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Alghauli MA, Alqutaibi AY, Wille S, Kern M. The physical-mechanical properties of 3D-printed versus conventional milled zirconia for dental clinical applications: A systematic review with meta-analysis. J Mech Behav Biomed Mater 2024; 156:106601. [PMID: 38810545 DOI: 10.1016/j.jmbbm.2024.106601] [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: 01/21/2024] [Revised: 05/12/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
AIM OF STUDY This systematic review aimed to compare the physical-mechanical properties of 3D-printed (additively manufactured (AM)) zirconia compared to conventionally milled (subtractive manufactured: SM) zirconia specimens. MATERIALS AND METHODS A thorough search of Internet databases was conducted up to September 2023. The search retrieved studies that evaluated AM zirconia specimens and restorations regarding the physical-mechanical properties and mechanical behavior of zirconia. The main topic focused on 3Y-TZP. However, records of 4YSZ and 5YSZ were also included to gather more comprehensive evidence on additively manufactured zirconia ceramic. The quality of studies was assessed using the ROB2 tool, Newcastle Ottawa scale, and the Modified Consort Statement. Of 1736 records, 57 were assessed for eligibility, and 38 records were included in this review, only two clinical trials meet the inclusion criteria and 36 records were laboratory studies. There were no signs of mechanical complications and wear to antagonists with short-term clinical observation. SM thin specimens ≤1.5 mm showed statistically significant higher flexural strength than AM zirconia (p ≤ 0.01), while thicker specimens showed comparable outcomes (p > 0.5). The fracture resistance of dental restorations was dependent on the aging protocol, restoration type, and thickness. The bond strength of veneering ceramic to zirconia core was comparable. CONCLUSIONS The results pooled from two short-term clinical trials showed no signs of mechanical or biological complications of additively manufactured 3Y-TZP zirconia crowns. The flexural strength might depend on the specimens' thickness, but it showed promising results to be used in clinical applications, taking into account the printing technique and orientation, material composition (yttria content), solid loading, and sintering parameters. 3D-printed restorations fracture resistance improved when adhered to human teeth. The veneering ceramic bond was comparable to milled zirconia specimens. Long-term RCTs are recommended to confirm the mechanical behavior of 3D-printed restorations.
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Affiliation(s)
- Mohammed Ahmed Alghauli
- Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany; Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen.
| | - Ahmed Yaseen Alqutaibi
- Department of Prosthodontics, Faculty of Dentistry, Ibb University, Ibb, Yemen; Department of Substitutive Dental Science, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
| | - Sebastian Wille
- Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany
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Zhu H, Jiang J, Wang Y, Wang S, He Y, He F. Additive manufacturing of dental ceramics in prosthodontics: The status quo and the future. J Prosthodont Res 2024; 68:380-399. [PMID: 38346729 DOI: 10.2186/jpr.jpr_d_23_00119] [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] [Indexed: 07/09/2024]
Abstract
PURPOSE This review aims to summarize the available technologies, material categories, and prosthodontic applications of additive manufacturing (AM) dental ceramics, evaluate the achievable accuracy and mechanical properties in comparison with current mainstream computer-aided design/computer-aided manufacturing (CAD/CAM) subtractive manufacturing (SM) methods, and discuss future prospects and directions. STUDY SELECTION This paper is based on the latest reviews, state-of-the-art research, and existing ISO standards on AM technologies and prosthodontic applications of dental ceramics. PubMed, Web of Science, and ScienceDirect were amongst the sources searched for narrative reviews. RESULTS Relatively few AM technologies are available and their applications are limited to crowns and fixed partial dentures. Although the accuracy and strength of AM dental ceramics are comparable to those of SM, they have the limitations of relatively inferior curved surface accuracy and low strength reliability. Furthermore, functionally graded additive manufacturing (FGAM), a potential direction for AM, enables the realization of biomimetic structures, such as natural teeth; however, specific studies are currently lacking. CONCLUSIONS AM dental ceramics are not sufficiently developed for large-scale clinical applications. However, with additional research, it may be possible for AM to replace SM as the mainstream manufacturing technology for ceramic restorations.
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Affiliation(s)
- Han Zhu
- Department of Periodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, PR China
| | - Jimin Jiang
- Department of Periodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, PR China
| | - Yujie Wang
- Department of Periodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, PR China
| | - Sijie Wang
- Department of Periodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, PR China
| | - Yong He
- State Key Laboratory of Fluid Power and Mechatronic Systems, School of Mechanical Engineering, Zhejiang University, Hangzhou, PR China
| | - Fuming He
- Department of Periodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, PR China
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Mosaddad SA, Peláez J, Panadero RA, Ghodsi S, Akhlaghian M, Suárez MJ. Do 3D-printed and milled tooth-supported complete monolithic zirconia crowns differ in accuracy and fit? A systematic review and meta-analysis of in vitro studies. J Prosthet Dent 2024:S0022-3913(24)00283-X. [PMID: 38772783 DOI: 10.1016/j.prosdent.2024.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 05/23/2024]
Abstract
STATEMENT OF PROBLEM Additive (3-dimensional printing) and subtractive (milling) methods are digital approaches to fabricating zirconia restorations. Comparisons of their resultant fabrication accuracy and restoration fit are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the accuracy and fit of monolithic zirconia crowns fabricated by 3-dimensional printing and milling. MATERIAL AND METHODS The PubMed (Medline), Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar databases were searched up to August 2023. Eligible records were included, and the standardized mean difference (SMD) analyzed 4 outcomes: marginal fit, intaglio fit, trueness, and precision. Publication bias was analyzed with Trim-and-fill, the Egger regression test, and Begg funnel plot. Methodological quality was rated using the QUIN tool. RESULTS A total of 15 publications were found eligible out of the initial 6539 records. The 3-dimensional printing group demonstrated a lower marginal fit (SMD=1.46, 95% CI=[0.67, 2.26], P<.001; I2=83%, P<.001) and trueness (SMD=0.69, 95% CI=[0.20, 1.18], P=.006; I2=88%, P<.001) and a significantly higher precision (SMD=-2.19, 95% CI=[-2.90, -1.48], P<.001; I2=56%, P=.045). The intaglio fit did not differ significantly across the study groups (SMD=0.77, 95% CI=[-0.22, 1.77], P=.127; I2=87%, P<.001). CONCLUSIONS Given the high degree of heterogeneity, it can be cautiously concluded that while 3-dimensional printing led to greater precision, the outcomes of the 2 accuracy and adaptation parameters most crucial to the longevity of the restorations-trueness and marginal fit-showed the superiority of the milling technique.
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Affiliation(s)
- Seyed Ali Mosaddad
- Researcher, Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain; and Adjunct Faculty Member, Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
| | - Jesús Peláez
- Adjunct Professor, Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain.
| | - Rubén Agustín Panadero
- Professor, Department of Stomatology, Faculty of Medicine and Dentistry, Valencia University, Valencia, Spain
| | - Safoura Ghodsi
- Associate Professor, Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Akhlaghian
- Assistant Professor, Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - María J Suárez
- Professor, Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
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Alghauli M, Alqutaibi AY, Wille S, Kern M. 3D-printed versus conventionally milled zirconia for dental clinical applications: Trueness, precision, accuracy, biological and esthetic aspects. J Dent 2024; 144:104925. [PMID: 38471580 DOI: 10.1016/j.jdent.2024.104925] [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: 11/14/2023] [Revised: 02/11/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
OBJECTIVES This systematic review aimed to compare the clinical outcome, internal gap, trueness, precision, and biocompatibility of 3D-printed (AM) compared to milled (SM) zirconia restorations. DATA SOURCE A thorough search of Internet databases was conducted up to September 2023. The search retrieved studies compared AM zirconia to SM zirconia restorations regarding clinical outcome, fit, trueness, precision, and biocompatibility. STUDY SELECTION Of 1736 records, only 59 were screened for eligibility, and 22 records were included in this review. The quality of studies was assessed using the revised Cochrane risk-of-bias tool (ROB2), and the Modified Consort Statement. One clinical study exhibited a low risk of bias. All laboratory studies revealed some bias concerns. Short-term observation showed 100 % survival with no signs of periodontal complications. 3D-printed zirconia crowns showed statistically significant lower ΔE and a better match to adjacent teeth (p ≤ 0.5). The fit, trueness, and precision vary with the printing technique and the tooth surface. CONCLUSIONS 3D-printed zirconia crowns provide better aesthetic color and contour match to adjacent natural teeth than milled crowns. Both 3D printing and milling result in crowns within the clinically acceptable internal and marginal fit. Except for nanoparticle jetting, the marginal gap of SM crowns was smaller than AM crowns, however, both were clinically acceptable. Laminate veneers might be more accurately produced by 3D printing. 3D-printed axial surface trueness was better than milled axial surfaces. Long-term RCTs are recommended to confirm the clinical applicability of 3D-printed restorations. CLINICAL SIGNIFICANCE Internal fit and gap, precision, and trueness are fundamental requirements for successful dental restorations. Both techniques produce restorations with clinically acceptable marginal and internal fit. Axial surfaces and narrow or constricted areas favored 3D-printed than conventionally milled zirconia.
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Affiliation(s)
- Mohammed Alghauli
- Prosthodontics Department, College of Dentistry, Ibb University, Yemen; Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany.
| | - Ahmed Yaseen Alqutaibi
- Prosthodontics Department, College of Dentistry, Ibb University, Yemen; Prosthodontics Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
| | - Sebastian Wille
- Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontic, Propaedeutic and Dental Materials, Faculty of Dentistry, Kiel University, Kiel, Germany
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Sharma S, Kumar Upadhyay A, Prakash A, Singodia P, Ravi Kiran S, Shankar R. Treatment Complications of Head and Neck Cancers and Rehabilitation Measures: A Narrative Review. Cureus 2024; 16:e61173. [PMID: 38933634 PMCID: PMC11204137 DOI: 10.7759/cureus.61173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Head and neck cancers (HNCs) are malignant tumors mainly from squamous cells in the head and neck tissues. Treatment involves a multidisciplinary approach with surgery, radiotherapy, and chemotherapy. However, the long-term prognosis for patients with advanced-stage tumors is guarded, with a median survival time of approximately 24 months. HNC patients have very high rates of depression and anxiety and the highest suicide rate among all cancers due to the intense and challenging nature of the treatment, underscoring the importance of our collective efforts. Rehabilitation success depends on various factors, including tumor, patient, and treatment-related factors. Patients may require post-treatment oral rehabilitation measures, including implants, obturators, and flexible dentures. These measures are crucial, but they often need to be more utilized. Patients may face challenges in maintaining oral hygiene and managing mucositis. Additionally, it is essential to address other intricacies such as trismus, xerostomia, gustatory dysfunctions, neuropathy, speech impairments, and psychological disturbances. Unfortunately, there is little literature on post-treatment rehabilitative measures. Despite its crucial role in improving patients' quality of life, rehabilitation often receives inadequate attention compared to treatment. Our narrative review, which covers various factors that affect rehabilitation, including oral rehabilitation measures and post-treatment complications, is anticipated to deliver practical insights to professionals and inspire positive changes in their regular practice.
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Affiliation(s)
- Swati Sharma
- Prosthodontics, Crown and Bridge & Oral Implantology, Tata Main Hospital, Jamshedpur, IND
| | | | | | | | - Sarat Ravi Kiran
- Oral and Maxillofacial Surgery, Tata Main Hospital, Jamshedpur, IND
| | - Rama Shankar
- Oral and Maxillofacial Surgery, Tata Main Hospital, Jamshedpur, IND
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Branco AC, Santos T, Bessa LJ, Barahona I, Polido M, Colaço R, Serro AP, Figueiredo-Pina CG. Optimized 3D printed zirconia-reinforced leucite with antibacterial coating for dental applications. Dent Mater 2024; 40:629-642. [PMID: 38369404 DOI: 10.1016/j.dental.2024.02.021] [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: 07/18/2023] [Revised: 01/17/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES This study aims to produce by robocasting leucite/zirconia pieces with suitable mechanical and tribological performance, convenient aesthetics, and antibacterial properties to be used in dental crown replacement. METHODS Leucite pastes reinforced with 12.5%, 25%, and 37.5% wt. ZrO2 nanoparticles were prepared and used to print samples that after sintering were characterized in terms of density, shrinkage, morphology, porosity, mechanical and tribological properties and translucency. A coating of silver diamine fluoride (SDF) and potassium iodide (KI) was applied over the most promising material. The material's antibacterial activity and cytotoxicity were assessed. RESULTS It was found that the increase of ZrO2 reinforcement up to 25% enhanced both microhardness and fracture toughness of the sintered composite. However, for a superior content of ZrO2, the increase of the porosity negatively affected the mechanical behaviour of the composite. Moreover, the composite with 25% ZrO2 exhibited neglectable wear in chewing simulator tests and induced the lowest wear on the antagonist dental cusps. Although this composite exhibited lower translucency than human teeth, it was three times higher than the ZrO2 glazed material. Coating this composite material with SDF+KI conferred antibacterial properties without inducing cytotoxicity. SIGNIFICANCE Robocasting of leucite reinforced with 25% ZrO2 led to best results. The obtained material revealed superior optical properties and tribomechanical behaviour compared to glazed ZrO2 (that is a common option in dental practice). Moreover, the application of SDF+KI coating impaired S. aureus proliferation, which anticipates its potential benefit for preventing pathogenic bacterial complications associated with prosthetic crown placement.
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Affiliation(s)
- A C Branco
- CQE, Centro de Química Estrutural, Institute of Molecular Sciences, Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CDP2T, Centro de Desenvolvimento de Produto e Transferência de Tecnologia, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal; CiiEM, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | | | - L J Bessa
- CiiEM, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - I Barahona
- CiiEM, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - M Polido
- CiiEM, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal
| | - R Colaço
- IDMEC e Departamento de Engenharia Mecânica, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
| | - A P Serro
- CQE, Centro de Química Estrutural, Institute of Molecular Sciences, Departamento de Engenharia Química, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal; CiiEM, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal.
| | - C G Figueiredo-Pina
- CDP2T, Centro de Desenvolvimento de Produto e Transferência de Tecnologia, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Setúbal, Portugal; CiiEM, Egas Moniz Center for Interdisciplinary Research, Egas Moniz School of Health & Science, Almada, Portugal; CeFEMA, Centro de Física e Engenharia de Materiais Avançados, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal
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Toksoy D, Önöral Ö. Influence of glazing and aging on the marginal, axial, axio-occlusal, and occlusal fit of 3-unit monolithic zirconia restorations fabricated using additive and subtractive techniques. J Prosthet Dent 2024; 131:658.e1-658.e9. [PMID: 38342643 DOI: 10.1016/j.prosdent.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/13/2024]
Abstract
STATEMENT OF PROBLEM Studies are sparse on how glazing and aging influence the fit of additively fabricated monolithic zirconia restorations. PURPOSE The purpose of this in vitro study was to assess the effect of glazing and aging on the fit of 3-unit monolithic zirconia restorations fabricated using different techniques. MATERIAL AND METHODS A total of 32 monolithic zirconia restorations were fabricated for a typodont model by using 4 distinct techniques (subtractive fabrication [SF], stereolithography [SLA], digital light processing [DLP], and lithography-based ceramic manufacturing [LCM]). The silicone replica approach was adopted to measure the discrepancy values for premolar and molar abutments after sintering, glazing, and 1 year of aging. The silicone replicas were sliced into mesiodistal and buccopalatal cross-sections, and digital micrographs of the cross-sections were made with a ×80 stereomicroscope. An inherent measuring program was run to record the discrepancy values (µm). Repeated-measures 2-way ANOVAs with the Bonferroni post hoc test were used to statistically analyze the acquired data. (α=.05). RESULTS From the repeated measures 2-way ANOVAs, both the glazing×fabrication technique and the aging×fabrication technique interactions were not statistically significant (P>.05). Glazing significantly influenced premolar abutment marginal (P=.022) and occlusal (P=.007) discrepancy values, as well as molar abutment marginal discrepancy values (P=.047). Aging had a statistically significant effect on premolar abutment marginal (P=.008) and occlusal (P=.011) discrepancy values, as well as molar abutment occlusal discrepancy values (P=.039). In both the glazing and aging data, for all areas of interest, statistically significant differences were detected among the fabrication techniques (P<.05). The LCM group had the lowest discrepancy values, followed by the SLA, SF, and DLP groups. CONCLUSIONS The LCM and SLA groups outperformed the other groups in terms of fit accuracy. The glazing and aging procedures altered the discrepancy values. The marginal discrepancy values of all groups were below the threshold of clinical acceptability (<120 µm).
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Affiliation(s)
- Dilem Toksoy
- Research Assistant, Department of Prosthetic Dentistry, Faculty of Dentistry, Near East University, Nicosia, North Cyprus
| | - Özay Önöral
- Associate Professor, Department of Prosthetic Dentistry, Faculty of Dentistry, Near East University, Nicosia, North Cyprus.
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Su G, Zhang Y, Jin C, Zhang Q, Lu J, Liu Z, Wang Q, Zhang X, Ma J. 3D printed zirconia used as dental materials: a critical review. J Biol Eng 2023; 17:78. [PMID: 38129905 PMCID: PMC10740276 DOI: 10.1186/s13036-023-00396-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
In view of its high mechanical performance, outstanding aesthetic qualities, and biological stability, zirconia has been widely used in the fields of dentistry. Due to its potential to produce suitable advanced configurations and structures for a number of medical applications, especially personalized created devices, ceramic additive manufacturing (AM) has been attracting a great deal of attention in recent years. AM zirconia hews out infinite possibilities that are otherwise barely possible with traditional processes thanks to its freedom and efficiency. In the review, AM zirconia's physical and adhesive characteristics, accuracy, biocompatibility, as well as their clinical applications have been reviewed. Here, we highlight the accuracy and biocompatibility of 3D printed zirconia. Also, current obstacles and a forecast of AM zirconia for its development and improvement have been covered. In summary, this review offers a description of the basic characteristics of AM zirconia materials intended for oral medicine. Furthermore, it provides a generally novel and fundamental basis for the utilization of 3D printed zirconia in dentistry.
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Affiliation(s)
- Guanyu Su
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Yushi Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Chunyu Jin
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Qiyue Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Jiarui Lu
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Zengqian Liu
- Shi-Changxu Innovation Center for Advanced Materials, Institute of Metal Research, Chinese Academy of Sciences, Shenyang, 110016, China
- School of Materials Science and Engineering, University of Science and Technology of China, Hefei, 230026, China
| | - Qiang Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China
| | - Xue Zhang
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
| | - Jia Ma
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, No. 117 Nanjing North Street, Shenyang, 110001, China.
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Branco AC, Colaço R, Figueiredo-Pina CG, Serro AP. Recent Advances on 3D-Printed Zirconia-Based Dental Materials: A Review. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1860. [PMID: 36902976 PMCID: PMC10004380 DOI: 10.3390/ma16051860] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Zirconia-based materials are widely used in dentistry due to their biocompatibility and suitable mechanical and tribological behavior. Although commonly processed by subtractive manufacturing (SM), alternative techniques are being explored to reduce material waste, energy consumption and production time. 3D printing has received increasing interest for this purpose. This systematic review intends to gather information on the state of the art of additive manufacturing (AM) of zirconia-based materials for dental applications. As far as the authors know, this is the first time that a comparative analysis of these materials' properties has been performed. It was performed following the PRISMA guidelines and using PubMed, Scopus and Web of Science databases to select studies that met the defined criteria without restrictions on publication year. Stereolithography (SLA) and digital light processing (DLP) were the techniques most focused on in the literature and the ones that led to most promising outcomes. However, other techniques, such as robocasting (RC) and material jetting (MJ), have also led to good results. In all cases, the main concerns are centered on dimensional accuracy, resolution, and insufficient mechanical strength of the pieces. Despite the struggles inherent to the different 3D printing techniques, the commitment to adapt materials, procedures and workflows to these digital technologies is remarkable. Overall, the research on this topic can be seen as a disruptive technological progress with a wide range of application possibilities.
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Affiliation(s)
- Ana Catarina Branco
- Centro de Química Estrutural (CQE), Departamento de Engenharia Química, Institute of Molecular Sciences, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal
- Centro de Desenvolvimento de Produto e Transferência de Tecnologia, Department of Mechanical Engineering, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Estefanilha, 2910-761 Setúbal, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
| | - Rogério Colaço
- Departamento de Engenharia Mecânica, Instituto de Engenharia Mecânica, Instituto Superior Técnico, Universidade de Lisboa, 1049-001 Lisboa, Portugal
| | - Célio Gabriel Figueiredo-Pina
- Centro de Desenvolvimento de Produto e Transferência de Tecnologia, Department of Mechanical Engineering, Escola Superior de Tecnologia de Setúbal, Instituto Politécnico de Setúbal, Estefanilha, 2910-761 Setúbal, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
- Center of Physics and Engineering of Advanced Materials, Instituto Superior Técnico, University of Lisbon, Av. Rovisco Pais, 1049-001 Lisboa, Portugal
| | - Ana Paula Serro
- Centro de Química Estrutural (CQE), Departamento de Engenharia Química, Institute of Molecular Sciences, Instituto Superior Técnico, Universidade de Lisboa, Av. Rovisco Pais, 1049-001 Lisbon, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário Egas Moniz, Quinta da Granja, Monte de Caparica, 2829-511 Caparica, Portugal
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Jung JM, Kim GN, Koh YH, Kim HE. Manufacturing and Characterization of Dental Crowns Made of 5-mol% Yttria Stabilized Zirconia by Digital Light Processing. MATERIALS (BASEL, SWITZERLAND) 2023; 16:1447. [PMID: 36837076 PMCID: PMC9963883 DOI: 10.3390/ma16041447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
We herein report manufacturing of dental crowns made of 5-mol% yttria partially stabilized zirconia (5Y-PSZ) with desired mechanical properties, optical translucency and dimensional accuracy using digital light processing (DLP). To this end, all processing parameters were carefully controlled and optimized. First, 5Y-PSZ particles with a bimodal distribution were prepared via calcination of as-received granules and subsequent ball-milling and then used to formulate 5Y-PSZ suspensions with a high solid loading of 50 vol% required for high densification after sintering. Dispersant content was also optimized. To provide high dimensional accuracy, initial dimensions of dental crowns for 3D printing were precisely determined by considering increase and decrease in dimensions during photopolymerization and sintering, respectively. Photopolymerization time was also optimized for a given layer thickness of 50 μm to ensure good bonding between layers. A multi-step debinding schedule with a slow heating rate was employed to avoid formation of any defects. After sintering at 1500 °C for 2 h, 5Y-PSZ could be almost fully densified without noticeable defects within layers and at interfaces between layers. They had high relative densities (99.03 ± 0.39%) with a high cubic phase content (59.1%). These characteristics allowed for achievement of reasonably high mechanical properties (flexural strength = 625.4 ± 75.5 MPa and Weibull modulus = 7.9) and % transmittance (31.4 ± 0.7%). In addition, 5Y-PSZ dental crowns showed excellent dimensional accuracy (root mean square (RMS) for marginal discrepancy = 44.4 ± 10.8 μm and RMS for internal gap = 22.8 ± 1.6 μm) evaluated by the 3D scanning technique.
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Affiliation(s)
- Jae-Min Jung
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul 02841, Republic of Korea
- School of Biomedical Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Gyu-Nam Kim
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul 02841, Republic of Korea
- School of Biomedical Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Young-Hag Koh
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul 02841, Republic of Korea
- School of Biomedical Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Hyoun-Ee Kim
- Department of Materials Science and Engineering, Seoul National University, Seoul 08826, Republic of Korea
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Carek A, Slokar Benić L, Komar D, Krebelj E. Roughness of the Surface of Zirconia Reinforced Lithium Disilicate Ceramic Treated by Different Procedures. MATERIALS (BASEL, SWITZERLAND) 2022; 16:ma16010265. [PMID: 36614604 PMCID: PMC9822208 DOI: 10.3390/ma16010265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 05/27/2023]
Abstract
Lithium disilicate and zirconia are the two most popular materials for aesthetic and dental prosthetic work; however, due to their limitations, a new material is being researched, namely zirconia-reinforced lithium disilicate, the surface of which is treated with different procedures to achieve the best possible surface properties. In this study, the surface of zirconia-reinforced lithium disilicate glass-ceramic was treated using different methods (conventional and laser) to determine the effects of the treatment procedures on the surface properties and surface roughness to achieve a higher strength of adhesion from the self-adhesive resin cement to zirconia-reinforced lithium disilicate. The treated surfaces were investigated using profilometry, X-ray diffraction and energy dispersive X-ray fluorescence. The results obtained were statistically evaluated. The results show that the surface roughness is highest for the samples treated with Er:YAG (erbium-doped yttrium aluminium garnet laser) and silanisation. Furthermore, the surface treatment procedures applied did not change the composition of the surface.
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Affiliation(s)
- Andreja Carek
- School of Dental Medicine, University of Zagreb, Ivana Gundulića 5, 10000 Zagreb, Croatia
| | - Ljerka Slokar Benić
- Faculty of Metallurgy, University of Zagreb, Aleja narodnih heroja 3, 44000 Sisak, Croatia
| | - Daniel Komar
- School of Dental Medicine, University of Zagreb, Ivana Gundulića 5, 10000 Zagreb, Croatia
| | - Ena Krebelj
- School of Dental Medicine, University of Zagreb, Ivana Gundulića 5, 10000 Zagreb, Croatia
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