Development of ZTA (80% Al2O3/20% ZrO2) pre-sintered blocks for milling in CAD/CAM systems.

The present work aims to develop a production method of pre-sintered zirconia-toughened-alumina (ZTA) composite blocks for machining in a computer-aided design and computer-aided manufacturing (CAD-CAM) system. The ZTA composite comprised of 80% Al2O3 and 20% ZrO2 was synthesized, uniaxially and isostatically pressed to generate machinable CAD-CAM blocks. Fourteen green-body blocks were prepared and pre-sintered at 1000 °C. After cooling and holder gluing, a stereolithography (STL) file was designed and uploaded to manufacture disk-shaped specimens projected to comply with ISO 6872:2015. Seventy specimens were produced through machining of the blocks, samples were sintered at 1600 °C and two-sided polished. Half of the samples were subjected to accelerated autoclave hydrothermal aging (20h at 134 °C and 2.2 bar). Immediate and aged samples were characterized by scanning electron microscopy (SEM) and X-ray diffraction (XRD). Optical and mechanical properties were assessed by reflectance tests and by biaxial flexural strength test, Vickers indentation and fracture toughness, respectively. Samples produced by machining presented high density and smooth surfaces at SEM evaluation with few microstructural defects. XRD evaluation depicted characteristic peaks of alpha alumina and tetragonal zirconia and autoclave aging had no effect on the crystalline spectra of the composite. Optical and mechanical evaluations demonstrated a high masking ability for the composite and a characteristic strength of 464 MPa and Weibull modulus of 17, with no significant alterations after aging. The milled composite exhibited a hardness of 17.61 GPa and fracture toughness of 5.63 MPa m1/2, which remained unaltered after aging. The synthesis of ZTA blocks for CAD-CAM was successful and allowed for the milling of disk-shaped specimens using the grinding method of the CAD-CAM system. ZTA composite properties were unaffected by hydrothermal autoclave aging and present a promising alternative for the manufacture of infrastructures of fixed dental prostheses.

Quantum mechanical analysis of yttrium-stabilized zirconia and alumina: implications for mechanical performance of esthetic crowns.

BACKGROUND: Yttrium-stabilized zirconia (YSZ) and alumina are the most commonly used dental esthetic crown materials. This study aimed to provide detailed information on the comparison between yttrium-stabilized zirconia (YSZ) and alumina, the two materials most often used for esthetic crowns in dentistry. METHODOLOGY: The ground-state energy of the materials was calculated using the Cambridge Serial Total Energy Package (CASTEP) code, which employs a first-principles method based on density functional theory (DFT). The electronic exchange-correlation energy was evaluated using the generalized gradient approximation (GGA) within the Perdew (Burke) Ernzerhof scheme. RESULTS: Optimization of the geometries and investigation of the optical properties, dynamic stability, band structures, refractive indices, and mechanical properties of these materials contribute to a holistic understanding of these materials. Geometric optimization of YSZ provides important insights into its dynamic stability based on observations of its crystal structure and polyhedral geometry, which show stable configurations. Alumina exhibits a distinctive charge, kinetic, and potential (CKP) geometry, which contributes to its interesting structural framework and molecular-level stability. The optical properties of alumina were evaluated using pseudo-atomic computations, demonstrating its responsiveness to external stimuli. The refractive indices, reflectance, and dielectric functions indicate that the transmission of light by alumina depends on numerous factors that are essential for the optical performance of alumina as a material for esthetic crowns. The band structures of both the materials were explored, and the band gap of alumina was determined to be 5.853 eV. In addition, the band structure describes electronic transitions that influence the conductivity and optical properties of a material. The stability of alumina can be deduced from its bandgap, an essential property that determines its use as a dental material. Refractive indices are vital optical properties of esthetic crown materials. Therefore, the ability to understand their refractive-index graphs explains their transparency and color distortion through how the material responds to light..The regulated absorption characteristics exhibited by YSZ render it a highly attractive option for the development of esthetic crowns, as it guarantees minimal color distortion. CONCLUSION: The acceptability of materials for esthetic crowns is strongly determined by mechanical properties such as elastic stiffness constants, Young's modulus, and shear modulus. YSZ is a highly durable material for dental applications, owing to its superior mechanical strength.

Topographical and crystalline change on surface by sandblasting improve flexural and shear bond strength of niobia-modified yttria-stabilized tetragonal zirconia polycrystal.

This study aimed to investigate the effects of sandblasting on the physical properties and bond strength of two types of translucent zirconia: niobium-oxide-containing yttria-stabilized tetragonal zirconia polycrystals ((Y, Nb)-TZP) and 5 mol% yttria-partially stabilized zirconia (5Y-PSZ). Fully sintered disc specimens were either sandblasted with 125 µm alumina particles or left as-sintered. Surface roughness, crystal phase compositions, and surface morphology were explored. Biaxial flexural strength (n=10) and shear bond strength (SBS) (n=12) were evaluated, including thermocycling conditions. Results indicated a decrease in flexural strength of 5Y-PSZ from 601 to 303 MPa upon sandblasting, while (Y, Nb)-TZP improved from 458 to 544 MPa. Both materials significantly increased SBS after sandblasting (p<0.001). After thermocycling, (Y, Nb)-TZP maintained superior SBS (14.3 MPa) compared to 5Y-PSZ (11.3 MPa) (p<0.001). The study concludes that (Y, Nb)-TZP is preferable for sandblasting applications, particularly for achieving durable bonding without compromising flexural strength.

Two-Photon-Excited FLIM of NAD(P)H and FAD-Metabolic Activity of Fibroblasts for the Diagnostics of Osteoimplant Survival.

Bioinert materials such as the zirconium dioxide and aluminum oxide are widely used in surgery and dentistry due to the absence of cytotoxicity of the materials in relation to the surrounding cells of the body. However, little attention has been paid to the study of metabolic processes occurring at the implant-cell interface. The metabolic activity of mouse 3T3 fibroblasts incubated on yttrium-stabilized zirconium ceramics cured with aluminum oxide (ATZ) and stabilized zirconium ceramics (Y-TZP) was analyzed based on the ratio of the free/bound forms of cofactors NAD(P)H and FAD obtained using two-photon microscopy. The results show that fibroblasts incubated on ceramics demonstrate a shift towards the free form of NAD(P)H, which is observed during the glycolysis process, which, according to our assumptions, is related to the porosity of the surface of ceramic structures. Consequently, despite the high viability and good proliferation of fibroblasts assessed using an MTT test and a scanning electron microscope, the cells are in a state of hypoxia during incubation on ceramic structures. The FLIM results obtained in this work can be used as additional information for scientists who are interested in manufacturing osteoimplants.

Effect of glass-ceramic coating versus alumina air-abrasion on the bond strength and residual stress of zirconia.

OBJECTIVES: To assess the effect of glass-ceramic coated zirconia versus alumina air-abraded zirconia on the shear bond strength (SBS) of resin cement and investigate the residual stresses present on both mechanically pre-treated surfaces. MATERIALS AND METHODS: A total of 180 zirconia disks, with diameters of 10 mm and 5 mm, were divided into two groups: DCMhotbond glass-ceramic coated, followed by hydrofluoric acid etching (DCM), and alumina air-abraded (AB). All mechanically pre-treated disks were conditioned with G-Multi Primer and bonded using G-Cem Linkforce Cement. Ninety specimens were immersed in distilled water for 24 h and subsequently allocated into three groups based on aging conditions (n = 15/subgroups): immediate testing, 5000 thermal cycles, and 10,000 thermal cycles. Then, the shear bond strength was assessed, and the obtained data were subjected to analysis using a two-way ANOVA, followed by a one-way ANOVA and Tukey's HSD post hoc test (α = 0.05). The residual stresses present on both mechanically pre-treated surfaces were examined using X-ray diffraction analysis. RESULTS: The mean SBS values of the DCM and AB groups showed no significant difference under each aging condition. The SBS of DCM groups was not affected by thermal cycles, whereas the SBS of AB groups exhibited a significant decrease following thermal cycles. Glass-ceramic coated surfaces exhibited higher compressive stresses than alumina air-abrasion. CONCLUSIONS: The DCMhotbond glass-ceramic coated zirconia showed comparable bond strength to the alumina air-abrasion technique. CLINICAL RELEVANCE: The DCMhotbond glass-ceramic coating technique is a promising alternative for zirconia surface pre-treatment. However, further investigations are needed before suggesting its clinical use.

Advanced lithium disilicate: A comparative evaluation of translucency and fatigue failure load to other ceramics for monolithic restorations.

The aim of this in vitro study was to evaluate the surface roughness, translucency, fatigue failure load (FFL), and number of cycles for fatigue failure (CFF) of a recently released lithia-based material called advanced lithium disilicate and three other ceramics indicated for monolithic restorations. First, ALD (advanced lithium disilicate, CEREC Tessera, Dentsply Sirona), LD (lithium disilicate, IPS e. max CAD, Ivoclar), LS (lithium silicate-disilicate, Suprinity, Vita Zahnfabrik), and 4Y-PSZ (Yttria-stabilized zirconia, IPS e.max ZirCAD MT, Ivoclar) discs (n = 15, Ø = 10 mm and thickness = 1.0 mm) were fabricated from CAD/CAM blocks/discs, A2 shade. The discs were sintered/crystallized and subsequently analyzed by a rugosimeter (Mitutoyo SJ-410) to determine Ra and Rz surface roughness parameters. Next, they were evaluated to determine the translucency parameter (TP) using a bench-top spectrophotometer (SP60, EX-Rite). The discs were subsequently cemented to glass fiber epoxy resin discs, and the specimens were tested under cyclic loading (Step-test), immersed in distilled water at a frequency of 20 Hz, with an initial cyclic load of 200 N for 5,000 cycles and increments of 50 N every 10,000 cycles until failure. Fatigue failure load (FFL) and number of cycles for fatigue failure (CFF) were recorded for subsequent Kaplan Meier analysis, with post-hoc Mantel-Cox and Weibull analysis (α = 0.05). Complementary fractographic, topographic and energy dispersive spectroscopy analyses (EDS) were performed. 4Y-PSZ showed higher survival (p < 0.05), with higher FFL and CFF (1077 N; 180,333 cycles), followed by LD (980 N; 161,000 cycles), LS (937 N; 152,333 cycles) and ALD (910 N; 147,000 cycles). No differences were observed between the tested groups regarding Weibull modulus. ALD presented TP (28.14) equal to DL (28.27) and higher than LS (25.51). All lithia-based materials had higher translucency than 4Y-PSZ (TP = 8.62) (p < 0.05). ALD appears to have a similar elemental composition to LD and LSD for oxygen and silicon. ALD and LSD have a similar zirconium content. Fractures originated on the cemented surface of the ceramic discs. Lithia-based ceramics showed lower surface roughness, with ALD (Ra = 0.04 µm; Rz = 0.66 µm) showing the lowest values (p < 0.05). Despite showing lower FFL when compared to LD and 4Y-PSZ, ALD has compatible translucency and mechanical fatigue performance with its indication for fabricating monolithic, anterior and posterior adhesively cemented single-unit restorations. However, further studies are needed to substantiate its clinical performance.

Morphologic Analysis of Zirconia Ceramics: Effect of Different Surface Treatments.

PURPOSE: To investigate the effects of airborne-particle abrasion and nanosilica (nano-Si) infiltration treatment on the surface characteristics of dental zirconia. MATERIALS AND METHODS: A total of 15 unsintered zirconia ceramic green bodies (10 × 10 × 3 mm) were divided into three groups (n = 5): Group C, no treatment after sintering; Group S, airborne-particle abrasion with 50-µm aluminum oxide particles after sintering; and Group N, infiltration of nano-Si followed by sintering and hydrofluoric acid (HF) etching. The zirconia disks' surface roughness was analyzed by atomic force microscopy (AFM). The surface morphology of the specimens was analyzed using scanning electron microscopy (SEM), and the chemical composition was analyzed by energy-dispersive x-ray (EDX). Data were statistically analyzed by the Kruskal-Wallis test (P < .05). RESULTS: Zirconia surface treatments by infiltration of nano-Si, sintering, and HF etching showed multiple changes in the surface features. The surface roughness of Groups C, S, and N were 0.88 ± 0.07 µm, 1.26 ± 0.10 µm, and 1.69 ± 0.15 µm, respectively. The surface roughness of Group N was significantly higher than that of Groups C and S (P < .05). EDX analysis showed peaks that corresponded to silica (Si) after infiltration with colloidal Si that disappeared following acid etching. CONCLUSIONS: Infiltrating nano-Si increases the surface roughness of zirconia. The formation of retentive nanopores on the surface potentially improves the zirconia-resin cement bonding strengths.

Influence of coloring techniques on the surface characteristics and color stability of a monolithic zirconia ceramic.

STATEMENT OF PROBLEM: The color of monolithic zirconia restorations is obtained by presintering or postsintering coloring techniques. However, studies on the differences in surface characteristics and their influence on color stability are lacking. PURPOSE: The purpose of this in vitro study was to evaluate the influence of shading and staining techniques for a zirconia ceramic on the surface characteristics and colorimetric parameters (color difference, translucency, and whiteness index) after exposure to coffee or red wine and then polishing. MATERIAL AND METHODS: Ceramic disks (N=30; Ø10×1mm) were allocated into 3 groups: preshaded-shaded by the manufacturer (IPS e.max ZirCAD MT, shade A2); manually shaded-unshaded zirconia (IPS e.max ZirCAD MT, bleaching shade-BL) colored by the brushing technique, before sintering; stained-unshaded zirconia (IPS e.max ZirCAD MT BL) colored by the staining technique, after sintering. Spectrophotometric color assessments ensured the same initial perceived color (Vita Classical A2) for specimens included in the study (∆E00<1.77 acceptability threshold). Surface characteristics were assessed by scanning electron microscopy and atomic force microscopy. The specimens were immersed in coffee (n=5) or red wine (n=5) for 12 and 24 days and subsequently polished. The data were statistically and descriptively analyzed for color differences (∆E00), translucency parameters (TP00), and whiteness indexes for dentistry (WID), considering acceptability and perceptibility thresholds. RESULTS: The shaded groups found an irregular ceramic surface with uniformly sized zirconia crystals. The stained group found a glass-covered smoother surface. Significant alterations in color parameters (∆E00, TP00, WID) were observed with immersion in pigmenting beverages (P<.001) both after 12 days, and after 24 days. The shaded specimens had greater color alterations after immersion but benefited from the polishing procedure, which reduced color differences below an acceptable threshold in comparison with the baseline. Stained specimens had lower color alterations after immersion, but the polishing protocol was detrimental as it whitened the ceramic by subsurface exposure. CONCLUSIONS: The coloring technique influences the surface characteristics of zirconia ceramic and also the color parameters after exposure to colored beverages and polishing.

Failure behavior of zirconia crowns subjected to air abrasion with different particle sizes.

This study aimed to investigate the failure behavior of 3 mol.% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) prosthetic crowns air-abraded with aluminum oxide (AO) particles of different sizes. Ninety ceramic premolar crowns were produced with 3Y-TZP frameworks veneered with porcelain. Crowns were randomly divided into three groups, according to the size of the air abrasion AO particles (n = 30): (GC) untreated (control); (G53) 53 µm; (G125) 125 µm. Air abrasion was performed with 0.25 mpa pressure, 10-mm distance, for 10 s. Crowns were adhesively cemented to dentin analog abutments. Specimens were loaded in compression to failure, in 37oC distilled water, using a universal testing machine (n = 30). Fractographic analysis was performed using a stereomicroscope and SEM. The roughness of the crown's inner surface was evaluated using an optical profilometer (n = 10). Fracture load data were statistically analyzed with Weibull analysis and roughness data with Kruskal-Wallis (α = 0.05). GC had the lowest characteristic fracture load (L0), while G53 and G125 had higher and statistically similar L0 values. The Weibull modulus (m) was similar among groups. The failure modes observed were catastrophic failure and porcelain chipping. There were no differences between the roughness parameters for the experimental groups (p > 0.05). The size of the AO particles did not affect the fracture load and failure mode of 3Y-TZP crowns. Air abrasion with 53 µm and 125 µm particles resulted in a higher fracture load of ceramic crowns than the untreated group while maintaining their reliability and surface characteristics.

The Effect of Nano-Silica Surface Infiltration on Bond Strength of a Phosphate-Monomer-containing Composite Cement to Zirconia.

PURPOSE: To evaluate the bonding receptiveness of zirconia treated with nano-silica surface infiltration and the bond strength of composite cement after aging. MATERIALS AND METHODS: Zirconia ceramic green bodies (Ceramill zolid, Amann Girbach) with dimensions of 10 x 10 x 4 mm were divided into three groups (n = 4): group C (control: no treatment after sintering), group S (sandblasted: 50-µm alumina airborne particle abrasion after sintering) and group N (nanosintered: infiltrated with nano-silica colloid, sintered, and then etched with hydrofluoric acid). Phase transformations were examined through X-ray diffraction (XRD). Composite resin (Filtek Z250, 3M Oral Care) was bonded to zirconia using the 10-MDP-containing composite cement Panavia F (Kuraray Noritake). The composite-cement/zirconia bond strength was immediately measured using the microtensile bond strength test (µTBS) as well as after three months of artificial aging in water (n = 20 microstick specimens/group). Failure mode patterns were examined using SEM. RESULTS: The specimens of groups C and S, as tested by XRD, exhibited almost full tetragonal phases, while a small extent of tetragonal-monoclinic phase transformation (t→m) was observed for group N. Group N achieved the highest bond strengths (41.5 ± 8.6 MPa), which was significantly higher than that measured for groups C and S (p < 0.05). There was a significant drop in µTBS after 90 days of water storage for groups C and S. SEM revealed a decrease in the percentage of cohesive failure in groups N and S after water storage. CONCLUSIONS: Infiltrating zirconia with nano-silica is a reliable method to establish a strong and stable bond to zirconia. The combination of surface infiltration with nano-silica and application of a phosphate monomer-containing composite cement can significantly improve the composite-cement/zirconia bond strength.

Novel three-dimensional Ti3C2-MXene embedded zirconium alginate aerogel adsorbent for efficient phosphate removal in water.

Excessive phosphorus in water causes environmental security problems like eutrophication. Advanced two-dimensional material MXene has attracted raising attention in aquatic adsorption, while lack of selectivity and difficult recovery limit its application in phosphate removal. In this study, Ti3C2-MXene embedded zirconium-crosslinked SA (MX-ZrSA) beads were synthesized and their phosphate adsorption performance under different conditions was assessed. Investigations using SEM/EDS, XRD, BET, TGA and contact angle meter reveal that the addition of Ti3C2-MXene enhanced the thermal stability, mechanical strength, hydrophilicity, and formed loose network-like mesoporous inner structure with large surface area. The theoretical maximum adsorption capacity was 492.55 mg P/g and was well fitted by Freundlich and optimized Langmuir models. The Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy analysis showed that chemisorption was involved, and the formation of Zr-O-P and Ti-O-P complexes accounted for high selectivity and affinity to phosphate. The adsorption experiments in real waters and lab-scale continuous flow Anaerobic-Anoxic-Oxic reactor further indicated the application potential of MX-ZrSA beads. Our study will provide insight into MXene and SA aerogel synergistic adsorption of aquatic contaminants and help with the removal and recovery of finite phosphorus resource.

Effects of Particle Abrasion Media and Pressure on Flexural Strength and Bond Strength of Zirconia.

OBJECTIVES: To compare the effects of particle abrasion medium and pressure on shear bond strength and biaxial flexural strength of three generations of zirconia (Lava Frame, Lava Plus, and Lava Esthetic) with the goal of optimizing the bond to zirconia. METHODS: 280 discs (14 mm diameter; 1 mm thickness) of each zirconia were milled and sintered. Specimens of each material were randomly distributed into 14 groups (n=20); half were tested for shear bond strength and half were tested for biaxial flexural strength. The specimens were particle abraded on one surface by 2 different media (50 µm alumina particles or 50 µm glass beads) for 10 seconds at three different pressures (15, 30, and 45 psi or 0.1, 0.2, 0.3 MPa). Untreated specimens served as positive control. A tube (1.50 mm diameter) filled with dual cured resin cement (Panavia SA) was placed onto the surface and light cured. Specimens were stored in water (37°C for 24 hours) and shear bond strength was measured in a universal testing machine (Instron). Biaxial flexural strength of each specimen was measured according to ISO 6872. Shear bond strength and biaxial flexural strength were compared individually with a 2-way analysis of variance (ANOVA) for factors surface treatment and zirconia composition. RESULTS: Significant differences were seen between surface treatments (p<0.01), zirconia composition (p<0.01) and their interaction (p<0.01) for both bond strength and flexural strength. With alumina particle abrasion, higher pressure produced higher bonds for Lava Frame and Lava Plus zirconia while the bond of Lava Esthetic declined with increased pressure. Higher pressure (>0.2 MPa or 30 psi) with alumina decreased biaxial flexural strength with Lava Esthetic zirconia. CONCLUSIONS: Particle abrasion with alumina produced a significantly better combination of bond strength while maintaining biaxial strength of three zirconia materials than particle abrasion with glass beads. The bond strength also depended upon the pressure of particle abrasion and the generation of zirconia used.

Influence of nanostructured alumina coating on the clinical performance of zirconia cantilevered resin-bonded fixed dental prostheses: Up to 3-year results of a prospective, randomized, controlled clinical trial.

STATEMENT OF PROBLEM: The debonding of zirconia cantilevered resin-bonded fixed dental prostheses remains a technical complication because zirconia's chemical inertness impedes adequate surface preparation for bonding. Limited clinical evidence on the performance of various pretreatment methods for the bonding surface of zirconia resin-bonded fixed dental prostheses is available. PURPOSE: The present prospective, randomized, controlled clinical trial aimed at evaluating the performance of zirconia resin-bonded fixed dental prostheses prepared with nanostructured alumina coating. MATERIAL AND METHODS: The study adopted a prospective, randomized, controlled, double-blind (patients, operator) design to compare the performance of nanostructured alumina coating with that of conventional airborne-particle abrasion. Twenty-seven healthy patients needing a replacement of a missing maxillary or mandibular central or lateral incisor were screened and rated to be eligible, and 31 zirconia cantilevered resin-bonded fixed dental prostheses were randomly allocated into 1 of 2 groups. The first group (n=15), where the restoration bonding surface was airborne-particle abraded with 50-µm alumina, served as a control group. In the second group (n=16), the restorations were pretreated with nanostructured alumina coating. Treatment and data collection were standardized. The primary outcome evaluated was the survival of the RBFDPs as defined by the restoration not debonding. The Kaplan-Meier analysis of cumulative survival was performed, and nonparametric tests were used to determine patient-specific differences between both study groups (age, sex, restored arch, tooth replaced, bonding surface area) (α=.05). Retainer wing surfaces of debonded resin-bonded fixed dental prostheses were inspected under a scanning electron microscope. RESULTS: Within a mean ±standard deviation observation period of 22.4 ±7.7 months (minimum, 8.3; maximum, 37.9 months), 3 debondings occurred, and the survival rate was 90.3%. The survival rate was 93.8% for the nanostructured alumina coating and 86.7% for the control group, with no statistically significant differences (log-rank, P=.54). No patient-specific differences were found between study groups (P>.05). As per the scanning electron micrographs, the majority of the nanostructured alumina-coated surfaces had large areas of nanostructured alumina residue, whereas the airborne-particle abraded surfaces exhibited predominantly adhesive failure with less cement residue. CONCLUSIONS: Over a mean observation period of 2 years, both zirconia pretreatments showed promising and comparable clinical results; therefore, nanostructured alumina coating could be regarded as a viable alternative pretreatment method to airborne-particle abrasion.

Single-retainer all-ceramic resin-bonded fixed dental prostheses: Long-term outcomes in the esthetic zone.

OBJECTIVES: To present an update on the concept of cantilevered single-retainer all-ceramic resin-bonded fixed dental prostheses (RBFDPs) first presented 25 years ago in the Journal of Esthetic Dentistry. OVERVIEW: The initially presented case of the concept was followed clinically over 26 years and is presented along with two additional clinical long-term cases using varying methods to obtain an esthetic and hygienic ovate pontic design. Veneered alumina and zirconia ceramic (3 mol% yttria-tetragonal zirconia polycrystalline ceramic; 3Y-TZP) was used and bonded with a phosphate monomer containing luting resin after 50 µm alumina particle air-abrasion at 0.25 MPa pressure. The restorations replacing incisors did not debond and soft tissues in the pontic area were maintained over 26 years. CONCLUSIONS: Cantilevered single-retainer all-ceramic RBFDPs today made from veneered 3Y-TZP zirconia ceramic can be considered a standard of care for the replacement of single incisors and provide an excellent esthetic outcome with a long-term preservation of soft tissues in the pontic area. CLINICAL SIGNIFICANCE: Bonding nonretentive oxides ceramics such as alumina and zirconia ceramic with phosphate monomer containing luting resins after alumina particle air-abrasion is durable over decades. This proves that bonding to zirconia ceramic is not of any problem when adequate methods are used. Single-retainer zirconia ceramic RBFDPs maintain soft tissues in the edentulous area of single missing incisors and often deem implants unessential for this indication.

Effect of airborne-particle abrasion with a novel spherical abrasive on the zirconia surface.

STATEMENT OF PROBLEM: A novel zirconia-alumina composite (ZAC) particle has yet to be studied for airborne-particle abrasion in a bonding protocol for the zirconia surface. PURPOSE: The purpose of this in vitro study was to evaluate the shear bond force of resin cement to yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) when using spherical ZAC particles to conduct airborne-particle abrasion and modify the topography of Y-TZP. MATERIAL AND METHODS: Spherical 30- to 70-µm ZAC particles were fabricated by using a hybrid gel technique. A total of 160 Ø6.6×4.0-mm zirconia disks were fabricated from 4 commercially available zirconia blanks, e.max ZirCAD zirconia (EM), NexxZr T zirconia (NE), Lava Plus High Translucency zirconia (LP), and Imagine High Translucency Zirconia (IM), by using computer-aided manufacturing technology. As-sintered specimens without further surface treatment were used as controls (ZR0). Surface treatment groups included sharp-edged alumina airborne-particle abrasion (ABC), 50 µm, 0.2 MPa; airborne-particle abrasion with ZAC particle at 0.2 MPa (2ZA); and airborne-particle abrasion with spherical ZAC particle at 0.4 MPa (4ZA). All surface treatment groups were airborne-particle abraded at the specified pressures for 10 seconds at a standardized distance of 10 mm. The surface roughness (Ra) and area roughness (Sa) of specimens from each group were measured. Following the application of an adhesive (Scotchbond Universal), Ø6.6×4.0-mm resin cement (RelyX Ultimate) buttons were fabricated for shear bond testing by using a universal testing machine at a 5-mm/min crosshead speed (n=10). The data were analyzed by using a 2-way ANOVA, Tukey HSD test, and regression analysis (α=0.05). Scanning electron microscopy (SEM) was performed to observe changes of the zirconia surface and the failure modes of each group before and after shear bond testing. RESULTS: The mean ±standard deviation shear bond force values ranged from 272.6 ±41.4 N to 686.7 ±152.8 N. Statistically significant higher force values than those of the controls (P<.05) were obtained by using airborne-particle abrasion. No significant differences were found among any of the airborne-particle abrasion treatment groups (P>.05). The mean of Ra values ranged from 0.27 µm to 0.74 µm, and the mean of Sa values, from 0.48 µm to 1.48 µm. SEM observation revealed that the zirconia surface was made jagged by abrasion with sharp-edged alumina particles. The spherical ZAC particles create microcraters on the zirconia surface. Fractographic observation disclosed that failures were adhesive-cohesive failure modes with residual resin cement attached on the zirconia surface. CONCLUSIONS: The surface treatment of zirconia with sharp-edged alumina or the spherical ZAC abrasives improved the bonding force between the zirconia and resin cement. No statistically significant differences in shear bond force values were found between airborne-particle abrasion surface treatment groups.

Strength and flexibility of lithium disilicate bonded to polyetherketoneketone.

STATEMENT OF PROBLEM: Polyetherketoneketone (PEKK) is a high-performance polymer gaining popularity in dentistry for the fabrication of crowns, fixed partial dentures, removable partial denture frameworks, and frameworks for implant-supported fixed complete dentures. Despite a lack of performance data, lithium disilicate crowns have been bonded to retentive elements in PEKK frameworks. PURPOSE: The purpose of this in vitro study was to compare the bond strengths and flexibility of lithium disilicate to PEKK or zirconia. MATERIAL AND METHODS: Forty-five PEKK, 15 zirconia, and 60 lithium disilicate beam-shaped specimens (12.5×2×2 mm) were fabricated. The ends of the PEKK beams were subjected to 3 different surface treatments before the application and light polymerization of a primer: 50-µm aluminum oxide airborne-particle abrasion, nonthermal air plasma, and argon-oxygen plasma. The zirconia specimen bonding surfaces were prepared with 50-µm aluminum oxide airborne-particle abrasion and the application of primer. Lithium disilicate specimens were etched with 4.5% hydrofluoric acid, and primer was applied. The lithium disilicate specimens were luted with an adhesive resin cement to the PEKK and zirconia specimens by using light-activated and chemically activated polymerization. Fifteen monolithic specimens of PEKK, lithium disilicate, and zirconia (25×2×2 mm) were also fabricated. All specimens were incubated overnight in 100% humidity before testing. Bonded and monolithic specimens were loaded in a universal testing machine, and 4-point bend tests were conducted until failure (n=15). The flexural modulus and strength were calculated and statistically analyzed with 1-way analysis of variance and Student-Newman-Keuls post hoc tests (α=.05). RESULTS: All bonded specimens failed at the adhesive interface. The zirconia-lithium disilicate bond strength was approximately twice that of the strongest group of PEKK (airborne-particle abrasion group) bonded to lithium disilicate (42 ±12 MPa and 24 ±13 MPa, respectively) and was approximately 9 times more rigid (71 ±19 GPa and 8 ±2 GPa, respectively). Monolithic PEKK fractured at 238 ±22 MPa, monolithic zirconia at 771 ±128 MPa, and monolithic lithium disilicate at 173 ±26 MPa. Monolithic PEKK was approximately 30 times more flexible than monolithic zirconia (6 ±1 GPa and 178 ±16 GPa, respectively). All values were statistically significantly different (P<.05), except for the bond strength between lithium disilicate and PEKK treated with airborne-particle abrasion and nonthermal air plasma and the flexural moduli of PEKK to lithium disilicate. CONCLUSIONS: Bond strength between PEKK and lithium disilicate was significantly weaker than that between zirconia and lithium disilicate. Monolithic PEKK was significantly more flexible than monolithic zirconia.

EFFECT OF SURFACE TREATMENT PROTOCOLS OF ZIRCONIUM DIOXIDE MULTILAYER RESTORATIONS ON FUNCTIONAL PROPERTIES OF THE HUMAN ORAL MUCOSA STROMAL CELLS.

Aim - to study the effect of protocols of surface treatment of zirconium dioxide multilayer restorations on the functional properties of stromal cells of the human oral mucosa using molecular biological methods. For all experiments, identical standardized specimens of different types of zirconia with a diameter of 10 mm and a height of 1 mm were used. These types included Katana (Kuraray Noritake Dental, Tokyo, Japan) HTML (control) UTML, STML and ZirCAD Prime (Ivoclar Vivadent). DMEM/F12 growth medium (Paneco, Russian Federation) with addition of fetal calf serum (Gibco, USA) up to 10% and penicillin-streptomycin (Paneco, Russian Federation) up to 1% was used in the experiment. Cells were detached from the culture substrate with trypsin-EDTA solution (Paneco, RF) and their number and viability were assessed using an automatic counter TC-20 (Bio-Rad, USA). For repopulation, samples were transferred into wells of a 96-well culture plate (1 sample in 1 well) and cell suspension was layered at the rate of 12.5 thousand or 25 thousand live cells per well. After 48 hours, the cytotoxic properties of the tested samples were evaluated in vitro. According to the results of MTT test we can conclude that samples of ZirCad Prime and Katana UTML groups do not show cytotoxic properties (score "0" on the cytotoxicity scale according to GOST R ISO 10993-5-2009 "National Standard of the Russian Federation. Medical devices. Evaluation of biological effect of medical devices. Part 5. Studies on cytotoxicity: in vitro methods"). The samples of Katana STML group samples were slightly reduced compared to the control (about 12%), nevertheless, these samples can also be considered non-cytotoxic. Analyzing the direct contact with the material in all samples, a good occupancy of the material by cells was observed, in particular, the polished surface prevailed over the glazed one, however, this difference is not statistically significant. Analysis of human oral stromal cells to zirconium dioxide showed no statistically significant effect of different surface treatment protocols. However, the number of fibroblasts prevailed on the polished surface.

Physicochemical and biological characterization of silica-coated alumina particles.

OBJECTIVES: A tribochemical silica-coating (TSC) method has been developed to improve the adhesion of dental resin composites to various substrates. The method utilizes airborne-particle abrasion using particles having a silica surface and an alumina core. The impact of the TSC method has been extensively studied but less attention has been paid to the characterization of the silica-modified alumina particles. Due to the role of silicate ions in cell biology, e.g. osteoblast function and bone mineralization, silica-modified alumina particles could also be potentially used as a biomaterial in scaffolds of tissue regeneration. Thus, we carried out detailed physicochemical characterization of the silica-modified alumina particles. METHODS: Silica-modified alumina particles (Rocatec, 3 M-ESPE) of an average particle size of 30 µm were studied for the phase composition, spectroscopic properties, surface morphology, dissolution, and the capability to modify the pH of an immersion solution. The control material was alumina without silica modification. Pre-osteoblastic MC3T3-E1 cells were used to assess cell viability in the presence of the particles. Cell viability was tested at 1, 3, 7 and 10 days of culture with various particle quantities. Multivariate ANOVA was used for statistical analyses. RESULTS: Minor quantities of silica enrichment was verified on the surface of alumina particles and the silica did not evenly cover the alumina surface. In the dissolution test, no change in the pH of the immersion solution was observed in the presence of the particles. Minor quantities of silicate ions were dissolved from the particles to the cell culture medium but no major differences were observed in the viability of pre-osteoblastic cells, whether the cells were cultured with silica-modified or plain alumina particles. SIGNIFICANCE: Characterization of silica-modified alumina particles demonstrated differences in the particle surface structure compared to control alumina. Dissolution of silica layer in Tris buffer or SBF solution varied from that of cell culture medium: minor quantities of dissolved Si were observed in cell culture test medium. The cell viability test did not shown significant differences between control alumina and its silica-modified counterpart.

Influence of Aging and Surface Treatment on the Composite Bond Strength to Translucent 3Y-TZP Zirconia.

PURPOSE: The purpose of this study was to assess the effect of aging and alumina-particle air abrasion at different pressures on the bond strength of two luting composites to a translucent 3Y-TZP zirconia. MATERIALS AND METHODS: Half of the 192 disk-shaped zirconia specimens were aged in an autoclave (group A) for 20 h (134°C, 2 bar), and the other half was not aged (group N). For each group, a different surface treatment was applied: as-sintered (group SIN), alumina-particle air abrasion either at 1 bar (group 1B) or at 2.5 bar (group 2.5B). Disks were bonded to Plexiglas tubes filled with composite resin using a phosphate monomer-based luting composite (group SA) or with a separate phosphate monomer containing primer before using a phosphate-monomer-free luting composite (group V5). All specimens were subjected to tensile bond strength testing (TBS) before and after thermocycling. RESULTS: There were no statistically significant differences caused by autoclave aging for the test groups before thermocycling, except for the A-SIN-SA group, where the TBS decreased significantly. The variation of the aluminaparticle air abrasion pressure showed no statistically significant effect, except in the N-1B-V5 group, where TBS was significantly lower than N-2.5B-V5. After thermocycling, the TBS of most groups decreased significantly. Specimens of the primer group, which were abraded at 1 bar, showed a significant decrease in TBS in comparison with alumina-particle air abrasion at 2.5 bar. CONCLUSION: Twenty hours of autoclave aging had almost no influence on the bond strength of the test groups. For the primer/resin bonding system, higher pressure during alumina-particle air abrasion might help obtain a higher and more durable bond strength to zirconia.

Stability of fatigued and aged ZTA compared to 3Y-TZP and Al2O3 ceramic systems.

To evaluate the effect of fatigue and aging on the crystalline content and reliability of a zirconia-toughened-alumina (ZTA) composite compared to its individual counterpart materials (3Y-TZP and Al2O3). Thirty-six disc-shaped specimens per group were obtained to comply with ISO 6872:2015. Crystalline content, microstructure and reliability of experimental groups were evaluated in four stages: 1) immediate; 2) aged; 3) fatigued; 4) aged + fatigue. Aging was performed in autoclave and Step-Stress-Accelerated-Life-Testing (SSALT) was performed using three stress profiles. Weibull statistics were used to determine Weibull parameters and life-expectancy. A significant increase in monoclinic phase in 3Y-TZP was observed after aging (19.31%), fatigue (17.88%) and aging + fatigue (55.81%), while ZTA evidenced minimal variation among all conditions (<5.69%). 3Y-TZP presented higher reliability than ZTA at 300 and 500 MPa, and ZTA outperformed Al2O3 at the same stress missions. None of the ceramics yielded acceptable reliability at 800 MPa. A higher characteristic strength was observed for 3Y-TZP, followed by ZTA and Al2O3. While after aging ZTA and Al2O3 remained stable, 3Y-TZP exhibited a significant increase in the characteristic stress. Aging did not affect the reliability of ZTA and Al2O3. 3Y-TZP demonstrated an increase in monoclinic content and characteristic strength after aging.