhang
- Department of Biomaterials and Biomimetics, NYU College of Dentistry, 433 First Avenue, Room 810, New York, NY 10010, USA.
| | - J Robert Kelly
- Department of Biomedical Engineering, University of Connecticut Health Center, Mailstop 1615, 263 Farmington Avenue, Farmington, CT 06030-1615, USA
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17
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Park CJ, Phark JH, Chee WW. Evaluation of Fracture Resistance of Varying Thicknesses of Zirconia Around Implant Abutment Cylinders. J ORAL IMPLANTOL 2017; 43:328-332. [DOI: 10.1563/aaid-joi-d-16-00204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Zirconia is becoming increasingly used as a restorative material for implant-supported restorations; however, information is lacking with respect to the minimum thickness of zirconia surrounding the implant components. The purpose of this study is to evaluate the resistance to fracture of different thicknesses of zirconia luted to implant components. Thirty cylinders of zirconia (Prettau, Zirkonzahn) with 13-mm height, designed with indented occlusal surface for loading, and varying wall thicknesses (0.5 mm, 1 mm, 1.5 mm; n = 10/group) were milled using a computer-aided design/computer-aided manufacturing system (Modellier, Zirkonzahn), after which they were sintered. Titanium temporary cylinders (ITCS41, Biomet3i) were attached to 30 implant analogs (ILA20, Biomet3i) that were embedded into polymethylmethacrylate blocks (Palapress Vario, Heraeus Kulzer) with dimensions of 4.5 × 1.8 × 2 cm. Zirconia specimens were cemented to the titanium cylinders using a self-adhesive, dual-cure resin cement (Panavia SA, Kuraray). Load to failure test was performed under compression until fracture using a universal testing machine (Instron5965, Instron) at a crosshead speed of 0.5 mm/min and measured in N (Newton). Statistical analysis was performed using 1-way analysis of variance and Tukey B test at α = .05 (SPSS19, IBM). Mean load to failure was 1059.94 N, 2019.46 N, and 4074.79 N for groups 0.5 mm, 1 mm, and 1.5 mm, respectively. Values were significantly different between the groups (P < .05). Study limitations are that it is in vitro, specimens do not replicate tooth dimensions, and forces are static and directed toward the occlusal portion of each specimen. Within these limitations and considering the average human bite force, a thickness of 0.5 mm to 1 mm of this particular type of zirconia around this type of implant component can avoid fracture with these dimensions.
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Affiliation(s)
| | | | - Winston W. Chee
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif
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18
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Blatz MB, Vonderheide M, Conejo J. The Effect of Resin Bonding on Long-Term Success of High-Strength Ceramics. J Dent Res 2017; 97:132-139. [PMID: 28876966 DOI: 10.1177/0022034517729134] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Digital manufacturing, all-ceramics, and adhesive dentistry are currently the trendiest topics in clinical restorative dentistry. Tooth- and implant-supported fixed restorations from computer-aided design (CAD)/computer-aided manufacturing (CAM)-fabricated high-strength ceramics-namely, alumina and zirconia-are widely accepted as reliable alternatives to traditional metal-ceramic restorations. Most recent developments have focused on high-translucent monolithic full-contour zirconia restorations, which have become extremely popular in a short period of time, due to physical strength, CAD/CAM fabrication, and low cost. However, questions about proper resin bonding protocols have emerged, as they are critical for clinical success of brittle ceramics and treatment options that rely on adhesive bonds, specifically resin-bonded fixed dental prostheses or partial-coverage restorations such as inlays/onlays and veneers. Resin bonding has long been the gold standard for retention and reinforcement of low- to medium-strength silica-based ceramics but requires multiple pretreatment steps of the bonding surfaces, increasing complexity, and technique sensitivity compared to conventional cementation. Here, we critically review and discuss the evidence on resin bonding related to long-term clinical outcomes of tooth- and implant-supported high-strength ceramic restorations. Based on a targeted literature search, clinical long-term studies indicate that porcelain-veneered alumina or zirconia full-coverage crowns and fixed dental prostheses have high long-term survival rates when inserted with conventional cements. However, most of the selected studies recommend resin bonding and suggest even greater success with composite resins or self-adhesive resin cements, especially for implant-supported restorations. High-strength ceramic resin-bonded fixed dental prostheses have high long-term clinical success rates, especially when designed as a cantilever with only 1 retainer. Proper pretreatment of the bonding surfaces and application of primers or composite resins that contain special adhesive monomers are necessary. To date, there are no clinical long-term data on resin bonding of partial-coverage high-strength ceramic or monolithic zirconia restorations.
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Affiliation(s)
- M B Blatz
- 1 Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - M Vonderheide
- 1 Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
| | - J Conejo
- 1 Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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19
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Papaspyridakos P, Kang K, DeFuria C, Amin S, Kudara Y, Weber HP. Digital workflow in full-arch implant rehabilitation with segmented minimally veneered monolithic zirconia fixed dental prostheses: 2-year clinical follow-up. J ESTHET RESTOR DENT 2017; 30:5-13. [DOI: 10.1111/jerd.12323] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Panos Papaspyridakos
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
- Department of Prosthodontics; University of Rochester Eastman Institute for Oral Health; Rochester New York
| | - Kiho Kang
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
| | - Catherine DeFuria
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
| | - Sarah Amin
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
| | - Yukio Kudara
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
| | - Hans-Peter Weber
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
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20
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A load-to-fracture and strain analysis of monolithic zirconia cantilevered frameworks. J Prosthet Dent 2017; 118:752-758. [PMID: 28506651 DOI: 10.1016/j.prosdent.2017.01.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 01/31/2017] [Accepted: 01/31/2017] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM The dimensions of implant-supported fixed cantilevered prostheses are important to prevent mechanical and biological complications. Information on the optimum thickness and cantilever length for improving the strength of zirconia cantilevered frameworks is limited in the literature. PURPOSE The purpose of this in vitro study was to investigate the effect of cantilever length and occlusocervical thickness on the load-to-fracture and strain distribution of zirconia frameworks. MATERIAL AND METHODS Twenty-seven rectangular prism-shaped specimens (6 mm thick buccolingually) were fabricated using a computer-aided design and computer-aided manufacturing (CAD-CAM) milling technique. The specimens were prepared in 9 groups (n=3) according to their vertical dimensions (6×6 mm, 8×6 mm, and 10×6 mm) and cantilever loading distance (7 mm, 10 mm, and 17 mm). All specimens were heat treated in a porcelain furnace and thermocycled for 20000 cycles before the tests. Each framework was secured using a clamp attached to the first 20 mm of the framework. A 3-dimensional image correlation technique was used for a full-field measurement of strain during testing. A load-to-fracture test was used until the specimens fractured. Maximum force and principal strain data were analyzed by 2-way analysis of variance using the maximum likelihood estimation method (α=.05). RESULTS No statistically significant effects (P>.05) were found for occlusocervical thickness and cantilever length or between them on the strain distribution. The results showed that the effect of occlusocervical thickness and cantilever length was significant on the load to fracture (P<.001). No statistically significant interaction was observed between the 2 factors (P>.05). CONCLUSIONS Increased occlusocervical thickness and decreased cantilever length allowed the cantilever to withstand higher loads. The occlusocervical thicknesses and cantilever lengths of zirconia frameworks tested withstood the maximum reported occlusal force. The properties of components in the implant-abutment framework assembly should be considered in the interpretation of these results.
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21
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Microstructure and nanoindentation analyses of low-temperature aging on the zirconia-porcelain interface. J Mech Behav Biomed Mater 2017; 66:119-126. [DOI: 10.1016/j.jmbbm.2016.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 11/03/2016] [Accepted: 11/07/2016] [Indexed: 11/20/2022]
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22
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Zhang F, Inokoshi M, Batuk M, Hadermann J, Naert I, Van Meerbeek B, Vleugels J. Strength, toughness and aging stability of highly-translucent Y-TZP ceramics for dental restorations. Dent Mater 2016; 32:e327-e337. [PMID: 27697332 DOI: 10.1016/j.dental.2016.09.025] [Citation(s) in RCA: 188] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 06/01/2016] [Accepted: 09/03/2016] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim was to evaluate the optical properties, mechanical properties and aging stability of yttria-stabilized zirconia with different compositions, highlighting the influence of the alumina addition, Y2O3 content and La2O3 doping on the translucency. METHODS Five different Y-TZP zirconia powders (3 commercially available and 2 experimentally modified) were sintered under the same conditions and characterized by X-ray diffraction with Rietveld analysis and scanning electron microscopy (SEM). Translucency (n=6/group) was measured with a color meter, allowing to calculate the translucency parameter (TP) and the contrast ratio (CR). Mechanical properties were appraised with four-point bending strength (n=10), single edge V-notched beam (SEVNB) fracture toughness (n=8) and Vickers hardness (n=10). The aging stability was evaluated by measuring the tetragonal to monoclinic transformation (n=3) after accelerated hydrothermal aging in steam at 134°C, and the transformation curves were fitted by the Mehl-Avrami-Johnson (MAJ) equation. Data were analyzed by one-way ANOVA, followed by Tukey's HSD test (α=0.05). RESULTS Lowering the alumina content below 0.25wt.% avoided the formation of alumina particles and therefore increased the translucency of 3Y-TZP ceramics, but the hydrothermal aging stability was reduced. A higher yttria content (5mol%) introduced about 50% cubic zirconia phase and gave rise to the most translucent and aging-resistant Y-TZP ceramics, but the fracture toughness and strength were considerably sacrificed. 0.2mol% La2O3 doping of 3Y-TZP tailored the grain boundary chemistry and significantly improved the aging resistance and translucency. Although the translucency improvement by La2O3 doping was less effective than for introducing a substantial amount of cubic zirconia, this strategy was able to maintain the mechanical properties of typical 3Y-TZP ceramics. SIGNIFICANCE Three different approaches were compared to improve the translucency of 3Y-TZP ceramics.
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Affiliation(s)
- Fei Zhang
- KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, Belgium.
| | - Masanao Inokoshi
- KU Leuven BIOMAT, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Belgium; Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8510, Japan
| | - Maria Batuk
- Electron Microscopy for Materials Science (EMAT), University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp, Belgium
| | - Joke Hadermann
- Electron Microscopy for Materials Science (EMAT), University of Antwerp, Groenenborgerlaan 171, B-2020 Antwerp, Belgium
| | - Ignace Naert
- KU Leuven BIOMAT, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Belgium
| | - Bart Van Meerbeek
- KU Leuven BIOMAT, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Belgium
| | - Jef Vleugels
- KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, Belgium
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Spies BC, Kohal RJ, Balmer M, Vach K, Jung RE. Evaluation of zirconia-based posterior single crowns supported by zirconia implants: preliminary results of a prospective multicenter study. Clin Oral Implants Res 2016; 28:613-619. [DOI: 10.1111/clr.12842] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Benedikt Christopher Spies
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Freiburg Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Freiburg Germany
| | - Marc Balmer
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Kirstin Vach
- Center for Medical Biometry and Medical Informatics; Institute for Medical Biometry and Statistics; Medical Center - University of Freiburg; Freiburg Germany
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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Shi JY, Zhang XM, Qiao SC, Qian SJ, Mo JJ, Lai HC. Hardware complications and failure of three-unit zirconia-based and porcelain-fused-metal implant-supported fixed dental prostheses: a retrospective cohort study with up to 8 years. Clin Oral Implants Res 2016; 28:571-575. [PMID: 26990006 DOI: 10.1111/clr.12836] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Jun-Yu Shi
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; College of Stomatology; Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Stomatology; Shanghai China
| | - Xiao-Meng Zhang
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; College of Stomatology; Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Stomatology; Shanghai China
| | - Shi-Chong Qiao
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; College of Stomatology; Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Stomatology; Shanghai China
| | - Shu-Jiao Qian
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; College of Stomatology; Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Stomatology; Shanghai China
| | - Jia-Ji Mo
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; College of Stomatology; Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Stomatology; Shanghai China
| | - Hong-Chang Lai
- Department of Oral and Maxillo-facial Implantology; Shanghai Ninth People's Hospital; College of Stomatology; Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Stomatology; Shanghai China
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25
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26
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Abdulmajeed AA, Lim KG, Närhi TO, Cooper LF. Complete-arch implant-supported monolithic zirconia fixed dental prostheses: A systematic review. J Prosthet Dent 2016; 115:672-677.e1. [PMID: 26809220 DOI: 10.1016/j.prosdent.2015.08.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 01/08/2023]
Abstract
STATEMENT OF PROBLEM Monolithic zirconia prostheses are emerging as a promising option in the implant-based rehabilitations of edentulous patients, yet their clinical performance is not fully documented. PURPOSE The purpose of this systematic review was to assess the clinical performance of complete-arch implant-supported monolithic zirconia fixed dental prostheses. MATERIAL AND METHODS The electronic databases PubMed, Science Direct, and Cochrane Library were searched for clinical studies on complete-arch implant-supported monolithic zirconia fixed dental prostheses. Human studies with a mean follow-up of at least 1 year and published in an English-language peer-reviewed journal up to June 2015 were included. Two independent examiners conducted the search and the review process. RESULTS The search generated 903 titles. Eighteen qualifying studies were retrieved for full-text evaluation. Nine studies were included on the basis of preestablished criteria. Eight studies reported satisfactory clinical and esthetic outcomes. One study demonstrated prosthesis failure. Clinical studies are lacking on the long-term outcome of complete-arch implant-supported monolithic zirconia prostheses. CONCLUSIONS Complete-arch dental implant restoration with monolithic zirconia is associated with high short-term success. Despite the many advantages and short-term favorable reports, studies of longer duration are necessary to validate the broad application of this therapy.
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Affiliation(s)
- Aous A Abdulmajeed
- Assistant Professor, Department of Prosthetic Dentistry, Institute of Dentistry, University of Turku, Turku, Finland; and Adjunct Assistant Professor, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Kevin G Lim
- Resident, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Timo O Närhi
- Professor, Department of Prosthetic Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Lyndon F Cooper
- Associate Dean for Research and Department Head, Oral Biology, University of Illinois at Chicago, College of Dentistry, Chicago, Ill.
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Spies BC, Witkowski S, Butz F, Vach K, Kohal RJ. Bi-layered zirconia/fluor-apatite bridges supported by ceramic dental implants: a prospective case series after thirty months of observation. Clin Oral Implants Res 2015; 27:1265-1273. [DOI: 10.1111/clr.12731] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Benedikt Christopher Spies
- Medical Center - University of Freiburg; Center for Dental Medicine; Department of Prosthetic Dentistry; Freiburg Germany
| | - Siegbert Witkowski
- Medical Center - University of Freiburg; Center for Dental Medicine; Department of Prosthetic Dentistry; Freiburg Germany
| | - Frank Butz
- Medical Center - University of Freiburg; Center for Dental Medicine; Department of Prosthetic Dentistry; Freiburg Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg; Center for Medical Biometry and Medical Informatics; Institute for Medical Biometry and Statistics; Freiburg Germany
| | - Ralf-Joachim Kohal
- Medical Center - University of Freiburg; Center for Dental Medicine; Department of Prosthetic Dentistry; Freiburg Germany
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Patzelt SBM, Spies BC, Kohal RJ. CAD/CAM-fabricated implant-supported restorations: a systematic review. Clin Oral Implants Res 2015; 26 Suppl 11:77-85. [DOI: 10.1111/clr.12633] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 12/20/2022]
Affiliation(s)
| | - Benedikt C. Spies
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Freiburg Germany
| | - Ralf J. Kohal
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Freiburg Germany
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Clinical Advantages and Limitations of Monolithic Zirconia Restorations Full Arch Implant Supported Reconstruction: Case Series. Int J Dent 2015; 2015:392496. [PMID: 26124835 PMCID: PMC4466384 DOI: 10.1155/2015/392496] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 09/23/2014] [Indexed: 11/25/2022] Open
Abstract
Purpose. The purpose of this retrospective case series is to evaluate the clinical advantages and limitations of monolithic zirconia restorations for full arch implant supported restorations and report the rate of complications up to 2 years after insertion. Materials and Methods. Fourteen patients received implant placement for monolithic zirconia full arch reconstructions. Four implants were placed in seven arches, eleven arches received six implants, two arches received seven implants, two arches received eight implants, and one arch received nine implants. Results. No implant failures or complications were reported for an implant survival rate of 100% with follow-up ranging from 3 to 24 months. Conclusions. Monolithic zirconia CAD-/CAM-milled framework restorations are a treatment option for full arch restorations over implants, showing a 96% success rate in the present study. Some of the benefits are accuracy, reduced veneering porcelain, and minimal occlusal adjustments. The outcome of the present study showed high success in function, aesthetics, phonetics, and high patient satisfaction.
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Håff A, Löf H, Gunne J, Sjögren G. A retrospective evaluation of zirconia-fixed partial dentures in general practices: An up to 13-year study. Dent Mater 2015; 31:162-70. [DOI: 10.1016/j.dental.2014.11.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 06/27/2014] [Accepted: 11/14/2014] [Indexed: 11/26/2022]
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31
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Catastrophic failure of a monolithic zirconia prosthesis. J Prosthet Dent 2015; 113:86-90. [DOI: 10.1016/j.prosdent.2014.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 07/11/2014] [Accepted: 07/15/2014] [Indexed: 11/23/2022]
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AlTarawneh S, Limmer B, Reside GJ, Cooper L. Dual Jaw Treatment of Edentulism Using Implant-Supported Monolithic Zirconia Fixed Prostheses. J ESTHET RESTOR DENT 2015; 27:63-70. [DOI: 10.1111/jerd.12137] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Sandra AlTarawneh
- Department of Prosthodontics; Faculty of Dentistry; University of Jordan; Amman Jordan
- Faculty of Dentistry; University of North Carolina; Chapel Hill NC USA
| | - Bryan Limmer
- Private Practice; Trailhead Dental; Wheat Ridge CO USA
| | - Glenn J. Reside
- Department of Oral and Maxillofacial Surgery; School of Dentistry; University of North Carolina; Chapel Hill NC USA
| | - Lyndon Cooper
- Department of Prosthodontics; School of Dentistry; University of North Carolina; Chapel Hill NC USA
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Le M, Papia E, Larsson C. The clinical success of tooth- and implant-supported zirconia-based fixed dental prostheses. A systematic review. J Oral Rehabil 2015; 42:467-80. [DOI: 10.1111/joor.12272] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M. Le
- Department of Materials Science and Technology; Faculty of Odontology; Malmö University; Malmö Sweden
| | - E. Papia
- Department of Materials Science and Technology; Faculty of Odontology; Malmö University; Malmö Sweden
| | - C. Larsson
- Department of Materials Science and Technology; Faculty of Odontology; Malmö University; Malmö Sweden
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Zhang Y. Making yttria-stabilized tetragonal zirconia translucent. Dent Mater 2014; 30:1195-203. [PMID: 25193781 DOI: 10.1016/j.dental.2014.08.375] [Citation(s) in RCA: 276] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/18/2014] [Accepted: 08/08/2014] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to provide a design guideline for developing tetragonal yttria-stabilized zirconia with improved translucency. METHODS The translucency, the in-line transmission in particular, of 3mol.% yttria-stabilized tetragonal zirconia (3Y-TZP) has been examined using the Rayleigh scattering model. The theory predicts that the in-line transmission of 3Y-TZP can be related to its thickness with grain size and birefringence the governing parameters. To achieve a threshold value of translucency, the critical grain size of 3Y-TZP was predicted for various thicknesses (0.3-2.0mm). The threshold value was defined by a measured average in-line transmission value of a suite of dental porcelains with a common thickness of 1mm. Our theoretical predictions were calibrated with one of the very few experimental data available in the literature. RESULTS For a dense, high-purity zirconia, its in-line transmission increased with decreasing grain size and thickness. To achieve a translucency similar to that of dental porcelains, a nanocyrstalline 3Y-TZP structure was necessitated, due primarily to its large birefringence and high refractive index. Such a grain size dependence became more pronounced as the 3Y-TZP thickness increased. For example, at a thickness of 1.3mm, the mean grain size of a translucent 3Y-TZP should be 82nm. At 1.5mm and 2mm thicknesses, the mean grain size needed to be 77nm and 70nm, respectively. SIGNIFICANCE A promising future for zirconia restorations, with combined translucency and mechanical properties, can be realized by reducing its grain size.
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Affiliation(s)
- Yu Zhang
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010, USA.
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On the interfacial fracture of porcelain/zirconia and graded zirconia dental structures. Acta Biomater 2014; 10:3756-61. [PMID: 24769152 DOI: 10.1016/j.actbio.2014.04.016] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 04/10/2014] [Accepted: 04/16/2014] [Indexed: 11/23/2022]
Abstract
Porcelain fused to zirconia (PFZ) restorations are widely used in prosthetic dentistry. However, their susceptibility to fracture remains a practical problem. The failure of PFZ prostheses often involves crack initiation and growth in the porcelain, which may be followed by fracture along the porcelain/zirconia (P/Z) interface. In this work, we characterized the process of fracture in two PFZ systems, as well as a newly developed graded glass-zirconia structure with emphases placed on resistance to interfacial cracking. Thin porcelain layers were fused onto Y-TZP plates with or without the presence of a glass binder. The specimens were loaded in a four-point-bending fixture with the thin porcelain veneer in tension, simulating the lower portion of the connectors and marginal areas of a fixed dental prosthesis (FDP) during occlusal loading. The evolution of damage was observed by a video camera. The fracture was characterized by unstable growth of cracks perpendicular to the P/Z interface (channel cracks) in the porcelain layer, which was followed by stable cracking along the P/Z interface. The interfacial fracture energy GC was determined by a finite-element analysis taking into account stress-shielding effects due to the presence of adjacent channel cracks. The resulting GC was considerably less than commonly reported values for similar systems. Fracture in the graded Y-TZP samples occurred via a single channel crack at a much greater stress than for PFZ. No delamination between the residual glass layer and graded zirconia occurred in any of the tests. Combined with its enhanced resistance to edge chipping and good esthetic quality, graded Y-TZP emerges as a viable material concept for dental restorations.
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Kwon T, Bain PA, Levin L. Systematic review of short- (5-10 years) and long-term (10 years or more) survival and success of full-arch fixed dental hybrid prostheses and supporting implants. J Dent 2014; 42:1228-41. [PMID: 24975989 DOI: 10.1016/j.jdent.2014.05.016] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 05/27/2014] [Accepted: 05/30/2014] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The aim of this systematic review was to investigate the short-term (5-10 year mean follow-up) and long-term (10 year or more) survival and success of fixed full arch dental hybrid prosthesis and supporting dental implants. METHODS Studies reporting interventions with full-arch fixed dental hybrid prostheses were identified by searching PubMed/Medline (NCBI), Web of Science (Thomson Reuters), the Cochrane Register of Controlled Clinical Trials (EBSCO), and Dentistry and Oral Sciences Source (DOSS; EBSCO) from the earliest available dates through July 17, 2013. Through a series of review process by two examiners, potentially qualifying studies were identified and assessed with respect to the inclusion criteria. RESULTS A total of 18 studies were included for the quality assessment and the systematic review. Within the limitation of available studies, high short-term survival rates of full arch fixed dental hybrid prostheses (93.3-100%) and supporting implants (87.89-100%) were found. However, the availability of studies investigating long-term outcomes seemed scarce. Furthermore, the included studies were subjected to potential sources of bias (i.e. publication, reporting, attrition bias). CONCLUSIONS Despite seemingly high short-term survival, long-term survival of implant supported full arch fixed dental hybrid prosthesis could not be determined due to limited availability of true long-term studies. Although it may be a valuable option for a patient with a completely edentulous ridge(s), the strategic removal of teeth with satisfactory prognosis for the sake of delivering an implant supported full-arch dental hybrid prosthesis should be avoided.
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Affiliation(s)
- TaeHyun Kwon
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Paul A Bain
- Countway Library of Medicine, Harvard Medical School, Boston, MA, USA
| | - Liran Levin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Faculty of Medicine, Technion, IIT, Haifa, Israel; Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
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Spies BC, Stampf S, Kohal RJ. Evaluation of Zirconia-Based All-Ceramic Single Crowns and Fixed Dental Prosthesis on Zirconia Implants: 5-Year Results of a Prospective Cohort Study. Clin Implant Dent Relat Res 2014; 17:1014-28. [DOI: 10.1111/cid.12203] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Susanne Stampf
- Center for Medical Biometry and Medical Informatics; Medical Center - University of Freiburg; Freiburg Germany
| | - Ralf-Joachim Kohal
- Clinic of Prosthodontics, School of Dentistry; Albert-Ludwigs-University; Freiburg Germany
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Thalji GN, Cooper LF. Implant-Supported Fixed Dental Rehabilitation with Monolithic Zirconia: A Clinical Case Report. J ESTHET RESTOR DENT 2014; 26:88-96. [DOI: 10.1111/jerd.12078] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Ghadeer N. Thalji
- Department of Prosthodontics; College of Dentistry; University of Iowa; Iowa City IA
| | - Lyndon F. Cooper
- Department of Prosthodontics; School of Dentistry; University of North Carolina; Chapel Hill NC
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Koenig V, Vanheusden AJ, Le Goff SO, Mainjot AK. Clinical risk factors related to failures with zirconia-based restorations: an up to 9-year retrospective study. J Dent 2013; 41:1164-74. [PMID: 24135294 DOI: 10.1016/j.jdent.2013.10.009] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/03/2013] [Accepted: 10/06/2013] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The first objective of this study was to retrospectively evaluate zirconia-based restorations (ZBR). The second was to correlate failures with clinical parameters and to identify and to analyse chipping failures using fractographic analysis. METHODS 147 ZBR (tooth- and implant-supported crowns and fixed partial dentures (FPDs)) were evaluated after a mean observation period of 41.5 ± 31.8 months. Accessorily, zirconia implant abutments (n=46) were also observed. The technical (USPHS criteria) and the biological outcomes of the ZBR were evaluated. Occlusal risk factors were examined: occlusal relationships, parafunctional habits, and the presence of occlusal nightguard. SEM fractographic analysis was performed using the intra-oral replica technique. RESULTS The survival rate of crowns and FPDs was 93.2%, the success rate was 81.63% and the 9-year Kaplan-Meier estimated success rate was 52.66%. The chipping rate was 15% and the framework fracture rate was 2.7%. Most fractographic analyses revealed that veneer fractures originated from occlusal surface roughness. Several parameters were shown to significantly influence veneer fracture: the absence of occlusal nightguard (p=0.0048), the presence of a ceramic restoration as an antagonist (p=0.013), the presence of parafunctional activity (p=0.018), and the presence of implants as support (p=0.026). The implant abutments success rate was 100%. CONCLUSIONS The results of the present study confirm that chipping is the first cause of ZBR failure. They also underline the importance of clinical parameters in regards to the explanation of this complex problem. This issue should be considered in future prospective clinical studies. CLINICAL SIGNIFICANCE Practitioners can reduce chipping failures by taking into account several risk parameters, such as the presence of a ceramic restoration as an antagonist, the presence of parafunctional activity and the presence of implants as support. The use of an occlusal nightguard can also decrease failure rate.
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Affiliation(s)
- Vinciane Koenig
- Department of Fixed Prosthodontics, Institute of Dentistry, University of Liège Hospital (ULg, CHU, LIMARC), 45 Quai G. Kurth, Liège 4020, Belgium
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Abstract
OBJECTIVES Clinical data on survival rates reveal that all-ceramic dental prostheses are susceptible to fracture from repetitive occlusal loading. The objective of this review is to examine the underlying mechanisms of fatigue in current and future dental ceramics. DATA/SOURCES The nature of various fatigue modes is elucidated using fracture test data on ceramic layer specimens from the dental and biomechanics literature. CONCLUSIONS Failure modes can change over a lifetime, depending on restoration geometry, loading conditions and material properties. Modes that operate in single-cycle loading may be dominated by alternative modes in multi-cycle loading. While post-mortem examination of failed prostheses can determine the sources of certain fractures, the evolution of these fractures en route to failure remains poorly understood. Whereas it is commonly held that loss of load-bearing capacity of dental ceramics in repetitive loading is attributable to chemically assisted 'slow crack growth' in the presence of water, we demonstrate the existence of more deleterious fatigue mechanisms, mechanical rather than chemical in nature. Neglecting to account for mechanical fatigue can lead to gross overestimates in predicted survival rates. CLINICAL SIGNIFICANCE Strategies for prolonging the clinical lifetimes of ceramic restorations are proposed based on a crack-containment philosophy.
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