Effect of slow-cooling protocol on biaxial flexural strengths of bilayered porcelain-ceria-stabilized zirconia/alumina nanocomposite (Ce-TZP/A) disks.

OBJECTIVE: The present study investigated the biaxial flexural strengths of bilayered ceria-stabilized zirconia/alumina nanocomposite (Ce-TZP/A) disks with various layering porcelains veneered using a slow-cooling protocol. METHODS: Five porcelain materials (VITA VM9, Cercon Ceram Kiss, and Vintage ZR with experimental coefficient of thermal expansions; CTEs of 8.45, 9.04, and 9.61ppm/°C) were veneered on Ce-TZP/A disks and slow-cooled after firing to fabricate bilayered specimens (core-to-porcelain thickness: 0.8mm/1.5mm). Biaxial flexural strengths of the specimens with the porcelain layer in tension were tested based on the piston-on-three-ball method (ISO 6872:2008). The data were statistically analyzed using Weibull distribution and Fisher's exact test. RESULTS: Tensile stresses were observed in the entire porcelain layer while compressive stress at the surface of the Ce-TZP/A layer shifted to tensile stress at the interface between the materials. The cases of small CTE mismatches between the materials showed high Weibull characteristic strengths at the internal and external surfaces of the specimens, except the VM9 group (CTE: 9.0-9.2ppm/°C). The maximum tensile stress was observed on the surface of the porcelain layer, where cracks originated and continuously propagated into the Ce-TZP layer. The Ce-TZP/A fractured into two pieces for large CTE mismatches between the materials, resulting in significantly lower flexural strengths than those fracturing into three pieces for small CTE mismatches. SIGNIFICANCE: Flexural strengths and fracture behaviors of bilayered porcelain-Ce-TZP/A disks were influenced by the CTE mismatches, and a small CTE mismatch between the materials was preferred when using a slow-cooling protocol.

Biaxial flexural strength of the bilayered disk composed of ceria-stabilized zirconia/alumina nanocomposite (Ce-TZP/A) and veneering porcelain.

OBJECTIVE: Herein we investigated the flexural strengths of bilayered ceria-stabilized zirconia/alumina nanocomposite (Ce-TZP/A) disks using different veneering porcelains. METHODS: Commercial (VITA VM9, Cercon Ceram Kiss, and IPS e.max Ceram) and experimental porcelains (Vintage ZR with coefficient of thermal expansions: CTEs of 8.45, 9.04, and 9.61ppm/°C) with various layer thicknesses (1.0, 1.5, and 2.0mm) were applied to Ce-TZP/A disks (0.8mm thickness, n=180). Biaxial flexural tests of the specimens with the porcelain layer in tension were evaluated based on the piston-on-three-ball method (ISO 6872: 2008). The calculated strengths were statistically analyzed using the two-parameter Weibull distribution with the maximum likelihood estimation. RESULTS: Although no significant differences were observed among the experimental porcelains, most specimens with the thinner layer of commercial porcelain showed higher Weibull characteristic strengths at the external surfaces than those with the thicker layer. Irrespective of the porcelain material, the thinner porcelain layer showed significantly higher strengths at the interface between the layers. Fracture origins were always observed at the bottom surface and continuously propagated into Ce-TZP/A substrates. The maximum tensile stress was located at the interface in specimens with the 1.0mm porcelain layer, except for IPS e.max Ceram. Porcelain delamination was dominant in the case of the higher CTE value and thicker layer thickness of the porcelain. SIGNIFICANCE: The calculated biaxial flexural strengths and the stress distributions for bilayered Ce-TZP/A disks were dependent on the porcelain materials. Optimum behavior was observed for a combination of a small CTE mismatch between the materials and a low core-to-porcelain thickness ratio.

Fixed Dental Prostheses and Single-Tooth Crowns Based on Ceria-Stabilized Tetragonal Zirconia/Alumina Nanocomposite Frameworks: Outcome After 2 Years in a Clinical Trial.

PURPOSE: This clinical trial tested bilayered restorations based on ceria-stabilized tetragonal zirconia/alumina frameworks veneered with feldspathic ceramic. MATERIALS AND METHODS: A total of 67 crowns and 40 fixed dental prostheses (FDPs) were luted in 57 patients with self-etching/self-adhesive composite resin cement. Dental status and integrity of restorations were evaluated at 2 weeks, 6 months, and then annually. RESULTS: A total of 66 crowns and 36 FDPs (88% posterior) survived for success rates of 93.4% for crowns and 89% for FDPs at 2 years. In particular, 11 cohesive ceramic chippings were observed in 5 crowns and 6 FDPs. CONCLUSION: The material allows excellent marginal adaptation. Susceptibility to veneering failures might be due to framework design and the necessities of esthetics.