Novel glass-ceramics for dental restorations

Effects of Plasma Treatment on the Strength of Bonding to Ceramic Surfaces in Orthodontics-A Comprehensive Review

Over the past several decades, orthodontic treatment has been increasingly sought out by adults, many of whom have undergone restorative dental procedures that cover enamel. Because the characteristics of restorative materials differ from those of enamel, typical bonding techniques do not yield excellent restoration-bracket bonding strengths. Plasma treatment is an emerging surface treatment that could potentially improve bonding properties. The purpose of this paper is to evaluate currently available studies assessing the effect of plasma treatment on the shear bond strength (SBS) and failure mode of resin cement/composite on the surface of ceramic materials. PubMed and Google Scholar databases were searched for relevant studies, which were categorized by restorative material and plasma treatment types that were evaluated. It was determined that cold atmospheric plasma (CAP) treatment using helium and H2O gas was effective at raising the SBS of feldspathic porcelain to a bonding agent, while CAP treatment using helium gas might also be a potential treatment method for zirconia and other types of ceramics. More importantly, CAP treatment using helium has the potential for being carried out chairside due to its non-toxicity, low temperature, and short treatment time. However, because all the studies were conducted in vitro and not tested in an orthodontic setting, further research must be conducted to ascertain the effectiveness of specific plasma treatments in comparison to current orthodontic bonding treatments in vivo.

Investigation of Spark Plasma Sintering on Microstructure-Properties of Zirconia Reinforced Fluormica Glass for Dental Restorations

BACKGROUND

Conventional sintering methods of dental ceramics have limitations of high temperature and slow cooling rates with requirements of additional heat treatment for crystallization. Spark plasma sintering (SPS) is an emerging technique that has the potential to process dental restorations with dense microstructures and tailor-made clinically relevant properties with optimized processing parameters. This study explored the potential of the SPS of zirconia-reinforced fluormica glass (FM) for dental restorative materials.

METHODS

FM glass frit was obtained through the melt-quench technique (44.5 SiO2-16.7 Al2O3-9.5 K2O-14.5 MgO-8.5 B2O3-6.3 F (wt.%)). The glass frit was ball-milled with 20 wt.% of 3 mol% yttria-stabilized zirconia (FMZ) for enhanced fracture toughness. The mixtures were SPS sintered at a pressure of 50 MPa and a heating rate of 100 °C/min for 5 min with an increase in temperature from 650-750 °C-850 °C-950 °C. Phase analysis was carried out using XRD and microstructural characterization with SEM. Micro-hardness, nano-indentation, porosity, density, indentation fracture toughness, and genotoxicity were assessed.

CONCLUSIONS

The increase in the SPS temperature of FMZ influenced its microstructure and resulted in reduced porosity, improved density, and optimal mechanical properties with the absence of genotoxicity on human gingival fibroblast cells.

Effect of crystal orientation on flexural strength of pressable lithium disilicate glass-ceramics

This study examined the crystal orientation of four kinds of pressable lithium disilicate glass-ceramics and evaluated the effect of crystal orientation on flexural strength. Bar-shaped (24 mm in length, 1.2 mm in thickness, 4.0 mm in width), disk-shaped (12 mm in diameter, 0.5 mm in thickness), and crown-shaped (maxillary first molar) specimens were prepared according to the manufacturer's instructions. Three-point and biaxial flexural strengths were measured for bar- and disk-shaped specimens. Microstructure analysis was performed using X-ray diffractometry and scanning electron microscopy. Three-point flexural strength was improved by parallel crystal orientation along the longitudinal direction of the bar-shaped specimen. There was no relationship between two-dimensional crystal orientation and biaxial flexural strength. The results of this study assumed that biaxial flexural strength was improved by the crystal orientation in the cross-sectional direction. Pressed restorations are expected to possess higher strength than milled restorations due to their crystal orientation.

Influence of the Fabrication Technique on the Marginal and Internal Adaptation of Ceramic Onlays

This study aimed to evaluate the marginal and internal adaptation of partial coverage crowns (ceramic onlays) fabricated with Press, CEREC BlueCam, and CEREC OmniCam systems, using two preparation designs and evaluating the internal discrepancies at different locations. Two phantom maxillary premolars (master teeth) received different preparation designs, with (BX) and without (NB) a modified occlusal box with round internal angles. Sixty IPS e-max ceramic restorations were fabricated with three systems: Press (n=20), CEREC BlueCam (n=20), and CEREC OmniCam (n=20). Both marginal and internal discrepancy width were measured by using a stereomicroscope at ×25 magnification. The data were evaluated statistically using analysis of variance followed by Tukey's Honestly Significant Difference test (α=0.05). The ceramic restorations fabricated with the Press system presented significantly smaller marginal and internal disadaptations than the BlueCam and OmniCam CEREC systems (p<0.0001). Regarding the preparation designs, preparation BX presented the smallest marginal discrepancies for all fabrication systems and larger internal discrepancies than for restorations fabricated with the Press system. The occlusal location presented a larger internal discrepancy compared with the axial locations. Although the three systems resulted in the fabrication of restorations within a clinically acceptable adaptation with marginal discrepancies below 100 μm, the Press system presented the smallest marginal and internal discrepancies. An improved marginal adaptation was observed in the preparation design with a modified occlusal box with rounded internal angles.

Flexural strength, fracture toughness, three-body wear, and Martens parameters of pressable lithium-X-silicate ceramics

OBJECTIVES

To test and compare five pressable lithium-X-silicate-ceramics on their mechanical and wear properties.

METHODS

Specimens were pressed and prepared from: i. Amber Press (AP), ii. Celtra Press (CP), iii. Initial LiSi Press (IL), iv. Livento Press (LP), and v. IPS e.max Press (IE). Four-point flexural strength (FS), SEVNB fracture toughness (K_IC), three-body wear (3BW), Martens hardness (HM) and indentation modulus (E_IT) were measured. For CP, FS and HM were measured with and without additional Power Firing. Each subgroup contained 15 specimens. Data were analyzed using Kolmogorov-Smirnov, one-way ANOVA followed by Scheffé test, Kruskal-Wallis-H-, Mann-Whitney-U-, and Spearman-Rho-test (p < 0.05). The Weibull modulus was calculated using the maximum likelihood estimation method.

RESULTS

AP and CP presented higher FS than IL. LP presented the highest Weibull modulus. CP showed lower K_IC values than AP, and AP was not significant compared to LP and IE. The most 3BW material loss was observed for CP. CP revealed higher HM values than the remaining ceramics. IL presented lower E_IT compared to AP and CP. The following correlations were observed between the test parameters: 3BW with FS (r = 0.279, p = 0.015), with HM (r = -0.378, p = 0.001), and with E_IT (r = -0.344, p = 0.004); E_IT with FS (r = 0.203, p = 0.028); and HM with FT (r = -0.223, p = 0.027) and E_IT (r = 0.884, p < 0.001). No correlations were observed between FS and K_IC (r = 0.046; p = 0.346).

SIGNIFICANCE

AP followed by LP showed the highest and IL followed by CP the lowest properties tested. Power Firing of CP improved the flexural strength. Ceramics with high flexural strength and Martens parameters showed lower wear. Materials with high Martens hardness presented lower fracture toughness values and ones with high indentation modulus showed high flexural strength.

Effect of microstructure on the mechanical properties of lithium disilicate glass-ceramics

The mechanical properties of lithium disilicate glass-ceramics depend on various factors, a prominent one being their microstructure. The aim of this review article is to elucidate the effect of processing parameters such as annealing temperature, holding time, number of heating stages and chemical composition and additives on the microstructure and physical properties of these glass-ceramics.

Zirconia toughened mica glass ceramics for dental restorations

OBJECTIVE

The objective of the present study is to understand the role of yttria stabilized zirconia (YSZ) in achieving the desired spectrum of clinically relevant mechanical properties (hardness, elastic modulus, fracture toughness and brittleness index) and chemical solubility of mica glass ceramics.

METHODS

The glass-zirconia mixtures with varying amounts of YSZ (0, 5, 10, 15 and 20wt.%) were ball milled, compacted and sintered to obtain pellets of glass ceramic-YSZ composites. Phase analysis was carried out using X-ray diffraction and microstructural characterization with SEM revealed the crystal morphology of the composites. Mechanical properties such as Vickers hardness, elastic modulus, indentation fracture toughness and chemical solubility were assessed.

RESULTS

Phase analysis of sintered pellets of glass ceramic-YSZ composites revealed the characteristic peaks of fluorophlogopite (FPP) and tetragonal zirconia. Microstructural investigation showed plate and lath-like interlocking mica crystals with embedded zirconia. Vickers hardness of 9.2GPa, elastic modulus of 125GPa, indentation toughness of 3.6MPa·m^1/2, and chemical solubility of 30μg/cm² (well below the permissible limit) were recorded with mica glass ceramics containing 20wt.% YSZ.

SIGNIFICANCE

An increase in hardness and toughness of the glass ceramic-YSZ composites with no compromise on their brittleness index and chemical solubility has been observed. Such spectrum of properties can be utilised for developing a machinable ceramic for low stress bearing inlays, onlays and veneers.

Ocular prosthesis incorporating IPS e-max press scleral veneer and a literature review on non-integrated ocular prosthesis

The article highlights a new method for the fabrication of an ocular prosthesis by the incorporation of a ceramic scleral veneer. The steps of fabrication include impression making, wax try-in, performing a "cut-back" on a selected stock eye, insertion of the IPS e-max press scleral veneer, finishing and insertion. It also includes a detailed review on non-integrated ocular prostheses.

Bioactive and inert dental glass-ceramics

The global market for dental materials is predicted to exceed 10 billion dollars by 2020. The main drivers for this growth are easing the workflow of dentists and increasing the comfort of patients. Therefore, remarkable research projects have been conducted and are currently underway to develop improved or new dental materials with enhanced properties or that can be processed using advanced technologies, such as CAD/CAM or 3D printing. Among these materials, zirconia, glass or polymer-infiltrated ceramics, and glass-ceramics (GCs) are of great importance. Dental glass-ceramics are highly attractive because they are easy to process and have outstanding esthetics, translucency, low thermal conductivity, high strength, chemical durability, biocompatibility, wear resistance, and hardness similar to that of natural teeth, and, in certain cases, these materials are bioactive. In this review article, we divide dental GCs into the following two groups: restorative and bioactive. Most restorative dental glass-ceramics (RDGCs) are inert and biocompatible and are used in the restoration and reconstruction of teeth. Bioactive dental glass-ceramics (BDGCs) display bone-bonding ability and stimulate positive biological reactions at the material/tissue interface. BDGCs are suggested for dentin hypersensitivity treatment, implant coating, bone regeneration and periodontal therapy. Throughout this paper, we elaborate on the history, processing, properties and applications of RDGCs and BDGCs. We also report on selected papers that address promising types of dental glass-ceramics. Finally, we include trends and guidance on relevant open issues and research possibilities. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 619-639, 2017.

Influence of translucence/opacity and shade in the flexural strength of lithium disilicate ceramics

Background:

Lithium disilicate ceramic system consists of glass ceramic ingots with different grades of translucence which may influence its flexural strength.

Aims:

To assess the three-point flexural strength of the different lithium disilicate-based ceramic ingots (IPS e.max Press/Ivoclar Vivadent) with different levels of translucence and shade.

Materials and Methods:

Six groups of ceramic ingots were selected to represent different levels of translucence and shade (HTA1, HTBL2, LTA2, LTB2, MO2, and HO). They measured 25 mm × 5 mm × 2 mm (n = 10), according to ISO 6872 specifications, and tested on a universal test machine (EMIC).

Statistical Analysis Used:

A one-way analysis of variance (ANOVA) was used (α = 0.05).

Results:

The results (in MPa) were: HTA1 = 392.98; HTBL2 = 390.74; LTA2 = 390.46; LTB2 = 389.92; MO2 = 390.43; HO = 391.96. ANOVA showed no significant difference among groups (P = 0.1528).

Conclusions:

Different levels of translucence, opacity and shade of ingots did not affect their mechanical strength, and the use of these ceramics should be guided by the esthetic demands of each clinical situation.