Conventional, Speed Sintering and High-Speed Sintering of Zirconia: A Systematic Review of the Current Status of Applications in Dentistry with a Focus on Precision, Mechanical and Optical Parameters

Current speed sintering and high-speed sintering protocols compromise the translucency but not strength of yttria-stabilized zirconia

OBJECTIVES

To investigate the impacts of speed and high-speed sintering on the densification, microstructure, phase composition, translucency, and flexural strength of yttria-stabilized zirconia (YSZ).

METHODS

A total of 162 disc-shaped specimens (n = 18) were cold-isostatically pressed from 3YSZ (Zpex), 4YSZ (Zpex 4), and 5YSZ (Zpex Smile) powders (Tosoh Corporation) and sintered according to the following protocols: conventional (control, ∼12 h), speed (∼28 min for 3YSZ; ∼60 min for 4YSZ and 5YSZ), and high-speed (∼18 min) sintering. Dimensions of zirconia specimens after sintering and polishing (1-μm diamond grit finish) were Ø13.75 × 1 mm. Density, microstructure, phase content, translucency parameter, and biaxial flexural strength were evaluated using Archimedes', SEM, XRD, spectrophotometric, and piston-on-3-ball methods, respectively. Data were analyzed with either one-way ANOVA and Tukey's test or Kruskal-Wallis with Dunn's test (α = 0.05).

RESULTS

For all YSZ compositions, conventional sintering yielded the highest density followed by speed then high-speed sintering. All sintering protocols resulted in similar strength values; however, speed and high-speed sintering protocols afforded significantly lower translucency relative to conventional sintering. XRD analysis revealed similar spectra for YSZs sintered by various protocols. The speed sintered specimens had the smallest grain size whereas the high-speed sintered 5YSZ possessed the largest grain size among all groups. SEM examination of all YSZ compositions revealed that the average pore size was an order of magnitude smaller than the average grain size.

SIGNIFICANCE

Speed and high-speed sintering of YSZs yield similar strength but diminished density and translucency relative to their conventionally sintered counterparts.

Flexural strength, flexural modulus and microhardness of milled vs. fused deposition modeling printed Zirconia; effect of conventional vs. speed sintering

BACKGROUND

Various methods can be used for creating zirconia dental restorations, including 3-dimensional (3D) printing and computer-aided design/ computer-aided manufacturing (CAD/CAM) milling. The fused deposition modeling (FDM) printing method for zirconia presents numerous advantages, albeit research on the mechanical properties of these materials and resultant restorations remains scarce. Such developments are undeniably intriguing and warrant further investigation. The objective of the present study was to evaluate the impact of the sintering firing cycle (Conventional vs. Speed sintering) on the flexural strength, flexural modulus, and Vickers Microhardness of milled vs. FDM printed zirconia.

METHODS

A total of 60 bars (2 × 5 × 27 mm) were fabricated for flexural strength testing, along with 40 discs (12 × 1.5 mm) for Vickers microhardness testing. Half of the specimens underwent conventional sintering, while the other half underwent a speed sintering cycle. The flexural strength and modulus were determined by a three-point bending test in a universal testing machine. The microhardness of the specimens was evaluated using a Vickers microhardness tester. Statistical analysis was performed using a two-way ANOVA test with a post-hoc Tukey test (p < 0.05).

RESULTS

CAD/CAM milled zirconia had significantly higher flexural strength and modulus than FDM-printed zirconia. The sintering process did not significantly affect the flexural strength or modulus of milled or FDM-printed zirconia. The milled speed sintering group had significantly higher values in the Vickers microhardness test compared to the other groups.

CONCLUSIONS

The mechanical properties of FDM-printed zirconia specimens were not found to be comparable to those of milled zirconia. Speed sintering cycle may produce milled zirconia restorations with similar flexural strength and modulus to conventional sintering, and even higher Vickers Microhardness values.

Effect of Milling Speed on the Properties of Zirconia Restorations

Background

The purpose of this study was to evaluate the effect of milling speed on the surface roughness, marginal gap, marginal gap volume, marginal offset, and fracture load of zirconia restorations.

Material and Methods

A mandibular molar #30 typodont tooth was digitally scanned and an ideal crown preparation for a zirconia restoration was digitally created. A single master model die of the crown preparation was milled out of a resin material. The master die was scanned, and a final restoration was designed using the bio-copy feature of the typodont tooth. Ten zirconia restorations were milled (CEREC Primemill, Dentsply Sirona) per each of three milling speeds (super-fast, fine, and extra-fine), sintered, and seated on the master die. Surface roughness, marginal gap, marginal gap volume, and marginal offset were measured using a non-contact profilometer. Then, all restorations were cemented to the dies and loaded to failure in a material testing device. Data were analyzed with one-way ANOVA and Tukey's post hoc tests per property (alpha=0.05).

Results

Super-fast milling speed resulted in restorations with statistically significant greater surface roughness and marginal gap volume compared to fine and extra-fine milling speeds. No significant difference in marginal gap, marginal offset, and fracture load were found based on milling speed.

Conclusions

Zirconia restorations milled at slower speeds may result in similar or slightly better properties compared to super-fast speed. Key words:Milling speed, properties, zirconia restorations.

Effect of high-speed sintering on the marginal and internal fit of CAD/CAM-fabricated monolithic zirconia crowns

This study compared the marginal and internal fit of zirconia crowns fabricated using conventional and high-speed induction sintering. A typodont mandibular right first molar was prepared and 60 zirconia crowns were fabricated: 30 crowns using conventional sintering and 30 crowns using high-speed sintering. We presented a new evaluation methodology to measure the marginal and internal fit of restorations through digital scanning, aligning the two datasets, and measuring the distance between two arbitrary point sets of the datasets. For the marginal fit, we calculated the maximum values of the shortest distances between the marginal line of the prepared tooth and that of the crown. The calculated values ranged from 359 to 444 μm, with smaller values for the high-speed sintered crowns (P < 0.05). For the internal fit, we employed mesh sampling and computed the geodesic distances between the prepared tooth surface and the crown intaglio surface. The measured values ranged from 177 to 229 μm with smaller values for the high-speed sintered crowns, but no significant difference was found (P > 0.05). Based on our results, the high-speed sintering method can be considered a promising option for single-visit zirconia treatment in dental practice.

Effect of High-Speed Sintering on the Optical Properties, Microstructure, and Phase Distribution of Multilayered Zirconia Stabilized with 5 mol% Yttria

As dental 5 mol% yttria-stabilized (5Y-) zirconia demand high esthetics, it is necessary to clarify how the optical properties are affected by high-speed sintering, which is not yet fully understood. Our study aimed to investigate the effect of high-speed sintering on the translucency and opalescence parameters (TP and OP, respectively), as well as their related microstructure and phase distribution, using two types of multilayered 5Y-zirconia. Multilayered 5Y-zirconia (Cercon xt ML, Lava Esthetic) were cut layer-by-layer, followed by conventional and high-speed sintering. The TP and OP values were subsequently obtained using a spectrophotometer, and field emission scanning electron microscopy images were used to analyze the average grain size. The phase fractions were analyzed using X-ray diffraction. Regardless of the zirconia type, the TP was slightly lowered by high-speed sintering in all the layers except the dentin layer (DL) for Lava Esthetic (p < 0.05). The OP decreased by high-speed sintering in the DL for Cercon xt ML and in all the layers for Lava Esthetic (p < 0.05). The decrease in translucency after high-speed sintering was attributed to a decrease in the yttria-rich t'-phase with low tetragonality, along with an increase in the yttria-lean t-phase with high tetragonality.

Impact of different CAD/CAM materials on internal and marginal adaptations and fracture resistance of endocrown restorations with: 3D finite element analysis

PURPOSE

To assess and compare the impact of various computers aided design/manufacturing (CAD/CAM) materials on internal and marginal discrepancies, fracture resistance and failure probability of Endocrown restorations with 3D Finite Element analysis.

MATERIAL AND METHODS

Forty devitalized human maxillary first molars were collected. After endodontic treatment, they classified into 4 groups (n = 10) based on the materials used for endocrown fabrication. Group V (Vita-Enamic), Group N (Nacera Hybrid), Group T (Translucent Prettau Zirconia) and Group P (Pekkton ivory). All samples were exposed to artificial aging method simulating one year of clinical service. Silicone replica technique and stereomicroscope (25X) utilized to evaluate the marginal and internal gaps of endocrowns at different areas. Fracture resistance test used for cemented specimens followed by qualitative investigation utilizing Stereomicroscopy. Four models representing four endocrown systems used for restoration of severely-damaged endodontically treated upper first molar were generated for finite element analysis (FEA). Axially and centrally static occlusal compressive load was applied. Modified Von Mises and maximum principal stress values on the remaining tooth structure, cement lines and restorative materials were assessed independently. Resulted data were statistically analyzed at P-value ≤ 0.05.

RESULTS

In the current study, the highest mean values of internal and marginal discrepancies (μm) among studied groups were reported for Zirconia group (100.300 and 102.650) respectively, while the lowest mean value of internal discrepancy (μm) was observed for Nacera group (69.275) and the lowest mean value of marginal discrepancy (μm) was observed for PEKK group (78.4750). Regarding internal discrepancy, Vita-Enamic and PEKK groups did not exhibit any statistically significant differences (P = 0.293), however zirconia and the other tested groups exhibited statistically significant differences in the mean values of the marginal gap region (p 0.05).On the other hand, PEKK group showed the highest mean value of fracture resistance (1845.20 N) and the lowest value was observed for Vita-Enamic group (946.50 N). Regarding to stress distributions through 3D FEA, and according to modified von Mises (mvM) analysis, the greatest possible stress values were noticed in PEKK model in relation to tooth structure, cement line, and flowable composite as the following: (93.1, 64.5, 58.4 MPa) respectively, while Zirconia revealed lower maximum stress values (11.4, 13.6, 11.6 MPa) respectively.

CONCLUSIONS

Statistically excellent marginal and internal fit was observed for PEKK in relation to other used endocrown materials. Also, PEKK material explained fracture resistance comparable to zirconia value while the lowest value was detected for Vita Enamic material.

Transient thermal stresses developed during speed sintering of 3 mol% yttria-stabilized tetragonal zirconia polycrystals

OBJECTIVES

To investigate transient thermal stresses that developed in 3Y-TZP green compacts during speed sintering.

METHODS

A total of 312 disc-shaped green compacts (Ø17.1 ×1, 1.5, 2, 2.5, 3 mm) were cold-isostatically pressed from 3Y-TZP powder (Zpex, Tosoh Corp.) for speed sintering studies as well as compositional analysis and biaxial flexural strength measurements (both at room temperature and following heating at 90 °C/min to 500 °C). Flexural strength was determined using the piston-on-3-ball method. Phase assemblies were analyzed using the X-ray diffraction method. Effects of heating/cooling rates on transient stresses were investigated by conducting definitive sintering studies to determine the threshold for fracture. Finite element analysis (FEA) was used to validate the experimental findings using measured thermomechanical properties.

RESULTS

The bulk and relative density of the green compact were 2.95 ± 0.03 g/cm3 and 48.52% ± 0.45%. The flexural strength was drastically decreased from 10.3 ± 0.4 MPa to 1.09 ± 0.07 MPa following heating at 90 °C/min to 500 °C. The monoclinic and tetragonal contents were 54.9% and 45.1%, respectively. The threshold for fracture was located at 500 °C during the first heating stage with a 90 °C/min heating rate in specimens of 2.5 mm thickness or greater. No fractures occurred in the second heating stage and cooling phase. The FEA estimated that the principal transient tensile stress was ∼1.14 MPa at 500 °C during the heating phase, which exceeded the corresponding flexural strength (1.09 ± 0.07 MPa).

SIGNIFICANCE

Advanced FEA methods are an accurate and efficient tool to analyze the history of transient stresses during sintering of ceramic dental restorations.