Wear Properties of Conventional and High-Translucent Zirconia-Based Materials

Advances in zirconia-based dental materials: Properties, classification, applications, and future prospects

OBJECTIVES

Zirconia (ZrO2) ceramics are widely used in dental restorations due to their superior mechanical properties, durability, and ever-improving translucency. This review aims to explore the properties, classification, applications, and recent advancements of zirconia-based dental materials, highlighting their potential to revolutionize dental restoration techniques.

STUDY SELECTION, DATA AND SOURCES

The most recent literature available in scientific databases (PubMed and Web of Science) reporting advances of zirconia-based materials within the dental field is thoroughly examined and summarized, covering the major keywords "dental zirconia, classification, aesthetic, LTD, applications, manufacturing, surface treatments".

CONCLUSIONS

An exhaustive overview of the properties, classifications, and applications of dental zirconia was presented, alongside an exploration of future prospects and potential advances. This review highlighted the importance of addressing challenges such as low-temperature degradation resistance and optimizing the balance between mechanical strength and translucency. Also, innovative approaches to improve the performances of zirconia as dental material was discussed.

CLINICAL SIGNIFICANCE

This review provides a better understanding of zirconia-based dental biomaterials for dentists, helping them to make better choice when choosing a specific material to fabricate the restorations or to place the implant. Moreover, new generations of zirconia are still expected to make progress on key issues such as the long-term applications in dental materials while maintaining both damage resistance and aesthetic appeal, defining the directions for future research.

Evaluation of Hardness and Wear of Conventional and Transparent Zirconia Ceramics, Feldspathic Ceramic, Glaze, and Enamel

The aim of the study was to compare the hardness, coefficient of friction, and wear experienced by four different ceramic samples: 3Y-TZP zirconium oxide ceramics-Zi-Ceramill Zi (Amman Girrbach), 5Y-PSZ transparent zirconium oxide ceramics-Zol-Ceramill Zolid (Amman Girrbach), Sak-feldspathic ceramics-Sakura Interaction (Elephant), and Glaze (Amman Girrbach). The Vickers hardness of the samples was measured. Friction tests ball-on-disc were performed between the discs of four ceramics and a zirconia ceramic ball, then a premolar tooth as a counter-sample. The mass loss and the friction coefficients of the ceramic samples were determined. The tooth counter-samples were 3D scanned, and enamel attrition depths and mass were measured. The following hardness values (HV1) were obtained: 1454 ± 46 HV1 for Zi, 1439 ± 62 HV1 for Zol, 491 ± 16 HV1 for Sak, 593 ± 16 HV1 for Glaze, and 372 ± 41 HV1 for enamel. The mass losses of the teeth in contact with ceramics were 0.1 mg for Zi, 0.1 mg for Zol, 5.5 mg for Sak, and 4 mg for Glaze. Conventional and transparent zirconium oxide ceramics are four times harder than enamel and three times harder than veneering ceramics. Zirconia ceramics exhibit lower wear and a more homogenous, smoother surface than the other ceramics. Tooth tissues are subject to greater attrition in contact with veneering ceramics than with polished zirconium oxide ceramics.

Anterior Esthetic Restorations with the Stratified Stamp Technique: A Case Report

Anterior teeth restoration represents a challenge for dentists, who often rely on the dental technician's wax-up. The proposed Stratified Stamp Technique (SST) allows for clinically reproducing the wax-up in a quick and easy way. A patient with fractures and discoloration on the upper central incisors was treated with resin-based composite direct restorations. Using SST, a 1 mm thick thermoformed polyethylene-terephthalate-glycol (PETG) template, based on the technician's wax-up, was produced. Enamel Selective Area Reduction (SAR) was performed to guarantee adequate space for the restorations, and the fracture margins were rounded and finished. Traditional layering procedures according to the five color dimensions of teeth were performed, except for the final labial layer, which was realized with warm composite loaded inside the template and polymerized through it, in order to ensure accurate tooth morphology reproduction. SST offers a reliable method for transferring technician's wax-up morphology to direct composite restorations in anterior teeth. Compared with other methods, SST allows for better isolation with a rubber dam and permits traditional layering with multiple composite shades, thus leading to satisfactory esthetic outcomes.

Wear of lithium disilicate opposed by various ceramic materials

OBJECTIVES

To compare volumetric wear of lithium disilicate against different ceramic (3 mol% yttria-stabilized (3Y) zirconia, 5 mol% yttria-stabilized (5Y) zirconia, lithium disilicate, porcelain and enamel antagonists).

MATERIALS AND METHODS

Forty lithium disilicate (e.max CAD) specimens (n = 8/antagonist) were wet sanded to 1200grit SiC and mounted into a UAB wear device. Antagonist spheres (diameter = 4.75 mm) were made from polished 3Y zirconia, 5Y zirconia, lithium disilicate, porcelain and human enamel. A two-body wear test was performed with 20 N load and 1.5 mm slide for 400,000 cycles at 1 Hz. 33% glycerin was used as a lubricant. Wear facets were measured with optical profilometry. Wear scar areas of antagonists were measured with digital microscopy. Scanning electron microscopy was performed on wear facets and scars. Vicker's microhardness was measured of all antagonist materials. All data were compared with 1-way ANOVA and Tukey post-hoc analysis.

RESULTS

Significant differences in lithium disilicate volumetric wear (mm3 ) occurred with various antagonist materials: 0.38 ± 0.01a (3Y zirconia), 0.33 ± 0.01b, (5Y zirconia), 0.16 ± 0.01c (lithium disilicate), 0.11 ± 0.03d, (enamel), and 0.07 ± 0.01e (porcelain). The lithium disilicate antagonist demonstrated a larger wear scar than other materials. Zirconia was the hardest material and enamel the least hard.

CONCLUSIONS

Zirconia causes significant wear on lithium disilicate and lithium disilicate causes significant wear against itself.

CLINICAL SIGNIFICANCE

When selecting a material to oppose an existing lithium disilicate crown, a porcelain or lithium disilicate surface would cause significantly less wear to the existing crown. If an existing zirconia crown exists opposed to a prepared tooth, lithium disilicate may not be an ideal material selection to restore the tooth.

Translucent Zirconia in Fixed Prosthodontics-An Integrative Overview

Over the past two decades, dental ceramics have experienced rapid advances in science and technology, becoming the fastest-growing field of dental materials. This review emphasizes the significant impact of translucent zirconia in fixed prosthodontics, merging aesthetics with strength, and highlights its versatility from single crowns to complex bridgework facilitated by digital manufacturing advancements. The unique light-conducting properties of translucent zirconia offer a natural dental appearance, though with considerations regarding strength trade-offs compared to its traditional, opaque counterpart. The analysis extends to the mechanical attributes of the material, noting its commendable fracture resistance and durability, even under simulated physiological conditions. Various zirconia types (3Y-TZP, 4Y-TZP, 5Y-TZP) display a range of strengths influenced by factors like yttria content and manufacturing processes. The study also explores adhesive strategies, underlining the importance of surface treatments and modern adhesives in achieving long-lasting bonds. In the realm of implant-supported restorations, translucent zirconia stands out for its precision, reliability, and aesthetic adaptability, proving suitable for comprehensive dental restorations. Despite its established benefits, the review calls for ongoing research to further refine the material's properties and adhesive protocols and to solidify its applicability through long-term clinical evaluations, ensuring its sustainable future in dental restorative applications.

Effect of the Abutment Rigidity on the Wear Resistance of a Lithium Disilicate Glass Ceramic: An In Vitro Study

Lithium disilicate (LDS) glass ceramics are among the most common biomaterials in conservative dentistry and prosthodontics, and their wear behavior is of paramount clinical interest. An innovative in vitro model is presented, which employs CAD/CAM technology to simulate the periodontal ligament and alveolar bone. The model aims to evaluate the effect of the abutment rigidity on the wear resistance of the LDS glass ceramic. Two experimental groups (LDS restorations supported by dental implants, named LDS-on-Implant, or by hybrid ceramic tooth replicas with artificial periodontal ligament, named LDS-on-Tooth-Replica) and a control group (LDS-Cylinders) were compared. Fifteen samples (n = 15) were fabricated for each group and subjected to testing, with LDS antagonistic cusps opposing them over 120,000 cycles using a dual axis chewing simulator. Wear resistance was analyzed by measuring the vertical wear depth (mm) and the volume loss (mm3) on each LDS sample, as well as the linear antagonist wear (mm) on LDS cusps. Mean values were calculated for LDS-Cylinders (0.186 mm, 0.322 mm3, 0.220 mm, respectively), LDS-on-Implant (0.128 mm, 0.166 mm3, 0.199 mm, respectively), and LDS-on-Tooth-Replica (0.098 mm, 0.107 mm3, 0.172 mm, respectively) and compared using one-way-ANOVA and Tukey's tests. The level of significance was set at 0.05 in all tests. Wear facets were inspected under a scanning electron microscope. Data analysis revealed that abutment rigidity was able to significantly affect the wear pattern of LDS, which seems to be more intense on rigid implant-abutment supports compared to resilient teeth replicas with artificial periodontal ligament.

Mechanical Properties of Translucent Zirconia: An In Vitro Study

Background: The introduction of translucent zirconia has improved mimetics: nevertheless, a reduction in the mechanical performance was registered. The study aim was to investigate the mechanical characteristics of a high-translucent zirconia used for monolithic restorations before and after the aging process compared to a low-translucent zirconia. Methods: A total of 23 specimens were used in the present study. Group A (n = 10) was made of a high-translucent Y-TZP; group B (n = 7) was made of a low-translucent Y-TZP and finally group C (n = 6) was an aged high-translucent Y-TZP. Flexural strength, fracture toughness, brittleness, microcrack’s propagation and grain size were analyzed. Results: The Vickers hardness was: 1483 ± 187 MPa (group C); 1102 ± 392 MPa (group A); 1284 ± 32 MPa (group B). The flexural strength was: 440 (±96.2) MPa (group C); 427 (±59.5) MPa (group A); 805 (±198.4) MPa (group B). The fracture toughness was: 5.1 (±0.7) MPa.m1/2 (group C); 4.9 (±0.9) MPa.m1/2 (group A); 8.9 (±1.1) MPa.m1/2 (group B). The brittleness was: 295 (±42.8) (group C), 230.9 (±46.4) (group A) and 144.9 (±20.3) (group B). The grain size was: 2.75 (±1.2) µm2 (group A); 0.16 (±0.05) µm2 (group B); 3.04 (±1.1) µm2 (group C). Conclusions: The significant reduction in the mechanical properties of high-translucent zirconia, compared to the traditional one, suggests their use in the anterior/lateral area (up to premolars).