Methodological approaches in graded dental ceramics: a scoping review protocol.

OBJECTIVES: This review will map the various methodological approaches used in graded dental ceramics and distinguish their material characteristics and properties. The aim is to identify gaps in the development and application of grading in dental ceramic systems. INTRODUCTION: The advantage of functionally graded materials is the absence of the weakest link, with no distinct boundaries, thereby eliminating the possibility of stress concentrations at the interfaces. Functionally graded materials are well established in nature, such as in human teeth, bone, and the bio-tissues of plants and animals. This concept has also been explored in dental ceramics to enhance fatigue resistance and strength. INCLUSION CRITERIA: This review will include observational studies and interventional studies, such as in vitro and experimental studies, on functionally graded dental ceramic systems. Studies that use finite element analysis to evaluate stress distributions, and studies on the mechanical performance of graded dental ceramics, irrespective of the type of ceramic material, design, or thickness of graded layers, will be considered. METHOD: The review will follow the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. MEDLINE (PubMed), Scopus, ProQuest Dissertations and Theses (EBSCOhost), Cochrane CENTRAL, and Google Scholar will be searched for English language studies. The search strategy will be based on MeSH terms and free-text specific terms, and will be adapted for each database. Two independent reviewers will screen titles and abstracts, and extract data from selected sources. The data extracted from the selected studies will be analyzed and presented in the form of tables and figures. REVIEW REGISTRATION: Open Science Framework: https://osf.io/ahsp7.

Methodological approaches in graded dental ceramics.

BACKGROUND: Functionally graded materials (FGM) with indistinct boundaries potentially eliminate the damaging stresses occurring at the interfaces. FGM applications in dental ceramics have enhanced their fatigue resistance and interfacial toughness. OBJECTIVES: This scoping review aims to map graded designs in dental ceramics, distinguish their methodological approaches with their material characteristics and properties, and understand the factors affecting the outcomes of each of the graded approaches. METHODS: A systematic electronic search was performed with the databases MEDLINE (PubMed), Scopus, Cochrane Library, EBSCO, and Google Scholar along with a manual search. RESULTS: About 2675 articles were initially found from all the searches with no date restriction till July 2023. After rejecting duplicates and based on exclusion criteria, about 52 articles were included. SIGNIFICANCE: Methodological approaches in grading such as glass-infiltration and silica-infiltration have been investigated on pre-sintered zirconia. The type of infiltration and the method of infiltrate application significantly influenced the phase transformation of zirconia, its microstructure, surface hardness, fracture toughness, flexural strength, wear, and fatigue strength of graded dental zirconia. Interlayers were accommodated between metal-ceramic and veneer-core all-ceramic layers. Fractions of zirconia-porcelain and alumina-porcelain showed high bending strength and better stress distribution. The results of finite element analysis studies predicted that using 10-layered graded layers reduced the stresses at the crown-cement-dentin interface.

Investigation of Spark Plasma Sintering on Microstructure-Properties of Zirconia Reinforced Fluormica Glass for Dental Restorations.

BACKGROUND: Conventional sintering methods of dental ceramics have limitations of high temperature and slow cooling rates with requirements of additional heat treatment for crystallization. Spark plasma sintering (SPS) is an emerging technique that has the potential to process dental restorations with dense microstructures and tailor-made clinically relevant properties with optimized processing parameters. This study explored the potential of the SPS of zirconia-reinforced fluormica glass (FM) for dental restorative materials. METHODS: FM glass frit was obtained through the melt-quench technique (44.5 SiO2-16.7 Al2O3-9.5 K2O-14.5 MgO-8.5 B2O3-6.3 F (wt.%)). The glass frit was ball-milled with 20 wt.% of 3 mol% yttria-stabilized zirconia (FMZ) for enhanced fracture toughness. The mixtures were SPS sintered at a pressure of 50 MPa and a heating rate of 100 °C/min for 5 min with an increase in temperature from 650-750 °C-850 °C-950 °C. Phase analysis was carried out using XRD and microstructural characterization with SEM. Micro-hardness, nano-indentation, porosity, density, indentation fracture toughness, and genotoxicity were assessed. CONCLUSIONS: The increase in the SPS temperature of FMZ influenced its microstructure and resulted in reduced porosity, improved density, and optimal mechanical properties with the absence of genotoxicity on human gingival fibroblast cells.