Impact of High-Speed Sintering of Three-Unit 3Y-TZP and 4Y-TZP Fixed Dental Prostheses on Fracture Load With and Without Artificial Aging.

PURPOSE: To investigate the impact of high-speed sintering and artificial aging on the fracture load of three-unit zirconia fixed dental prostheses (FDPs). MATERIALS AND METHODS: Three-unit FDPs manufactured from 3Y-TZP (Ceramill Zolid, Amann Girrbach) and 4Y-TZP (Ceramill Zolid HT+, Amann Girrbach; N = 128, n = 64/group) were sintered at 1,580°C (high-speed sintering) or at 1,450°C (control group; n = 32/subgroup). Specimens were bonded to steel abutment models using Multilink Automix (Ivoclar Vivadent), and fracture load was examined without (n = 16/subgroup) and with artificial aging (6,000 thermocycles [5°C/55°C] and 1,200,000 chewing cycles [50 N]; n = 16/subgroup). Univariate analysis of variance, unpaired t test, and Weibull modulus were computed (P < .05). RESULTS: Sintering protocol (P = .944), artificial aging (P = .630), and zirconia material (P = .445) did not show an influence on the fracture load of three-unit FDPs. High-speed sintering led to superior Weibull modulus results for artificially aged 4Y-TZP specimens, while all other groups showed values in the same range. CONCLUSION: The present study shows promising results for the novel high-speed sintering protocol, as it led to comparable fracture load and similar, or even superior, Weibull modulus results compared to the control group. The 4Y-TZP material presented fracture load results similar to the tried-and-tested 3Y-TZP. Artificial aging did not influence zirconia's resistance to fracture for either 3Y-TZP or 4Y-TZP.

Translucency, flexural strength, fracture toughness, fracture load of 3-unit FDPs, Martens hardness parameter and grain size of 3Y-TZP materials.

OBJECTIVE: This investigation tested pre-shaded 3Y-TZP materials on optical, mechanical and structural properties and calculated correlations between these properties. METHODS: Seven A2-shaded 3Y-TZP zirconia materials were investigated on translucency (T) via UV-vis-spectrophotometer, fracture load of 3-unit FDPs (FL), biaxial flexural strength (FS), Chevron-Notch Beam (CNB), fracture toughness (KIC) and Martens parameter (hardness: HM and indentation modulus: EIT). FL, FS and KIC were measured in a universal testing machine. The grain size was evaluated by scanning electron microscopy (SEM). Data was analyzed using one-way ANOVA followed by post hoc Scheffé, Kruskal-Wallis-, Mann-Whitney-U- and Pearson-test (p<0.05). RESULTS: For translucency, negative correlations were found with results of facture load (R=-0.444, p<0.001) and KIC (R=-0.503, p<0.001). While a positive correlation was found between translucency and flexural strength (R=0.238, p=0.019), between fracture load and EIT (R=0.227, p<0.029), between fracture load and KIC (R=0.362, p<0.001) as well as between fracture load and the grain size (R=0.598, p=0.007). While the grain size positively correlated with EIT (R=0.534, p=0.017) as well as EIT with HM (R=0.720, p<0.001). SIGNIFICANCE: Despite of being based on the same raw material, tested zirconia materials significantly differed regarding optical, mechanical (except biaxial flexural strength and Martens hardness) and structural properties. Materials with highest optical properties were those with lowest mechanical properties (CER, COP).

Impact of high-speed sintering, layer thickness and artificial aging on the fracture load and two-body wear of zirconia crowns.

OBJECTIVE: To investigate the impact of high-speed sintering, layer thickness and artificial aging in a chewing simulator on the fracture load (FL) and two-body wear (2BW) of 4Y-TZP crowns. METHODS: 4Y-TZP crowns (Ceramill Zolid HT+, Amann Girrbach AG) in three different layer thicknesses (0.5, 1.0, 1.5; N=192, n=64/group) were manufactured using CAD/CAM technology and sintered at 1580°C (high-speed sintering) or 1450°C (control group). Specimens were polished in two-steps and bonded to standardized CoCr abutments with Multilink Automix (Ivoclar Vivadent). 2BW after 6000 thermo- and 1,200,000 chewing-cycles employing enamel antagonists was determined using best fit machining. FL was tested before and after artificial aging. Univariate ANOVAs, post hoc Scheffé, unpaired t-, Kruskal-Wallis- and Mann-Whitney-U-test were computed (p<0.05). RESULTS: High-speed sintering resulted in less 2BW of the zirconia than the control group (p=0.013). High-speed sintering (p=0.001-0.006) and an increase in layer thickness (p<0.001-0.012) resulted in higher FL values, while artificial aging led to a reduction of FL (p<0.001). SIGNIFICANCE: As high-speed sintering resulted in less two-body wear of the zirconia and comparable or even higher fracture load results than the control group, this cost- and time efficient alternative presents promising mechanical results.

Different polishing methods for zirconia: impact on surface, optical, and mechanical properties.

OBJECTIVES: To test the impact of polishing strategies on zirconia properties. MATERIALS AND METHODS: One hundred eight zirconia specimens were divided into nine groups (n = 12/group). Seven groups were polished in the white-stage with either (1) a felt wheel (FW), (2) a felt wheel combined with a polishing paste (FWP), (3) a goat hair brush (GB), (4) a goat hair brush combined with a polishing paste (GBP), (5) a green-state finishing kit (FK), (6) a universal polisher (UP), or (7) with SiC polishing paper (PP), and sintered. Thereafter, the seven groups were divided into two subgroups each and polished using (1) a fine polisher (one-step, n = 6) or (2) a rough and fine polisher (two-steps, n = 6). The positive control group (polish-lab-kit, PLK) was sintered and polished in two-steps. The no polished group (NP) acted as negative control group. Translucency (T%) was measured after white-stage polishing and sintering, and after sintered-stage polishing. Surface free energy (SFE), surface roughness (SR), and flexural strength (FS) were determined. Data were analyzed using one-way ANOVA with Tukey-B post-hoc, t test, and Wilcoxon-test (p < 0.05). RESULTS: FWP, GB, FK, UP, and PP presented decreased T% after one-step, while FWP, GB, GBP, FK, and UP presented decreased T% following two-steps polishing. FW showed the highest T% after white-stage, one-, and two-steps polishing. PP presented the lowest SFE. Two-steps polishing resulted in a lower SR for FW, FWP, GB, FK, UP, and PP and increased FS in all groups. CONCLUSIONS: White-stage polishing improved zirconia properties. Two-steps polishing in the sintered stage, especially when combined with a polishing paste, can decrease SR and increase T% and FS. CLINICAL RELEVANCE: With polishing in the sintered-stage impairing the polishing material and being time consuming, alternatives such as white-stage polishing should be investigated.

Impact of high-speed sintering on translucency, phase content, grain sizes, and flexural strength of 3Y-TZP and 4Y-TZP zirconia materials.

STATEMENT OF PROBLEM: The lengthy sintering time of zirconia is costly and limits applications. The consequences of shortening the sintering time are mainly unknown. PURPOSE: The purpose of this in vitro study was to test and compare 2 high-speed sintering protocols and 1 conventional sintering protocol on the translucency, phase content, grain sizes, and flexural strength of 3 zirconia materials. MATERIAL AND METHODS: In total, 450 specimens of 3 zirconia materials-two were 3 mol% yttria-stabilized tetragonal zirconia polycrystals (3Y-TZPs), Ceramill ZI and Zolid (ZD), and a 4 mol% yttria-stabilized tetragonal zirconia polycrystal (4Y-TZP), Zolid HT+ (n=150)-and 5 thicknesses (1.0, 1.5, 2.0, 2.5, and 3.0 mm; n=30) were sintered according to 2 high-speed sintering protocols (final temperature 1570 °C and 1590 °C; n=10) and a reference sintering protocol (1450 °C; n=10). After measuring the monoclinic phase content with Raman spectrometry (n=3), the specimens were polished, and translucency was determined. The biaxial flexural strength of specimens with a thickness of 1.0 mm and 1.5 mm was tested (n=20). Statistical evaluation included 1-way ANOVA, the Kolmogorov-Smirnov, Kruskal-Wallis, Mann-Whitney-U, and Spearman-Rho tests and the Bonferroni correction (α=.0011). RESULTS: For ZI, the sintering protocols did not affect the translucency or biaxial flexural strength. ZD and HT+ showed significantly lower translucency for high-speed sintering protocols (P≤.001), but the biaxial flexural strength remained the same after the high-speed sintering protocol at 1590 °C. Grain sizes increased with increasing final sintering temperature for ZI and HT+, whereas translucency generally decreased with increasing material thickness. No monoclinic phase was detected in any group. CONCLUSIONS: The flexural strength was maintained with high-speed sintering but led to a decrease in translucency for ZD and HT+.

The human papillomavirus type 8 E2 protein induces skin tumors in transgenic mice.

Transgenic mice expressing early genes of the cutaneous human papillomavirus 8 (HPV8) spontaneously develop skin papillomas, epidermal dysplasia, and squamous cell carcinoma (6%). As the HPV8 protein E2 revealed transforming capacity in vitro, we generated three epidermal specific HPV8-E2-transgenic FVB/N mouse lines to dissect its role in tumor development. The rate of tumor formation in the three lines correlated with the different E2-mRNA levels. More than 60% of heterozygous line 2 mice, but none of the HPV8-negative littermates, spontaneously developed ulcerous lesions of the skin over an observation period of up to 144 weeks, beginning on average 74+/-22 weeks after birth. Most lesions presented infundibular hyperplasia and acanthosis combined with low-grade dysplasia. Severe dysplasia of the epidermis occurred in 6%. Two carcinomas revealed a sharply demarcated spindle-cell component. Only 3 weeks after a single UV irradiation, 87% of heterozygous line 2 and 36% of line 35 mice developed skin tumors. A rapidly growing invasive tumor composed of spindle cells arose 10 weeks after irradiation of a line-35 animal. The histology of skin cancers in HPV8-E2 mice is reminiscent of a subset of highly aggressive squamous cell carcinoma in immunosuppressed transplant recipients with a massive spindle-cell component.

Expression of matrix metalloproteinase (MMP)-2, MMP-9, MMP-13, and MT1-MMP in skin tumors of human papillomavirus type 8 transgenic mice.

Human papillomaviruses (HPV) are small DNA viruses that induce a wide variety of hyperproliferative lesions in cutaneous and mucosal epithelia. It is proposed that HPV is involved in non-melanoma skin cancer development. We have previously shown that HPV8 transgenic mice spontaneously develop papillomatous skin tumors. Histology revealed epidermal hyperplasia, acanthosis and hypergranulosis and in some cases squamous cell carcinomas (SCC). Zymographic and immunoblot analysis of normal skin extracts identified increased amounts of matrix metalloproteinase (MMP)-9, MMP-13 and MT1-MMP in HPV8-positive mice compared with HPV8-negative animals. In situ gelatin zymography of tumor specimens displayed a strong proteolytic activity in papillomas, and SCC putatively attributed to the increased amounts of activated MMP-9 found in tissue extracts. In addition, immunoblot analysis revealed increased amounts of active MMP-13 and MT1-MMP in tumor extracts as compared with control extracts. Immunohistochemical stainings of SCC specimens depicted MMP-13 to be specifically expressed in stromal fibroblasts neighboring the tumor islands, whereas MT1-MMP was detected both in tumor cells and in stromal cells. Taken together, these results implicate a role for MMPs in the development of HPV8-induced cutaneous tumors.