Role of coefficient of thermal expansion on bond strength of ceramic veneered yttrium-stabilized zirconia

Recent Advances on 3D-Printed Zirconia-Based Dental Materials: A Review

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.

Evaluation of Marginal/Internal Fit and Fracture Load of Monolithic Zirconia and Zirconia Lithium Silicate (ZLS) CAD/CAM Crown Systems

Fit accuracy and fracture strength of milled monolithic zirconia (Zi) and zirconia-reinforced lithium silicate (ZLS) crowns are important parameters determining the success of these restorations. This study aimed to evaluate and compare the marginal and internal fit of monolithic Zi and ZLS crowns, along with the fracture load, with and without mechanical aging. Thirty-two stone dies acquired from a customized master metal molar die were scanned, and ceramic crowns (16 Zi Ceramill Zolid HT⁺ and 16 ZLS Vita Suprinity) were designed and milled. Absolute marginal discrepancies (AMD), marginal gaps (MG), and internal gaps (IG) of the crowns, in relation to the master metal die, were evaluated using x-ray nanotomography (n = 16). Next, thirty-two metal dies were fabricated based on the master metal die, and crowns (16 Zi; 16 ZLS) cemented and divided into four groups of eight each; eight Zi with mechanical aging (MA), eight Zi without mechanical aging (WMA), eight ZLS (MA), and eight ZLS (WMA). Two groups of crowns (Zi-MA; ZLS-MA) were subjected to 500,000 mechanical cycles (200 ± 50 N, 10 Hz) followed by axial compressive strength testing of all crowns, until failure, and the values were recorded. Independent sample t tests (α = 0.05) revealed no significant differences between Zi and ZLS crowns (p > 0.05); for both internal and marginal gaps, however, there were significant differences in AMD (p < 0.005). Independent samples Mann–Whitney U and Kruskal–Wallis tests revealed significant differences between the two materials, Zi and ZLS, regardless of fatigue loading, and for the individual material groups based on aging (α = 0.05). Multiple comparisons using Bonferroni post-hoc analysis showed significant differences between Zi and ZLS material groups, with or without aging. Within the limitations of this study, the ZLS crown fit was found to be on par with Zi, except for the AMD parameter. As regards fracture resistance, both materials survived the normal range of masticatory forces, but the Zi crowns demonstrated greater resistance to fracture. The monolithic Zi and ZLS crowns seem suitable for clinical application, based on the fit and fracture strength values obtained.

On the behaviour of zirconia-based dental materials: A review

Zirconia-based dental materials are extensively used in clinical practice due to their tooth-like appearance, biofunctionality, biocompatibility, and affordability. However, premature clinical failures of veneering porcelains raise a concern about their integrity. Extensive studies have been performed over a decade to resolve this issue, but it is challenging to reference all information effectively. A single source identifying the significance of potential parameters on material performance has not previously been available. An evidence-based meta-narrative review technique was used to review the characteristic parameters that can affect the overall behaviour of zirconia-based materials. Keywords were chosen to assess manuscripts based on scientific coherence with this paper's research objective. Online keyword searches were carried out on ScienceDirect, PubMed, and SAGE databases for relevant published manuscripts from year 1985-2020.261 out of 3170 identified manuscripts were included. A total of 10 parameters were identified and classified into the material, manufacturing, and geometric aspects. The effect of every parameter was reviewed on the performance of the material. A discrepancy in findings was observed and is attributed to the fact that there is no standard methodology. This review acts as a single source that summarizes various parameters' contribution to zirconia-based dental materials' performance. This review facilitates manufacturing improvements by accounting for every parameter's effect on overall performance.

Effect of different coloring liquids on the flexural strength of multilayered zirconia

PURPOSE

The purpose of this study was to evaluate the effect of two coloring liquids (aqueous and acid-based coloring liquids) and the position of multilayered zirconia on the flexural strength of multilayered zirconia.

MATERIALS AND METHODS

The multilayered zirconia specimens were divided into upper and lower positions. The specimens were divided into three subgroups (n=10): non-shaded, acid-based coloring liquid, and aqueous coloring liquid. The specimens were cut using a milling machine and were immersed in either a acid-based coloring liquid or aqueous coloring liquid 2 times for 5 seconds. The specimens were sintered in a sintering furnace according to the manufacturer's introduction. The flexural strength of the specimen was measured using a universal testing machine and the surface of the specimen was observed using a field emission scanning electron microscope.

RESULTS

The flexural strength of multilayered zirconia was 400 – 500 MPa. There was no statistically significant difference among all groups (P>.05).The flexural strength of the multilayered zirconia was not influenced by the kind of coloring liquid used (P>.05). The flexural strength of the multilayered zirconia colored with the coloring liquids was not influenced by its position (P>.05).

CONCLUSION

The different coloring liquid application did not affect the flexural strength of multilayered zirconia of all positions.

Influence of different veneering techniques and thermal tempering on flexural strength of ceramic veneered yttria partially stabilized tetragonal zirconia polycrystalline restoration

Background

Different technique for ceramic veneering and thermal tempering process are expected to be a reason for alteration in strength of ceramic veneered zirconia. This study evaluates the effect of different veneering technique and varied thermal tempering process on flexural strength of ceramic veneered zirconia.

Material and Methods

Ceramic veneered zirconia bars (25 mm length, 4 mm width, 0.7&1.0mm of zirconia & ceramic thickness) were prepared from zirconia block (e.max® ZirCAD), sintered at 1500°C for 4 hours, and veneered with ceramics with different techniques including CAD-fused using e.max CAD® (C), Pressed-on using e.max® Zirpress (P), and layering using e.max® ceram (L), with different tempering process through fast (F), medium (M), and slow (L) cooling (n=15). The specimens were determined for flexural strength on a universal testing machine. ANOVA and Bonferroni's multiple comparisons were used to determine for significant difference (α=0.05). Weibull analysis was applied for survival probability, Weibull modulus (m), and characteristics strength (σc). The interfaces were microscopically examined. The phase transformation of zirconia was determined using X ray diffraction.

Results

The mean±sd (MPa), m, σc of flexural strength were 922.06±83.45, 12.78, 958.32 for CF, 924.26±74.64, 14.28, 959.62 for CM, 930.25±92.42, 11.83, 970.83 for CS, 518.29±59.97, 10.11, 542.97 for PF, 516.50±67.51, 8.75, 539.17 for PM, and 520.51±42.38, 14.59, 544.51 for PS, 604.36±64.09, 11.28, 630.67 for LF, 583.81±56.95, 11.67, 609.81 for LM, 547.33±52.23, 12.19, 569.36 for LS. The flexural strength was significantly affected by veneering technique (p<0.05). No significant effect on flexural strength upon tempering process was evidenced (P >0.05). Phase transformation from t→m related with veneering and tempering procedure.

Conclusions

Strength of ceramic veneered zirconia associated with different veneering techniques, but not directly related with tempering process. CAD-on ceramic veneering zirconia is benefit for enhancing the strength of ceramic bilayer and was recommended as a method for ceramic veneering zirconia. Key words:CAD-CAM, cooling process, flexural strength, thermal tempering, zirconia.

Flexural strength of various types of computerized machinable ceramic veneered to yttria stabilized tetragonal zirconia polycrystalline ceramic upon different hybridized techniques

Objective: This study determined biaxial flexural strength (BFS) of computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic veneered yttria-stabilized tetragonal zirconia poly-crystalline (Y-TZP) related with hybridization techniques and veneering materials.

Material and methods: One hundred and twenty zirconia Y-TZP (0.8 mm thick and 12 mm in diameter) were prepared and randomly divided into eight groups, to be conjugated with different veneering ceramics: Vitabloc (Vm), e.max-CAD (Em), Vita-Suprinity (Vs) and Celtra-Duo (Cd), using different hybridized techniques, CAD-bonded (Cb) versus CAD-fused (Cf). BFS was determined using piston on three balls and analyzed for Weilbull reliability. An analysis of variance (ANOVA) and Bonferroni’s multiple comparisons were determined for significant differences. Microscopic structures were examined with scanning electron microscope (SEM), along with X-ray diffraction (XRD).

Results: BFS (mean±sd; MPa), Weibull modulus (m), and characteristic strength (σ_o) of each group were 630.46±65.08, 10.72, and 659.47 for VmCb, 709.03±102.88, 7.67, and 753.03 for VmCf, 651.83±69.48, 9.47, and 685.82 for EmCb, 721.17±121.28, 5.99, and 777.04 for EmCf, 692.83±89.10, 8.56, and 731.87 for VsCb, 888.61±164.26, 5.80, and 959.08 for VsCf, 687.17±59.39, 12.85, and 713.95 for CdCb, and 953.12±134.30, 7.97, and 1010.65 for CdCf. The BFS of ceramic veneered zirconia were significantly affected by different veneering ceramics, hybridized techniques, and their interactions (p<0.05). Cd showed highest BFS, followed by Vs, Em and Vm respectively. Both Cd and Vs showed significant higher BFS than Em and VM (p<0.05). No significant difference of BFS between Cd and Vs and between Em and Vm were indicated (p>0.05). Cf technique showed significantly higher impact on BFS than Cb (p<0.05). Veneering zirconia with either Cd or Vs using Cf technique revealed significantly higher flexural strength than others combinations (p<0.05).

Conclusions: Type of veneering ceramics and hybridization techniques affected BFS of ceramic veneered Y-TZP. Veneering zirconia with either Cd or Vs using Cf-process produced superior BFS.