Effect of sodium/calcium hypochlorite on adhesion and adaptation of fiber posts luted with a dual resin cement

Abstract This study aimed to evaluate the effect of different concentrations of sodium hypochlorite (NaOCl) and calcium hypochlorite [Ca(OCl)2] on the bond strength and adaptation of glass fiber posts luted with a dual-curing resin cement. Fifty decoronated premolars were sectioned 14 mm from the apex and endodontically treated. The root canal filling was partially removed. The specimens were divided into 5 groups (n=10) according to the irrigant for post space irrigation: 0.9% sodium chloride (NaCl), (control); 2.5% NaOCl; 5.25% NaOCl; 2.5% Ca(OCl)2; and 5.25% Ca(OCl)2. For each group, irrigation was performed with 5 ml of solution. Afterward, the posts were luted with a dual-curing resin cement. One slice from each third was obtained and submitted to the push-out test and failure modes analysis. An additional slice from the middle third was submitted to confocal images for analysis of adaptation failures (gaps). Two-way ANOVA, Tukey's post-hoc, Kruskal-Wallis with Bonferroni adjusted, and chi-square tests, analyzed data. The group treated with 5.25% NaOCl showed lower bond strength values and generated more cohesive failures compared to the control (p < 0.05). Bond strength decreased from coronal to apical in the post space (p < 0.001). The groups treated with NaOCl had the highest percentages of gaps compared to the control (p < 0.05). Regardless of concentration, Ca(OCl)2 did not influence the bond strength and the occurrence of gaps (P > 0.05). Ca(OCl)2 is a good option for irrigating the post space before luting a fiber post with a dual-curing resin cement.

Resumo Este estudo teve como objetivo avaliar o efeito de diferentes concentrações de hipoclorito de sódio (NaOCl) e hipoclorito de cálcio [Ca(OCl)2] na resistência de união e adaptação de pinos de fibra de vidro cimentados com um cimento resinoso dual. Cinquenta pré-molares tiveram suas coroas removidas, foram seccionados a 14 mm do ápice e tratados endodonticamente. A obturação do canal radicular foi parcialmente removida. Os espécimes foram divididos em 5 grupos (n=10) de acordo com o irrigante para irrigação do espaço do pino: cloreto de sódio 0.9% (NaCl), (controle); NaOCl 2.5%; NaOCl 5.25%; Ca(OCl)2 2.5%; e Ca(OCl)2 5.25%. Para cada grupo, a irrigação foi realizada com 5 ml da solução. Posteriormente, os pinos foram cimentados com um cimento resinoso dual. Uma fatia de cada terço foi obtida e submetida ao teste push-out e análise dos modos de falha. Um corte adicional do terço médio foi submetido a imagens confocais para análise de falhas de adaptação (gaps). Os dados foram analisados pelos testes ANOVA de duas vias, post-hoc de Tukey, Kruskal-Wallis com ajuste de Bonferroni e qui-quadrado. O grupo tratado com NaOCl 5.25% apresentou menores valores de resistência de união e gerou mais falhas coesivas em relação ao controle (p < 0.05). A resistência de união diminuiu de coronal para apical no espaço do pino (p < 0.001). Os grupos tratados com NaOCl apresentaram os maiores percentuais de gaps em relação ao controle (p < 0.05). Independentemente da concentração, o Ca(OCl)2 não influenciou a resistência de união e a ocorrência de gaps (P > 0.05). O Ca(OCl)2 é uma boa opção para irrigar o espaço do pino antes de cimentar um pino de fibra com um cimento resinoso dual.

Fatigue resistance of monolithic and multilayer zirconia crowns using veneer layering or CAD-on technique

Abstract This study aims to evaluate the fatigue resistance of monolithic zirconia (Yz) and multilayer ceramic structures using the CAD-on technique in different thicknesses. Fifty (N=50) standardized single crowns preparations were made in fiberglass-reinforced epoxy resin (NEMA grade G10), digitalized, and restorations were machined in CAD-CAM, composing 5 groups (n= 10): Control: 1.5 mm (milled zirconia framework + manual layered porcelain); Yz monolithic 1.5 mm; Yz monolithic 1.0 mm; CAD-on 1.5 mm; and CAD-on 1.0 mm (milled zirconia framework 0.5 mm thickness bonded by a low fuse ceramic to a milled lithium disilicate layer of 1.0 mm or 0.5 mm, respectively). The G10 bases were conditioned with 10% hydrofluoric acid; the crowns were air abraded with 110 μm alumina particles; and then luted onto each other with self-adhesive resin cement. A cyclic fatigue test was performed (initial load: 400N for 10,000 cycles, frequency of 20 Hz, step size of 200N) until failure, and the data was submitted to a survival statistical analysis. No failures were observed at Yz monolithic 1.5 mm. High and similar performance was observed for Cad-On groups and Yz monolithic 1.0 mm. The control group depicted the worst behavior. The Weibull modulus of CAD-on 1.5 mm was higher than the control while being similar to the other conditions. Both the monolithic systems and the CAD-on technique showed high and similar fatigue fracture behavior and survival rates, which were also higher than the control bilayer system. Both systems reduced the occurrence of delamination failures, making them suitable for clinical use.

Resumo Este estudo teve como objetivo avaliar o comportamento à fadiga de estruturas cerâmicas monolíticas de zircônia (Yz) e multicamadas utilizando a técnica CAD-on em diferentes espessuras. Cinquenta (N=50) preparos unitários padronizados foram confeccionados em resina epóxi reforçada com fibra de vidro (NEMA grau G10), digitalizados e as restaurações usinadas em CAD-CAM, compondo 5 grupos (n= 10): Controle: 1,5 mm (estrutura de zircônia fresada + porcelana estratificada manualmente); Yz monolítica 1,5 mm; Yz monolítica 1,0 mm; CAD-on em 1,5 mm; e CAD-on 1,0 mm (estrutura de zircônia fresada com 0,5 mm de espessura ligada por uma cerâmica de baixa fusão a uma camada de dissilicato de lítio fresado de 1,0 mm ou 0,5 mm, respectivamente). As bases do G10 foram condicionadas com ácido fluorídrico a 10%; as coroas foram jateadas com partículas de alumina de 110 μm; e então cimentadas uma sobre a outra com cimento resinoso autoadesivo. Foi realizado um teste de fadiga cíclica (carga inicial: 400N para 10.000 ciclos, frequência de 20 Hz, step de 200N) até a falha, e os dados foram submetidos a uma análise estatística de sobrevivência. Nenhuma falha foi observada para Yz monolítica de 1,5 mm. Desempenho alto e semelhante foi observado para os grupos Cad-On e Yz monolítica 1,0 mm. O grupo controle apresentou o pior comportamento. O módulo de Weibull do CAD-on 1,5 mm foi maior que o grupo controle, sendo semelhante às outras condições. Tanto os sistemas monolíticos quanto a técnica CAD-on apresentaram alto e semelhante desempenho mecânico e taxas de sobrevivência, que também foram superiores ao sistema bicamada de controle. Ambos os sistemas reduziram a ocorrência de falhas de delaminação, tornando-os adequados para uso clínico.

How are meta-analyses being conducted and reported in dentistry? A meta-research study

Aim: This study aimed to evaluate how meta-analyses are conducted and reported in dentistry. Methods: We conducted a search to identify dentistry-related Systematic Reviews (SRs) indexed in PubMed in 2017 (from January 01 until December 31) and published in the English language. We included only SRs reporting at least one meta-analysis. The study selection followed the 4-phase flow set forth in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), and it was independently conducted by two researchers. Data extraction was performed by one of three reviewers, and data related to conducting and reporting of the meta-analysis were collected. Descriptive data analysis was performed summarizing frequencies for categorical items or median and interquartile range for continuous data. Results: We included 214 SRs with meta-analyses. Most of the studies reported in the title that a meta-analysis was conducted. We identified three critical flaws in the included studies: Ninety (90) meta-analyses (43.1%) did not specify the primary outcome; most of the meta-analyses reported that a measure of statistical heterogeneity was used to justify the use of a fixed-effect or random-effects meta-analysis model (n=114, 58.5%); and a great part did not assess publication bias (n=106, 49.5%). Conclusion: We identified deficiencies in the reporting and conduct of meta-analysis in dentistry, suggesting that there is room for improvement. Educational approaches are necessary to improve the quality of such analyses and to avoid biased and imprecise results

The influence of roughness on the resistance to impact of different CAD/CAM dental ceramics

Abstract This study aimed to investigate the effect of surface roughness (polished vs. CAD/CAM milling simulation) on impact strength of five dental ceramics for manufacturing CAD/CAM monolithic restorations. Specimens of five ceramics (FC- feldspathic glass-ceramic; PICN- polymer-infiltrated ceramic-network; ZLS- zirconia-reinforced lithium silicate glass-ceramic; LD- lithium disilicate glass-ceramic; YZ- yttria-stabilized tetragonal zirconia polycrystal ceramic) to be tested under impact (15×10×2mm3; n= 15) were divided into two groups, according to surface treatment: polishing (pol) and grinding (gri) as CAD/CAM milling simulation. Impact strength was tested using the Dynstat method. Roughness, topographic, fractographic and finite element analyses were performed. The impact strength data were analyzed by Weibull, and Pearson correlation was used to correlate roughness and impact strength data. The CAD/CAM milling simulation led to significantly (p<0.05) greater roughness (Ra and Rz) and statistically reduced the impact strength for PICN (polPICN= 4.59 to griPICN= 1.09; ±76% decrease), for LD (polLD= 17.69 to griLD= 10.09; ±43% decrease) and for YZ (polYZ= 74.99 to griYZ= 20.67; ±72% decrease) ceramics; and also promoted a more irregular topography with scratches and grooves. Fractographic and FEA analyses depicted the origin of failure at the higher stress concentration side during the impact test, where the pendulum impacted. The CAD/CAM milling simulation significantly decreased the impact strength of the evaluated ceramic materials.

Resumo Este estudo teve como objetivo investigar o efeito da rugosidade da superfície (polido vs. simulação da usinagem em CAD/CAM) na resistência ao impacto de cinco cerâmicas odontológicas indicadas na fabricação de restaurações monolíticas em CAD/CAM. Espécimes de cinco cerâmicas (FC- vitrocerâmica feldspática; PICN- rede de cerâmica infiltrada com polímero; ZLS- vitrocerâmica de silicato de lítio reforçada com zircônia; LD- vitrocerâmica de dissilicato de lítio; YZ- cerâmica policristalina de zircônia tetragonal estabilizada com ítria), a serem testados sob impacto (15 × 10 × 2mm3; n= 15), foram divididos em dois grupos, de acordo com o tratamento superficial: polimento (pol) e desgaste (gri), usado como simulação da usinagem em CAD/CAM. A resistência ao impacto foi testada usando o método Dynstat. Foram realizadas as análises de rugosidade, topografia, fractografia e análise de elementos finitos. Os dados de resistência ao impacto foram analisados pela análise de Weibull, e a correlação de Pearson foi usada para correlacionar os dados de rugosidade e resistência ao impacto. A simulação da usinagem em CAD/CAM levou a uma rugosidade (Ra e Rz) significativamente maior (p < 0,05) para todas as cerâmicas, e reduziu estatisticamente a resistência ao impacto para as cerâmicas PICN (polPICN = 4,59 para griPICN = 1,09; redução de ± 76%), LD (polLD = 17,69 para griLD = 10,09; ± 43% de redução) e YZ (polYZ = 74,99 para griYZ = 20,67; ± 72% de redução); e também promoveu uma topografia mais irregular apresentando riscos e sulcos acentuados. As análises de fractografia e de elementos finitos mostraram a origem da falha no lado de maior concentração de tensão durante o teste de impacto, onde o pêndulo impactou o espécime. A simulação da usinagem em CAD/CAM reduziu significativamente a resistência ao impacto dos materiais cerâmicos avaliados.

Influence of testing environment on static fatigue behavior of a glass and a polycrystalline ceramic

Abstract It aims on evaluate the effect of the test environment on static fatigue behavior of lithium disilicate-based (LD), and yttrium oxide-stabilized zirconia (YSZ) ceramics. Specimens of LD (IPS e.max CAD, Ivoclar Vivadent) and YSZ (IPS e.max ZirCAD MO, 3 mol% Y2O3, Ivoclar Vivadent) were randomly allocated into three groups: tested in air, inert (paraffin oil, Sigma Aldrich) or distilled water. The static fatigue test (n=15) was performed using a piston-on-three ball assembly, adapted from ISO 6872, as follows: starting load 100 N for LD and 300 N for YSZ; loading application time set to 1 hour for each loading step; step size of 50 N for LD and 100 N for YSZ, applied successively until fracture. Data from static fatigue strength (MPa) and time to fracture (hours) were recorded. Fractographic analysis was executed. Survival analysis corroborates absence of influence of environment on static fatigue outcomes (fatigue strength, time to fracture and survival rates) for YSZ. For LD, specimens tested in air presented statistically superior survival rate and static fatigue strength (p= 0.025). In regards of time to fracture, LD tested in air were superior than when tested in distilled water (p=0.019) or inert (p=0.017) environments. No statistical differences for Weibull modulus were observed. Failures started on the tensile stress surface. Thus, the test environment did not affect slow crack growth (SCG) mechanisms during static fatigue test of YSZ ceramics, but it plays a significant role for the static fatigue behavior of lithium disilicate-based glass ceramics, indicating a high susceptibility to SCG.

Resumo O presente estudo objetivou investigar a influência do ambiente de teste no comportamento a fadiga estática (resistência à fratura e tempo para falha) de cerâmicas à base de dissilicato de lítio (LD) e zircônia estabilizada com ítria (YSZ). Espécimes de LD (IPS e.max CAD, Ivoclar Vivadent) e YSZ (IPS e.max ZirCAD MO, 3mol% Y2O3, Ivoclar Vivadent) foram obtidos e alocados aleatoriamente em três grupos: testado em ar, em líquido inerte (óleo de parafina) ou em água destilada. O teste de fadiga estática (n= 15) foi realizado usando o teste pistão sobre três esferas, ISO 6872, da seguinte forma: carga inicial 100 N para LD e 300 N para YSZ; tempo de aplicação de carregamento definido para 1 hora para cada etapa de carregamento; tamanho do passo de 50 N para LD e 100 N para YSZ, aplicados sucessivamente até a fratura. Dados de resistência à fadiga estática (MPa) e tempo até a fratura (horas) foram registrados. A análise fractográfica foi executada. A análise de sobrevivência corrobora a ausência de influência do ambiente de teste nos resultados de fadiga estática (resistência à fadiga, tempo de fratura e taxas de sobrevivência) para a YSZ. Para LD, os corpos de prova testados em ar apresentaram taxa de sobrevivência e resistência à fadiga estática estatisticamente superiores (p= 0,025). Em relação ao tempo de fratura, os espécimes LD testados em ar foram superiores aos testados em água destilada (p= 0,019) ou em ambiente inerte (p= 0,017). Não foram observadas diferenças estatísticas para o módulo de Weibull. Todas as falhas começaram no lado onde se concentra a tensão de tração (lado de baixo) durante o teste. Com base nisso, observa-se que o ambiente de teste não afetou os mecanismos de crescimento lento de trinca durante o teste de fadiga estática da cerâmica YSZ, mas desempenha um papel significativo na resistência à fadiga estática da cerâmica de vidro à base de dissilicato de lítio, indicando alta susceptibilidade ao crescimento lento e subcrítico de trincas.

Polishing of ground y-tzp ceramic is mandatory for improving the mechanical behavior

Abstract It evaluated the effect of aging by Low Temperature Degradation (LTD), executed after post- processing surface treatments (polishing, heat treatment and glazing), on the surface characteristics (micromorphology and roughness) and on the structural stability (phase transformation and mechanical behavior-flexural strength and structural reliability) of a ground yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic. Discs of Y-TZP (VITA In-Ceram YZ) were manufactured (ISO:6872-2015; 15 mm in diameter and 1.2 ± 0.2 mm in thickness) and randomly assigned into 10 groups according two factors: "aging" in 2 levels (with or without) and "surface treatment" in 5 levels (Ctrl: as-sintered; Gr: grinding with coarse diamond bur; Gr + HT: grinding plus heat treatment; Gr + Pol: grinding plus polishing; Gr + Gl: grinding plus glazing). Roughness (n=30), biaxial flexural test (n=30), phase transformation (n=2), and surface topography (n=2) analyses were performed. Aging led to an intense increase in monoclinic (m) phase content for all the tested conditions, being the as-sintered samples (Ctrl= 65.6%) more susceptible to the t-m phase transformation. Despite of increasing the m-phase content, aging was not detrimental for characteristic strength (except to the grinding condition). There was no significant reduction in the Weibull modulus after surface treatments. Additionally, heat treatment and glazing after grinding led to a decrease in characteristic strength, while polishing presented the highest characteristic strength values. Thus, polishing is mandatory after grinding the Y-TZP ceramic, while performing glazing or heat-treatment alone after grinding lead to the worst mechanical performance.

Resumo Este estudo avaliou o efeito do envelhecimento através da degradação a baixas temperaturas (low temperaturare degradation - LTD) após a realização de tratamentos de superfície pós- sinterização (polimento, tratamento térmico e glaze) nas características superficiais (micromorfologia e rugosidade), e na estabilidade estrutural (transformação de fase e comportamento mecânico - resistência flexural e confiabilidade estrutural) de uma cerâmica de zircônia tetragonal policristalina estabilizada por ítria (Y-TZP) desgastada. Discos de cerâmica Y-TZP (VITA In-Ceram YZ) foram confeccionados (ISO:6872-2015; 15mm de diâmetro e 1,2 ± 0,2mm de espessura) e randomicamente divididos em 10 grupos de acordo com dois fatores: "envelhecimento" (com e sem) e "tratamento de superfície" (Ctrl - sem tratamento; Gr - desgaste com ponta diamantada grossa; Gr + HT - desgaste mais tratamento térmico; Gr + Pol - desgaste mais polimento; Gr + Gl - desgaste mais glazeamento). Foram realizadas as análises de rugosidade (n=30), flexão biaxial (n=30), transformação de fase (n=2) e topografia de superfície (n=2). O envelhecimento levou a um aumento intenso no conteúdo de fase monoclínica (m) em todas as condições testadas, sendo observada uma maior susceptibilidade de transformação de fase t-m nas amostras do grupo controle (Ctrl= 65.6%). Apesar de provocar elevada transformação de fase, o envelhecimento não apresentou efeitos negativos nos desfechos avaliados. Não houve redução significativa do módulo de Weibull após os tratamentos. Além disso, o tratamento térmico e o glaze após desgaste levaram a uma redução da resistência característica, enquanto que o grupo polimento apresentou o mais alto valor de resistência característica. O glaze e o tratamento térmico geraram o pior desempenho mecânico, portanto a realização do polimento após desgaste de uma cerâmica Y-TZP é obrigatória.

Effect of Grinding and Multi-Stimuli Aging on the Fatigue Strength of a Y-TZP Ceramic

Abstract This study aimed to investigate the effect of grinding and multi-stimuli aging on the fatigue strength, surface topography and the phase transformation of Y-TZP ceramic. Discs were manufactured according to ISO-6872:2008 for biaxial flexure testing (diameter: 15 mm; thickness: 1.2 mm) and randomly assigned considering two factors "grinding" and "aging": C- control (as-sintered); CA- control + aging; G- ground; GA- ground + aging. Grinding was carried out with coarse diamond burs under water-cooling. Aging protocols consisted of: autoclave (134°C, 2 bars pressure, 20 hours), followed by storage for 365 days (samples were kept untouched at room temperature), and by mechanical cycling (106 cycles by 20 Hz under a load of 50% from the biaxial flexure monotonic tests). Flexural fatigue strengths (20,000 cycles; 6 Hz) were determined under sinusoidal cyclic loading using staircase approach. Additionally, surface topography analysis by FE-SEM and phase transformation analysis by X-ray Diffractometry were performed. Dixon and Mood methodology was used to analyze the fatigue strength data. Grinding promotes alterations of topographical pattern, while aging apparently did not alter it. Grinding triggered t-m phase transformation without impacting the fatigue strength of the Y-TZP ceramic; and aging promoted an intense t-m transformation that resulted in a toughening mechanism leading to higher fatigue strength for as-sintered condition, and a tendency of increase for ground condition (C < CA; G = GA). It concludes that grinding and aging procedures did not affect deleteriously the fatigue strength of the evaluated Y-TZP ceramic, although, it promotes surface topography alterations, except to aging, and t-m phase transformation.

Resumo Este estudo objetivou investigar o efeito do desgaste e envelhecimento (estímulos combinados) na resistência à fadiga, topografia superficial e transformação de fase de uma cerâmica Y-TZP. Discos para teste de flexão biaxial foram confeccionados segundo as normas da ISO-6872:2008 (15 mm Ø; 1,2 mm espessura) e randomicamente distribuídos de acordo com os fatores "desgaste" e "envelhecimento": C- controle (sinterizado); CA- controle envelhecido; G- desgaste; GA- desgaste envelhecido. O desgaste foi feito com pontas diamantadas de granulação grossa sob irrigação com água. Os protocolos de envelhecimento consistiram em: autoclave (134°C, 2 bar de pressão, 20 horas), 365 dias armazenados em temperatura ambiente, e ciclagem mecânica (106 ciclos a 20 Hz em um intervalo de carga de até 50% da carga monotônica observada em testes estáticos). A resistência à fadiga foi determinada para 20.000 ciclos à 6 Hz sob carregamento sinusoidal através do método de escada. Adicionalmente, análises de topografia superficial em microscopia eletrônica de varredura e de transformação de fase por difração de raios-X foram executadas. A metodologia de Dixon e Mood foi usada para analisar os dados de resistência à fadiga. Foi observado que o desgaste promove uma alteração de padrão topográfico superficial; enquanto o envelhecimento aparentemente não demonstra influência. Em relação à transformação de fase e resistência à fadiga, o desgaste desencadeou um aumento de fase m sem impactar na resistência à fadiga da cerâmica Y-TZP; já o envelhecimento promoveu uma intensa transformação de fase, resultando no mecanismo de tenacificação, que gerou um aumento na resistência à fadiga para a condição sinterizada e uma tendência a aumento na condição desgaste (C < CA; G = GA). Os dados elucidam que o desgaste e o envelhecimento não impactaram negativamente na resistência à fadiga da cerâmica Y-TZP, apesar de promoverem alterações de topografia superficial e intensa transformação de fase de t-m respectivamente.

Effect of grinding and aging on subcritical crack growth of a Y-TZP ceramic

Abstract This study aimed to investigate slow crack growth (SCG) behavior of a zirconia ceramic after grinding and simulated aging with low-temperature degradation (LTD). Complementary analysis of hardness, surface topography, crystalline phase transformation, and roughness were also measured. Disc-shaped specimens (15 mm Ø × 1.2 mm thick, n = 42) of a full-contour Y-TZP ceramic (Zirlux FC, Amherst) were manufactured according to ISO:6872-2008, and then divided into: Ctrl - as-sintered condition; Ctrl LTD - as-sintered after aging in autoclave (134°C, 2 bar, 20 h); G - ground with coarse diamond bur (grit size 181 μm); G LTD - ground and aged. The SCG parameters were measured by a dynamic biaxial flexural test, which determines the tensile stress versus stress rate under four different rates: 100, 10, 1 and 0.1 MPa/s. LTD led to m-phase content increase, as well as grinding (m-phase content: Ctrl - 0%; G - 12.3%; G LTD - 59.9%; Ctrl LTD - 81%). Surface topography and roughness analyses showed that grinding created an irregular surface (increased roughness) and aging did not promote any relevant surface change. There was no statistical difference on surface hardness among different conditions. The control group presented the lowest strength values in all tested rates. Regarding SCG, ground conditions were less susceptible to SCG, delaying its occurrence. Aging (LTD) caused an increase in SCG susceptibility for the as-sintered condition (i.e. G < G LTD < Ctrl < Ctrl LTD).

Effect of several repair techniques on the bond strength between composite resin and degraded Y-TZP ceramic / Efeito de várias técnicas de reparo na resistência de união entre resina composta e zircônia degradada

Objective: To evaluate the bond strength of different repair treatments for composite resin to aged Y-TZP ceramics. Material and Methods: Zirconia blocks were cut into smaller specimens, sintered according to manufacturer's recommendations (final dimensions of 4×4×3 mm), and randomly allocated into nine groups (n=15) according to the surface treatment and presence/ absence of aging of the substrate (subjected to lowtemperature degradation - LTD), as follows: without LTD (Control: without treatment; TBS: tribochemical silica coating + silane + adhesive); with LTD (Control-LTD: without treatment; TBS-LTD: TBS with hydrothermal degradation; MoS-LTD: Monobond S + adhesive; MoPLTD: Monobond Plus + adhesive; MZP-LTD: Metal/ Zirconia Primer + adhesive; USB-LTD: Single Bond Universal; AP-LTD: Alloy primer + adhesive). LTD was simulated in an autoclave (134 °C, 2 bar, 5 h). The ceramic blocks were embedded in PVC cylinders with a self-curing acrylic resin; each surface treatment protocol was performed; a composite resin cylinder ( : 3.25 mm and height: 3 mm) was then build-up using split metallic matrices. All the specimens were aged (thermocycling + storage in water for 90 days) and subjected to the shear bond strength test using a universal testing machine (1 mm/min). The failure mode was classified into four types: adhesive, composite resin cohesive fracture, ceramic cohesive fracture, and mixed. The bond strength values were subjected to Mann­Whitney test. Results: Only air-abraded samples (TBS and TBS­LTD) survived thermocycling. More than 80% of the samples of the other groups presented pre-test failures. TBS groups presented higher values of bond strength (3.94) compared to TBSLTD (0.96). The predominant type of failure for the surviving samples were adhesive. Conclusion: Air particle abrasion is mandatory to improve the bond strength of the Y-TZP substrate; an aged substrate presents an even more unfavorable scenario for adhesion. (AU)

Objetivo: Avaliar a resistência de união ao cisalhamento gerada por diferentes técnicas de reparo em resina composta aderida em zircônia envelhecida (sujeita a degradação a baixa temperatura - LTD). Material e Métodos: blocos de zircônia foram seccionados em espécimes, sinterizados de acordo com o fabricante (dimensões finais de 4x4x3 mm), e aleatorizados em nove grupos (n=15) de acordo com o tratamento de superfície e presença/ausência de envelhecimento do substrato (LTD), conforme: sem LTD (Control: sem tratamento; TBS: tribosilicatização + silano + adesivo); com LTD (Control-LTD: Monobond S + adesivo; MoP-LTD: Monobond plus + adesivo; MZPLTD: Meta/Zirconia primer + adesivo). LTD foi simulada em autoclave (134 °C, 2 bar, 5 h). Os blocos de cerâmica foram embutidos em cilindros de PVC com resina acrílica autopolimerizável; cada tratamento de superfície foi realizado; um cilindro de resina composta ( : 3,25 mm 3 mm de altura) foi confeccionado usando matrizes metálicas bipartidas. Todos os espécimes foram envelhecidos (termociclagem + armazenagem em água por 90 dias) e sujeitos ao teste de cisalhamento usando um equipamento de teste universal (1 mm/ min). O modo de falha foi classificado em quatro grupos: adesivo, fratura coesiva em resina composta, fratura coesiva da cerâmica, e mista. Os valores de adesão foram sujeitos ao teste de Mann-Whitney. Resultados: somente as amostras jateadas (TBS e TBSLTD) sobreviveram a termociclagem. Mais que 80% dos espécimes dos outros grupos apresentaram falhas préteste. Os grupos TBS apresentaram os maiores valores de resistência ao cisalhamento (3,94) comparado com TBS-LTD (0,96). Os tipos predominantes de falha para os espécimes sobreviventes foi adesiva. Conclusão: o jateamento é recomendável para aumentar a resistência adesiva à zircônia; um substrato envelhecido apresenta um cenário mais desfavorável de adesão. (AU)

Effect of ceramic thickness, grinding, and aging on the mechanical behavior of a polycrystalline zirconia

Abstract Monolithic restorations of Y-TZP have been recommended as a restorative alternative on prosthetic dentistry as it allows a substantial reduction of ceramic thickness, which means a greater preservation of tooth structure. However, the influence of grinding and aging when using a thinner layer of the material is unclear. This investigation aimed to evaluate and compare the effects of ceramic thickness (0.5 mm and 1.0 mm), grinding and aging (low-temperature degradation) on the mechanical behavior and surface characteristics of a full-contour Y-TZP ceramic. Y-TZP disc-shaped specimens (15 mm diameter) were manufactured with both thicknesses and randomly assigned into 4 groups considering the factors 'grinding with diamond bur' and 'aging in autoclave'. Surface topography (roughness, 3D profilometry and SEM), phase transformation, flexural strength and structural reliability (Weibull) analyses were executed. Grinding affected the surface topography, while aging did not promote any effect. An increase in m-phase content was observed after grinding and aging, although different susceptibilities were observed. Regardless of zirconia's thickness, no deleterious effect of grinding or aging on the mechanical properties was observed. Thus, in our testing assembly, reducing the thickness of the Y-TZP ceramic did not alter its response to grinding and low temperature degradation and did not impair its mechanical performance.

Mechanical behavior of yttria-stabilized tetragonal zirconia polycrystal: Effects of different aging regimens

Abstract This study aimed to characterize and compare the effect of different aging regimens on surface characteristic (topography and roughness), structural stability (phase transformation) and mechanical performance (Weibull analysis) of a Y-TZP ceramic. Discs (15 × 1.2 mm; VITA In-Ceram YZ) were prepared according to ISO 6872-2015 for biaxial flexural strength testing and randomly assigned into five groups (n = 30): as-sintered, no aging treatment (CTRL); 20 h in autoclave at 134°C, 2 bar pressure (AUT); intermittent mechanical loading at 20 Hz/106 load pulses (MechLoad); AUT followed by MechLoad (AUT+MechLoad); and storage in distilled water at 37°C, for 1 year (STO). The following analyses were performed: roughness (n = 30), surface topography (n = 2), phase transformation (n = 2) and biaxial flexure strength (n = 30). Phase transformation (increase of m-phase content) was shown to be a spontaneous, unavoidable and time-dependent process, occurring even under ambient conditions (dry storage after 1 year = 6.0% increase), and is considerably accelerated in the presence of moisture (STO = 17.6%; AUT= 63.1%; and AUT+MechLoad = 59.9%). For roughness parameters, only Ra was affected by aging, and the highest values were observed for AUT+MechLoad (0.25 ± 0.07 µm). For Weibull analysis, structural reliability (Weibull moduli) and characteristic strength were not impaired after aging, and some aging conditions led to increased values (highest weibull moduli in AUT, and highest characteristic strength in STO). Phase transformation proves to be a time-dependent spontaneous mechanism that is accelerated in the presence of different stimuli. However, none of the aging regimens had a negative effect on the characteristic strength and structural reliability of Y-TZP ceramic.

Effect of grinding and heat treatment on the mechanical behavior of zirconia ceramic

Abstract The present study investigated the effect of grinding on roughness, flexural strength, and reliability of a zirconia ceramic before and after heat treatment. Seven groups were tested (n = 15): a control group (labeled CG, untreated), and six groups of samples ground with diamond discs, simulating diamond burs, with grits of 200 µm (G80); 160 µm (G120), and 25 µm (G600), either untreated or heat-treated at 1200°C for 2 h (labeled A). Yttria tetragonal zirconia polycrystal discs were manufactured, ground, and submitted to roughness and crystalline phase analyses before the biaxial flexural strength test. There was no correlation between roughness (Ra and Rz) and flexural strength. The reliability of the materials was not affected by grinding or heat treatment, but the characteristic strength was higher after abrasion with diamond discs, irrespective of grit size. The X-ray diffraction data showed that grinding leads to a higher monoclinic (m) phase content, whereas heat treatment produces reverse transformation, leading to a fraction of m-phase in ground samples similar to that observed in the control group. However, after heat treatment, only the G80A samples presented strength similar to that of the control group, while the other groups showed higher strength values. When zirconia pieces must be adjusted for clinical use, a smoother surface can be obtained by employing finer-grit diamond burs. Moreover, when the amount of monoclinic phase is related to the degradation of zirconia, the laboratory heat treatment of ground pieces is indicated for the reverse transformation of zirconia crystals.