Effect of cementation delay on bonding of self-adhesive resin cement to yttria-stabilized tetragonal zirconia polycrystal ceramic treated with nonthermal argon plasma.

STATEMENT OF PROBLEM: Nonthermal argon plasma (NTAP) has been reported to improve the bond strength of resin cements to yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics. However, the effect of the inevitable delay before cementation and after treating Y-TZP ceramics with NTAP is unclear. PURPOSE: The purpose of this in vitro study was to investigate whether delays of 8, 12, and 24 hours between the Y-TZP ceramic treatment with NTAP and the cementation would affect the surface energy and the bond strength of a self-adhesive resin cement to Y-TZP ceramic. MATERIAL AND METHODS: Sixty plates and 50 blocks of 3Y-TZP ceramic were divided into 2 groups (n=30 and n=25): as-sintered (AS) and airborne-particle abraded with 50-µm Al2O3 (APA). These groups were further divided into 5 subgroups (n=6 and n=5) according to the delay between the NTAP treatment and the measurement of surface energy and microtensile bond strength (µTBS) evaluation: (0, 8, 12, and 24 hours). For both 3Y-TZP surface conditions (AS and APA), a control group without NTAP treatment was used (ASC and APAC). The surface energy (SE) was evaluated with a goniometer and the 3Y-TZP elemental composition with X-ray photoelectron spectroscopy (XPS). For the µTBS test, the 3Y-TZP ceramic blocks were cemented to composite resin blocks with a self-adhesive resin cement. After storage in distilled water at 37 °C for 24 hours, the 3Y-TZP-composite resin blocks were sectioned into beams and submitted to a µTBS test. Data were submitted to 2-way ANOVA and the Tukey HSD test (α=.05). RESULTS: For the AS group, NTAP increased the SE irrespective of the delay before measurement: ASC<0 hour=8 hours=12 hours=24 hours (P<.05). For the APA group, except after 12 hours, NTAP also increased the surface energy (P<.05). XPS analysis showed an increase in the oxygen/carbon ratio after NTAP treatment for both groups. For the AS group, NTAP increased the µTBS after 0, 8, and 12 hours (P<.05), whereas for the APA group this occurred only after 8 hours (P<.05). For the AS and APA groups, the highest µTBS was reached after 8 hours (P<.05). CONCLUSIONS: Treatment of 3Y-TZP ceramic with NTAP improved the SE and increased the µTBS of self-adhesive resin cement to 3Y-TZP ceramic. These effects were time dependent, with better results at 8 hours after NTAP treatment.

Effect of intra-oral aging on t→m phase transformation, microstructure, and mechanical properties of Y-TZP dental ceramics.

The aim of the present study was to evaluate the influence of intra-oral aging on the tetragonal-to-monoclinic (t→m) phase transformation of two Y-TZP dental ceramics - Lava Frame (Frame) and Lava Plus (Plus) - and determine the impact of this response on their microstructures and mechanical properties: flexural strength, Young's modulus, microhardness and fracture toughness. Standardized ceramic specimens were analyzed by X-ray diffraction (XRD), scanning electron microscopy (SEM) and atomic force microscopy (AFM). After the baseline analysis, the specimens were attached to personalized intra-oral resin appliances and exposed to the oral cavity of 20 subjects for 60 days and then analyzed again. Specimens produced for mechanical properties evaluation were also analyzed before and after the 60-day intra-oral aging. The data were analyzed using two-way ANOVA and Tukey HSD's post hoc test (α=0.05). Weibull analysis was used to evaluate the strength reliability. Both Y-TZP ceramics suffered t→m phase transformation after 60-day intra-oral aging (Plus=4.7%/Frame=7.7%). SEM and AFM analyses showed dislodgement of ZrO2 grains and a significant increase in roughness after intra-oral aging for both ceramics. Both Y-TZP ceramics suffered a decrease on flexural strength, Young's modulus and fracture toughness after intra-oral aging (p<0.05). Only Plus presented a decrease of microhardness after intra-oral aging (p<0.05). Intra-oral aging for 60 days produced t→m phase transformation, changed the microstructure and decreased the mechanical properties of two Y-TZP dental ceramics.