Research progress on the low-temperature degradation of zirconia in prosthetic dentistry / 中华口腔医学杂志

Zirconia is widely used in the field of dentistry because of its superior mechanical and esthetic characteristics. However, the tetragonal zirconia polycrystal restorations commonly used in clinics will degrade at low temperatures in the oral environment, resulting in increased surface roughness, microcracks, and decreased mechanical properties. Low-temperature degradation of zirconia can be affected by grain size, stress, stabilizer content and type, surface treatment, sintering conditions, and other factors. Through a literature review and analysis, this review summarizes the research progress on the low-temperature degradation of zirconia in prosthetic dentistry to provide references for the improvement of zirconia in clinical and research applications.

Effects of powder size and pre-sintering heating rate on dental recycled zirconia / 中华口腔医学杂志

Objective: To evaluate the effects of pre-sintering heating rate and powder size on dental recycled zirconia. Methods: Recycled zirconia powders were sieved to obtain the large (50 μm<particle diameter≤125 μm) and small (particle diameter≤50 μm) particles, these powders were then formed into green bodies. According to the pre-sintering heating rates, the recycled-zirconia green bodies were divided into 3 groups: group A, pre-sintering heating rate of 2 ℃/min; group B, pre-sintering heating rate of 5 ℃/min; group C, pre-sintering heating rate of 8 ℃/min. The relative density open porosity and machinability of the recycled zirconia pre-sintered bodies were evaluated and compared with the commercial zirconia pre-sintered bodies. Zirconia pre-sintered bodies were then fully sintered according to the manufacturer's instructions. The relative density, open porosity, linear shrinkage and flexural strength of fully sintered zirconia were further compared. The microstructure of fracture surfaces and the crystalline structure were analyzed by scanning electron microscope and X-ray diffractometer, respectively. Results: With the same particle size, the recycled zirconia pre-sintered at different heating rates showed no significant differences in the relative densities, and the open porosities (P>0.05). When the pre-sintering heating rates were 2 ℃/min, 5 ℃/min, and 8 ℃/min, the flexural strengths of the large-particle recycled zirconia were (421.2±54.7), (444.2±70.1) and (427.5±68.4) MPa, the flexural strengths of the small-particle recycled zirconia were (750.1±74.1), (777.2±95.5) and (746.7±73.0) MPa, respectively. The flexural strength of commercial zirconia was (988.4±129.8) MPa. The flexural strengths of the recycled zirconia were significantly lower than that of the commercial zirconia (P<0.05). At the same pre-sintering heating rate, the flexural strengths of the small-particle recycled zirconia were significantly higher than that of the large-particle recycled zirconia (P<0.05). Conclusions: Compared with the large particles, small-particle recycled zirconia powders can effectively improve the properties of recycled zirconia, while the pre-sintering heating rate has no effect on the properties of the recycled zirconia.

Effects of femtosecond laser treatment on surface characteristics and flexural strength of zirconia / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the effects of femtosecond laser treated microgrooved surface on microscopic topography, phase transformation, and three-points flexural strength of zirconia, and to provide reference for surface microstructure optimization of zirconia implant.@*METHODS@#According to different surface treatment methods, 57 computer aided design/computer aided manufacture (CAD/CAM) zirconia bars (20.0 mm×4.0 mm×1.4 mm) were evenly divided into three groups: sintered group, no treatment after sintering, taken as control; sandblasted group, sandblasted with 110 μm aluminium oxide (Al2O3) after sintering; microgrooved group, femtosecond laser fabricated microgrooves with 50 μm width, 30 μm depth, and 100 μm pitch. Surface microscopic topography was observed with scanning electron microscope (SEM) and 3D laser microscope. Further, surface roughness in each group and microgroove size were measured. Crystal phase was analyzed with X-ray diffraction. Specimens were subjected to three- points flexural strength test, and Weibull distribution was used to analyze their strength characteristics.@*RESULTS@#SEM showed that sintered surface was flat with clear grain structure; sandblasted surface exihibited bumps and holes with sharp margins and irregular shape; microgrooves were regularly aligned without evident defect, and nano-scale particles were observed on the surface inside of the microgrooves. Ra value of microgrooved group [(9.42±0.28)] μm was significantly higher than that of sandblasted group [(1.04±0.03) μm] and sintered group [(0.60±0.04) μm], and there was statistical difference between sandblasted group and sintered group (P < 0.001). The microgroove size was precise with (49.75±1.24) μm width, (30.85±1.02) μm depth, and (100.58±1.94) μm pitch. Crystal phase analysis showed that monoclinic volume fraction of sandblasted group (18.17%) was much higher than that of sintered group (1.55%), while microgrooved group (2.21%) was similar with sintered group. The flexural strength of sandblasted group (986.22±163.25) MPa had no statistical difference with that of sintered group (946.46±134.15) MPa (P=0.847), but the strength in microgrooved group (547.92±30.89) MPa dropped significantly compared with the other two groups (P < 0.001). Weibull modulus of sintered, sandblasted, microgrooved groups were 7.89, 6.98, and 23.46, respectively.@*CONCLUSION@#Femtosecond laser was able to form micro/nanostructured microgrooves on zirconia surface, which deleteriously affected the flexural strength of zirconia.

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.

Current Status and Growth of Nuclear Theranostics in Singapore / 대한핵의학회잡지

The concept of theranostics, where individual patient-level biological information is used to choose the optimal therapy for that individual, has become more popular in the modern era of ‘personalised’ medicine. With the growth of theranostics, nuclear medicine as a specialty is uniquely poised to grow along with the ever-increasing number of concepts combining imaging and therapy. This special report summarises the status and growth of Theranostic Nuclear Medicine in Singapore.We will cover our experience with the use of radioiodine, radioiodinated metaiodobenzylguanidine, peptide receptor radionuclide therapy, prostate specific membrane antigen radioligand therapy, radium-223 and yttrium-90 selective internal radiation therapy.We also include a section on our radiopharmacy laboratory, crucial to our implementation of theranostic principles. Radionuclide theranostics has seen tremendous growth and we hope to be able to grow alongside to continue to serve the patients in Singapore and in the region.

Comparison of the Neodymium-doped Yttrium Aluminum Garnet Capsulotomy Rate with Viscoimplantation and the Hydroimplantation Intraocular Lens Technique

PURPOSE: To investigate the rate of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser capsulotomy in the hydroimplantation intraocular lens (IOL) technique. METHODS: This retrospective study was comprised of 6,192 eyes in 3,790 patients who underwent surgery from January 2013 to September 2017 and then were followed up for at least 1 year. The eyes of these patients were divided into two groups: either viscoimplantation or hydroimplantation. The follow-up examinations were carried out on the 1st day, 4th day, 1st month, and 3 months to 1 year postoperatively. The Nd:YAG capsulotomy rates were evaluated by the different IOL implantation techniques and IOL materials. RESULTS: The mean follow-up duration of the patients was in the viscoimplantation group 14.85 ± 2.43 and 15.05 ± 1.93 months in the hydroimplantation group. The Nd:YAG capsulotomy rate was significantly lower in the hydroimplantation group compared with the viscoimplantation group for the entire hydrophilic IOL model (p < 0.001). In addition, the Nd:YAG rate was lower in the hydroimplantation group that used a hydrophilic IOL than it was in the viscoimplantation group, which used a hydrophobic IOL. CONCLUSIONS: The hydroimplantation technique reduced the Nd:YAG capsulotomy rate.

Effect of surface treatments on the bond strength of indirect resin composite to resin matrix ceramics

PURPOSE: The purpose of this study was to evaluate the shear bond strength (SBS) of an indirect resin composite (IRC) to the various resin matrix ceramic (RMC) blocks using different surface treatments. MATERIALS AND METHODS: Ninety-nine cubic RMC specimens consisting of a resin nanoceramic (RNC), a polymer-infiltrated hybrid ceramic (PIHC), and a flexible hybrid ceramic (FHC) were divided randomly into three surface treatment subgroups (n = 11). In the experimental groups, untreated (Cnt), tribochemical silica coating (Tbc), and Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) laser irradiation (Lsr) with 3 W (150 mJ/pulse, 20 Hz for 20 sec.) were used as surface treatments. An indirect composite resin (IRC) was layered with a disc-shape mold (2 × 3 mm) onto the treated-ceramic surfaces and the specimens submitted to thermal cycling (6000 cycles, 5 – 55℃). The SBS test of specimens was performed using a universal testing machine and the specimens were examined with a scanning electron microscope to determine the failure mode. Data were statistically analyzed with two-way analysis of variance (ANOVA) and Tukey HSD test (α=.05). RESULTS: According to the two-way ANOVA, only the surface treatment parameter was statistically significant (P<.05) on the SBS of IRC to RMC. The SBS values of Lsr-applied RMC groups were significantly higher than Cnt groups for each RMC material, (P<.05). Significant differences were also determined between Tbc surface treatment applied and untreated (Cnt) PIHC materials (P=.039). CONCLUSION: For promoting a reliable bond strength during characterization of RMC with IRC, Nd:YAG laser or Tbc surface treatment technique should be used, putting in consideration the microstructure and composition of RMC materials and appropriate parameters for each material.

Y-TZP surface treatments and their effects on the bond strength to resin cement

Aim: This study evaluated the effect of surface treatments of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramics on their bond strength to a resin cement. Methods: Seventy zirconia blocks (6 × 6 × 2 mm3, IPS e.max ZirCAD) were assigned into 7 groups (n=10) ­ as-sintered (AS), no treatment; tribochemical silica coating + silanization (TBS; Cojet-sand; ProSil); airabrasion with 45 µm alumina particles + universal primer (AAP; Monobond®Plus); fusion sputtering (FS); SiO2 nanofilm + silanization (SN; ProSil); FS+SN+ silanization (FSSN; ProSil); FS+SN+Universal Primer (FSSNP; Monobond®Plus). Afterwards, a resin cement (RelyX™ ARC) was applied inside cylinders (Ø = 0.96 mm × 1 mm height) placed on the zirconia surfaces. Microshear bond strength tests (µSBS) were carried out (1 mm/min). Failure and phase transformation analysis were performed. Bond strength data (MPa) were subjected to Kruskal-Wallis/Mann Whitney tests. Results: TBS (27 ± 1.2) and AAP (24.7 ± 0.8) showed higher bond strengths than the other groups, followed by FSSNP (15.5 ± 4.2) and FSSN (13.3 ± 3.6). FS (3.4 ± 0.44) and SN (9.5 ± 2.7) showed the lowest values (p < 0.001). Most of the specimens exhibited an adhesive failure. Conclusion: Air-abrasion by silica-coated alumina particles followed by silanization or by alumina particles followed by universal primer resulted in the highest resin bond strength to zirconia. Fusion sputtering and silica nanofilm deposition induced low strengths. However, when these methods are applied in combination and with a primer (FSSN and FSSNP), higher bond strengths may be achieved. Low bond strengths are obtained when no zirconia treatment is performed

A new approach for Y-TZP surface treatment: evaluations of roughness and bond strength to resin cemen

Abstract Objective This study aims to evaluate the effect of sonochemical treatment on the surface of yttria-stabilized tetragonal zirconia (Y-TZP) before and after the final sintering. Material and Methods Twenty-eight Y-TZP discs were divided into four groups (n=7), according to surface treatment: PRE: pre-sintering sonication with 30% nominal power for 15 min; POS: post-sintering sonication with 30% nominal power for 15 min; JAT: air abrasion with 50-μm alumina particles; and CON: control group with no treatment. The POS and JAT groups were sintered before sonication and the PRE group after sonication. Surface roughness was analyzed using confocal microscopy, after which resin cement cylinders were placed on the surface of the Y-TZP discs and subjected to mechanical microshear bond strength test until fracture. Surface roughness and microshear bond strength values underwent ANOVA and the Tukey tests. Results The surface roughness values for the PRE group (299.91 nm) and the POS group (291.23 nm) were not significantly different (p≥0.05), statistically, and the surface roughness value of the JAT group (925.21 nm) was higher than those of PRE and POS (p=0.007) groups. The mechanical microshear bond strength test showed that there was no statistically significant difference between the groups (p=0.08). Conclusions Therefore, the results showed that sonochemical treatment modifies the Y-TZP surface and is similar to the well-established sandblasting surface treatment regarding the strength of the bond with the resin cement.

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.

Can the application of multi-mode adhesive be a substitute to silicatized/silanized y-tzp ceramics?

Abstract This study evaluated the effectiveness of a multi-mode adhesive (SBU-Scotch Bond Universal/3M) as a substitute for silica coating and silane application on the bonding of zirconia ceramics to resin cement. One-hundred and twenty sintered zirconia ceramic blocks (5 x 5 x 5 mm) were obtained, finished by grounding with silicon carbide paper (#600, #800, #1000 and #1200) and randomly divided into 12 groups (n=10) in accordance with the factors "surface treatment" (ScSi - silicatization + silanization; ScSBU - silicatization + SBU; SBU - SBU without photoactivation and SBUp - SBU photoactivated) and "ceramic" (Lava / 3M ESPE, Ceramill Zirconia / Amann Girrbach and Zirkonzahn / Zirkonzahn). Dual resin cement cylinders (RelyX Ultimate/3M ESPE) were subsequently produced in the center of each block using a silicon matrix (Ø=2 mm, h=5 mm) and photoactivated for 40 s (1200 mW/cm2). The samples were stored for 30 days in distilled water (37ºC) and submitted to shear bond strength test (1 mm/min, 100 KgF). Data (MPa) were analyzed under ANOVA (2 levels) and Tukey test (5%). Complementary analyzes were also performed. ANOVA revealed that only the factor "surface treatment" was significant (p=0.0001). The ScSi treatment (14.28A) promoted statistically higher bond strength values than the other ScSBU (9.03B), SBU (8.47B) and SBUp (7.82B), which were similar to each other (Tukey). Failure analysis revealed that 100% of the failures were mixed. The silica coating followed by the silanization promoted higher bond strength values of resin cement and ceramic, regardless of the zirconia ceramic or SBU.

Resumo Este estudo avaliou a efetividade de um adesivo "multi-mode" (Single Bond Universal/3M) como um substituto para a silicatização e aplicação do silano na resistência de união das cerâmicas de zircônia e um cimento resinoso. Para isso, 120 blocos cerâmicos sinterizados de zircônia nas dimensões de (5 x 5 x 5 mm) foram obtidos, lixados com lixas de granulação decrescente (#600, #800, #1000 e #1200) e divididos aleatoriamente em 12 grupos (n = 10), de acordo com os fatores "tratamento de superfície" (ScSi - silicatização + silanização; ScSBU - silicatização + Single Bond; SBU - SBU sem fotoativação e SBUp - SBU com fotoativação) e "cerâmica" (Lava/3M ESPE, Ceramill Zircônia/ Amann Girrbach e Zirkonzahn/Zirkonzahn). Posteriormente, cilindros de cimento resinoso dual (RelyX Ultimate/3M ESPE) foram confeccionados no centro de cada bloco com auxílio de uma matriz de silicone (Ø=2 mm; h=5 mm) e fotopolimerizados por 40 s (1200 mW/ cm²). Em seguida, as amostras foram armazenadas durante trinta dias em água destilada (37 °C) e submetidas ao ensaio de resistência de união ao cisalhamento (1 mm/min, 100 kgF). Os dados (MPa) foram analisados sob ANOVA (2 fatores) e teste de Tukey (5%). Análises complementares também foram realizadas. ANOVA revelou que apenas o fator "tratamento de superfície" foi significativo (p=0,0001). O tratamento ScSi (14.28A) promoveu valores de adesão estatisticamente superiores aos demais ScSBU (9.03B), SBU (8.47B) e SBUp (7.82B), os quais foram semelhantes entre si (Tukey). A Análise de falhas revelou que 100% da falhas que ocorreram foram mistas. A silicatização seguida da silanização promoveu a melhor resistência de união entre cimento resinoso e a cerâmica, independentemente do tipo da cerâmica ou do SBU.

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.

Subsurface Fractional Ablative Resurfacing of a Periareolar Scar Using 1,064-nm Picosecond Laser with Micro-Lens Array

Although picosecond lasers were invented as an effective treatment of pigmented lesions, the Food and Drug Administration has also approved picosecond lasers with fractional mode for treating acne scars and wrinkles on the face. In this report, we introduce a noteworthy case in which we treated a periareolar scar using a 1,064-nm picosecond laser with fractional mode. A 32-year-old female patient who had a periareolar scar due to a breast reconstruction procedure with a latissimus dorsi myocutaneous flap hoped to remove the postoperative scar. We applied a 1,064-nm picosecond neodymium-doped yttrium aluminium garnet (Nd:YAG) laser with a micro-lens array (MLA) to the scar twice, with a 1-month interval between treatments. The scar improved after the second laser treatment and the patient was satisfied with the outcome. The treatment of a postoperative periareolar scar through subsurface fractional ablative resurfacing using a 1,064-nm Nd:YAG picosecond laser with a MLA produced significant improvements in the texture and aesthetic appearance of the scar, without any wound complications.

A Case of Late-onset Capsular Block Syndrome, Resulting in the Misdiagnosis of Intraocular Lens Opacity

PURPOSE: We report a case of late-onset capsular block syndrome, which resulted in a misdiagnosis of intraocular lens (IOL) opacity. CASE SUMMARY: A 59-year-old man visited our clinic with reduced visual acuity in the right eye from 1 year prior. He had undergone uncomplicated bilateral cataract surgery by phacoemulsification with IOL implants at another hospital 10 years before. There was no specific history with the exception of hypertension. After being diagnosed in the ophthalmology clinic with IOL degeneration and opacity in the right eye, he was referred to our hospital for IOL replacement. Upon examination, his right uncorrected visual acuity was 0.06 and intraocular pressure was 22 mmHg. The refractive error could not be checked due to IOL opacity. Slit-lamp microscopy revealed a cloudy, milky IOL. Anterior-segment optical coherence tomography of the right eye showed retention of a highly reflective material in the lens capsule behind the IOL. Posterior capsule enlargement of the right eye was confirmed on ultrasound biomicroscopy. After neodymium-doped yttrium aluminium garnet (Nd:YAG) laser capsulotomy was performed, the homogeneous space disappeared and the eye recovered normal visual acuity. CONCLUSIONS: Capsular block syndrome is a rare complication that can occur shortly (1 day to 2 days) after cataract surgery. Late-onset capsular block syndrome, which occurs 10 years after surgery differs from typical clinical manifestations. Thus, capsular block syndrome is an important consideration upon the presentation of opacification due to IOL degeneration.

Comparison of the marginal fit of milled yttrium stabilized zirconium dioxide crowns obtained by scanning silicone impressions and by scanning stone replicas

PURPOSE: To determine the discrepancy in monolithic zirconium dioxide crowns made with computer-aided design and computer-aided manufacturing (CAD/CAM) systems by comparing scans of silicone impressions and of master casts. MATERIALS AND METHODS: From a Cr-Co master die of a first upper left molar, 30 silicone impressions were taken. The 30 silicone impressions were scanned with the laboratory scanner, thus obtaining 30 milled monolithic yttrium stabilized zirconium dioxide (YSZD) crowns (the silicone group). They were poured and the working models were scanned, obtaining 30 milled monolithic yttrium stabilized zirconium dioxide (YSZD) crowns (the plaster group). Three predetermined points were analyzed in each side of the crown (Mesial, Distal ,Vestibular and Palatal), and the marginal fit was evaluated with SEM (×600). The response variable is the discrepancy from the master model. A repeated measures ANOVA with two within subject factors was performed to study significance of main factors and interaction. RESULTS: Mean marginal discrepancy was 22.42±35.65 µm in the silicone group and 8.94±14.69 µm in the plaster group. The statistical analysis showed significant differences between the two groups and also among the four aspects. Interaction was also significant (P=.02). CONCLUSION: The mean marginal fit values of the two groups were within the clinically acceptable values. Significant differences were found between the groups according to the aspects studied. Various factors influenced the accuracy of digitizing, such as the design, the geometry, and the preparation guidance, as well as the texture, roughness and the color of the scanned material.

Endoscopic Treatment for Pancreatic Cystic Lesions / 대한소화기학회지

The decision of the appropriate treatment for pancreatic cystic lesions (PCLs) is becoming increasingly important as the number of incidentally found PCLs increases. A range of modalities have been attempted because there has been an increasing demand for minimally invasive treatment for PCLs due to the large burden of a surgical resection. Endoscopic treatment using endoscopic ultrasonography (EUS), a representative of minimally invasive therapy, can be categorized into two types: ablation therapy by the injection of drugs and topical thermal coagulative therapy through the high topical energy. A number of studies reported the feasibility and efficacy of these treatments; the most common is EUS-guided ablation for PCLS with ethanol alone or in combination with anticancer drugs. Although ablation therapies with drug injection have proven safety and feasibility, there is no consensus regarding the actual treatment effects and indications of these modalities. EUS-guided radiofrequency ablation was recently attempted as a representative method of local thermal coagulation, but further studies will be needed because of the lack of evidence of its feasibility and safety. In addition, a range of treatments for malignant tumors rather than PCLs have been attempted, such as EUS-guided photodynamic therapy, EUS-guided neodymium-doped yttrium aluminum garnet laser, and high-intensity focused ultrasound, based on the data from animal experiments. Through further study, endoscopic treatment is expected to become established as a useful treatment modality for PCLs.

Erbium-doped Yttrium Aluminum Garnet Laser to Treat Familial Acanthosis Nigricans / 대한피부과학회지

No abstract available.

Clinical Factors Influencing Outcomes of 1064 nm Neodymium-Doped Yttrium Aluminum Garnet (Nd:YAG) Laser Treatment for Onychomycosis

No abstract available.

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).

Can low-fusing glass application affect the marginal misfit and bond strength of Y-TZP crowns?

Abstract To evaluate the effect of different surface treatments on the marginal misfit and retentive strength between Y-TZP crowns and an epoxy resin. Forty (40) epoxy resin (G10) abutments (height: 5mm, conicity: 60, finish line: large chamfer) with equal dimensions were milled and included in polyurethane to simulate the periodontal ligament. Next, 40 Y-TZP crowns (thickness: 1mm) were milled (Cerec in Lab) and randomly divided into four groups (n=10) according to the surface treatment: GS(glaze spray), GP(glaze powder/liquid), P(zirconia primer) and RS(tribochemical silica coating). The conditioned surfaces were cemented with dual self-adhesive cement, light cured and submitted to thermomechanical cycling (2x106, 100N, 4Hz, 5°/55°C). Marginal misfit was analyzed by a stereomicroscope and SEM. Retentive strength test was performed (1mm/min) until crown debonding. Glaze layer thickness was also performed to GS and GP groups. Marginal misfit data were analyzed by Kruskal Wallis and Dunn tests; one-way ANOVA and Tukey (5%) analyzed the tensile strength data. The marginal misfit of the GS (48.6±19.9μm) and GP (65.4±42.5μm) were statistically lower than the RS (96±62.9μm) and P (156±113.3μm) (p=0.001). The retentive strength of the GP (470.5±104.1N) and GS (416.8±170.2N) were similar to the P (342.1±109.7N), but statistically higher than those of the RS (208.9±110N). The GS and GP glaze layer was 11.64μm and 9.73μm respectively. Thus, glaze application promoted lower marginal discrepancy and higher retentive strength values than conventional techniques.