Mechanical properties of 3D-printed and milled composite resins for definitive restorations: An in vitro comparison of initial strength and fatigue behavior.

OBJECTIVE: To evaluate the flexural strength and fatigue behavior of a novel 3D-printed composite resin for definitive restorations. MATERIALS AND METHODS: Fifty disc-shaped specimens were manufactured from each of a nanohybrid composite resin (NHC), polymer-infiltrated ceramic network (PICN), and 3D-printed composite resin (3D) with CAD-CAM technology. Biaxial flexural strength (σin ) (n = 30 per group) and biaxial flexural fatigue strength (σff ) (n = 20 per group) were measured using piston-on-three-balls method, employing a staircase approach of 105 cycles. Weibull statistics, relative-strength degradation calculations, and fractography were performed. The results were analyzed with 1-way ANOVA and Games-Howell post hoc test (α = 0.05). RESULTS: Significant differences in σin and σff among the groups (p < 0.001) were detected. The NHC group provided the highest mean ± standard deviation σin and σff (237.3 ± 31.6 MPa and 141.3 ± 3.8 MPa), followed by the PICN (140.3 ± 12.9 MPa and 73.5 ± 9.9 MPa) and the 3D (83.6 ± 18.5 MPa and 37.4 ± 23.8 MPa) groups. The 3D group exhibited significantly lower Weibull modulus (m = 4.7) and up to 15% higher relative strength degradation with areas of nonhomogeneous microstructure as possible fracture origins. CONCLUSIONS: The 3D-printed composite resin exhibited the lowest mechanical properties, where areas of nonhomogeneous microstructure developed during the mixing procedure served as potential fracture origins. CLINICAL SIGNIFICANCE: The clinical indications of the investigated novel 3D-printed composite resin should be limited to long-term provisional restorations. A cautious procedure for mixing the components is crucial before the 3D-printing process, since nonhomogeneous areas developed during the mixing could act as fracture origins.

Influence of nanostructured alumina coating on the clinical performance of zirconia cantilevered resin-bonded fixed dental prostheses: Up to 3-year results of a prospective, randomized, controlled clinical trial.

STATEMENT OF PROBLEM: The debonding of zirconia cantilevered resin-bonded fixed dental prostheses remains a technical complication because zirconia's chemical inertness impedes adequate surface preparation for bonding. Limited clinical evidence on the performance of various pretreatment methods for the bonding surface of zirconia resin-bonded fixed dental prostheses is available. PURPOSE: The present prospective, randomized, controlled clinical trial aimed at evaluating the performance of zirconia resin-bonded fixed dental prostheses prepared with nanostructured alumina coating. MATERIAL AND METHODS: The study adopted a prospective, randomized, controlled, double-blind (patients, operator) design to compare the performance of nanostructured alumina coating with that of conventional airborne-particle abrasion. Twenty-seven healthy patients needing a replacement of a missing maxillary or mandibular central or lateral incisor were screened and rated to be eligible, and 31 zirconia cantilevered resin-bonded fixed dental prostheses were randomly allocated into 1 of 2 groups. The first group (n=15), where the restoration bonding surface was airborne-particle abraded with 50-µm alumina, served as a control group. In the second group (n=16), the restorations were pretreated with nanostructured alumina coating. Treatment and data collection were standardized. The primary outcome evaluated was the survival of the RBFDPs as defined by the restoration not debonding. The Kaplan-Meier analysis of cumulative survival was performed, and nonparametric tests were used to determine patient-specific differences between both study groups (age, sex, restored arch, tooth replaced, bonding surface area) (α=.05). Retainer wing surfaces of debonded resin-bonded fixed dental prostheses were inspected under a scanning electron microscope. RESULTS: Within a mean ±standard deviation observation period of 22.4 ±7.7 months (minimum, 8.3; maximum, 37.9 months), 3 debondings occurred, and the survival rate was 90.3%. The survival rate was 93.8% for the nanostructured alumina coating and 86.7% for the control group, with no statistically significant differences (log-rank, P=.54). No patient-specific differences were found between study groups (P>.05). As per the scanning electron micrographs, the majority of the nanostructured alumina-coated surfaces had large areas of nanostructured alumina residue, whereas the airborne-particle abraded surfaces exhibited predominantly adhesive failure with less cement residue. CONCLUSIONS: Over a mean observation period of 2 years, both zirconia pretreatments showed promising and comparable clinical results; therefore, nanostructured alumina coating could be regarded as a viable alternative pretreatment method to airborne-particle abrasion.

Anterior Esthetic Rehabilitation of an Alveolar Cleft Using Novel Minimally Invasive Prosthodontic Techniques: A Case Report.

Missing lateral incisors are the most frequent dental disorder associated with cleft alveolus. When orthodontic closure of the edentulous space is not possible, more aggressive prosthodontic treatments are required. Contemporary resin-bonded fixed dental prostheses (RBFDPs) represent a promising, time-efficient alternative treatment with fewer biological complications. This clinical report proposes a modified approach to the esthetic rehabilitation of a patient with a complete unilateral cleft lip and palate on the left side and an incomplete cleft lip and alveolar cleft on the right side. Digital diagnostics, treatment planning, and clinical procedures involved in the fabrication of facially bonded RBFDPs are presented. This modified technique enables the concurrent replacement of lateral incisors and correction of the malformed central incisors as well as increasing the retention of the restorations.

Influence of surface airborne-particle abrasion and bonding agent application on porcelain bonding to titanium dental alloys fabricated by milling and by selective laser melting.

STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacturing (CAD-CAM) technologies have provided alternatives to lost-wax casting for the fabrication of titanium frameworks in metal-ceramic fixed dental prostheses (FDPs). The findings on varying metal surface characteristics resulting from application of different fabrication technologies indicate a need to reevaluate the traditional titanium surface conditioning protocols. PURPOSE: The purpose of this in vitro study was to investigate the effects of surface airborne-particle abrasion (APA) and bonding agent application on the porcelain bond to titanium dental alloys fabricated by subtractive computer numerical controlled (CNC) milling and by additive selective laser melting (SLM) methods. MATERIAL AND METHODS: Eight groups of Ti-6Al-4V substrates (n=11) were fabricated-half of them by CNC milling and half by SLM. The groups represented a fully crossed experimental protocol of APA with 110-µm Al2O3 particles under a pressure of 0.2 MPa (intact-controls or abraded) and bonding agent application (with or without bonding agent) for the CNC milled and SLM titanium substrates. Ultra-low fusing dental porcelain was applied to the differently prepared titanium substrates, and the titanium-ceramic bond strength was determined by a 3-point bend test according to the International Organization for Standardization (ISO) standard 9693-1:2012. Average profile roughness (Ra) values were obtained for intact and APA titanium substrates fabricated by CNC milling and by SLM. Representative titanium-ceramic interfaces were analyzed by using a field emission scanning electron microscope (FE-SEM) and energy dispersive spectroscopy (EDS). Titanium-ceramic bond strength data were analyzed statistically by 3-way ANOVA and the Tukey HSD test. Ra data were analyzed by 2-way ANOVA, followed by regression analyses (α=.05). RESULTS: The method applied for the digital fabrication of titanium (either subtractive CNC milling or additive SLM) did not affect the titanium-ceramic bond (P=.247). APA (P<.001), as well as the application of a bonding agent (P<.001), increased the titanium-ceramic bond strength. When these 2 procedures were combined, the porcelain bond strength to CNC milled titanium was 37.3 ±4.1 MPa and that to SLM titanium was 36.7 ±4.9 MPa. APA increased the surface roughness of CNC milled titanium (P=.002) but decreased the roughness of the SLM substrates (P<.001). CONCLUSIONS: A protocol comprising APA and application of a bonding agent ensures the highest porcelain bond strength to both CNC milled and SLM titanium, with the obtained values being well above the minimal value for metal-ceramic systems as specified by ISO 9693-1:2012.

Lactational exposure to dioxin-like polychlorinated biphenyl 169 and nondioxin-like polychlorinated biphenyl 155: Effects on rat femur growth, biomechanics and mineral composition.

Exposure to polychlorinated biphenyls (PCBs), which are persistent lipophilic environmental pollutants, has a variety of adverse effects on wildlife and human health, including bone mineralization, growth and mechanical strength. The present study evaluated the effects of lactational exposure to nondioxin-like PCB-155 and dioxin-like PCB-169, individually and in combination, on pubertal rat femur development and its biomechanics. After offspring delivery, Wistar rat mothers were divided into four groups, i.e., PCB-169, PCB-155, PCB-155+169 and control, and were administered PCBs intraperitoneally. Data on bone geometry, biomechanics and mineral composition were obtained by analysis of femurs from 42-day-old offspring by microCT scanning, three-point bending test and inductively coupled plasma mass spectrometry. Decreased somatic mass and femur size, i.e., mass, periosteal circumference and cross sectional area, were observed in the PCB-169 and PCB-155 groups. Additionally, lactational exposure to planar PCB-169 resulted in harder and more brittle bones containing higher amounts of minerals. Combined exposure to structurally and functionally different PCBs demonstrated only mild alterations in bone width and mineralization. To conclude, our results demonstrated that alterations, observed on postnatal day 42, were primarily induced by PCB-169, while toxicity from both of the individual congeners may have been reduced in the combined group.

Alterations in geometry, biomechanics, and mineral composition of juvenile rat femur induced by nonplanar PCB-155 and/or planar PCB-169.

Exposure to widespread lipophilic and bioaccumulative polychlorinated biphenyls (PCBs) induces diverse biochemical and toxicological responses in various organs, including the bone. The aim of this study was to evaluate the changes in growth rate, geometry, serum, and bone biochemical parameters and biomechanics of juvenile rat femur induced by lactational exposure to nonplanar PCB-155 and planar PCB-169 individually and in combination. Fifteen lactating Wistar rats were divided into four groups (PCB-169, PCB-155, PCB-155+169, and control), and PCBs were administered intraperitoneally at different time points after delivery. Femurs from 22-day-old offspring were analyzed by microCT, three-point bending test and inductively coupled plasma-mass spectrometry (ICP-MS) to obtain data on bone geometry, biomechanics and mineral composition. The serum levels of calcium, phosphate and alkaline phosphatase were also determined. Lactational exposure to planar PCB-169 resulted in shorter and thinner femurs, reduced endosteal and periosteal perimeters, smaller total cross-sectional and medullary areas, and lowered serum bone marker levels and calcium levels in the bone, while femur mechanical properties were not significantly altered. The changes observed in the combination exposure (PCB-155+169) group were similar to those observed in the PCB-169 group but were less pronounced. In summary, our results demonstrate that alterations in lactationally exposed offspring were primarily induced by planar PCB-169. The milder outcome in the combined group suggested that the PCB-169-mediated toxic effects on the bone might be reduced by a nonplanar PCB-155 congener. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 1135-1146, 2017.

Implant-prosthetic rehabilitation after radiation treatment in head and neck cancer patients: a case-series report of outcome.

BACKGROUND: Slovenia has a high burden of head and neck cancer. Patients are mostly treated with surgery followed by radiation therapy. Advanced surgical and prosthodontic techniques have expanded the rehabilitation options. The aim of the study was to review the outcome of implant-prosthetic treatment after radiation therapy. PATIENTS AND METHODS: Twenty irradiated head and neck cancer patients who received a removable implant-supported denture at the University Medical Centre Ljubljana were included in the study. Kaplan-Meier survival analysis, Cox proportional hazard models and logistic regression were used to assess the implant survival and success rate. RESULTS: Twenty patients had 100 implants inserted. The estimated implant survival rate was 96% after 1 year and 87% after 5 years. Failures were mostly observed before loading (91.2%). Implants inserted in the transplanted bone were significantly more likely to fail. Out of 89 implants supporting the dentures, 79 implants (88.7%) were successful, meaning that they were functionally loaded and exhibited no pain, radiolucency or progressive bone loss. Prosthetic treatment was significantly less successful in older patients. The attachment system and the number of implants did not have a statistically significant influence on the success rate. CONCLUSIONS: Implant-supported dentures have been shown to be a reliable treatment modality after head and neck cancer surgery and radiation therapy. Possible early failures should be communicated with the patients.

Effect of Er:YAG laser pretreatment on bond strength of a composite core build-up material to fiber posts.

The study evaluated the micro push-out bond strength of resin material (Multicore Flow) to two types of fiber posts (FP), namely fiber-reinforced composite (FRC) Postec and Radix Fiber posts using Er:YAG laser pretreatment. FP were divided into four groups, two being control groups. Before the core build-up procedure, representative specimens from each group were chosen to determine the surface roughness (Ra) at three different areas using a contact profilometer, while after the procedure, 1.5-mm-thick discs were sectioned and the micro push-out method was used to assess the bond strength of the core build-up material to the fiber post in each group. Two-way analysis of variance was used for statistical analysis with the level of significance set at p < 0.05. Scanning electron microscopy was used to analyze the post surfaces after Er:YAG laser pretreatment and to classify the failure mode after loading. The type of pretreatment (p < 0.001) and an interaction between the pretreatment and type of post (p < 0.001) had a significant effect on the bond strength, while the type of post did not (p = 0.965). The mean bond strength in the Er:YAG laser pretreatment group was significantly lower compared to the FRC Postec posts control group (p < 0.001), while there was no significant difference between the Radix Fiber posts groups (p = 0.680). Mean Ra values from the Er:YAG laser pretreatment groups were significantly higher compared to control groups (p < 0.001). Er:YAG laser pretreatment at tested parameters negatively affected the bond strength of Multicore to FP and cannot be recommended as a standard procedure.

Effect of airborne particle abrasion and regeneration firing on the strength of 3D-printed 3Y and 5Y zirconia ceramics.

OBJECTIVES: This study aimed to assess the effect of airborne particle abrasion (APA) and regeneration firing (RF) on the subsurface damage and strength distribution of 3D-printed 3Y-TZP and 5Y-PSZ zirconia parts for dental applications. METHODS: Disc-shaped specimens were prepared using vat photopolymerization (VPP) technology from 3Y and 5Y zirconia ceramics, followed by thermal debinding and sintering. APA treatment with 50 µm Al2O3 particles and RF at 1000 °C for 15 min were applied. Microstructural analysis was conducted using FIB-SEM, and XRD analysis determined crystalline phase content. Biaxial flexural strength was measured using the ball on three balls method and analyzed with Weibull statistics. ANOVA and Tukey HSD test were employed to compare strength differences between groups. RESULTS: APA treatment increased the flexural strength of the 3Y specimens but decreased it for the 5Y specimens. RF treatment reversed the effect, restoring the strength to as-sintered levels for both materials. APA-treated 3Y specimens exhibited characteristic strength values above 1400 MPa, attributed to phase-transformation toughening. As sintered 5Y specimens showed strength values above 600 MPa. APA treatment increased the Weibull modulus of the 5Y specimens, indicating a narrower defect size distribution. SIGNIFICANCE: The study demonstrates that the impact of APA and RF treatments on the mechanical properties and reliability of VPP-fabricated 3Y-TZP and 5Y-PSZ ceramics is comparable to conventionally prepared zirconia. VPP technology for 3D printing provides a viable approach for future manufacturing of dental restorations with potential clinical applications.

Bonding Performance of Surface-Treated Zirconia Cantilevered Resin-Bonded Fixed Dental Prostheses: In Vitro Evaluation and Finite Element Analysis.

Debonding of zirconia cantilevered resin-bonded fixed dental prostheses (RBFDPs) remains the main treatment complication, therefore, the present in vitro study aimed to evaluate the effect of different surface pretreatments on the bonding of zirconia RBFDPs. Eighty milled zirconia maxillary central incisors, with complementary zirconia cantilevered RBFDPs, were randomly subjected to four different surface pretreatments (n = 20): as-machined (AM); airborne-particle abraded (APA); coated with nanostructured alumina coating (NAC); incisor air-abraded and RBFDP coated (NAC_APA). After bonding, half of each group (n = 10) was stored in deionized water (150 days/37 °C), thermocycled (37,500 cycles, 5-55 °C), and cyclically loaded (50 N/1.2 × 106). Load-bearing capacity (LBC) was determined using a quasi-static test. Additionally, finite element analysis (FEA) and fractography were performed. t-test and one-way ANOVA were used for statistical-analysis. Before aging, the NAC group provided superior LBC to other groups (p < 0.05). After aging, the AM specimens debonded spontaneously, while other groups exhibited comparable LBC (p ˃ 0.05). The FEA results correlated with the in vitro experiment and fractography, showing highly stressed areas in the bonding interface, cement layer, and in RBFDP's retainer wing and connector. The NAC RBFDPs exhibited comparable long-term bonding performance to APA and should be regarded as a zirconia pretreatment alternative to APA.

Factors Influencing the Survival Rate of Teeth and Implants in Patients after Tumor Therapy to the Head and Neck Region-Part 2: Implant Survival.

During prosthetic rehabilitation after tumor therapy (TT) in the head and neck region, the dentist must assess whether the prognosis of the remaining teeth is sufficiently good or whether implants should be used to anchor dentures. Thus, the aim of the present study was to compare the survival rate of teeth and implants after TT and to evaluate factors potentially influencing implant survival. One hundred fifteen patients (male: 70.3%; mean age: 63.2 ± 12.4 years) having received dental treatment before and after TT at the Martin Luther University Halle-Wittenberg were enrolled in the study. Clinical examination including assessment of dental status and stimulated salivary flow rate was performed. Information about disease progression and therapy was retrieved from medical records. After TT, from a total of 1262 teeth, 27.2% had to be extracted. Of 308 implants inserted after TT, 7.0% were lost. Teeth exhibited lower 5-year survival probability (76.8%) than implants (89.9%; p = 0.001). The risk of loss (RL) of implants increased with age, nicotine use, intraoral defects, and RCT. Radiotherapy did not independently increase the RL. Thus, implants seem to be a reliable treatment option in case of progressive tooth decay after TT, particularly after RT.

In vivo aging of zirconia dental ceramics - Part I: Biomedical grade 3Y-TZP.

OBJECTIVE: In vivo aging of biomedical grade 3Y-TZP ceramics in the oral environment was assessed and compared to artificially accelerated in vitro hydrothermal aging extrapolations at 37°C. METHODS: 88 discs were pressed and sintered (1450-1500°C) from two commercial 3Y-TZP compositions containing 0.25% Al2O3 to generate finer- and coarser-grained specimens. As-sintered (AS) and airborne-particle abraded (APA; 50µm Al2O3) surfaces were investigated. In vivo aging was performed by incorporating specimens in lingual flanges of complete dentures of 12 edentulous volunteers who wore them continuously for up to 24 months. For comparison, in vitro hydrothermal aging at 134°C was also performed and analysed by XRD and (FIB)-SEM. Data was statistically analysed with linear regression models. RESULTS: Finer and coarser-grained specimens exhibited statistically insignificant differences in aging in vivo. The monoclinic fraction (Xm) on AS surfaces abruptly increased to ∼8% after 6 months. The aging process then proceeded with slower linear kinetics (∼0.24%/month). After 24 months, Xm reached ∼12%. The calculated maximum transformed layer was 0.385µm representing one layer of transformed grains. APA surfaces were highly aging resistant. The initial Xm of ∼4.0% linearly increased by 0.03%/month in vivo. In vitro aging exhibited an initial induction period, followed by linear aging kinetics. Coarser-grained AS surfaces aged significantly faster than fine-grained (2.41%/h compared to 2.16%/h). APA discs aged at a rate of 0.3%/h in vitro. Microcracking within a single grain and pull-out of grain clusters were observed on aged AS surfaces. SIGNIFICANCE: Biomedical grade 3Y-TZP was susceptible to in vivo aging. After 2 years in vivo, the aging kinetics were almost 3-times faster than the generally accepted in vitro-in vivo extrapolation.

In vivo ageing of zirconia dental ceramics - Part II: Highly-translucent and rapid-sintered 3Y-TZP.

OBJECTIVE: 3Y-TZP ceramics with reduced alumina content have improved translucency and are used in monolithic dental restorations without porcelain-based veneers. The workflow can be further streamlined with rapid sintering. This study was designed to assess how these approaches affect ageing when the materials are exposed to the oral environment in vivo. METHODS: 43 discs were fabricated from 3Y-TZP powder with 0.05% Al2O3 and sintered with conventional or rapid regimens (1450 °C 2 h, 1530 °C 2 h, or 1530 °C 25 min). Their surfaces were polished or airborne-particle abraded with 50 µm Al2O3. The discs were incorporated in complete dentures of 16 volunteers and worn continuously for up to 48 months. Ageing changes on disc surfaces were monitored every 6 months by X-ray diffraction, scanning electron microscopy and atomic force microscopy. Data was statistically analysed with linear models. RESULTS: The amount of monoclinic phase on polished surfaces increased linearly, reaching up to 40% after 48 months in vivo. The ageing process observed for rapid sintering was 1.6 times faster compared to conventional sintering. A nano-scale increase in roughness with microcracking was also detected on polished surfaces. Airborne-particle abraded surfaces did not exhibit clear signs of ageing during the course of the study. SIGNIFICANCE: Highly-translucent 3Y-TZP ceramics are more susceptible to ageing than classic 3Y-TZP. After 4 years in vivo, the extent of degradation did not yet constitute grounds for clinical concern, but was more pronounced in materials prepared with rapid sintering.

Influence of thermo-mechanical cycling on porcelain bonding to cobalt-chromium and titanium dental alloys fabricated by casting, milling, and selective laser melting.

PURPOSE: The aim has been to determine the effect of thermo-mechanical cycling on shear-bond-strength (SBS) of dental porcelain to Co-Cr and Ti-based alloys fabricated by casting, computer-numerical-controlled milling, and selective-laser-melting (SLM). METHODS: Seven groups (n=22/group) of metal cylinders were fabricated by casting (Co-Cr and commercially pure-cpTi), milling (Co-Cr, cpTi, Ti-6Al-4V) or by SLM (Co-Cr and Ti-6Al-4V) and abraded with airborne-particles. The average surface roughness (Ra) was determined for each group. Dental porcelain was applied and each metal-ceramic combination was divided into two subgroups - stored in deionized water (24-h, 37°C), or subjected to both thermal (6000-cycles, between 5 and 60°C) and mechanical cycling (105-cycles, 60N-load). SBS test-values and failure modes were recorded. Metal-ceramic interfaces were analyzed with a focused-ion-beam/scanning-electron-microscope (FIB/SEM) and energy-dispersive-spectroscopy (EDS). The elastic properties of the respective metal and ceramic materials were evaluated by instrumented-indentation-testing. The oxide thickness on intact Ti-based substrates was measured with Auger-electron-spectroscopy (AES). Data were analyzed using ANOVA, Tukey's HSD and t-tests (α=0.05). RESULTS: The SBS-means differed according to the metal-ceramic combination (p<0.0005) and to the fatigue conditions (p<0.0005). The failure modes and interface analyses suggest better porcelain adherence to Co-Cr than to Ti-based alloys. Values of Ra were dependent on the metal substrate (p<0.0005). Ti-based substrates were not covered with thick oxide layers following digital fabrication. CONCLUSIONS: Ti-based alloys are more susceptible than Co-Cr to reduction of porcelain bond strength following thermo-mechanical cycling. The porcelain bond strength to Ti-based alloys is affected by the applied metal processing technology.

Ageing kinetics and strength of airborne-particle abraded 3Y-TZP ceramics.

OBJECTIVE: The combined effects of alumina airborne-particle abrasion and prolonged in vitro ageing on the flexural strength of 3Y-TZP ceramic have been studied. The aim was to identify the different effects on the surface and subsurface regions that govern the performance of this popular bioceramic known for its susceptibility to low-temperature degradation (LTD). METHODS: As-sintered or airborne-particle abraded 3Y-TZP discs were subjected to ageing at 134°C for up to 480h. Biaxial flexural strength was measured and the relative amount of monoclinic phase determined using X-ray diffraction. The transformed zone depth (TZD) was observed on cross-sections with scanning electron microscopy coupled with a focused ion beam. Segmented linear regression was used to analyze the flexural strength and TZD as functions of the ageing time. RESULTS: A two-step linear ageing kinetics was detected in airborne-particle abraded specimens, reflecting the different microstructures through which the LTD proceeds into the bulk. A 10µm thick altered zone under the abraded surface was involved in both the surface strengthening and the increased ageing resistance. When the zone was annihilated by the LTD, the strength of the ceramic specimens and the speed of LTD returned to the values measured before abrasion. Even at prolonged ageing times, the strength of abraded groups was not lower than that of as-sintered groups. SIGNIFICANCE: Both the ageing kinetics and the flexural strength were prominently affected by airborne-particle abrasion, which altered the subsurface microstructure and phase composition. Airborne-particle abrasion was not harmful to the 3Y-TZP ceramics' stability.

Complexity of the relationships between the sintering-temperature-dependent grain size, airborne-particle abrasion, ageing and strength of 3Y-TZP ceramics.

OBJECTIVES: This study was designed to explore the complex relationships between the sintering-temperature-dependent grain size, airborne-particle abrasion, ageing and strength of 3Y-TZP ceramics. METHODS: Biomedical grade 3Y-TZP powder was used to fabricate 180 discs. Half of them were sintered at 1400°C for 2h and half at 1500°C for 2h. A total of 18 groups of 10 were formed and subjected to the fully crossed experimental protocol of airborne-particle abrasion with Al2O3 at 2.5bar (no abrasion, 50µm, 110µm) and accelerated ageing at 134°C (no ageing, 12h, 48h). The relative amount of monoclinic phase was determined with XRD. The biaxial flexural strength was measured and statistically analyzed using the three-way ANOVA followed by predetermined contrasts and Tukey's HSD test (α=0.05). RESULTS: The low-temperature-sintered, fine-grained ceramic exhibited an excellent ageing resistance, while the high-temperature-sintered, coarse-grained ceramic experienced a higher surface strengthening and a substantially improved ageing resistance with respect to the airborne-particle abrasion. The overall performance of this material was superior. SIGNIFICANCE: Our results show that the sintering temperature has a minor effect on the flexural strength, but it plays a crucial role in the surface strengthening and the ageing behaviour of 3Y-TZP dental ceramics.

The effect of nano-structured alumina coating on resin-bond strength to zirconia ceramics.

OBJECTIVES: The aim of this study was to functionalize the surface of yttria partially stabilized tetragonal zirconia ceramics (Y-TZP) with a nano-structured alumina coating to improve resin bonding. MATERIALS AND METHODS: A total of 120 densely sintered disc-shaped specimens (15.5+/-0.03 mm in diameter and 2.6+/-0.03 mm thick) were produced from biomedical-grade TZ-3YB-E zirconia powder (Tosoh, Tokyo, Japan), randomly divided into three groups of 40 and subjected to the following surface treatments: AS - as-sintered; APA - airborne-particle abraded; POL - polished. Half of the discs in each group received an alumina coating that was fabricated by exploiting the hydrolysis of aluminium nitride (AlN) powder (groups AS-C, APA-C, POL-C). The coating was characterized using scanning electron microscopy (SEM), atomic force microscopy (AFM), and transmission electron microscopy (TEM). The shear-bond strength of the self-etching composite resin (RelyX Unicem, 3M ESPE, USA) was then studied for the coated and uncoated surfaces of the as-sintered, polished and airborne-particle abraded specimens before and after thermocycling (TC). RESULTS: The SEM/TEM analyses revealed that the application of an alumina coating to Y-TZP ceramics created a highly retentive surface for resin penetration. The coating showed good surface coverage and a uniform thickness of 240 nm. The resin-bond strength to the groups AS-C, APA-C, POL-C was significantly higher than to the groups AS, APA and POL, both before and after TC (p< or =0.05). During TC all the specimens in the POL and AS groups debonded spontaneously. In contrast, the TC did not affect the bond strength of the AS-C, POL-C and APA-C groups. SIGNIFICANCE: A non-invasive method has been developed that significantly improves resin-bond strength to Y-TZP ceramics. After surface functionalization the bond survives thermocycling without reduction in strength. The method is relatively simple and has the potential to become an effective conditioning method for zirconia ceramics.

Study of water migration by micro MR imaging.

Magnetic Resonance (MR) microscopy is a noninvasive tool that enables high resolution imaging of water concentration in non-magnetic materials. In this study, water migration in a dense porous material (dental cement) was monitored by 1D MR microscopy. The measured concentration profiles were later analyzed via three different migration models: an imbibition model, a diffusion model and a combined model. From the best fit to the experimental data, model parameters were obtained.

Fracture resistance and reliability of new zirconia posts.

STATEMENT OF PROBLEM: The radicular portion of zirconia endodontic posts often need to be reshaped to achieve a definitive form and may be airborne-particle abraded to improve adhesion during luting. Therefore, the surface of the tetragonal zirconia ceramics may be transformed and damaged, influencing the mechanical properties of the material. PURPOSE: This study compared the fracture resistance of prefabricated zirconia posts with a new retentive post-head after different surface treatments. MATERIAL AND METHODS: Experimental zirconia posts of 2 different diameters, 1.3 mm and 1.5 mm, were produced from commercially available zirconia powder. A cylindro-conical outline form was used for the root portion of the system and a post-head with 3 retentive rings was designed. Sixty posts of each diameter were divided into 3 groups (n=20). Group 1 was ground with a coarse grit diamond bur; Group 2 was airborne-particle abraded with 110-microm fused alumina particles, and Group 3 was left as-received (controls). Posts were luted into the root-shaped artificial canals with the Clearfil adhesive system and Panavia 21 adhesive resin luting agent. The posts were loaded in a universal testing machine at an inclination of 45 degrees with the constant cross-head speed of 1 mm/min. The fracture load (N) necessary to cause post fracture was recorded, and the statistical significance of differences among groups was analyzed with 1-way ANOVA followed by the Fischer LSD test (alpha=.05). The variability was analyzed using Weibull statistics. RESULTS: Load to fracture values of all zirconia posts depended primarily on post diameter. Mean fracture loads (SD) in Newtons were 518.4 (+/-101.3), 993.6 (+/-224.1), and 622.7 (+/-110.3) for Groups 1 through 3, respectively, for thicker posts, and 385.9 (+/-110.3), 627.0 (+/-115.1), and 451.2 (+/-81.4) for Groups 1 through 3, respectively, for thinner posts. Airborne-particle-abraded posts exhibited significantly higher resistance to fracture (P<.05) than those in the other 2 groups for diameters 1.3 mm and 1.5 mm. Grinding reduced Weibull modulus compared with controls, and the values were 4.1 and 6.5 for thicker and thinner posts, respectively. CONCLUSION: Within the limitations of this study, the results suggest that grinding leads to a significant drop in load to fracture of zirconia posts, whereas airborne-particle abrasion increased the fracture load.