Current status of zirconia restoration

Effect of the application of surface treatments before and after sintering on the flexural strength, phase transformation and surface topography of zirconia

OBJECTIVES

To evaluate the effects of airborne-particle abrasion (APA) and Er,Cr:YSGG laser irradiation on 4-point-flexural strength, phase transformation and morphologic changes of zirconia ceramics treated at pre-sintered or post-sintered stage.

METHODS

Three hundred and forty-two bar shaped zirconia specimens were milled with different sizes according to the flexural strength test (n = 10), X-ray diffraction (XRD) (n = 4) and field emission scanning electron microscope (FE-SEM) (n = 4) analyses. For each test protocol, specimens were divided into 4 main groups whether the surface treatments applied before or after sintering and whether the specimens received heat treatment or not as pre-sintered, post-sintered no-heat and post-sintered heat-treated groups, and a group was served as control. Main groups were further divided into 6 equal subgroups according to surface treatment method applied (2 W-, 3 W-, 4 W-, 5 W-, 6 W-laser irradiations and APA). Surface treatments were applied to pre-sintered groups before sintering and to post-sintered groups after sintering. Post-sintered heat-treated groups were subjected to veneer ceramic firing simulation after surface treatments. Flexural strength and flexural modulus values were statistically analysed and monoclinic phase content was calculated. Weibull analysis was used to evaluate strength reliability and fractographic analysis was conducted.

RESULTS

Highest flexural strength values were detected at post-sintered no-heat APA and 4W-laser groups (P < 0.05). Pre-sintered groups showed statistically lower flexural strength values. Heat treatment decreased the strength of the specimens. Monoclinic phase content was only detected at post-sintered no-heat groups and the highest amount was detected at APA group. Rougher surfaces and deeper irregularities were detected at FE-SEM images pre-sintered groups.

CONCLUSIONS

Application of surface treatments at pre-sintered stage may be detrimental for zirconia ceramics in terms of flexural strength.

CLINICAL SIGNIFICANCE

Treating the surface of zirconia ceramic before sintering process is not recommended due to significant decrease in flexural strength values. 2 W-4 W Er,Cr:YSGG laser irradiations can be regarded as alternative surface treatment methods when zirconia restoration would be subjected to veneer ceramic firing procedures.

Guided tooth preparation for a pediatric zirconia crown

BACKGROUND AND OVERVIEW

Unesthetic primary incisors can produce negative self-perceptions in preschool-aged children. In recent years, because of increased esthetic demands, prefabricated zirconia crowns have become increasingly popular. However, zirconia crowns cannot be crimped, and the clinician must prepare the teeth to fit the zirconia crowns. Therefore, extended preparation and fitting times are necessary, especially for inexperienced practitioners. A 1- to 2-millimeter subgingival feather margin also is required. Gingival hemorrhage after subgingival preparation compromises the retention of zirconia crowns.

CASE DESCRIPTION

In this clinical report, the author presents a step-by-step description of the clinical and laboratory procedures for restoring a discolored traumatized incisor with a zirconia crown. The author used a polyvinyl siloxane occlusal registration material as an impression material and made 2 identical casts. The author fabricated 3 reduction guides after prospective tooth preparation on the casts. The author rapidly prepared the discolored incisor with the reduction guides and ultrasonic burs. A zirconia crown provided an optimal esthetic result and gingival health.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Because the reduction guides provided a visibility intraorally, fast tooth reduction, less trial placement, and passive adaptation of the crown were successful. Because the ultrasonic burs prevented gingival injuries, hemorrhage control was not necessary. The presented technique reduced the patient's discomfort and total chair time. Therefore, this alternative technique is helpful for inexperienced practitioners.

Comparison of bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and a universal adhesive

Objectives

The aim of this study is to compare the shear bond strengths of ceramic brackets bonded to zirconia surfaces using different zirconia primers and universal adhesive.

Materials and Methods

Fifty zirconia blocks (15 × 15 × 10 mm, Zpex, Tosoh Corporation) were polished with 1,000 grit sand paper and air-abraded with 50 µm Al₂O₃ for 10 seconds (40 psi). They were divided into 5 groups: control (CO), Metal/Zirconia primer (MZ, Ivoclar Vivadent), Z-PRIME Plus (ZP, Bisco), Zirconia Liner (ZL, Sun Medical), and Scotchbond Universal adhesive (SU, 3M ESPE). Transbond XT Primer (used for CO, MZ, ZP, and ZL) and Transbond XT Paste was used for bracket bonding (Gemini clear ceramic brackets, 3M Unitek). After 24 hours at 37°C storage, specimens underwent 2,000 thermocycles, and then, shear bond strengths were measured (1 mm/min). An adhesive remnant index (ARI) score was calculated. The data were analyzed using one-way analysis of variance and the Bonferroni test (p = 0.05).

Results

Surface treatment with primers resulted in increased shear bond strength. The SU group showed the highest shear bond strength followed by the ZP, ZL, MZ, and CO groups, in that order. The median ARI scores were as follows: CO = 0, MZ = 0, ZP = 0, ZL = 0, and SU = 3 (p < 0.05).

Conclusions

Within this experiment, zirconia primer can increase the shear bond strength of bracket bonding. The highest shear bond strength is observed in SU group, even when no primer is used.

The effects of lasers on bond strength to ceramic materials: A systematic review and meta-analysis

Lasers have recently been introduced as an alternative means of conditioning dental ceramic surfaces in order to enhance their adhesive strength to cements and other materials. The present systematic review and meta-analysis aimed to review and quantitatively analyze the available literature in order to determine which bond protocols and laser types are the most effective.

A search was conducted in the Pubmed, Embase and Scopus databases for papers published up to April 2017. PRISMA guidelines for systematic review and meta-analysis were followed.

Fifty-two papers were eligible for inclusion in the review. Twenty-five studies were synthesized quantitatively. Lasers were found to increase bond strength of ceramic surfaces to resin cements and composites when compared with control specimens (p-value < 0.01), whereas no significant differences were found in comparison with air-particle abraded surfaces.

High variability can be observed in adhesion values between different analyses, pointing to a need to standardize study protocols and to determine the optimal parameters for each laser type.

Influence of a surface conditioner to pre-sintered zirconia on the biaxial flexural strength and phase transformation

OBJECTIVES

To assess the influence of a surface conditioner applied to pre-sintered yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) on the biaxial flexural strength and phase transformation.

METHODS

Conditioner-coated specimens (12mm diameter×0.8mm thickness) were prepared by application of a slurry conditioner using a brush on pre-sintered Y-TZP discs, followed by sandblasting with 50-μm Al₂O₃ after sintering (C-SB) or no further treatment (C-NT). The remaining conditioner-free specimens were subjected to sandblasting before sintering (NC-SB) or were maintained without treatment (NC-NT). Surface roughness measurements and scanning electron microscopy (SEM) in conjunction with energy dispersive X-ray spectroscopy (SEM-EDX) were performed for surface characterizations. The phase transformation of Y-TZP was identified by X-ray diffraction (XRD), and the biaxial flexural strength was measured using the piston-on-three-ball test according to ISO 6872:2015. The data were analyzed using nonparametric Kruskal-Wallis tests and Weibull distributions with the maximum likelihood estimation.

RESULTS

Sandblasting resulted in significantly rougher surfaces, irrespective of conditioner application. Conditioner layers were observed on surfaces in the C-NT and C-SB specimens. Monoclinic contents were present in a very small amount in the C-SB specimens. Both median biaxial flexural and characteristic strengths of all specimens exceeded ISO 6872:2015 requirements (Class 5: >800MPa), except the NC-SB specimens which showed significantly the lowest strength (p<0.001). Although no statistical difference was observed in Weibull modulus among the specimens (p=0.598), the NC-SB specimens showed the highest.

SIGNIFICANCE

Surface conditioner application does not affect the biaxial flexural strength and phase stability of Y-TZP and can be considered practical for clinical use.

Load-bearing capacity of various CAD/CAM monolithic molar crowns under recommended occlusal thickness and reduced occlusal thickness conditions

PURPOSE

The goal of this study was to evaluate the fracture resistances of various monolithic crowns fabricated by computer-aided design and computer-aided manufacturing (CAD/CAM) with different thickness.

MATERIALS AND METHODS

Test dies were fabricated as mandibular molar forms with occlusal reductions using CAD/CAM. With different occlusal thickness (1.0 or 1.5 mm), a polymer-infiltrated ceramic network (Enamic, EN), and zirconia-reinforced lithium silicate (Suprinity, SU and Celtra-Duo, CD) were used to fabricate molar crowns. Lithium disilicate (e.max CAD, EM) crowns (occlusal: 1.5 mm) were fabricated as control. Seventy crowns (n=10 per group) were bonded to abutments and stored in water for 24 hours. A universal testing machine was used to apply load to crown until fracture. The fractured specimens were examined with a scanning electron microscopy.

RESULTS

The type of ceramics and the occlusal thickness showed a significant interaction. With a recommended thickness (1.5 mm), the SU revealed the mean load similar to the EM, higher compared with those of the EN and CD. The fracture loads in a reduced thickness (1.0 mm) were similar among the SU, CD, and EN. The mean fracture load of the SU and CD enhanced significantly when the occlusal thickness increased, whereas that of the EN did not.

CONCLUSION

The fracture loads of monolithic crowns were differently influenced by the changes in occlusal thickness, depending on the type of ceramics. Within the limitations of this study, all the tested crowns withstood the physiological masticatory loads both at the recommended and reduced occlusal thickness.

Effect of hydrofluoric acid surface treatments on micro-shear bond strength of CAD/CAM ceramics

Introduction

Dental ceramics are appreciated as highly esthetic restorative materials that can simulate the appearance of natural dentition better than other materials. The aim of this study was to evaluate the effect of hydrofluoric acid concentration and etching time on micro-shear bond strength (μSBS) to IPS e.max CAD and Vita Mark II of a dual cured resin cement (Panavia F2.0).

Methods

This study was an experimental in vitro study, performed in the dental material research center of Babol University of Medical Sciences in 2016. Two hydrofluoric acid concentrations (5% and 10%) and three different etching times (20, 60 and 120 seconds) were used to etch the specimens respectively. A silane coupling agent (Clearfil porcelain activator) and priming and bonding agent (Clearfil SE bond) were used on the etched surfaces in accordance to the manufacturer’s instructions of use. Then resin cement was applied on the prepared ceramic surfaces and light cured. μSBS between resin cement and the porcelains were measured with a universal testing machine. Mode of failure was observed with 40× magnification by means of a Stereo microscope. Data were analyzed with ANOVA and independent-samples t-test and Chi-square tests.

Results

In both e.max and Vita Mark II groups, μSBS were not significantly different when different etching times (one-way ANOVA) and HF acid concentrations (Independent-samples t-test) were used (p>0.05), but the highest μSBS was shown in e.max specimens etched 60 s with 5% HF and Vita Mark II specimens etched 20 s with 10% HF. μSBS of e.max was significantly higher than Vita Mark II (p=0.00).

Conclusion

Best surface treatment for e.max and Vita Mark II ceramics is 20 s etch using 5 % hydrofluoric acid.

Fracture Resistance of Monolithic Glass-Ceramics Versus Bilayered Zirconia-Based Restorations

PURPOSE

To compare the fracture resistance of monolithic reinforced glass-ceramic restorations with bilayer zirconia-based restorations.

MATERIALS AND METHODS

Fifteen ceramic crowns were fabricated on epoxy dies duplicated from a stainless steel master die. They were divided into 3 equal groups (n = 5) according to the type of ceramic material used: group I, monolithic lithium disilicate (IPS e.max CAD), group V, monolithic zirconia-reinforced lithium silicate (Vita Suprinity), and group B (bilayered zirconia substructure with veneering ceramic). All specimens were cemented on epoxy dies with a self-adhesive resin cement (Rely X Unicem), subjected to a chewing simulator, and then loaded until fracture in a universal testing machine. The results were tabulated and statistically analyzed using one-way ANOVA to compare among the 3 materials. The Bonferroni post hoc test was used for pairwise comparisons when the ANOVA test was significant.

RESULTS

Zirconia-reinforced lithium silicate (Vita Suprinity) crowns showed the highest statistically significant (p < 0.05) mean fracture resistance values (1742.9 ± 102.7 N), followed by lithium disilicate (IPS e.max CAD) (1565.2 ± 89.7 N). Bilayered zirconia-based crowns showed the lowest statistically significantly mean fracture resistance values (1267.8 ± 86.1 N).

CONCLUSIONS

Monolithic reinforced glass-ceramics (lithium disilicate and zirconia-reinforced lithium silicate) have better fracture resistance than bilayered zirconia-based ceramics.

CLINICAL IMPLICATIONS

The use of monolithic reinforced ceramic restorations (lithium disilicate and zirconia-reinforced lithium silicate) is preferred to bilayered zirconia-based restorations to avoid chipping of the ceramic veneer.

The influence of yttrium-segregation-dependent phase partitioning and residual stresses on the aging and fracture behaviour of 3Y-TZP ceramics

The yttrium-segregation-dependent phase partitioning and residual stress development that influence both the aging and the fracture behaviour in 3Y-TZP bioceramics were studied by sintering alumina-free 3Y-TZP, varying the sintering temperature and the time, to yield ceramics with identical grain size distributions, but with different phase compositions. The structure and stability of the resulting tetragonal phases, in the form of transformable, yttria-lean t-ZrO₂ (YLZ) and non-transformable, yttria-rich t″-ZrO₂ and/or t'-ZrO₂ (YRZ), were studied by X-ray diffraction (XRD) and focused ion beam scanning electron microscopy (FIB-SEM). The accelerated aging kinetics was fitted to the Mehl-Avrami-Johnson equation. The specimen sintered at the lowest sintering temperature but with the longest dwell time contained the smallest and the largest concentrations of yttria in the YLZ and YRZ phases, respectively, as well as the largest amount of YRZ. As a consequence, it exhibited the fastest linear aging kinetics accompanied by more extensive micro-cracking of the transformed layer, as well as largest amount of intergranular fracture and the greatest resistance to fracture. These properties were ascribed to the increased transformability of the YLZ phase and the greatest propensity of the YRZ phase to relax the accumulated residual stresses during transformation (tetragonal to monoclinic, t-m) manifested asa∼2.4% unit-cell volume increase. The observed relaxation provides additional understanding of the t-m transformation mechanism, which governs both the aging and fracture behaviour of 3Y-TZP.

STATEMENT OF SIGNIFICANCE

A novel approach to understanding the effect of yttrium segregation on t-m transformation of 3Y-TZP zirconia bioceramics is presented. Carefully designed sintering strategy facilitated fabrication of ceramics with identical grain size distributions but with different yttrium concentrations. The influence of phase partitioning on stability and structure of transformable yttria-lean tetragonal phase (YLZ) and non-transformable yttria-rich phases (YRZ; t″- and t'-prime) and on the formation of residual stresses in YRZ were investigated. It is shown that YRZ phases are under compressive stresses in YLZ matrix, since a systematic relaxation after ageing was observed and explained for the first time. It puts additional perspective on the understanding of the t-m transformation mechanism ultimately governing both the ageing and fracture behaviour of 3Y-TZP.

Effect of thickness and surface modifications on flexural strength of monolithic zirconia

STATEMENT OF PROBLEM

A recommended minimum thickness for monolithic zirconia restorations has not been reported. Assessing a proper thickness that has the necessary load-bearing capacity but also conserves dental hard tissues is essential.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of thickness and surface modifications on monolithic zirconia after simulated masticatory stresses.

MATERIAL AND METHODS

Monolithic zirconia disks (10 mm in diameter) were fabricated with 1.3 mm and 0.8 mm thicknesses. For each thickness, 21 disks were fabricated. The specimens of each group were further divided into 3 subgroups (n=7) according to the surface treatments applied: untreated (control), airborne-particle abrasion with 50-μm Al₂O₃ particles at a pressure of 400 kPa at 10 mm, and grinding with a diamond rotary instrument followed by polishing. The biaxial flexure strength was determined by using a piston-on-3-balls technique in a universal testing machine. Flexural loading was applied with a 1.4-mm diameter steel cylinder, centered on the disk, at a crosshead speed of 0.5 mm/min until fracture occurred. X-ray diffraction (XRD) and scanning electron microscopy (SEM) analyses were performed. The data were statistically analyzed with 2-way ANOVA, Tamhane T2, 1-way ANOVA, and Student t tests (α=.05).

RESULTS

The 1.3-mm specimens had significantly higher flexural strength than the 0.8-mm specimens (P<.05). Airborne-particle abrasion significantly increased the flexural strength (P<.05). Grinding and polishing did not affect the flexural strength of the specimens (P>.05).

CONCLUSIONS

The mean flexural strength of 0.8-mm and 1.3-mm thick monolithic zirconia was greater than reported masticatory forces. Airborne-particle abrasion increased the flexural strength of monolithic zirconia. Grinding did not affect flexural strength if subsequently polished.

In vitro evaluation of the polishing effect and optical properties of monolithic zirconia

STATEMENT OF PROBLEM

The relationship between surface roughness and the optical characteristics of zirconia prostheses may be affected by the type of shaded block.

PURPOSE

The purpose of this in vitro study was to investigate changes in surface roughness and brightness of monolithic zirconia blocks of different shades after polishing.

MATERIAL AND METHODS

The surface roughness averages of 3 different kinds of shaded zirconia blocks (Zenostarof T0 [T0], Zenostar sun [Ts], and Zenostar sun chroma [Tsc]) were compared after surface polishing. Fifteen specimens of differing thicknesses were produced per block. (1 mm and 3 mm). Surface morphology and compositions were analyzed by using filed emission scanning electron microscopy (FE-SEM) and energy dispersive spectrometry. A 1-way ANOVA and the post hoc Scheffé test were performed (α=.05). The correlations between surface roughness and brightness were determined using the Pearson correlation analysis (α=.01).

RESULTS

After phased polishing, Ts had the highest average roughness, followed by T0 and then Tsc. A statistically significant difference in roughness was observed between Ts and Tsc (P<.05). Ts exhibited multiple distinct layers in the FE-SEM image. Carbon was detected in the Ts specimens only. Brightness was highest in T0, followed by Ts and then Tsc. A positive correlation was observed between brightness and surface roughness for all specimens (P<.01). This correlation was stronger in the thicker specimens.

CONCLUSIONS

The results of this study suggest that polishing affects monolithic zirconia differently depending on shade. The polishing of monolithic zirconia reduces both surface roughness and brightness. The optical properties of monolithic zirconia vary by thickness and can be opaque or translucent.

Micro-Raman Vibrational Identification of 10-MDP Bond to Zirconia and Shear Bond Strength Analysis

So far, there is no report regarding the micro-Raman vibrational fingerprint of the bonds between 10-methacryloyloxy-decyl dihydrogen phosphate (10-MDP) and zirconia ceramics. Thus, the aim of this study was to identify the Raman vibrational peaks related to the bonds of 10-MDP with zirconia, as well as the influence on microshear bond strength. Micro-Raman spectroscopy was employed to assess the vibrational peak of 10-MDP binding to zirconia. Microshear bond strength of the dual-cure resin cement to zirconia with the presence of 10-MDP in composition of experimental ceramic primer and self-adhesive resin cement was also surveyed. Statistical analysis was performed by one-way ANOVA and Tukey's test (p < 0.05). Peaks at 1545 cm⁻¹ and 1562 cm⁻¹ were found to refer to zirconia binding with 10-MDP. The presence of 10-MDP in both experimental ceramic primer and self-adhesive resin cement improved microshear bond strength to zirconia ceramic. It can be concluded that the nondestructive method of micro-Raman spectroscopy was able to characterize chemical bonds of 10-MDP with zirconia, which improves the bond strengths of resin cement.

A multi technique study of a new lithium disilicate glass-ceramic spray-coated on ZrO2 substrate for dental restoration

An alkali niobate-silicate veneer ceramic for ZrO

Binary titanium alloys as dental implant materials-a review

Titanium (Ti) has been used for long in dentistry and medicine for implant purpose. During the years, not only the commercially pure Ti but also some alloys such as binary and tertiary Ti alloys were used. The aim of this review is to describe and compare the current literature on binary Ti alloys, including Ti–Zr, Ti–In, Ti–Ag, Ti–Cu, Ti–Au, Ti–Pd, Ti–Nb, Ti–Mn, Ti–Mo, Ti–Cr, Ti–Co, Ti–Sn, Ti–Ge and Ti–Ga, in particular to mechanical, chemical and biological parameters related to implant application. Literature was searched using the PubMed and Web of Science databases, as well as google without limiting the year, but with principle key terms such as ‘ Ti alloy’, ‘binary Ti ’, ‘Ti-X’ (with X is the alloy element), ‘dental implant’ and ‘medical implant’. Only laboratory studies that intentionally for implant or biomedical applications were included. According to available literatures, we might conclude that most of the binary Ti alloys with alloying <20% elements of Zr, In, Ag, Cu, Au, Pd, Nb, Mn, Cr, Mo, Sn and Co have high potential as implant materials, due to good mechanical performance without compromising the biocompatibility and biological behaviour compare to cp-Ti.

Effects of small-grit grinding and glazing on mechanical behaviors and ageing resistance of a super-translucent dental zirconia

OBJECTIVES

The purpose of this study is to elucidate the effects of small-grit grinding on the mechanical behaviors and ageing resistance of a super-translucent dental zirconia and to investigate the necessity of glazing for the small-grit ground zirconia.

METHODS

Small-grit grinding was performed using two kinds of silicon carbide abrasive papers. The control group received no grinding. The unground surfaces and the ground surfaces were glazed by an experienced dental technician. Finally, the zirconia materials were thermally aged in water at 134°C for 5h. After aforementioned treatments, we observed the surface topography and the microstructures, and measured the extent of monoclinic phase, the nano-hardness and nano-modulus of the possible transformed zone and the flexural strength.

RESULTS

Small-grit grinding changed the surface topography. The zirconia microstructure did not change obviously after surface treatments and thermal ageing; however, the glaze in contact with zirconia showed cracks after thermal ageing. Small-grit grinding did not induce a phase transformation but improved the flexural strength and ageing resistance. Glazing prevented zirconia from thermal ageing but severely diminished the flexural strength. The nano-hardness and nano-modulus of the surface layer were increased by ultrafine grinding.

CONCLUSIONS

The results suggest that small-grit grinding is beneficial to the strength and ageing resistance of the super-translucent dental zirconia; however, glazing is not necessary and even impairs the strength for the super-translucent dental zirconia.

CLINICAL SIGNIFICANCE

This study is helpful to the researches about dental grinding tools and maybe useful for dentists to choose reasonable zirconia surface treatments.

Changes to Glazed Dental Ceramic Shade, Roughness, and Microhardness after Bleaching and Simulated Brushing

PURPOSE

To evaluate shade stability, surface roughness, microhardness, and compressive strength of a glazed feldspathic ceramic subjected to bleaching and simulated brushing.

MATERIALS AND METHODS

Eighty-eight glazed feldspathic ceramic specimens were made from microparticulate leucite and divided into eight groups (n = 10). The whitening products used were: Opalescence Trèswhite Supreme (Ultradent), Opalescence®\ PF 15% (Ultradent), and Oral-B 3D White Whitestrips. All substances for whitening were used for 4 hours/day for a period of 14 days; the control group was not bleached. Next, half of the specimens were individually brushed. Microhardness and surface roughness data were subjected to three-way ANOVA and Tukey test. The diametrical tensile strength data were subjected to two-way ANOVA. The shade change data were analyzed using Kruskal-Wallis, Mann-Whitney, and the Student-Newman-Keuls test. The significance level was set at 5%.

RESULTS

Glazed feldspathic ceramic surface microhardness was significantly affected by bleaching agents (p = 0.007). Initially, glazed ceramic microhardness was significantly higher than that observed after contact with the bleaching agents, whether or not brushing was performed. The specimens submitted to bleaching in preloaded trays presented lower surface roughness values after brushing (p = 0.037). The surface roughness was significantly lower in the brushed specimens (p = 0.044). The diametrical tensile strength was not significantly affected by the application of bleaching agents (p = 0.563) or by brushing (p = 0.477). When the specimens were brushed, however, shade change was significantly influenced by the bleaching agent used (p = 0.041).

CONCLUSIONS

Bleaching agents associated with brushing cycles can alter surface properties and shade stability of glazed feldspathic ceramics, though such findings may not reflect the performance of unglazed feldspathic ceramics.

Translucency and low-temperature degradation of silica-doped zirconia: A pilot study

The purpose of this study was to examine the translucency and low-temperature degradation of silica-doped experimental Y-TZP (Yttria-stabilized tetragonal zirconia polycrystal) containing almost no alumina. The experimental Y-TZP samples were sintered at either 1,450 or 1,500°C. The samples of commercially available translucent Y-TZP and conventional Y-TZP were used as controls. The contrast ratio (CR) and translucency parameter (TP) were obtained to compare the translucencies. In addition, the specimens were also subjected to an accelerated aging test. The results showed that the experimental Y-TZP sintered at 1,500°C and translucent Y-TZP exhibited almost the same level of translucency. During the accelerated aging test, the translucent Y-TZP underwent a substantial increase in monoclinic content, an index of degradation after the aging test. However, neither the experimental Y-TZP nor the conventional Y-TZP exhibited any appreciable change. It was concluded that the silica-doped Y-TZP will develop translucency and resistance to degradation when sintered at 1,500°C.

A review of engineered zirconia surfaces in biomedical applications

Zirconia is widely used for load-bearing functional structures in medicine and dentistry. The quality of engineered zirconia surfaces determines not only the fracture and fatigue behaviour but also the low temperature degradation (ageing sensitivity), bacterial colonization and bonding strength of zirconia devices. This paper reviews the current manufacturing techniques for fabrication of zirconia surfaces in biomedical applications, particularly, in tooth and joint replacements, and influences of the zirconia surface quality on their functional behaviours. It discusses emerging manufacturing techniques and challenges for fabrication of zirconia surfaces in biomedical applications.

Effect of grinding and polishing on roughness and strength of zirconia

STATEMENT OF PROBLEM

The clinical applications of high-translucency monolithic zirconia restorations have increased. Chairside and laboratory adjustments of these restorations are inevitable, which may lead to increased roughness and reduced strength. The influence of grinding and polishing on high-translucency zirconia has not been investigated.

PURPOSE

The purpose of this in vitro study was to compare the roughness averages (Ra) of ground and polished zirconia and investigate whether roughness influenced strength after aging.

MATERIAL AND METHODS

High-translucency zirconia disks were milled, sintered, and glazed according to the manufacturer's recommendations. Specimens were randomized to 4 equal groups. Group G received only grinding; groups GPB and GPK received grinding and polishing with different polishing systems; and group C was the (unground) control group. All specimens were subjected to hydrothermal aging in an autoclave at 134°C at 200 kPa for 3 hours. Roughness average was measured using a 3-dimensional (3D) optical interferometer at baseline (Ra1), after grinding and polishing (Ra2), and after aging (Ra3). A biaxial flexural strength test was performed at a rate of 0.5 mm/min. Statistical analyses were performed using commercial software (α=.05).

RESULTS

Group G showed a significantly higher mean value of Ra3 (1.96 ±0.32 μm) than polished and glazed groups (P<.001), which showed no statistically significant difference among them (GPB, 1.12 ±0.31 µm; GPK, 0.88 ±0.31 µm; C: 0.87 ±0.25 μm) (P>.05). Compared with baseline, the roughness of groups G and GPB increased significantly after surface treatments and after aging, whereas aging did not significantly influence the roughness of groups GPK or C. Group G showed the lowest mean value of biaxial flexural strength (879.01 ±157.99 MPa), and the highest value was achieved by group C (962.40 ±113.84 MPa); no statistically significant differences were found among groups (P>.05). Additionally, no significant correlation was detected between the Ra and flexural strength of zirconia.

CONCLUSIONS

Grinding increased the roughness of zirconia restorations, whereas proper polishing resulted in smoothness comparable with glazed surfaces. The results provide no evidence that grinding and polishing affect the flexural strength of zirconia after aging.

Twenty-nine-month follow-up of a paediatric zirconia dental crown

The aim of this paper is to present the long-term follow-up of one paediatric zirconia crown on a deciduous molar. Preformed crowns are part of the armamentarium in paediatric dentistry. In recent years, aesthetic alternatives to preformed metal crowns have been developed, first preveneered crowns and then zirconia crowns. This paper describes the restoration of a primary molar with a zirconia crown (EZ-Pedo, Loomis, California, USA) in an 8-year-old boy. In this clinical case, the protocol for the implementation and maintenance of zirconia crowns is detailed. The patient was followed up for 29 months until the natural exfoliation of his primary molar. The adaptation of the zirconia crown, the gingival health and the wear on the opposing tooth were considered. In this case, the paediatric zirconia crown allowed sustainable functional restoration while restoring a natural appearance of the tooth.

Effect of Sandblasting Angle and Distance on Biaxial Flexural Strength of Zirconia-based Ceramics

AIM

Surface treatment is necessarily required for bonding of zirconia to the veneering porcelain and luting cements. Sandblasting is the most common and probably the most efficient surface treatment method. Sandblasting roughens the surface and may affect the flexural strength of zirconia. Different sandblasting protocols may yield variable results. This study sought to assess the effect of sandblasting angle and distance on the biaxial flexural strength of zirconia-based ceramics.

MATERIALS AND METHODS

This in vitro experimental study was conducted on 50 zirconia discs measuring 1.2 ± 0.2 mm in thickness and 15 ± 0.2 mm in diameter, which were randomly divided into five groups (n = 10) of one control and four experimental groups subjected to sandblasting with 110 μm aluminum oxide particles under 2 bar pressure for 10 seconds at 15 and 25 mm distances and 45 and 90° angles (between the nozzle head and zirconia surface). Surface roughness was measured by a roughness tester and samples were subjected to thermocycling followed by biaxial flexural strength testing according to ISO6872. The data were analyzed using one-way analysis of variance (p < 0.05).

RESULTS

No statistically significant difference was noted in the mean biaxial flexural strength of the five groups (p = 0.40). Different sandblasting protocols yielded significantly different surface roughness values (p < 0.001). The highest and the lowest mean surface roughness belonged to 15 mm/90° (0.51 μm) and control (0.001 μm) groups respectively.

CONCLUSION

Change in sandblasting angle and distance had no significant effect on the biaxial flexural strength of zirconia-based ceramic, but surface roughness was significantly different in the study groups. Clinical significances: Regardless of sandblasting angle, increasing distance to 25 mm significantly decreases surface roughness that may negatively affect zirconia bond strength.

Effects of taper and space settings of telescopic Ce-TZP/A crowns on retentive force and settling

The aim of this study was to investigate the effect of the taper and space setting of using Ce-TZP/A on retentive force and secondary crown settling. The taper were 2°, 4°, and 6°, and the space settings were 0 and 10 μm. The applied loads were 50 and 100 N. The taper had a significant effect on retentive force and settling at both loads (p<0.05). The space settings did not have a significant effect on retentive force or settling at either load (p<0.05). The taper of the telescopic crowns and the load affected the retentive force and the settling.

Three-dimensional finite element analysis of zirconia all-ceramic cantilevered fixed partial dentures with different framework designs

The purpose of this study were: to perform stress analyses using three-dimensional finite element analysis methods; to analyze the mechanical stress of different framework designs; and to investigate framework designs that will provide for the long-term stability of both cantilevered fixed partial dentures (FPDs) and abutment teeth. An analysis model was prepared for three units of cantilevered FPDs that assume a missing mandibular first molar. Four types of framework design (Design 1, basic type; Design 2, framework width expanded buccolingually by 2 mm; Design 3, framework height expanded by 0.5 mm to the occlusal surface side from the end abutment to the connector area; and Design 4, a combination of Designs 2 and 3) were created. Two types of framework material (yttrium-oxide partially stabilized zirconia and a high precious noble metal gold alloy) and two types of abutment material (dentin and brass) were used. In the framework designs, Design 1 exhibited the highest maximum principal stress value for both zirconia and gold alloy. In the abutment tooth, Design 3 exhibited the highest maximum principal stress value for all abutment teeth. In the present study, Design 4 (the design with expanded framework height and framework width) could contribute to preventing the concentration of stress and protecting abutment teeth.

Stereolithography: A new method for processing dental ceramics by additive computer-aided manufacturing

OBJECTIVES

The aim of this study was to compare the physical and mechanical properties of stereolithography (SLA)- manufactured alumina ceramics of different composition to those of subtractive- manufactured ceramics and to produce suitable dental crown frameworks.

METHODS

The physical and mechanical properties of a control and six experimental SLA ceramics prepared from slurries with small (S) and large (L) particles (0.46±0.03 and 1.56±0.04μm, respectively) and three dry matter contents (70%, 75%, 80%) were evaluated by dynamic rheometry, hydrostatic weighing, three3-point flexural strength measurements, and Weibull analyses, and by the micrometrics measurement of shrinkage ratio before and after the heat treatments.

RESULTS

S75 was the only small particle slurry with a significantly higher viscosity than L70. The viscosity of the S80 slurry made it impossible to take rheological measurements. The viscosities of the S75 and S80 slurries caused deformations in the printed layers during SLA manufacturing and were excluded from further consideration. SLA samples with low dry matter content had significantly lower and densityflexural strengths. Only SLA samples with a large particle size and high dry matter content (L75 and L80) were similar in density and flexural strength to the subtractive- manufactured samples. The 95% confidence intervals of the Weibull modulus of the L80 ceramic were higher (no overlap fraction) than those of the L75 ceramic and were similar to the control (overlap fraction). The Weibull characteristics of L80 ceramic were higher than those of L75 ceramic and the control. SLA can be used to process suitable crown frameworks but shows results in anisotropic shrinkage.

SIGNIFICANCE

The hH High particle size and dry matter content of the L80 slurry allowed made it possible to produce a reliable ceramic by SLA manufacturing with an anisotropic shrinkage, and a density, and flexural strength similar to those of a subtractive-manufactured ceramic. SLA allowed made it possible to build up a dense 3D alumina crown framework with controlled shape. Further studies on the marginal adaptation and shrinkage model of alumina crown frameworks will be required to optimize the process.

Evaluation of five primers and two opaque resins for bonding ceria-stabilized zirconia/alumina nanocomposite

The purpose of this study was to evaluate the effect of five primers [Super-Bond C&B Monomer (SB), Clearfil Ceramic Primer, Alloy Primer, M.L. Primer, and AZ Primer] and two undercoating opaque resins [Super-Bond C&B (S-opaque) and Ceramage Pre-opaque (C-opaque)] on the bonding of a resin composite veneering material to a ceria-stabilized tetragonal zirconia polycrystals/alumina nanocomposite (Ce-TZP/Al₂O₃). Disk-shaped specimens of Ce-TZP/Al₂O₃ were sandblasted with alumina and primed. The undercoating opaque resins and resin composites were subsequently applied to the specimen, and then light cured. After 5000 thermocycles at 4°C and 60°C, shear bond strengths were determined. Data were analyzed using analysis of variance, Tukey–Kramer honest significant difference test, and Student t test (n = 10, α = 0.05). With the exception of SB/S-opaque, all S-opaque groups exhibited significantly higher bond strengths than C-opaque groups. The use of S-opaque resin is recommended when veneering frameworks made of Ce-TZP/Al₂O₃.

Investigation of accuracy and reproducibility of abutment position by intraoral scanners

PURPOSE

We examined the accuracy, including trueness and precision, of the intraoral scanners comparing with laboratory scanner to reveal the error level of intraoral scanners.

METHODS

Measurements were performed using a computer numerical control coordinate measuring machine (CNCCMM) of the reference models as a control. Subsequently, intraoral scanners and a laboratory scanner were used for measurements of the reference trueness and precision of the distance were evaluated by image analyzing software.

RESULTS

With regard to reference model, there was a significant difference between in the trueness measured by C.O.S. (COS) and that measured by the other scanners. The trueness measured by the second-generation 3M™ true definition scanner (TDS2) and third-generation 3M™ true definition scanner (TDS3) was bigger than the one by TRIOS (TR) and KaVo (KA). With regard to reference model "B," error of the trueness measured by COS was significantly bigger, compared with the one measured by the other scanners. However, error range of intraoral scanners, except for COS, was considerably small and it should be covered with cement space.

CONCLUSIONS

The results of this study indicated that an optical impression method with an intraoral scanner could be applied to the implant therapy for multiple teeth missing.

Shear Bond Strength of Al₂O₃ Sandblasted Y-TZP Ceramic to the Orthodontic Metal Bracket

As the proportion of adult orthodontic treatment increases, mainly for aesthetic reasons, orthodontic brackets are directly attached to yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) restorations. This, study analyzed the shear bond strength (SBS) between various surface treated Y-TZP and orthodontic metal brackets. The Y-TZP specimens were conditioned by 110 μm Al₂O₃ sandblasting, or sandblasting followed by coating with one of the primers (silane, MDP, or an MDP-containing silane primer). After surface treatment, the orthodontic metal bracket was bonded to the specimen using a resin cement, and then 24 h storage in water and thermal cycling (5000 cycles, 5-55 °C), SBS was measured. Surface roughness was analyzed for surface morphology, and X-ray photoelectron spectroscopy (XPS) was employed for characterization of the chemical bond between the Y-TZP and the MDP-based primers (MDP, MDP containing silane primer). It was found that after surface treatment, the surface roughness of all groups increased. The groups treated with 110 μm Al₂O₃ sandblasting and MDP, or MDP-containing silane primer showed the highest SBS values, at 11.92 ± 1.51 MPa and 13.36 ± 2.31 MPa, respectively. The SBS values significantly decreased in all the groups after thermal cycling. Results from XPS analysis demonstrated the presence of chemical bonds between Y-TZP and MDP. Thus, the application of MDP-based primers after Al₂O₃ sandblasting enhances the resin bond strength between Y-TZP and the orthodontic metal bracket. However, bonding durability of all the surface-treated groups decreased after thermal cycling.

Residual compressive surface stress increases the bending strength of dental zirconia

OBJECTIVE

To assess the influence of surface treatment and thermal annealing on the four-point bending strength of two ground dental zirconia grades.

METHODS

Fully-sintered zirconia specimens (4.0×3.0×45.0mm³) of Y-TZP zirconia (LAVA Plus, 3M ESPE) and Y-TZP/Al₂O₃ zirconia (ZirTough, Kuraray Noritake) were subjected to four surface treatments: (1) 'GROUND': all surfaces were ground with a diamond-coated grinding wheel on a grinding machine; (2) 'GROUND+HEAT': (1) followed by annealing at 1100°C for 30min; (3) 'GROUND+Al₂O₃ SANDBLASTED': (1) followed by sandblasting using Al₂O₃; (4) 'GROUND+CoJet SANDBLASTED': (1) followed by tribochemical silica (CoJet) sandblasting. Micro-Raman spectroscopy was used to assess the zirconia-phase composition and potentially induced residual stress. The four-point bending strength was measured using a universal material-testing machine.

RESULTS

Weibull analysis revealed a substantially higher Weibull modulus and slightly higher characteristic strength for ZirTough (Kuraray Noritake) than for LAVA Plus (3M ESPE). For both zirconia grades, the 'GROUND' zirconia had the lowest Weibull modulus in combination with a high characteristic strength. Sandblasting hardly changed the bending strength but substantially increased the Weibull modulus of the ground zirconia, whereas a thermal treatment increased the Weibull modulus of both zirconia grades but resulted in a significantly lower bending strength. Micro-Raman analysis revealed a higher residual compressive surface stress that correlated with an increased bending strength.

SIGNIFICANCE

Residual compressive surface stress increased the bending strength of dental zirconia. Thermal annealing substantially reduced the bending strength but increased the consistency (reliability) of 'GROUND' zirconia.

A Step-by-Step Conservative Approach for CAD-CAM Laminate Veneers

The use of CAD/CAM technology has allowed the fabrication of ceramic restorations efficiently and with predictable results. Lithium disilicate is a type of glass ceramic material that can be used for the elaboration of laminate veneers, being monolithic restorations which require characterization through a covering ceramic in order to achieve acceptable esthetic results. The next case report shows a predictable clinical protocol for the rehabilitation of the anterior teeth through the preparation of CAD/CAM veneers (e.max CAD, Ivoclar Vivadent, Liechtenstein) which have been characterized by a nanofluorapatite ceramic (e.max Ceram, Ivoclar Vivadent, Liechtenstein) through the layering technique.

Soft tissue biological response to zirconia and metal implant abutments compared with natural tooth: microcirculation monitoring as a novel bioindicator

INTRODUCTION

Zirconia is often used for implant abutments for esthetics. The aim of this clinical study was to compare the effects of zirconia and metal abutments on periimplant soft tissue.

MATERIALS AND METHODS

Ten maxillary anterior implant patients, 5 with metal abutments and 5 with zirconia abutments, were enrolled in this trial. The soft tissue around the implant abutments was evaluated by 2-dimensional laser speckle imaging and thermography. The blood flow in soft tissue around natural teeth was also measured to correct for differences among the subjects.

RESULTS

Significantly greater blood flow was detected in the zirconia abutment group (95.64 ± 5.17%) relative to the metal abutment group (82.25 ± 8.92%) in free gingiva (P = 0.0317). Reduced blood flow (by almost 18%) was detected in the tissue surrounding metal abutments compared with the tissue surrounding natural teeth. The surface temperature showed no significant difference for all measurements.

CONCLUSIONS

These results suggest that blood flow in tissue surrounding zirconia abutments is similar to that in soft tissue around natural teeth. Moreover, zirconia abutments could be advantageous for the maintenance of immune function by improving blood circulation.

Discoloration of various CAD/CAM blocks after immersion in coffee

Objectives

This study evaluated color differences (ΔEs) and translucency parameter changes (ΔTPs) of various computer-aided design/computer-aided manufacturing (CAD/CAM) blocks after immersion in coffee.

Materials and Methods

Eight CAD/CAM blocks and four restorative composite resins were evaluated. The CIE L^*a^*b^* values of 2.0 mm thick disk-shaped specimens were measured using the spectrophotometer on white and black backgrounds (n = 6). The ΔEs and ΔTPs of one day, one week, and one month immersion in coffee or water were calculated. The values of each material were analyzed by two-way ANOVA and Tukey's multiple comparisons (α = 0.05). The ΔEs after prophylaxis paste polishing of 1 month coffee immersion specimens, water sorption and solubility were also evaluated.

Results

After one month in coffee, ΔEs of CAD/CAM composite resin blocks and restorative composites ranged from 1.6 to 3.7 and from 2.1 to 7.9, respectively, and ΔTPs decreased. The ANOVA of ΔEs and ΔTPs revealed significant differences in two main factors, immersion periods and media, and their interaction except for ΔEs of TEL (Telio CAD, Ivoclar Vivadent). The ΔEs significantly decreased after prophylaxis polishing except GRA (Gradia Block, GC). There was no significant correlation between ΔEs and water sorption or solubility in water.

Conclusions

The ΔEs of CAD/CAM blocks after immersion in coffee varied among products and were comparable to those of restorative composite resins. The discoloration of CAD/CAM composite resin blocks could be effectively removed with prophylaxis paste polishing, while that of some restorative composites could not be removed.

Comparison of marginal fit of cemented zirconia copings manufactured after digital impression with lava™ C.O.S and conventional impression technique

Background

Evaluation of the marginal fit of cemented zirconia copings manufactured after digital impression with Lava™ Chairside Oral Scanner in comparison to that of zirconia copings manufactured after conventional impressions with polyvinyl siloxane.

Methods

A prepared typodont tooth #36, was replicated 40 times with a vinyl silicone and precise model resin. The dies were randomly divided into two groups according to the impression taking technique. Digital impressions with Lava™ C.O.S. and conventional impressions were taken according to the group. Subsequently zirconia copings were manufactured and cemented on their respective dies with zinc oxide phosphate cement. After embedding in resin, mesio-distal section of each coping was performed with a diamond saw in order to obtain two slices. One half of the specimen was used for evaluation with an optical microscope (OM) and the other half for evaluation with a scanning electron microscope (SEM). Marginal gap (MG) and absolute marginal discrepancy (AMD) were measured mesial and distal on each slice.

Results

No significant difference of the marginal parameters between the digital and the conventional group was found. The mean values for MG in the digital group were 96.28 μm (+/−43.21 μm) measured with the OM and 99.26 μm (+/−48.73 μm) measured with the SEM, respectively. AMD mean values were 191.54 μm (+/−85.42 μm) measured with the optical microscope and 211.6 μm (+/−96.55 μm) with the SEM. For the conventional group the mean MG values were 94.84 μm (+/−50.77 μm) measured with the OM and 83.37 μm (+/−44.38 μm) measured with the SEM, respectively. AMD mean values were 158.60 μm (+/−69.14 μm) for the OM and 152.72 μm (+/−72.36) for the SEM.

Conclusions

Copings manufactured after digital impression with Lava™ C.O.S. show comparable marginal parameters with the copings manufactured after conventional impression with polyvinyl syloxane. The mean MG values of both groups fit in the clinically acceptable range.

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-016-0323-8) contains supplementary material, which is available to authorized users.

Effect of cement space on stress distribution in Y-TZP based crowns

OBJECTIVE

To evaluate the stress distribution in bi-layered Y-TZP based crowns, according to the occlusal internal spacing between coping and abutment.

METHODS

Twelve premolar shaped Y-TZP copings were made by a CAD/CAM system and seated on an abutment to evaluate the internal fit at the occlusal third using micro-CT images. Considering the fitting range obtained experimentally, two 3D finite element models, consisting on bone tissue, a titanium implant, a zirconia abutment, cement layer and a bi-layered Y-TZP ceramic crown were constructed based on the micro-CT images, one corresponding to the thinnest cement space and other representing the specimen with the thickest cement space obtained experimentally. A 250N axial load was applied at the center of the occlusal surface of the crown (≅0,8mm² area) and the first principal stress distribution was plotted and analyzed.

RESULTS

The greatest maximum principal stress occurred within the veneer ceramic right below the site of loading. The thickest cement model showed higher stress concentration at the center of occlusal surface of veneer and the center of occlusal internal surface of coping.

SIGNIFICANCE

Knowledge of stress distribution in ceramic crowns with different cement thicknesses will help clinicians to properly adjust crown fit, in seeking to avoid porcelain fractures.

In vitro evaluation of marginal discrepancy of monolithic zirconia restorations fabricated with different CAD-CAM systems

STATEMENT OF PROBLEM

Dental laboratories use different computer-aided design and computer-aided manufacturing (CAD-CAM) systems to fabricate fixed prostheses; however, limited evidence is available concerning which system provides the best marginal discrepancy.

PURPOSE

The purpose of this in vitro study was to evaluate the marginal fit of 5 different monolithic zirconia restorations milled with different CAD-CAM systems.

MATERIAL AND METHODS

Thirty monolithic zirconia crowns were fabricated on a custom-designed stainless steel die and were divided into 5 groups according to the type of monolithic zirconia crown and the CAD-CAM system used: group TZ, milled with an MCXL milling machine; group CZ, translucent zirconia milled with a motion milling machine; group ZZ, zirconia milled with a dental milling unit; group PZ, translucent zirconia milled with a zirconia milling unit; and group BZ, solid zirconia milled using an S1 VHF milling machine. The marginal fit was measured with a binocular microscope at an original magnification of ×100. The results were tabulated and statistically analyzed with 1-way ANOVA and post hoc surface range test, and pairwise multiple comparisons were made using Bonferroni correction (α=.05).

RESULTS

The type of CAD-CAM used affected the marginal fit of the monolithic restoration. The mean (±SD) highest marginal discrepancy was recorded in group TZI at 39.3 ±2.3 μm, while the least mean marginal discrepancy was recorded in group IZ (22.8 ±8.9 μm). The Bonferroni post hoc test showed that group TZI was significantly different from all other groups tested (P<.05).

CONCLUSIONS

Within the limitation of this in vitro study, all tested CAD-CAM systems produced monolithic zirconia restorations with clinically acceptable marginal discrepancies; however, the CAD-CAM system with the 5-axis milling unit produced the best marginal fit.

Prosthetic Rehabilitation After Fibular Free Flap Surgery of Mandibular Defects in a Patient With Oral Squamous Cell Carcinoma

OBJECTIVE

This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery.

DESIGN

A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects.

CONCLUSIONS

The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.

Examination of the Position Accuracy of Implant Abutments Reproduced by Intra-Oral Optical Impression

An impression technique called optical impression using intraoral scanner has attracted attention in digital dentistry. This study aimed to evaluate the accuracy of the optical impression, comparing a virtual model reproduced by an intraoral scanner to a working cast made by conventional silicone impression technique. Two implants were placed on a master model. Working casts made of plaster were fabricated from the master model by silicone impression. The distance between the ball abutments and the angulation between the healing abutments of 5 mm and 7 mm height at master model were measured using Computer Numerical Control Coordinate Measuring Machine (CNCCMM) as control. Working casts were then measured using CNCCMM, and virtual models via stereo lithography data of master model were measured by a three-dimensional analyzing software. The distance between ball abutments of the master model was 9634.9 ± 1.2 μm. The mean values of trueness of the Lava COS and working casts were 64.5 μm and 22.5 μm, respectively, greater than that of control. The mean of precision values of the Lava COS and working casts were 15.6 μm and 13.5 μm, respectively. In the case of a 5-mm-height healing abutment, mean angulation error of the Lava COS was greater than that of the working cast, resulting in significant differences in trueness and precision. However, in the case of a 7-mm-height abutment, mean angulation errors of the Lava COS and the working cast were not significantly different in trueness and precision. Therefore, distance errors of the optical impression were slightly greater than those of conventional impression. Moreover, the trueness and precision of angulation error could be improved in the optical impression using longer healing abutments. In the near future, the development of information technology could enable improvement in the accuracy of the optical impression with intraoral scanners.