Alumina-toughened zirconia for dental applications: Physicochemical, mechanical, optical, and residual stress characterization after artificial aging.

To characterize the physicomechanical properties of an alumina-toughened zirconia (ATZ). ATZ synthesis consisted of the addition of alumina particles in an yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP) matrix. Specimens were obtained by uniaxial and isostatic pressing ATZ and 3Y-TZP powders and sintering at 1600°C/1 h and 1550°C/1 h, respectively. Crystalline content and residual stress were evaluated using X-ray diffraction (XRD). Microstructure was characterized by scanning electron microscopy (SEM). Optical properties were determined by reflectance test. Mechanical properties were assessed by biaxial flexural strength test. All analyses were performed before and after aging (134°C, 20 h, 2 bar). XRD and SEM revealed a typical ATZ and 3Y-TZP crystalline content, chiefly tetragonal phase, with a dense polycrystalline matrix, though a smaller grain size for ATZ. Aging triggered a similar monoclinic transformation for both systems; however, ATZ exhibited higher residual compressive stresses than 3Y-TZP. While as-processed 3Y-TZP demonstrated significantly higher characteristic strength relative to ATZ, no significant difference was observed after aging (~215 MPa increase in the ATZ strength). ATZ presented significantly higher opacity relative to 3Y-TZP, although aging significantly increased the translucency of both systems (increase difference significantly higher in the 3Y-TZP compared to ATZ). ATZ physicomechanical properties support its applicability in the dental field, with a lower detrimental effect of aging relative to 3Y-TZP.

Comparative assessment of different recycling methods of orthodontic brackets for clinical use.

BACKGROUND: This study aimed to assess bond strength of the resin/bracket interface, under in-vitro shear stress, of metal brackets recycled by different clinical protocols. METHODS: Sixty stainless steel orthodontic brackets were bonded on acrylic resin. The Transbond XT™ resin was applied at the base of the bracket aided by a matrix, obtaining 1 mm of thickness, and photoactivated with a LED device (40 s; 500 mW/cm2). Samples were randomly divided into four groups (N.=15) according to the reconditioning/recycling protocol: aluminum oxide (AO) 90 µm; hydrofluoric acid 60 s (HA60); hydrofluoric acid 120 s (HA120); hydrofluoric acid 60 s + silane (HA60S). After recycling, the resin was applied at the base of the bracket for shear testing in a universal testing machine (0.5 mm/min). After reconditioning/recycling, the surfaces were analyzed by Scanning Electron Microscopy. Data obtained after the shear test were subjected to ANOVA and Tukey's test (P<0.05). RESULTS: The AO group presented higher values of shear bond strength compared to the other reconditioning/recycling protocols (P<0.05). The HA120 and HA60S groups presented statistically similar results, but HA120 presented strength below the recommended limit. CONCLUSIONS: The recycling technique by aluminum oxide sandblasting was more effective for reconditioning orthodontic brackets when compared to the other protocols. The reconditioning technique with 10% hydrofluoric acid followed by the application of silane bonding agent may be used as an alternative protocol.

Effect of different aging methods on the mechanical behavior of multi-layered ceramic structures.

OBJECTIVE: To evaluate the effect of two aging methods (mechanical cycling and autoclave) on the mechanical behavior of veneer and framework ceramic specimens with different configurations (monolithic, two and three-layers). METHODS: Three ceramics used as framework for fixed dental prostheses (YZ-Vita In-Ceram YZ; IZ-Vita In-Ceram Zirconia; AL-Vita In-Ceram AL) and two veneering porcelains (VM7 and VM9) were studied. Bar-shaped specimens were produced in three different designs: monolithic, two layers (porcelain-framework) and three layers (porcelain-framework-porcelain). Specimens were tested for three-point flexural strength at 1MPa/s in 37°C artificial saliva. Three different experimental conditions were evaluated (n=10): control; mechanical cycling (2Hz, 37°C artificial saliva); and autoclave aging (134°C, 2 bars, 5h). Bi-layered specimens were tested in both conditions: with porcelain or framework ceramic under tension. Fracture surfaces were analyzed using stereomicroscope and scanning electron microscopy. Results were statistically analyzed using Kruskal-Wallis and Student-Newman-Keuls tests. RESULTS: Only for AL group, mechanical cycling and autoclave aging significantly decreased the flexural strength values in comparison to the control (p<0.01). YZ, AL, VM7 and VM9 monolithic groups showed no strength degradation. For multi-layered specimens, when the porcelain layer was tested in tension (bi and tri-layers), the aging methods evaluated also had no effect on strength (p≥0.05). Total and partial failure modes were identified. SIGNIFICANCE: Mechanical cycling and autoclave aging protocols had no effect on the flexural strength values and failure behavior of YZ and IZ ceramic structures. Yet, AL monolithic structures showed a significant decrease in flexural strength with any of the aging methods.

Can 10% hydrofluoric acid be used for reconditioning of orthodontic brackets?

CONTEXT: Bracket debonding is a common problem during orthodontic treatment. This type of failure is associated to masticatory forces, poor adhesion, and the need for repositioning the piece. AIMS: The objective of this work was to compare the shear bond strength of debonded brackets that were reconditioned using different protocols (alumina blasting versus hydrofluoric etching). SETTINGS AND DESIGN: This was an in vitro experimental study with 45 stainless steel orthodontic brackets. SUBJECTS AND METHODS: They were randomly divided into three groups: (1) New brackets (n = 15), (2) brackets reconditioned using 10% hydrofluoric acid for 60 s (n = 15), and (3) brackets reconditioned by aluminum oxide blasting until complete removal of the remaining resin (n = 15). In Groups 2 and 3, the insertion of composite resin proceeded in two stages to simulate a type of bracket failure in which the bonding resin was left at the bracket base. For the shear test, the assembly composed by the metallic support, and specimen was taken to the Instron universal testing machine in which the specimens were loaded using a semicircle-shaped active tip in the region of the bonding interface parallel to the surface of the bracket at a speed of 0.5 mm/min. STATISTICAL ANALYSIS USED: The data were subjected to D'Agostino's normality test to have their distribution checked. Analysis of variance and Tukey's test (P < 0.01) were used to compare the findings between groups. RESULTS: The results indicated that Group 1 (new brackets) showed higher bond strength than that obtained for the group treated with hydrofluoric acid (Group 2, P < 0.01). The bond strength value obtained for the group treated with alumina blasting (Group 3) was statistically similar to those obtained for Groups 1 and 2. CONCLUSIONS: The aluminum oxide blasting technique was effective for the reconditioning of orthodontic brackets. Nevertheless, the reconditioning technique using 10% fluoridric acid for 60 s was not efficient for clinical use.

In Vitro Behavior of Osteoblasts on Zirconia After Different Intensities of Erbium, Chromium-Doped: Yttrium, Scandium, Gallium, and Garnet-Laser Irradiation.

OBJECTIVE: This study investigated the osteoblastic behavior to yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) surface after different intensities of erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser irradiation treatment. MATERIALS AND METHODS: Y-TZP blocks were randomized divided into 4 groups to Er,Cr:YSGG laser irradiation: group G1 = control (no laser irradiation); group G2 = 1.5 W; group G3 = 3.0 W; group G4 = 5.0 W, with air-water irrigation. The irradiated surface roughness (Sa and Ra) topography was evaluated. MC3T3-E1 osteoblast cells were cultured and seeded onto the treated surfaces at a plate density of 1 × 10 cells/mL. At the third and seventh days cell proliferation was measured by the colorimetric assay methods. The specimens were prepared to scanning electron microscope to observe adhesion and morphology of cells. RESULTS: MTT assay showed adhesion and proliferation of MC3T3-E1 cells in all groups. Compared with group G1 (control), the group G2 had a proliferation 1.4% higher (P > 0.05), the group G3 had a proliferation 3.1% higher (P < 0.05) and group G4 had a proliferation 4.5% higher (P < 0.01). After 7 days there was no difference among the groups (ANOVA, Newman-Keuls). CONCLUSIONS: Er,Cr:YSGG laser irradiation may have contributed to the greater and earlier cell spreading that was observed with the Y-TZP without alterations on surface topography.

Mono or polycrystalline alumina-modified hybrid ceramics.

OBJECTIVES: This study evaluated the effect of addition of alumina particles (polycrystalline or monocrystalline), with or without silica coating, on the optical and mechanical properties of a porcelain. METHODS: Groups tested were: control (C), polycrystalline alumina (PA), polycrystalline alumina-silica (PAS), monocrystalline alumina (MA), monocrystalline alumina-silica (MAS). Polycrystalline alumina powder was synthesized using a polymeric precursor method; a commercially available monocrystalline alumina powder (sapphire) was acquired. Silica coating was obtained by immersing alumina powders in a tetraethylorthosilicate solution, followed by heat-treatment. Electrostatic stable suspension method was used to ensure homogenous dispersion of the alumina particles within the porcelain powder. The ceramic specimens were obtained by heat-pressing. Microstructure, translucency parameter, contrast ratio, opalescence index, porosity, biaxial flexural strength, roughness, and elastic constants were characterized. RESULTS: A better interaction between glass matrix and silica coated crystalline particles is suggested in some analyses, yet further investigation is needed to confirm it. The materials did not present significant differences in biaxial flexural strength, due to the presence of higher porosity in the groups with alumina addition. Elastic modulus was higher for MA and MAS groups. Also, these were the groups with optical qualities and roughness closer to control. The PA and PAS groups were considerably more opaque as well as rougher. SIGNIFICANCE: Porcelains with addition of monocrystalline particles presented superior esthetic qualities compared to those with polycrystalline particles. In order to eliminate the porosity in the ceramic materials investigated herein, processing parameters need to be optimized as well as different glass frites should be tested.

A critical evaluation of bond strength tests for the assessment of bonding to Y-TZP.

OBJECTIVES: To compare three different designs for measuring the bond strength between Y-TZP ceramic and a composite material, before and after ceramic surface treatment, evaluating the influence of the size of the adhesive interface for each design. METHODS: 'Macro' tensile, microtensile, 'macro' shear, microshear, 'macro' push-out, and micropush-out tests were carried out. Two Y-TZP surface treatments were evaluated: silanization (sil) and tribochemical silica coating (30µm silica-modified Al2O3 particles+silanization) (TBS). Failure mode analysis of tested samples was also performed. RESULTS: Both the surface treatment and the size of the bonded interface significantly affected the results (p=0.00). Regardless of the type of surface treatment, the microtensile and microshear tests had higher values than their equivalent "macro" tests. However, the push-out test showed the highest values for the "macro" test. The tensile tests showed the greatest variability in results. The tribochemical silica coating method significantly increased bond strength for all tests. SIGNIFICANCE: Different test designs can change the outcome for Y-TZP/cement interfaces, in terms of mean values and reliability (variability). The 'micro' tests expressed higher bond strengths than their equivalent 'macro' tests, with the exception of the push-out test (macro>micro).

Effect of ceramic infrastructure on the failure behavior and stress distribution of fixed partial dentures.

OBJECTIVES: The effect of the ceramic infrastructure (IS) on the failure behavior and stress distribution of fixed partial dentures (FPDs) was evaluated. METHODS: Twenty FPDs with a connector cross-section of 16 mm(2) were produced for each IS and veneered with porcelain: (YZ) Vita In-Ceram YZ/Vita VM9 porcelain; (IZ) Vita In-Ceram Zirconia/Vita VM7 porcelain; (AL) Vita In-Ceram AL/Vita VM7 porcelain. Two experimental conditions were evaluated (n = 10). For control specimens, load was applied in the center of the pontic at 0.5 mm/min until failure, using a universal testing machine, in 37°C deionized water. For mechanical cycling (MC) specimens, FPDs were subjected to MC (2 Hz, 140 N, 10(6) cycles) and subsequently tested as described for the control group. For YZ, an extra group of 10 FPDs were built with a connector cross-section of 9 mm(2) and tested until failure. Fractography and FEA were performed. Data were analyzed by ANOVA and Tukey's test (α = 0.05). RESULTS: YZ16 showed the greatest fracture load mean value, followed by YZ16-MC. Specimens from groups YZ9, IZ16, IZ16-MC, AL16 and AL16-MC showed no significant difference for the fracture load. SIGNIFICANCE: The failure behavior and stress distribution of FPDs was influenced by the type of IS. AL and IZ FPDs showed similar fracture load values but different failure modes and stress distribution. YZ showed the best mechanical behavior and may be considered the material of choice to produce posterior FPDs as it was possible to obtain a good mechanical performance even with a smaller connector dimension (9 mm(2)).

Flexural strength and failure modes of layered ceramic structures.

OBJECTIVE: To evaluate the effect of the specimen design on the flexural strength (σ(f)) and failure mode of ceramic structures, testing the hypothesis that the ceramic material under tension controls the mechanical performance of the structure. METHODS: Three ceramics used as framework materials for fixed partial dentures (YZ--Vita In-Ceram YZ; IZ--Vita In-Ceram Zirconia; AL--Vita In-Ceram AL) and two veneering porcelains (VM7 and VM9) were studied. Bar-shaped specimens were produced in three different designs (n=10): monolithic, two layers (porcelain-framework) and three layers (TRI) (porcelain-framework-porcelain). Specimens were tested for three-point flexural strength at 1MPa/s in 37°C artificial saliva. For bi-layered design, the specimens were tested in both conditions: with porcelain (PT) or framework ceramic (FT) layer under tension. Fracture surfaces were analyzed using stereomicroscope and scanning electron microscopy (SEM). Young's modulus (E) and Poisson's ratio (ν) were determined using ultrasonic pulse-echo method. Results were statistically analyzed by Kruskal-Wallis and Student-Newman-Keuls tests. RESULTS: Except for VM7 and VM9, significant differences were observed for E values among the materials. YZ showed the highest ν value followed by IZ and AL. YZ presented the highest σ(f). There was no statistical difference in the σ(f) value between IZ and IZ-FT and between AL and AL-FT. σ(f) values for YZ-PT, IZ-PT, IZ-TRI, AL-PT, AL-TRI were similar to the results obtained for VM7 and VM9. Two types of fracture mode were identified: total and partial failure. SIGNIFICANCE: The mechanical performance of the specimens was determined by the material under tension during testing, confirming the study hypothesis.

Effect of the microstructure on the lifetime of dental ceramics.

OBJECTIVES: To evaluate the effect of the microstructure on the Weibull and slow crack growth (SCG) parameters and on the lifetime of three ceramics used as framework materials for fixed partial dentures (FPDs) (YZ - Vita In-Ceram YZ; IZ - Vita In-Ceram Zirconia; AL - Vita In-Ceram AL) and of two veneering porcelains (VM7 and VM9). METHODS: Bar-shaped specimens were fabricated according to the manufacturer's instructions. Specimens were tested in three-point flexure in 37°C artificial saliva. Weibull analysis (n=30) and a constant stress-rate test (n=10) were used to determine the Weibull modulus (m) and SCG coefficient (n), respectively. Microstructural and fractographic analyzes were performed using SEM. ANOVA and Tukey's test (α=0.05) were used to statistically analyze data obtained with both microstructural and fractographic analyzes. RESULTS: YZ and AL presented high crystalline content and low porosity (0.1-0.2%). YZ had the highest characteristic strength (σ(0)) value (911MPa) followed by AL (488MPa) and IZ (423MPa). Lower σ(0) values were observed for the porcelains (68-75MPa). Except for IZ and VM7, m values were similar among the ceramic materials. Higher n values were found for YZ (76) and AL (72), followed by IZ (54) and the veneering materials (36-44). Lifetime predictions showed that YZ was the material with the best mechanical performance. The size of the critical flaw was similar among the framework materials (34-48µm) and among the porcelains (75-86µm). SIGNIFICANCE: The microstructure influenced the mechanical and SCG behavior of the studied materials and, consequently, the lifetime predictions.

Al2O3/GdAlO3 fiber for dental porcelain reinforcement.

The aim of this study was to test the hypothesis that the addition of continuous or milled GdAlO3/Al2O3 fibers to a dental porcelain increases its mechanical properties. Porcelain bars without reinforcement (control) were compared to those reinforced with long fibers (30 vol%). Also, disk specimens reinforced with milled fibers were produced by adding 0 (control), 5 or 10 vol% of particles. The reinforcement with continuous fibers resulted in significant increase in the uniaxial flexural strength from 91.5 to 217.4 MPa. The addition of varied amounts of milled fibers to the porcelain did not significantly affect its biaxial flexural strength compared to the control group. SEM analysis showed that the interface between the continuous fiber and the porcelain was free of defects. On the other hand, it was possible to note the presence of cracks surrounding the milled fiber/porcelain interface. In conclusion, the reinforcement of the porcelain with continuous fibers resulted in an efficient mechanism to increase its mechanical properties; however the addition of milled fibers had no significant effect on the material because the porcelain was not able to wet the ceramic particles during the firing cycle.

Effect of processing induced particle alignment on the fracture toughness and fracture behavior of multiphase dental ceramics.

OBJECTIVE: To investigate the processing induced particle alignment on fracture behavior of four multiphase dental ceramics (one porcelain, two glass-ceramics and a glass-infiltrated-alumina composite). METHODS: Disks (Ø12 mm x 1.1mm-thick) and bars (3 mm x 4 mm x 20 mm) of each material were processed according to manufacturer instructions, machined and polished. Fracture toughness (K(Ic)) was determined by the indentation strength method using 3-point bending and biaxial flexure fixtures for the fracture of bars and disks, respectively. Microstructural and fractographic analyses were performed with scanning electron microscopy, energy dispersive spectroscopy and X-ray diffraction. RESULTS: The isotropic microstructure of the porcelain and the leucite-based glass-ceramic resulted in similar fracture toughness values regardless of the specimen geometry. On the other hand, materials containing second-phase particles with high aspect ratio (lithium disilicate glass-ceramic and glass-infiltrated-alumina composite) showed lower fracture toughness for disk specimens compared to bars. For the lithium disilicate glass-ceramic disks, it was demonstrated that the occurrence of particle alignment during the heat-pressing procedure resulted in an unfavorable pattern that created weak microstructural paths during the biaxial test. For the glass-infiltrated-alumina composite, the microstructural analysis showed that the large alumina platelets tended to align their large surfaces perpendicularly to the direction of particle deposition during slip casting of green preforms. SIGNIFICANCE: The fracture toughness of dental ceramics with anisotropic microstructure should be determined by means of biaxial testing, since it results in lower values.

Influence of pH on slow crack growth of dental porcelains.

OBJECTIVES: To evaluate the effect of pH of storage medium on slow crack growth (SCG) parameters of dental porcelains. METHODS: Two porcelains were selected: with (UD) and without (VM7) leucite particles, in order to assess if the microstructure would affect the response of the material to the pH variation. Disc specimens were produced following manufacturers' instructions. Specimens were stored in artificial saliva in pHs 3.5, 7.0 or 10.0 for 10 days and after that the fatigue parameters (n: SCG susceptibility coefficient and sigma(0): scaling parameter) were obtained by the dynamic fatigue test using the same pH of storage. Microstructural analysis of the materials was also performed. RESULTS: For VM7, the values of n obtained in the different pHs were similar and varied from 29.9 to 31.2. The sigma(0) value obtained in pH 7.0 for VM7 was higher than that obtained in the other pHs, which were similar. For porcelain UD, n values obtained in pHs 7.0 and 10.0 were similar (40.8 and 39.6, respectively), and higher than that obtained in pH 3.5 (26.5). With respect to sigma(0), the value obtained for porcelain UD in pH 10.0 was lower than those obtained in pHs 3.5 and 7.0, which were similar. SIGNIFICANCE: The effect of pH on the stress corrosion susceptibility (n) depended on the porcelain studied. While the n value of VM7 was not affected by the pH, UD presented lower n value in acid pH. For both porcelains, storage in acid or basic pH resulted in strength degradation.