The effect of surface treatment and thermocycling on the shear bond strength of orthodontic brackets to the Y-TZP zirconia ceramics: A systematic review

ABSTRACT Introduction: Various surface pre-treatment methods have been adapted to optimize the bonding between the zirconia ceramics and the orthodontic brackets. Objective: This review is aimed at systematically analyzing the relevant data available in the literature, to find out the most effective and durable bonding protocol. Methods: Database search was conducted in PubMed, Scopus, and ScienceDirect, during September 2020. The review was conducted according to the PRISMA guidelines. Results: Based on the inclusion criteria, 19 articles were selected for qualitative analysis. Meta-analysis could not be performed due to the heterogeneity of the methodology among the studies. Most of the studies scored medium risk of bias. Compared to the untreated surface, surface pretreatments like sandblasting and lasers were advantageous. Primers and universal adhesive were mostly used as an adjunct to the mechanical pretreatment of the zirconia surface. In most studies, thermocycling seemed to lower the shear bond strength (SBS) of the orthodontic brackets. Conclusion: Based on this qualitative review, surface pretreatments with lasers and sandblasting can be suggested to optimize the bracket bond strength. To clarify this finding, meta-analysis is anticipated. Hence, high heterogeneity of the included studies demands standardization of the methodology.

RESUMO Introdução: Diferentes métodos de pré-tratamento da superfície foram adaptados para otimizar a colagem entre os braquetes ortodônticos e as cerâmicas de zircônia. Objetivo: A presente revisão teve como objetivo analisar, de forma sistemática, os dados relevantes na literatura, para buscar o protocolo de colagem mais efetivo e duradouro. Métodos: As buscas foram feitas em setembro de 2020, nas seguintes bases de dados: PubMed, Scopus e ScienceDirect. A revisão foi feita de acordo com as diretrizes do PRISMA. Resultados: Com base nos critérios de inclusão, 19 artigos foram selecionados para análise qualitativa. A metanálise não pôde ser feita, devido à heterogeneidade na metodologia dos estudos incluídos. A maior parte dos estudos apresentou risco de viés moderado. Comparadas às superfícies não tratadas, as superfícies com pré-tratamento usando jateamento ou laser apresentaram vantagem. Primers e adesivos universais foram mais usados como adjuntos ao pré-tratamento mecânico da superfície de zircônia. Na maioria dos estudos, a termociclagem parece ter reduzido a resistência ao cisalhamento dos braquetes ortodônticos. Conclusões: Com base nessa revisão qualitativa, os pré-tratamentos de superfície com laser e jateamento podem ser sugeridos para otimizar a resistência ao cisalhamento dos braquetes. Para esclarecer esse achado, uma metanálise é necessária. Para isso, faz-se necessária a padronização da metodologia, para lidar com a alta heterogeneidade dos estudos incluídos.

Efeito do envelhecimento hidrotérmico e mecânico na performance à fadiga de zircônias de alta translucidez / Effect of hydrothermal and mechanical aging on the fatigue performance of high-translucency zirconias

O objetivo deste trabalho foi avaliar a resistência à fadiga e ciclos até a falha de 3 zircônias odontológicas após envelhecimento hidrotérmico isolado e um novo protocolo alternado. Discos de zircônia "Y"Z T (VITA), INCORIS "T"ZI (Dentsply Sirona) e "K"ATANA UTML (Noritake Kuraray) (N=135) ­ 1ª, 2ª e 3ª gerações, respectivamente ­, foram divididos em 9 grupos (n=15), com 3 tratamentos para cada zircônia: CF ­ Controle, somente com fadiga mecânica; EF ­ Envelhecido em reator hidrotérmico a 134 ºC por 20 h + Fadiga; EFA: 4 passos de envelhecimentos de 5h alternados com fadiga. O teste de fadiga em flexão biaxial foi realizado com configuração de pistão sob 3 esferas, utilizando o método step-stress (carga inicial: 100 Mpa, step: 50 MPa/10.000 ciclos, frequência: 20 Hz). Os dados foram analisados através de teste Kaplan-Meir e Mantel-Cox com α=0,05, além da análise de Weibull. Discos fraturados foram analisados em estereomicroscópio, Microscopia Eletrônica de Varredura (MEV) e Difratômetro de Raios-X (DRX). O envelhecimento isolado com fadiga aumentou a resistência do grupo TEF (810 ± 76 MPa), enquanto diminuiu a do YEF (516 ± 38 MPa), o protocolo alternado aumentou a resistência apenas para a YZ T (730 ± 59 MPa). A KATANA UMTL não apresentou diferenças para ambos os tratamentos. Igualmente, foi a única a não sofrer transformação de fase T-M. O grupo TEF apresentou maior taxa sobrevivência à fadiga (147,000.00 ciclos). A origem de fratura para todos os espécimes deu-se no lado de tração em defeitos pré-existentes. Zircônias de 2ª geração possuem melhor comportamento mecânico e longevidade pós-envelhecimento e fadiga. Embora seja menos resistente, a KATANA UTML não sofreu degradação

This study aimed to evaluate the fatigue strength and cycles for failure of 3 dental zirconias after isolated and a novel hydrothermal and mechanical fatigue cycling aging protocol. "Y"Z T (VITA), INCORIS "T"ZI (Dentsply Sirona) and "K"ATANA UTML (Noritake Kuraray) zirconia discs (N=135), were divided into 9 groups (n=15), according to 3 proposed treatments for each zirconia: CF (control ­ only mechanical fatigue cycling); AF (aging in hydrothermal reactor at 134°C for 20 h + mechanical fatigue cycling ); AFA (Alternating protocol: 4 steps of 5 h of hydrothermal aging intercalated with mechanical fatigue cycling). Mechanical fatigue aging was performed according to the step stress approach through biaxial flexural setup (piston-on-3-balls, initial strength: 100 MPa, step: 50 MPa/ci000, frequency: 20 Hz) until failure. Data were analyzed using KaplanMeier and Mantel-Cox test (α=0.05), in addition to Weibull analysis. Fractured discs were analyzed in stereomicroscope, Scanning Electron Microscopy and XRay Diffraction. Continuous hydrothermal and mechanical fatigue cycling decreased the fatigue strength of YAF group (516 ± 38 MPa), while the alternating protocol increased it (730 ± 59 MPa). KATANA UTML showed no differences for both treatments and did not undergo T-M phase transformation. The TAF group showed the highest fatigue strength (810 ± 76 MPa) and cycles for failure (147,000.00 cycles). The fracture origin for all specimens was on the tensile side in pre-existing defects. INCORIS TZI zirconia have higher fatigue strength after hydrothermal and mechanical fatigue aging. Although less resistant, KATANA UTML did not suffer chemical degradation

Effect of PVA-PEG Binders on Surface Roughness of Y-TZP Zirconia

@#Introduction: Y-TZP Zirconia is a ceramic used for dental implants because it has good biocompatibility and aesthetic properties, and it is affordable. Y-TZP formed from powder using uniaxial pressing with some added binder. The binders used are PVA, PEG and a combination of both. This combination reduce hardness and improve plasticity properties. Significantly increasing of the binder concentration and the surface roughness of the implant increases the porosity of the material as a place for the osseointegration process. Thus, the purpose of this study was to examine the different effect of PVA-PEG binders on the surface roughness of Y-TZP zirconia. Methods: Twelve samples were divided into three treatment groups: 100% PVA, 100% PEG and 4% PVA-PEG added to Y-TZP powder at a ratio of 95:5 (wt.%). The mixture was pressed using a uniaxial pressing machine, sintered and measured: the data was then analyzed using one-way ANOVA and Post Hoc LSD. Results: The result of the ANOVA showed that there were significant differences in the surface roughness of the Y-TZP with three different binders (P<0.05). The average surface roughness of the three binders are as follows: PVA 100% (0.8025±0.23472), PEG 100% (1.2325±0.23866), 4% of PVA-PEG (1.3450±0.27695). The LSD showed that there was significant differences between PVA 100% and PEG 100% (P<0.05), PVA 100% and 4% PVA-PEG (P<0.05). There was no significant difference between PEG 100% and 4% PVA-PEG (P>0.05). Conclusion: 4% PVA-PEG binders combination has effects on the surface roughness of Y-TZP zirconia

Effect of hydrofluoric acid-based etchant at an elevated temperature on the bond strength and surface topography of Y-TZP ceramics

OBJECTIVES: This study investigated the effects of a hydrofluoric acid (HA; solution of hydrogen fluoride [HF] in water)-based smart etching (SE) solution at an elevated temperature on yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics in terms of bond strength and morphological changes.MATERIALS AND METHODS: Eighty sintered Y-TZP specimens were prepared for shear bond strength (SBS) testing. The bonding surface of the Y-TZP specimens was treated with 37% phosphoric acid etching at 20°C–25°C, 4% HA etching at 20°C–25°C, or HA-based SE at 70°C–80°C. In all groups, zirconia primers were applied to the bonding surface of Y-TZP. For each group, 2 types of resin cement (with or without methacryloyloxydecyl dihydrogen phosphate [MDP]) were used. SBS testing was performed. Topographic changes of the etched Y-TZP surface were analyzed using scanning electron microscopy and atomic force microscopy. The results were analyzed and compared using 2-way analysis of variance.RESULTS: Regardless of the type of resin cement, the highest bond strength was measured in the SE group, with significant differences compared to the other groups (p < 0.05). In all groups, MDP-containing resin cement yielded significantly higher bond strength values than MDP-free resin cement (p < 0.05). It was also shown that the Y-TZP surface was etched by the SE solution, causing a large change in the surface topography.CONCLUSIONS: Bond strength significantly improved when a heated HA-based SE solution was applied to the Y-TZP surface, and the etched Y-TZP surface was more irregular and had higher surface roughness.

Effect of glazing application side and mechanical cycling on the biaxial flexural strength and Weibull characteristics of a Y-TZP ceramic

Abstract Glaze application on monolithic zirconia (Y-TZP) can be a practical approach to improve the mechanical properties of this material. Objective Our study evaluated the effect of glazing side and mechanical cycling on the biaxial flexure strength (BFS) of a Y-TZP. Methodology Eighty sintered Y-TZP discs (Ø:12 mm; thickness: 1.2 mm - ISO 6872) were produced and randomly assigned into eight groups (n=10), according to the factors "glazing side" (control - no glazing; GT - glaze on tensile side; GC - glaze on compression side; GTC - glaze on both sides) and "mechanical aging" (non-aged and aged, A - mechanical cycling: 1.2×106, 84 N, 3 Hz, under water at 37°C). Specimens were subjected to BFS test (1 mm/min; 1,000 Kgf load cell) and fractured surfaces were analyzed by stereomicroscopy and SEM. Hsueh's rigorous solutions were used to estimate the stress at failure of glazed specimens. Two-way ANOVA, Tukey's test (5%), and Weibull analysis were performed. Results The "glazing side", "mechanical aging" and the interaction of the factors were significant (p<0.05). Groups GC (1157.9±146.9 MPa), GT (1156.1±195.3 MPa), GTC (986.0±187.4 MPa) and GTC-A (1131.9±128.9 MPa) presented higher BFS than control groups (Tukey, 5%). Hsueh's rigorous solutions showed that the maximum tensile stress was presented in the bottom of zirconia layer, at the zirconia/glaze interface. Weibull characteristic strength (σo) of the GC was higher than all groups (p<0.05), except to GT, GTC-A and GTC, which were similar among them. The fractography showed initiation of failures from zirconia the tensile side regardless of the side of glaze application and fatigue. Conclusion Glazing zirconia applied on both tensile and compression sides improves the flexural strength of Y-TZP, regardless the mechanical aging.

The effects of surface grinding and polishing on the phase transformation and flexural strength of zirconia

PURPOSE: The purpose of this in vitro study was to evaluate the effect of surface grinding and polishing procedures using high speed zirconia diamond burs with different grit sizes on the phase transformation and flexural strength of zirconia.

Preparation and antibacterial properties of La-doped TiO2 films on 3Y-TZP ceramic surface / 口腔疾病防治

Objective @#To prepare the La-doped TiO2 film on the surface of 3Y-TZP ceramics in order to observe its antibacterial properties, providing an experimental basis for the application of antibacterial zirconia ceramics in the clinic.@*Method@# A cylindrical 3Y-TZP specimen with a diameter of 20 mm and a height of 3 mm was prepared. The sol-gel method was used to prepare 1% lanthanum (La)-doped TiO2 sol, and the La-TiO2 film-3Y-TZP ceramic was prepared by dip coating on the surface of 3Y-TZP. The TiO2 thin film-3Y-TZP ceramic was prepared by adding no lanthanum nitrate solution in the same way. The surface morphology of 3Y-TZP ceramic specimens (3Y-TZP group), TiO2 thin film-3Y-TZP ceramic specimens (TiO2 film group), and La-TiO2 thin film-3Y-TZP ceramic specimens (La-TiO2 film group) was observed by scanning electron microscopy, and photocatalysis, antibacterial and cytotoxicity experiments were carried out. For the photocatalytic experiment, four specimens were randomly selected from the La-TiO2 film group and TiO2 film group to observe the degradation rate of methylene blue at different time points under sunlight. In the antimicrobial experiment, five specimens were randomly selected from the La-TiO2 film group, TiO2 film group and 3Y-TZP group. The antimicrobial activity of each group was tested using the bacteriostatic circle method, and the bacteriostatic distance of each group was compared. In the cytotoxicity experiment, three samples were randomly selected from the La-TiO2 film group, TiO2 film group and 3Y-TZP group (negative control group), and the extracts were prepared. Here, 0.064% phenol solution were served as the positive control group. Morphological observation of L-929 cells in four groups was performed after 3 d of culture. Cell viability and relative cell proliferation were measured by MTT assay.@*Results@#La-TiO2 films with uniform distribution can be prepared on a 3Y-TZP surface by the dipping-drawing method. Photocatalytic experiments showed that the degradation rate of methylene blue in the La-TiO2 film group was (41.2 ± 1.5)% in daylight for 2 hours, which was higher than that in TiO2 film group (36.5 ± 2.4)%. A significant difference was noted between the two groups (t=3.321, P=0.016). The antimicrobial experiment showed that the antimicrobial distance of La-TiO2 group was (0.34 ± 0.08) mm, which was larger than that of TiO2 group (0.12 ± 0.02) mm. No obvious antimicrobial circle was noted in 3Y-TZP group, and the antimicrobial distance of the La-TiO2 film group was larger than that of TiO2 film group (F=63.798, P < 0.001). Cytotoxicity test showed that the relative proliferation rate of cells in La-TiO2 film group was (89.5 ± 1.3)%, and the cytotoxicity rating was grade 1. Significant differences were noted among the four groups (F=68.250, P < 0.001).@*Conclusion @#The La-doped TiO2 film can improve its photocatalytic activity and enhance the antibacterial activity of 3Y-TZP without obvious cytotoxicity.

Ageing assessment of zirconia implant prostheses by three different quantitative assessment techniques

PURPOSE: To evaluate the influence of cyclic loading on phase transformation of zirconia abutments and to compare the effectiveness of three different quantitative ageing assessment techniques. MATERIALS AND METHODS: Thirty two Y-TZP prostheses fabricated from two brands, InCoris ZI and Ceramill ZI, were cemented to titanium bases and equally divided into two subgroups (n=8): control group without any treatment and aged group with cyclic loading between 20 N and 98 N for 100,000 cycles at 4 Hz in distilled water at 37℃. The tetragonal-to-monoclinic phase transformation was assessed by (i) conventional x-ray diffraction (XRD), (ii) micro x-ray diffraction (µXRD), and (iii) micro-Raman spectroscopy. The monoclinic-phase fractions (M%) were compared by two-way ANOVA. RESULTS: InCoris Zi presented significantly higher M% than Ceramill Zi in both control and aged groups (P<.001). Both materials exhibited significant phase transformation with monoclinicphase of 1 to 3% more in aged groups than controls for all thre e assessment techniques. The comparable M% was quantified by both µXRD and XRD. The highest M% was assessed with micro-Raman. CONCLUSION: Cyclic loading produced significant phase transformation in tested Y-TZP prostheses. The micro-Raman spectroscopy could be used as an alternative to XRD and µXRD.

Simulated occlusal adjustments and their effects on zirconia and antagonist artificial enamel

PURPOSE: The aim of this study was to evaluate the effect of occlusal adjustments on the surface roughness of yttria-tetragonal zirconia polycrystal (Y-TZP) and wear of opposing artificial enamel.

The effect of continuous application of MDP-containing primer and luting resin cement on bond strength to tribochemical silica-coated Y-TZP

OBJECTIVES: This study investigated the effect of continuous application of 10-methacryloyloxydecyldihydrogen phosphate (MDP)-containing primer and luting resin cement on bond strength to tribochemical silica-coated yttria-stabilized tetragonal zirconia polycrystal (Y-TZP). MATERIALS AND METHODS: Forty bovine teeth and Y-TZP specimens were prepared. The dentin specimens were embedded in molds, with one side of the dentin exposed for cementation with the zirconia specimen. The Y-TZP specimen was prepared in the form of a cylinder with a diameter of 3 mm and a height of 10 mm. The bonding surface of the Y-TZP specimen was sandblasted with silica-coated aluminium oxide particles. The forty tribochemical silica-coated Y-TZP specimens were cemented to the bovine dentin (4 groups; n = 10) with either an MDP-free primer or an MDP-containing primer and either an MDP-free resin cement or an MDP-containing resin cement. After a shear bond strength (SBS) test, the data were analyzed using 1-way analysis of variance and the Tukey test (α = 0.05). RESULTS: The group with MDP-free primer and resin cement showed significantly lower SBS values than the MDP-containing groups (p < 0.05). Among the MDP-containing groups, the group with MDP-containing primer and resin cement showed significantly higher SBS values than the other groups (p < 0.05). CONCLUSIONS: The combination of MDP-containing primer and luting cement following tribochemical silica coating to Y-TZP was the best choice among the alternatives tested in this study.

Eficácia do uso de plasma em pressão atmosférica na adesão de cerâmicas zircônia / Efficacy of the use of plasma at atmospheric pressure in zirconia adhesion

Um dos maiores desafios atuais da ciência dos materiais dentários é a obtenção de união efetiva e durável às cerâmicas de alto conteúdo cristalino. O objetivo do presente estudo foi avaliar a resistência de união, energia de superfície e tipos de fratura de dois sistemas cerâmicos após diferentes formas de tratamento de superfície associada à aplicação do plasma em pressão atmosférica. Para o estudo foram obtidas quarenta placas de zircônia (12 mm x 5 mm x 1,5 mm) de dois tipos de cerâmicas zircônia (E.max ZirCad e Calypso), polidas e limpas por ultrassom durante 5 minutos. Divididas aleatoriamente em 2 grupos de acordo com o sistema cerâmico e 4 subgrupos (n=5) de acordo com o tratamento de superfície, (I) controle (primer), (II) jateamento com partículas micrométricas de alumina (Al2O3) + primer, (III) jateamento com partículas micrométricas de alumina (Al2O3) + plasma + primer, (IV) plasma + primer. Foram confeccionados cento e vinte cilindros de resina composta (Z100), utilizando matrizes cilíndricas (1,0 mm x 3,0 mm) cimentadas com cimento resinoso, Multilink N, sobre as placas de zircônia. Os espécimes foram armazenados em água destilada durante 24 horas a 37° C, depois testados para microcisalhamento em máquina de teste Shimadzu EZ a 1,0 mm/min. Os dados obtidos foram submetidos à análise estatística para comparação entre os grupos E.max e Calypso em relação à resistência à união (força/área ­ MPa), ângulo de contato e os tipos de fratura. Os dados foram analisados pelos testes ANOVA One-Way e Kruskal-Wallis para resistência de união (p=0,003) e (p=0,005) e ângulo de contato (p<0,001) e (p<0,001). Não houve diferença significativa para os dados de fratura (p=0,145), pelo teste quiquadrado, com predomínio de fraturas mistas. Os valores de resistência de união das cerâmicas Y-TZP apresentaram maiores valores quando o plasma foi associado ao jateamento com óxido de alumínio e/ou primer e a aplicação somente do plasma não superou os valores alcançados pelas outras formas de tratamento da superfície. Essa associação resultou em menores valores dos ângulos de contato. Houve maior frequência de fraturas mistas quando realizado somente o tratamento com óxido de alumínio e quando em associação com o plasma.(AU)

One of the major challenges today in the science of dental materials is the achievement of effective and durable bonding to ceramics with high crystalline content. The objective of the present study was to evaluate the efficacy of plasma at atmospheric pressure in the adhesion of ceramic zirconia through the bond strength, surface energy and type of fracture of two ceramic systems after different forms of surface treatment associated with the application of plasma at atmospheric pressure. For the study forty zirconia plates (12 mm x 5 mm x 1.5 mm) were obtained from two zirconia ceramics (E.max ZirCad and Calypso), polished and cleaned by ultrasound for 5 minutes. Randomly divided into 2 groups according to the ceramic system and 4 subgroups (n = 5) according to the surface treatment, control (primer), primer + blasting with micrometric alumina (Al2O3) particles, primer + blasting with micrometric particles of alumina (Al2O3) + plasma, primer + plasma. One hundred and twenty cylinders of composite resin (Z-100) were made using cylindrical matrices (1.0 mm x 3.0 mm) cemented on the zirconia plates. The specimens were stored in distilled water for 24 hours at 37°C, then tested for microshear on a Shimadzu EZ test machine at 0.5 mm / min. The obtained data were submitted to statistical analysis for comparison between the E.max and Calypso groups in relation to the bond strength (strength / area - Mpa), contact angle and fracture types. The data were analyzed by ANOVA One-Way and Kruskal-Wallis tests for bond strength (p=0.003) and (p=0.005) and contact angle (p<0.001) and (p<0.001). There was no significant difference for the fracture data (p = 0.145), by the chi-square test, with a predominance of mixed fractures. The bond strength values of the Y-TZP ceramics showed higher values when the plasma was associated with blasting with aluminum oxide and / or primer and the application of only the plasma did not exceed the values reached by the other forms of surface treatment. This association resulted in lower values of contact angles. It is a higher frequency of mixed fractures when only aluminum oxide treatment is performed and when it is associated with plasma.(AU)

Efecto de un tratamiento experimental de una superficie sobre la resistencia flexural en una zirconia Y-TZP / Effect of an experimental surface treatment on Y-TZP zirconia flexural strength

RESUMEN Objetivo: Analizar el efecto del microgranallado superficial como tratamiento experimental de regeneración, en la resistencia flexural y esfuerzos residuales de una Zirconia Y-TZP, una vez ha sido alterada con otros tratamientos mecánicos como microarenado y fresado. Métodos: Un total de 75 probetas de Zirconia Y-TZP fueron divididas en cinco grupos n=15 y sometidas a tratamientos de superficie así: fresado y microarenado (Grupos 2 y 4) microarenado + microgranallado y fresado + microgranallado (Grupos 3 y 5), y comparadas con un grupo control (Grupo 1), mediante Difracción de Rayos X (DRX), Microscopía electrónica de barrido (SEM), Microscopía confocal (CLSM) y sometida a falla en máquina universal de ensayos. Resultados: Los grupos de microgranallado y microarenado presentaron un aumento significativo de la resistencia flexural p=0.0082 con relación al grupo de fresado. Las mediciones mediante DRX no mostraron relación estadística con los cambios en la resistencia flexural. Significancia: Es posible que el microgranallado se considere un tratamiento para regenerar las propiedades mecánicas reducidas por fresado o arenado en la Zirconia Y-TZP.

ABSTRACT Objective: To analyze the effect of surface micro shot peening as an experimental regeneration treatment on the flexural strength and residual stresses of a Y-TZP Zirconia, once it has been altered with other mechanical treatments such as micro sandblasting and milling. Methods: A total of 75 Zirconia Y-TZP specimens were divided into five n = 15 groups and subjected to surface treatments such as: milling and micro sandblasting (Groups 2 and 4) micro sandblasting + micro shot peening; and milling + micro shot peening (Groups 3 and 5), compared to a control group (Group 1), by X-ray diffraction (XRD), scanning electron microscopy (SEM), confocal microscopy (CLSM) and subjected to failure in a universal testing machine. All the results were compared to find a statistical relationship between them using a mixed linear model and Tuckey. Results: The groups of micro shot peening and micro sandblasting presented a significant increase of the flexural strength p = 0.0082 vs the milling group. The XRD technique is not related to flexural strength measurements. Significance: It is possible that the micro shot peening be considered a treatment to regenerate the mechanical properties reduced by milling or sandblasting in Zirconia Y-TZP.

Characterization of Conventional and High-Translucency Y-TZP Dental Ceramics Submitted to Air Abrasion

Abstract This study evaluated the effect of air-abrasion on t®m phase transformation, roughness, topography and the elemental composition of three Y-TZP (Yttria-stabilized tetragonal zirconia polycrystal) dental ceramics: two conventional (Lava Frame and IPS ZirCad) and one with high-translucency (Lava Plus). Plates obtained from sintered blocks of each ceramic were divided into four groups: AS (as-sintered); 30 (air-abrasion with 30 mm Si-coated Al2O3 particles); 50 (air-abrasion with 50 mm Al2O3 particles) and 150 (air-abrasion with 150 mm Al2O3 particles). After the treatments, the plates were submitted to X-ray diffractometry; 3-D profilometry and SEM/EDS. The AS surfaces were composed of Zr and t phases. All treatments produced t®m phase transformation in the ceramics. The diameter of air-abrasion particles influenced the roughness (150>50>30>AS) and the topography. SEM analysis showed that the three treatments produced groove-shaped microretentions on the ceramic surfaces, which increased with the diameter of air-abrasion particles. EDS showed a decrease in Zr content along with the emergence of O and Al elements after air-abrasion. Presence of Si was also detected on the plates air-abraded with 30 mm Si-coated Al2O3 particles. It was concluded that irrespective of the type and diameter of the particles, air-abrasion produced t®m phase transformation, increased the roughness and changed the elemental composition of the three Y-TZP dental ceramics. Lava Plus also behaved similarly to the conventional Y-TZP ceramics, indicating that this high translucency ceramic could be more suitable to build monolithic ceramic restorations in the aesthetic restorative dentistry field.

Resumo Este estudo avaliou o efeito da abrasão a ar na transformação de fase t®m, na rugosidade, topografia e composição elementar de três cerâmicas Y-TZP (Zircônia tetragonal policristalina estabilizada por ítrio): duas convencionais (Lava Frame e ZirCad) e uma de alta translucidez (Lava Plus). Placas obtidas de blocos sinterizados de cada cerâmica foram divididos em quatro grupos: AS (pré-sinterizado); 30 (jateamento com partículas de Al2O3 de 30 mm cobertas com Si); 50 (jateamento com partículas de Al2O3 de 50 mm) e 150 (jateamento com partículas de Al2O3 de 150 mm). Após os tratamentos, as placas foram submetidas à difratometria de Rx, perfilometria 3-D e microscopia eletrônica de varredura com espectroscopia de energia dispersiva de Rx (SEM/EDS). As superfícies pré-sinterizadas apresentaram predominantemente Zr e fase tetragonal. Todos os tratamentos superficiais produziram transformação t®m nas cerâmicas avaliadas. A topografia e a rugosidade foram influenciadas pelo diâmetro das partículas abrasivas (150>50>30>AS). A análise através de SEM mostrou que os três tratamentos produziram fendas retentivas nas superfícies das cerâmicas, por influência do tamanho das partículas. A análise através de EDS mostrou uma diminuição da concentração de Zr, paralela ao surgimento de O e Al, após o jateamento. No grupo tratado com partículas de Al2O3 de 30 mm cobertas com Si foi também observado um aumento de Si após o jateamento. Concluiu-se que, independente do tipo e do diâmetro das partículas, o jateamento produziu transformação t®m, aumentou a rugosidade e alterou a composição elementar das cerâmicas avaliadas. A Lava Plus apresentou comportamento semelhante às cerâmicas convencionais, indicando que esta cerâmica de alta translucidez pode ser mais adequada à confecção de restaurações monolíticas no campo da odontologia estética restauradora.

Effect of adhesive luting on the fracture resistance of zirconia compared to that of composite resin and lithium disilicate glass ceramic

OBJECTIVES: The purpose of this study was to evaluate the effect of adhesive luting on the fracture resistance of zirconia compared to that of a composite resin and a lithium disilicate glass ceramic. MATERIALS AND METHODS: The specimens (dimension: 2 mm × 2 mm × 25 mm) of the composite resin, lithium disilicate glass ceramic, and yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) were prepared. These were then divided into nine groups: three non-luting groups, three non-adhesive luting groups, and three adhesive luting groups, for each restorative material. In the non-luting groups, specimens were placed on the bovine tooth without any luting agents. In the non-adhesive luting groups, only zinc phosphate cement was used for luting the specimen to the bovine tooth. In the adhesive luting groups, specimens were pretreated, and the adhesive luting procedure was performed using a self-adhesive resin cement. For all the groups, a flexural test was performed using universal testing machine, in which the fracture resistance was measured by recording the force at which the specimen was fractured. RESULTS: The fracture resistance after adhesive luting increased by approximately 29% in the case of the composite resin, 26% in the case of the lithium disilicate glass ceramic, and only 2% in the case of Y-TZP as compared to non-adhesive luting. CONCLUSIONS: The fracture resistance of Y-TZP did not increased significantly after adhesive luting as compared to that of the composite resin and the lithium disilicate glass ceramic.

Comparison of the optical properties of pre-colored dental monolithic zirconia ceramics sintered in a conventional furnace versus a microwave oven

PURPOSE: The purpose of this study was to compare the optical properties of pre-colored dental monolithic zirconia ceramics of various thicknesses sintered in a microwave and those in a conventional furnace. MATERIALS AND METHODS: A2-shade of pre-colored monolithic zirconia ceramic specimens (22.0 mm × 22.0 mm) in 3 thickness groups of 0.5, 1.0, and 1.5 mm were divided into 2 subgroups according to the sintering methods (n=9): microwave and conventional sintering. A spectrophotometer was used to obtain CIELab color coordinates, and translucency parameters and CIEDE2000 color differences (ΔE 00) were measured. The relative amount of monoclinic phase (X(m)) was estimated with x-ray diffraction. The surface topography was analyzed by atomic force microscope and scanning electron microscope. Statistical analyses were conducted with two-way ANOVA (α=.05). RESULTS: There were small interaction effects on CIE L*, a*, and TP between sintering method and thickness (P<.001): L* (partial eta squared η(p)²=0.115), a* (η(p)²=0.136), and TP (η(p)²=0.206), although higher b* values were noted for microwave sintering regardless of thickness. Color differences between two sintering methods ranged from 0.52 to 0.96 ΔE(00) units. The X(m) values ranged from 7.03% to 9.89% for conventional sintering, and from 7.31% to 9.17% for microwave sintering. The microwave-sintered specimen demonstrated a smoother surface and a more uniform grain structure compared to the conventionally-sintered specimen. CONCLUSION: With reduced processing time, microwave-sintered pre-colored dental monolithic zirconia ceramics can exhibit similar color perception and translucency to those by conventional sintering.

Effect of different grinding burs on the physical properties of zirconia

PURPOSE: Grinding with less stress on 3Y-TZP through proper selection of methods and instruments can lead to a long-term success of prosthesis. The purpose of this study was to compare the phase transformation and physical properties after zirconia surface grinding with 3 different grinding burs. MATERIALS AND METHODS: Forty disc-shaped zirconia specimens were fabricated. Each Ten specimens were ground with AllCeramic SuperMax (NTI, Kahla, Germany), Dura-Green DIA (Shofu Inc., Kyoto, Japan), and Dura-Green (Shofu Inc., Kyoto, Japan). Ten specimens were not ground and used as a control group. After the specimen grinding, XRD analysis, surface roughness test, FE-SEM imaging, and biaxial flexural strength test were performed. RESULTS: After surface grinding, small amount of monoclinic phase in all experimental groups was observed. The phase change was higher in specimens, which were ground with Dura-Green DIA and AllCeramic SuperMax burs. The roughness of surfaces increased in specimens, which were ground with Dura-Green DIA and AllCeramic SuperMax burs than control groups and ground with Dura-Green. All experimental groups showed lower flexural strength than control group, but there was no statistically significant difference between control group and ground with Dura-Green DIA and AllCeramic SuperMax burs. The specimens, which were ground with Dura- Green showed the lowest strength. CONCLUSION: The use of dedicated zirconia-specific grinding burs such as Dura-Green DIA and AllCeramic SuperMax burs decreases the grinding time and did not significantly affect the flexural strength of zirconia, and therefore, they may be recommended. However, a fine polishing process should be accompanied to reduce the surface roughness after grinding.

Effect of the amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics

PURPOSE: This study investigated the effect of amount of thickness reduction on color and translucency of dental monolithic zirconia ceramics. MATERIALS AND METHODS: One-hundred sixty-five monolithic zirconia specimens (16.3 mm x 16.3 mm x 2.0 mm) were divided into 5 groups (Group I to V) according to the number of A2-coloring liquid applications. Each group was then divided into 11 subgroups by reducing the thickness up to 1.0 mm in 0.1-mm increments (Subgroup 0 to 10, n=3). Colors and spectral distributions were measured according to CIELAB on a reflection spectrophotometer. All measurements were performed on five different areas of each specimen. Color difference (DeltaE*(ab)) and translucency parameter (TP) were calculated. Data were analyzed using one-way ANOVA and multiple comparison Scheffe test (alpha=.05). RESULTS: There were significant differences in CIE L* between Subgroup 0 and other subgroups in all groups. CIE a* increased (0.523.7) were obtained between Subgroup 0 and other subgroups. TP values generally increased as the thickness reduction increased in all groups (R2>0.89, P<.001). CONCLUSION: Increasing thickness reduction reduces lightness and increases a reddish, bluish appearance, and translucency of monolithic zirconia ceramics.

Effect of cement type on the color attributes of a zirconia ceramic

PURPOSE: This in vitro study evaluated the effects of four different cements on the color attributes of a zirconia ceramic. MATERIALS AND METHODS: 40 zirconia ceramic disk specimens (0.5 mm thickness, 10 mm diameter, 0.1 mm cement space) were fabricated by a computer-aided design and computer-aided manufacturing system. The specimens were divided into 4 groups of 10 specimens and cemented to composite substrates using four different cements including: Glass Ionomer, Panavia F2.0, Zinc Phosphate, and TempBond. The L*, a*, and b* color attributes of the specimens were measured before and after cementation by a spectrophotometer. Additionally, ΔE values were measured to determine color changes for the groups and then compared with the perceptional threshold of ΔE = 3.3. Repeated Measures ANOVA, Tukey Post Hoc, Bonferroni, One-way ANOVA, and One-sample t-test tests were used to analyze the data. All tests were carried out at the 0.05 level of significance. RESULTS: Statistically significant differences were detected in the ΔE values for Zinc Phosphate (P<.0001) and TempBond (P<.0001) groups. However, there were no statistically significant differences in this respect for Glass Ionomer (P=.99) and Panavia F2.0 (P=1) groups. The means and standard deviations of the ΔE values for Glass Ionomer, Panavia F2.0, Zinc Phosphate, and Tempbond groups were 2.11±0.66, 0.94±0.39, 5.77±0.83, and 7.50±1.16 Unit, respectively. CONCLUSION: Within the limitations of this study, it was concluded that Zinc Phosphate and Tempbond cements affected the color attributes of the tested zirconia ceramic beyond the perceptional threshold. However, Glass Ionomer and Panavia F2.0 cements created acceptable color changes.

Evaluation of shear bond strength between dual cure resin cement and zirconia ceramic after thermocycling treatment

PURPOSE: This study was performed to evaluate shear bond strength (SBS) between three dual-cured resin cements and silica coated zirconia, before and after thermocycling treatment. MATERIALS AND METHODS: Sixty specimens were cut in 15 x 2.75 mm discs using zirconia. After air blasting of 50 microm alumina, samples were prepared by tribochemical silica coating with Rocatec(TM) plus. The specimens were divided into three groups according to the dual-cure resin cement used: (1) Calibra silane+Calibra(R), (2) Monobond S+Multilink(R) N and (3) ESPN sil+RelyX(TM) Unicem Clicker. After the resin cement was bonded to the zirconia using a Teflon mold, photopolymerization was carried out. Only 10 specimens in each group were thermocycled 6,000 times. Depending on thermocycling treatment, each group was divided into two subgroups (n=10) and SBS was measured by applying force at the speed of 1 mm/min using a universal testing machine. To find out the differences in SBS according to the types of cements and thermocycling using the SPSS, two-way ANOVA was conducted and post-hoc analysis was performed by Turkey's test. RESULTS: In non-thermal aged groups, SBS of Multilink group (M1) was higher than that of Calibra (C1) and Unicem (U1) group (P<.05). Moreover, even after thermocycling treatment, SBS of Multilink group (M2) was higher than the other groups (C2 and U2). All three cements showed lower SBS after the thermocycling than before the treatments. But Multilink and Unicem had a significant difference (P<.05). CONCLUSION: In this experiment, Multilink showed the highest SBS before and after thermocycling. Also, bond strengths of all three cements decreased after thermocycling.

Biaxial flexural strength and phase transformation of Ce-TZP/Al2O3 and Y-TZP core materials after thermocycling and mechanical loading

PURPOSE: The purpose of the present study was to evaluate the effect of thermocycling and mechanical loading on the biaxial flexural strength and the phase transformation of one Ce-TZP/Al2O3 and two Y-TZP core materials. MATERIALS AND METHODS: Thirty disc-shaped specimens were obtained from each material. The specimens were randomly divided into three groups (control, thermocycled, and mechanically loaded). Thermocycling was subjected in distilled water for 10000 cycles. Mechanical loading was subjected with 200 N loads at a frequency of 2 Hz for 100000 times. The mean biaxial flexural strength and phase transformation of the specimens were tested. The Weibull modulus, characteristic strength, 10%, 5% and 1% probabilities of failure were calculated using the biaxial flexural strength data. RESULTS: The characteristic strengths of Ce-TZP/Al2O3 specimens were significantly higher in all groups compared with the other tested materials (P<.001). Statistical results of X-ray diffraction showed that thermocycling and mechanical loading did not affect the monoclinic phase content of the materials. According to Raman spectroscopy results, at the same point and the same material, mechanical loading significantly affected the phase fraction of all materials (P<.05). CONCLUSION: It was concluded that thermocycling and mechanical loading did not show negative effect on the mean biaxial strength of the tested materials.