Fracture characteristics and translucency of multilayer monolithic zirconia crowns of various thicknesses.

OBJECTIVES: Multilayer monolithic zirconia (M-Zr) crowns can be engineered to achieve gradational translucency and color intensity. However, this modification may compromise the mechanical strength, raising concerns regarding the ability of M-Zr crowns to withstand occlusal stresses. The effects of M-Zr crown thickness on translucency and ability to endure occlusal forces were investigated at different tooth positions (incisors, premolars, and molars). The objective was to determine the minimal thickness of M-Zr crowns used in tooth preparation to meet aesthetic and functional demands. METHODS: M-Zr samples (Vita A1) with four thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were prepared and subjected to translucency testing using a digital colorimeter by 3-third and 9-square division methods. Crown-shaped M-Zr samples with three thicknesses (1.0, 1.5, and 2.0 mm) and three tooth positions (incisor, premolar, and molar) were digitally designed, and 2.0 mm metal abutments were fabricated. The samples were bonded to the abutments; their fracture characteristics were evaluated using a universal testing machine, and their fracture surfaces examined using an optical microscope. Statistical analyses included the Shapiro-Wilk test, Pearson correlation, and one-way and two-way ANOVA with a post hoc Tukey HSD test (α = 0.05). RESULTS: Color analysis results revealed a significant negative correlation between thickness and translucency (r < -0.96, P < 0.01), with the highest values in the incisal region. Cross-sectional profiles confirmed the uniform thickness and morphology of the digitally designed M-Zr crowns. The results of fracture strength analysis showed position-dependent variability, a strong positive correlation with thickness (r > 0.96, P < 0.01), and fracture strengths consistently exceeding 1200 N across all tooth positions. Fracture patterns indicated that thinner crowns at the incisors and molars were more prone to cracking, whereas those at the premolars demonstrated significantly higher strength (4872.51 N, P < 0.05), only with crack or even no fracture occurring at 2.0 mm. CONCLUSIONS: Thickness significantly influenced both the translucency and fracture strength of M-Zr, with the tooth position playing an additional role, albeit to a lesser extent. Although thinner crowns exhibited lower strength at each tooth position, even at a thickness of 1.0 mm, fracture strength exceeding 1200 N was maintained, surpassing the typical occlusal forces. Thus, it can be asserted that M-Zr crowns with a minimum thickness of 1.0 mm can meet both aesthetic and functional requirements.

Evaluation of shade correspondence between high-translucency pre-colored zirconia and shade tab by considering the influence of cement shade and substrate materials.

Statement of problem: The relation between cement color and abutment substrate material and the corresponding effect on the color accuracy of high-transparency pre-colored zirconia (HT-Zr) remains unclear. Purpose: This in-vitro study aimed to investigate the difference in color accuracy when the HT-Zr is bonded to different materials-based substrates with differently colored resin cement. Materials and methods: Vita A1 shade HT-Zr with 1 mm thickness was used as the testing sample. The samples were first placed on zirconia (ZR), tooth color resin (CR), and metallic (MT) abutment substrates. Subsequently, four differently colored cements (translucent (TR), bleach, opaque, and A2 shade (A2)) were used for bonding HT-Zr onto the substrate, and the non-bonded group was used as the control group (CG). There were 15 groups in total (n = 10 per group). A digital colorimeter was used to obtain Commission Internationale de l'Eclairage (CIELab) color parameters. The translucency parameter (TP00) of the substrate and sample, as well as color difference (ΔE00) and chroma (C) between the different groups were calculated. Additionally, the ΔE00 and TP00 were compared with the moderately unacceptable match of ΔE00 = 3.6. The statistical analysis was conducted using ANOVA and Tukey HSD post-hoc test (α = 0.05). Results: HT-Zr exhibited high translucency (TP00 = 11.02 ± 0.18), and the mean ΔE00 of the testing samples ranged between 2.18 ± 0.20 and 13.14 ± 0.31. The ZR-CG and MT-A2 groups showed the highest and lowest lightness separately. The CR-CG group exhibited the highest C, and the ΔE00 was lower than that of 3.6. The MT-TR group showed the lowest C and the highest ΔE00. The inter-group comparison revealed that the ΔE00 for different cement is mostly lower than the acceptable color match of 1.0; moreover, the ΔE00 for all the substrates, excluding the CG group, is higher than 3.6. Conclusions: The abutment substrate materials and the cement color should be considered with caution when using HT-Zr, with the effect of abutment substrate materials being more apparent in color accuracy. HT-Zr restorations are not recommended for discolored or bleached abutments but only for natural-colored abutments to achieve the optimal color appearance.

Innovation Glass-Ceramic Spray Deposition Technology Improving the Adhesive Performance for Zirconium-Based Dental Restorations.

Glass-ceramic spray deposition (GCSD) is a novel technique for coating lithium disilicate (LD) glass-ceramics onto zirconia through simple tempering steps. GCSD has been proven to improve the bonding of zirconia to resin cement, but the effect of etching time on GCSD and the long-term durability of the bond achieved remain unknown. The effects of air abrasion with aluminum particles (ABB) and air abrasion (GAB) or etching with 5.0% hydrogen fluoride (HF) for 20, 60, 90, and 120 s (G20, G60, G90, and G120) on the resin cement−zirconia bond were studied. LD was included as a control (LDG). The microstructure, sub-micron roughness, wettability, and phase changes of samples were analyzed. After resin cement was bonded to zirconia, half of the samples were subjected to thermocycling (5000 cycles at 5−55 °C). The bond strengths of the samples were determined in shear bond strength (SBS) tests (n = 10 per group). An LD structure can be formed on zirconia after GCSD and proper etching processes, which result in high roughness and a hydrophilic nature. GCSD and HF etching significantly improved SBS, with G90 and G120 samples with pre- or post-thermocycling exhibiting SBS values comparable to those of LDG (p > 0.760). The surface characteristics of the LD layer are influenced by the etching time and affect the SBS of the bond of zirconia to resin cement. HF etching for 90−120 s after GCSD results in zirconia with SBS and bond durability comparable to LD.

Evaluating the Effect of Different Polymer and Composite Abutments on the Color Accuracy of Multilayer Pre-Colored Zirconia Polycrystal Dental Prosthesis.

With increasing aesthetic awareness and emphasis on time costs in today's society, monolithic multilayer precolored zirconia ceramics (M-Zr) facilitate aesthetic restorations in a convenient and straightforward manner without the need for veneering porcelain to modify the color. However, the effect of abutment materials on the final color of M-Zr remains unclear. Herein, we placed Vita A1 Shade M-Zr on six different abutment materials, zirconia (Y-TZP), 3D printed composite resin (CR), dental model resin (MR), polyetheretherketone (PEEK), polyetherketoneketone (PEKK), and cobalt−chromium alloy (Co−Cr), to evaluate their effect on the color accuracy of M-Zr. The color attributes (L*, a*, and b*) were measured using a dental spectrophotometer. The translucency parameter (TP), contrast ratio, color difference (ΔE) between each background substrate and the Vita A1 Shade Guide, and chroma values (C) were calculated to evaluate the color accuracy of M-Zr. A statistical analysis was performed using one-way analysis of variance and post hoc Tukey's HSD tests (α = 0.05). The experimental results indicate that the TP values and contrast ratio of the M-Zr samples were 14.85 and 0.83, respectively. Co−Cr had the highest ΔE (6.08) and lowest C value (7.52); PEKK had the lowest ΔE (2.60), and PEEK had the highest C value (12.23) (p < 0.05). Notably, the ΔE values of CR (3.13), PEEK (2.86), and PEKK were within clinical indicators (ΔE < 3.7). Based on these results, it can be concluded that the abutment material has a significant effect on the final color of the M-Zr, and PEEK or PEKK resulted in good color accuracy. When choosing the dental MR, traditional zirconia, or metals as abutment materials, colored or opaque cement might be required to eliminate color distortion and achieve desirable optical properties.

Effects of thickness of different types of high-translucency monolithic multilayer precolored zirconia on color accuracy: An in vitro study.

STATEMENT OF PROBLEM: High-translucency monolithic multilayer precolored zirconia provides acceptable esthetics and eliminates chipping of the veneering porcelain. However, the color is not always consistent with the standard Vita shade guide, and the color saturation may vary with the thickness of the zirconia. PURPOSE: The purpose of this in vitro study was to characterize the effect of thickness on the color accuracy of high-translucency monolithic multilayer precolored zirconia. MATERIAL AND METHODS: Plate-shaped (20×20 mm) Vita A2 shade high-translucency monolithic multilayer precolored zirconia specimens of 3 types (SHT Multilayer, AT Multilayer, and 3D Multilayer) in 4 thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were fabricated (N=120, n=10). A spectrophotometer was used to measure the color attributes (CIELab) against gray or A2 substrates to evaluate the color accuracy based on differences in color (ΔE) (versus the Vita shade guide) and chroma. Statistical analysis was performed by using the Pearson correlation, 2-way ANOVA, and post hoc Scheffé test (α=.05). RESULTS: Against gray substrates, thickness was significantly positively correlated with all color attributes. Against A2 substrates, L∗ values increased with an increase in thickness; however, a∗, b∗, and chroma values remained stable. Zirconia with a thickness of 1.0 mm exhibited the lowest ΔE, regardless of the type, except for AT Multilayer against A2 substrates, where the lowest ΔE was achieved at 0.5 mm. At thicknesses ≥1.0 mm, the ΔE between the 2 substrates was imperceivable. CONCLUSIONS: Thickness affected the color accuracy of different high-translucency monolithic multilayer precolored zirconia types. It appears that the optimal thickness in terms of color accuracy is 1.0 mm. These results could be used as a reference for the selection and preparation of abutments in clinical applications.

Color accuracy of different types of monolithic multilayer precolored zirconia ceramics.

STATEMENT OF PROBLEM: The use of monolithic multilayer precolored zirconia facilitates the production of esthetic restorations in a convenient and straightforward manner. However, the accuracy of the final color is not clear. PURPOSE: The purpose of this in vitro study was to determine the color accuracy of different types of monolithic multilayer precolored zirconia ceramics of varying thicknesses. MATERIAL AND METHODS: Eighty cubical A2-shade monolithic multilayer precolored zirconia ceramic specimens (15×15 mm) of 2 different thicknesses (1.0 mm and 1.5 mm) and 4 zirconia brands (UPCERA EXPLORE [UPEX], KATANA Zirconia STML [STML], Enamel ZR Multi-5 [EZM5], and Aidite 3D Pro Zir [A3DM]) were fabricated and divided into 8 groups (n=10). The Commission Internationale de l'Eclairage (CIELab) values were measured against 3 different backing substrates (gray, transparent, and A2) by using a spectrophotometer. The color difference (ΔE) between the backing substrates of each group and the Vita A2 Shade Guide, translucency parameter (TP), and chroma (C) values were calculated to evaluate the accuracy of the final color. Statistical analysis was performed by using ANOVA and the post hoc Tukey HSD tests (α=.05). RESULTS: The ΔE values for UPEX and STML exceeded the clinically acceptable thresholds for gray and transparent backing substrates (ΔE>3.7) and were higher than those for the A2 backing substrate. A3DM showed less ΔE from the shade guide for all the backing substrates (P<.05), and the corresponding ΔE values were within the clinically acceptable threshold (ΔE<3.7). The TP value was inversely proportional, and the C value was proportional to thickness. For the zirconia ceramics with identical thicknesses, UPEX and STML exhibited the highest TP values, and A3DM showed the lowest C value (P<.05). CONCLUSIONS: At a specific thickness, color accuracy was mainly affected by the type of monolithic multilayer precolored zirconia ceramic, and the high transparency of ceramics will cause color differences.