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Güntekin N, Kızılırmak B, Tunçdemir AR. Comparison of Mechanical and Optical Properties of Multilayer Zirconia After High-Speed and Repeated Sintering. MATERIALS (BASEL, SWITZERLAND) 2025; 18:1493. [PMID: 40271684 PMCID: PMC11989518 DOI: 10.3390/ma18071493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2025] [Revised: 03/03/2025] [Accepted: 03/25/2025] [Indexed: 04/25/2025]
Abstract
This study aims to investigate the mechanical and optical properties of two different multilayer monolithic zirconia materials after the high-speed and repeated sintering process recommended by the manufacturers. In this study, specimens with a diameter of 12 mm and a thickness of 1 mm were fabricated using KATANA Zirconia YML (Kuraray Noritake) and IPS e.max ZirCAD Prime (Ivoclar Vivadent) multilayer zirconia. These specimens were processed with two different protocols to be used in the sintering process: high-speed and conventional sintering. Both protocols were repeated three times, after which the changes in the mechanical, microstructural and optical properties of the specimens were compared and analyzed. According to the biaxial flexural strength result, KATANA Zirconia YML (840.84 MPa) showed higher biaxial flexural strength compared to IPS e.max ZirCAD Prime (627.64 MPa) after repeated high-speed sintering. When the optical properties were analyzed, the translucency parameters of the IPS e.max ZirCAD Prime block were reliable in certain protocols. A comparison of mechanical and optical properties after repeated and high-speed sintering reveals that both materials offer advantages for different application requirements. The high biaxial flexural strength of KATANA Zirconia YML is more suitable for applications requiring strength. The homogeneous translucency of IPS e.max ZirCAD Prime is esthetically and optically safer for high-speed and repeated sintering processes.
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Affiliation(s)
| | - Burcu Kızılırmak
- Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, 42090 Konya, Turkey; (N.G.); (A.R.T.)
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Hassan Shohdy EI, Sabet A, Sherif AH, Salah T. The effect of speed sintering on the optical properties and microstructure of multi-layered cubic zirconia. J Prosthodont 2025; 34:316-322. [PMID: 38288518 DOI: 10.1111/jopr.13822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/04/2024] [Indexed: 03/06/2025] Open
Abstract
PURPOSE Speed sintering was introduced to fabricate time-efficient chairside restorations, however, its influence on the microstructure and optical properties of zirconia is still unclear. This study investigated the influence of speed sintering on the microstructure and optical properties of ultra-translucent multi-layered cubic zirconia. MATERIALS AND METHODS Ultra-translucent cubic zirconia (Katana™ UTML; Kuraray Noritake Dental Inc., Aichi, Japan) was cut into a total of 80 specimens, twenty within each layer of the blank. The specimens were divided into 2 groups: speed and conventional sintering. The translucency parameter, opalescence, chromaticity, and color difference were recorded using a spectrophotometer. Scanning electron microscope images were used for crystallographic analysis. One-way ANOVA and Tukey's post-hoc test (p < 0.05) were used for data analysis. RESULTS Speed sintering significantly reduced the translucency and opalescence compared to conventional sintering excluding the opalescence of the dentin layer. Chromaticity significantly decreased with speed sintering in less chromatic layers and significantly increased in more chromatic layers. Mean color change ranged between 0.65 and 1.25 across different layers. Mean crystal size decreased with speed sintering. CONCLUSIONS With speed sintering, translucency, and opalescence decrease while chromaticity increases in the more chromatic layers. Additionally, no clinically perceptible color change was found compared to conventional sintering.
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Affiliation(s)
- Engy Ibrahim Hassan Shohdy
- Fixed Prosthodontics Department, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
| | - Ahmed Sabet
- Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
- Fixed Prosthodontics Department, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - Ashraf Hussien Sherif
- Fixed Prosthodontics Department, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
| | - Tarek Salah
- Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
- Faculty of Oral and Dental Medicine, Misr International University, Cairo, Egypt
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Juntavee N, Juntavee A, Jaralpong C. Color Characteristics of High Yttrium Oxide-Doped Monochrome and Multilayer Partially Stabilized Zirconia upon Different Sintering Parameters. Eur J Dent 2025; 19:227-239. [PMID: 38942053 PMCID: PMC11750310 DOI: 10.1055/s-0044-1787700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVES Sintering influences the optical properties of zirconia. This study examined the effect of altering sintering temperature and time of monochrome (Mo) and multilayer (Mu) 5 mol% yttria-partially stabilized zirconia (5Y-PSZ) on color characteristics. MATERIALS AND METHODS Three hundred specimens (width × length × thickness = 10 × 20 × 2 mm) were prepared from Mo and Mu (with cervical [C], middle [M], and incisal [I] region) 5Y-PSZ and randomly sintered at decreasing (Td: 1,450°C), regular (Tr: 1,500°C), and increasing (TI: 1,550°C) sintering temperature, with extremely short (He: 10 minutes), ultrashort (Hu: 15 minutes), short (Hs: 30 minutes), and regular (Hr: 135 minutes) sintering time (n = 15/group). Color appearance (EW ), translucency parameter (TP), contrast ratio (CR), opalescence parameter (OP), and color appearance difference (∆E diff) were evaluated in the CIE L*a*b* system. Microstructures were evaluated by scanning electron microscope (SEM) and X-ray diffractometer (XRD). STATISTICAL ANALYSIS Analysis of variance (ANOVA) and Bonferroni comparisons were determined for significant differences (p < 0.05). RESULTS Significant differences in color parameters upon zirconia type, sintering temperature, and sintering time, and their interactions were indicated (p < 0.05). Increasing sintering temperature and extended sintered time resulted in larger grain, reduced tetragonal-to-monoclinic phase transformation, and significantly increased the TP and OP, but decreased the CR and ∆E diff (p < 0.05). Decreasing sintering temperature and time led to clinically unacceptable color appearance. CONCLUSION Mo was found to be more translucent than Mu. To achieve the most favorable optical properties, increasing sintering temperature and extending sintering time are recommended. Decreasing sintering temperature is not suggested. However, shortened sintering time is feasible, but it needs sintering with increasing sintering temperature to achieve a promising color appearance.
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Affiliation(s)
- Niwut Juntavee
- Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Apa Juntavee
- Department of Preventive Dentistry, Division of Pediatric Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Chutikarn Jaralpong
- Division of Biomaterials and Prosthodontics Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Mazaheri Tehrani A, Nami M, Zarbakhsh A, Moscowchi A, Jalalian E. Impact of surface pre-treatment on bond strength between cement and zirconia: A systematic review and network meta-analysis. J Prosthet Dent 2025:S0022-3913(24)00830-8. [PMID: 39814646 DOI: 10.1016/j.prosdent.2024.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2024] [Revised: 12/04/2024] [Accepted: 12/09/2024] [Indexed: 01/18/2025]
Abstract
STATEMENT OF PROBLEM The optimal zirconia pretreatment, contingent upon the type of cement used, warrants further research. PURPOSE The purpose of this investigation was to evaluate the influence of various surface pretreatments on the bonding efficacy of cement to zirconia. MATERIAL AND METHODS A comprehensive search was conducted across the PubMed, Embase, Scopus, and Web of Science databases for in vitro studies related to bonding with zirconia up to April 2024, supplemented by a manual search. A network meta-analysis was executed to compare different types of cement. RESULTS Of the 6118 articles screened, 21 were selected for inclusion in this review. These studies examined various surface pretreatment techniques, primers, resin cements, aging protocols, and bond strength testing methods. The highest bond strengths were observed with 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-based cements. The network meta-analysis indicated that mechanical and mechano-chemical pretreatments yielded superior results across all cement types. CONCLUSIONS The existing evidence indicates that both surface pretreatments and the specific type of cement should be considered when interpreting the findings of in vitro studies for their application in clinical practice.
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Affiliation(s)
- Azita Mazaheri Tehrani
- Assistant Professor, Department of Prosthodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Majedeh Nami
- Assistant Professor, Department of Prosthodontics, School of Dentistry, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Arash Zarbakhsh
- Assistant Professor, Department of Prosthodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Researcher, Dental Research Center, Research Institute for Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ezatollah Jalalian
- Associate Professor, Department of Prosthodontics, Dental Branch, Islamic Azad University of Medical Sciences, Tehran, Iran
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Mohamed O, Kim H, Makowka S, AlMozayen A, Sawangsri K, Li R. Impact of speed sintering on the mechanical and optical properties of multilayered zirconia. J Prosthet Dent 2025; 133:280.e1-280.e6. [PMID: 39472162 DOI: 10.1016/j.prosdent.2024.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 09/24/2024] [Accepted: 09/26/2024] [Indexed: 01/13/2025]
Abstract
STATEMENT OF PROBLEM Speed sintering techniques have been introduced to shorten the sintering time of zirconia ceramics, yet their impact on multilayered zirconia properties remains understudied. PURPOSE The purpose of this in vitro study was to assess the effect of speed sintering on the optical properties and the mechanical flexural strength of multilayered zirconia materials. MATERIAL AND METHODS A total of 360 disks (Ø14 ±2 mm ×1.2 ±0.02 mm) were fabricated by following the International Organization for Standardization (ISO) 6872:2015 standard using 2 types of Vita A2 shade multilayered zirconia materials: IPS e.max ZirCAD Prime (ZP) and IPS e.max ZirCAD Prime Esthetic (ZPE). Each material comprised translucent (Tr), gradient l (Gr), and dentin (De) layers, with 60 disks per layer. Half were sintered using a standard sintering protocol and half using a speed sintering protocol. Biaxial flexural strength was accessed using a universal testing machine equipped with the Blue Hill Universal software program by following the ISO 6872:2015 standard, with 20 disks per subgroup. The spectrophotometric analysis of optical properties (contrast ratio [CR], translucency parameter [TP], and total transmittance [Tt%]) was performed using a dual-beam spectrophotometer (Ultrascan VIS) in accordance with the ISO 7491:2000 standard, with 10 disks per subgroup. The comparison of the optical properties and the mechanical flexural strength between the speed and standard protocol was analyzed using an unpaired t test (α=.05). RESULTS Speed sintering reduced biaxial flexural strength in all ZP layers (P<.05) and in ZPE-Gr (P<.05). A statistically significant difference in the CR was observed in the ZP-Tr, ZP-Gr, and ZPE-Gr layers (P<.05). The TP of the ZP-Gr, ZP-De, and ZPE-Gr layers was significantly lower when using the speed sintering protocol. Tt% was significantly lower with speed sintering for both materials (P<.05). CONCLUSIONS Speed sintering statistically changed both the optical (CR, TP, Tt%) and mechanical (flexural strength) properties of multilayered zirconia materials, but the differences may not be clinically relevant.
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Affiliation(s)
- Omar Mohamed
- Assistant Professor, University of Alabama at Birmingham, School of Dentistry, Birmingham, AL
| | - Hyeongil Kim
- Associate Professor, Restorative Dentistry Department, University at Buffalo School of Dental Medicine, Buffalo, NY
| | - Steven Makowka
- Facility Director, Materials Testing Facility, University at Buffalo School of Dental Medicine, Buffalo, NY
| | - Ahmed AlMozayen
- Clinical Assistant Professor, Restorative Dentistry Department, University at Buffalo School of Dental Medicine, Buffalo, NY
| | - Kedith Sawangsri
- Clinical Assistant Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH
| | - Rui Li
- Assistant Professor, Restorative Dentistry Department, University at Buffalo School of Dental Medicine, Buffalo, NY.
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Cho MH, Seol HJ. Impact of Speed Sintering on Translucency, Opalescence and Microstructure of Dental Zirconia with a Combination of 5 mol% and 3 mol% Yttria-Stabilized Zirconia. MATERIALS (BASEL, SWITZERLAND) 2024; 17:5148. [PMID: 39517423 PMCID: PMC11547037 DOI: 10.3390/ma17215148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2024] [Revised: 10/15/2024] [Accepted: 10/21/2024] [Indexed: 11/16/2024]
Abstract
Optical characteristics and microstructure of multilayered zirconia with different yttria contents in each layer can be influenced differently with a layer after speed sintering. The layer-wise translucency and opalescence of dental zirconia (E.max, E.max ZirCAD prime; Cercon, Cercon ht ML) after conventional (control) and speed sintering were analyzed using a spectrophotometer (n = 5). Specimens were subjected to microstructural analyses (n = 2) using field-emission scanning electron microscopy (FE-SEM) and phase analyses (n = 1) using high-resolution X-ray diffraction (HRXRD) and Rietveld refinement. The translucency parameter (TP) and opalescence parameter (OP) were analyzed using a 3-way ANOVA, followed by Scheffé's post hoc test (α = 0.05). The average grain size was analyzed using the Welch's t-test and Kruskal-Wallis test, followed by the Bonferroni-Dunn post hoc test (α = 0.05). Changes to the TP and OP after speed sintering were only observed in the dentin layers. Although the TP of E.max increased (p < 0.05), the difference was below the 50:50% perceptibility threshold (ΔE00 = 0.8). The OP of E.max decreased slightly, whereas that of Cercon increased slightly (p < 0.05). The microstructure and phase fraction of both zirconia barely changed. Therefore, speed sintering is considered to have a negligible clinical impact on the optical characteristics and microstructure.
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Affiliation(s)
- Mi-Hyang Cho
- Department of Dental Laboratory, Wonkwang Health Science University, Iksan-si 54538, Republic of Korea;
| | - Hyo-Joung Seol
- Department of Dental Materials, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan-si 50612, Republic of Korea
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Nonaka K, Teramae M, Pezzotti G. Effect of rapid cooling on residual stress and surface fracture toughness of dental zirconia. J Mech Behav Biomed Mater 2024; 157:106656. [PMID: 39033559 DOI: 10.1016/j.jmbbm.2024.106656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/24/2024] [Accepted: 07/07/2024] [Indexed: 07/23/2024]
Abstract
Short-time sintering of dental zirconia not only improves manufacturing efficiency of zirconia prosthetics, but also enables an attractive situation in which prosthetic treatment can be completed within a single visit. Although many studies have clarified the effects of heating rate and dwell time on the properties of dental zirconia during short-time sintering, there are only a few studies on rapid cooling. In this study, we investigated the effect of cooling rate on dental zirconia. It was found that the cooling rate had no effect on the three-point flexural strength, but a fast cooling rate improved fracture toughness at the material surface. Raman piezo-spectroscopy showed that a compressive stress layer formed in the neighborhood of the zirconia surface and that its thickness increased with increasing cooling rate. From the above results, it was concluded that the compressive stress layer formed on the surface by rapid cooling improved the apparent fracture toughness at the material surface.
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Affiliation(s)
- Kazumichi Nonaka
- Department of Research and Development, SHOFU INC., Higashiyama-ku, Kyoto, Japan.
| | - Mitsuji Teramae
- Department of Research and Development, SHOFU INC., Higashiyama-ku, Kyoto, Japan
| | - Giuseppe Pezzotti
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Matsugasaki, Sakyo-ku, Kyoto, Japan; Department of Molecular Genetics, Institute of Biomedical Science, Kansai Medical University, Osaka, 573-1010, Japan
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Akhlaghi O, Camposilvan E, Garnier V, Goharibajestani Z, Khabbaz S, Ow-Yang C, Jorand Y, Gremillard L, Chevalier J. Conventional sintering of nano-crystalline Yttria-Stabilized Zirconia enables high-strength, highly translucent and opalescent dental ceramics. Dent Mater 2024; 40:1031-1040. [PMID: 38755041 DOI: 10.1016/j.dental.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 04/30/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024]
Abstract
Development of restorative materials capable of mimicking optical and mechanical performance of natural teeth is a quest in aesthetic density. Yttria-Stabilized Zirconia (YSZ) ceramics represent one of the most popular choices for dental restorations, owing to their biocompatibility, white colour, and the possibility to use CAD-CAM technologies. In particular, YSZ doped with 3 mol. % yttria (3YSZ) is popular because it presents high strength. Nonetheless, the limited light transmission of commercially available high strength 3YSZ does not meet the requirements of highly aesthetic cases. On the other side, YSZ presenting a larger portion of yttria are more translucent but exhibit modest strength. Here, we report on fabrication of dense zirconia nanostructures in bulk form via conventional pressure-less sintering at temperatures down to 1100-1200 °C, achieving highly translucent and strong 3YSZ with significant opalescent behaviour. Both Hall-Petch and inverse Hall-Petch relationship were observed in 3YSZ samples with average grain size in the range of 250 nm and 55 nm, demonstrating the importance of grain size control to enhance both optical and mechanical properties of zirconia ceramics, simultaneously. Maximum biaxial strength of 1980 ± 260 MPa, in-line light transmission of 38% in the visible spectrum and opalescence approaching that of enamel were obtained at optimum grain size of 80 ± 5 nm. The notable optical properties are linked to the miniaturization of the residual pores and refinement of grain size towards the nanoscale while the superior mechanical strength is justified by the activation of different energy dissipation processes at nano and macroscale.
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Affiliation(s)
- Omid Akhlaghi
- INSA Lyon, Universite Claude Bernard Lyon 1, CNRS, MATEIS, UMR5510, 69621 Villeurbanne, France
| | | | - Vincent Garnier
- INSA Lyon, Universite Claude Bernard Lyon 1, CNRS, MATEIS, UMR5510, 69621 Villeurbanne, France.
| | | | - Sirous Khabbaz
- Materials Science & Nano-Engineering Program, Sabanci University, Tuzla, Istanbul 34956, Turkey
| | - Cleva Ow-Yang
- Materials Science & Nano-Engineering Program, Sabanci University, Tuzla, Istanbul 34956, Turkey; Nanotechnology Research and Application Center (SUNUM), Sabanci University, Tuzla, Istanbul 34956, Turkey
| | - Yves Jorand
- INSA Lyon, Universite Claude Bernard Lyon 1, CNRS, MATEIS, UMR5510, 69621 Villeurbanne, France
| | - Laurent Gremillard
- INSA Lyon, Universite Claude Bernard Lyon 1, CNRS, MATEIS, UMR5510, 69621 Villeurbanne, France
| | - Jérôme Chevalier
- INSA Lyon, Universite Claude Bernard Lyon 1, CNRS, MATEIS, UMR5510, 69621 Villeurbanne, France
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Mayinger F, Ender A, Strickstrock M, Elsayed A, Nassary Zadeh P, Zimmermann M, Stawarczyk B. Impact of the sintering parameters on the grain size, crystal phases, translucency, biaxial flexural strength, and fracture load of zirconia materials. J Mech Behav Biomed Mater 2024; 155:106580. [PMID: 38759588 DOI: 10.1016/j.jmbbm.2024.106580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 05/06/2024] [Accepted: 05/10/2024] [Indexed: 05/19/2024]
Abstract
OBJECTIVES To investigate the influence of the zirconia and sintering parameters on the optical and mechanical properties. METHODS Three zirconia materials (3/4Y-TZP, 4Y-TZP, 3Y-TZP) were high-speed (HSS), speed (SS) or conventionally (CS) sintered. Disc-shaped specimens nested in 4 vertical layers of the blank were examined for grain size (GS), crystal phases (c/t'/t/m-phase), translucency (T), and biaxial flexural strength. Fracture load (FL) of three-unit fixed dental prostheses was determined initially and after thermomechanical aging. Fracture types were classified, and data statistically analyzed. RESULTS 4Y-TZP showed a higher amount of c + t'-phase and lower amount of t-phase, and higher optical and lower mechanical properties than 3Y-TZP. In all materials, T declined from Layer 1 to 4. 3/4Y-TZP showed the highest FL, followed by 3Y-TZP, while 4Y-TZP showed the lowest. In 4Y-TZP, the sintering parameters exercised a direct impact on GS and T, while mechanical properties were largely unaffected. The sintering parameters showed a varying influence on 3Y-TZP. Thermomechanical aging resulted in comparable or higher FL. CONCLUSION 3/4Y-TZP presenting the highest FL underscores the principle of using strength-gradient multi-layer blanks to profit from high optical properties in the incisal area, while ensuring high mechanical properties in the lower areas subject to tensile forces. With all groups exceeding maximum bite forces, the examined three-unit FDPs showed promising long-term mechanical properties.
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Affiliation(s)
- Felicitas Mayinger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany.
| | - Andreas Ender
- Division of Computerized Restorative Dentistry, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Monika Strickstrock
- Faculty of Engineering and Computer Science, Material Science and Analysis, University of Applied Sciences Osnabrück, Albrechtstraße 30, 49076, Osnabrück, Germany
| | - Adham Elsayed
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Parissa Nassary Zadeh
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Marcus Zimmermann
- Division of Computerized Restorative Dentistry, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestraße 70, 80336, Munich, Germany
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Dash S, Srivastava G, Padhiary SK, Samal M, Çakmak G, Roccuzzo A, Molinero-Mourelle P. Validation of the pink esthetic score/white esthetic score at single tooth-supported prostheses in the esthetic zone: A randomized clinical trial. J ESTHET RESTOR DENT 2024; 36:976-984. [PMID: 38689391 DOI: 10.1111/jerd.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES To validate the reproducibility and inter/intra-observer variability of the Pink Esthetic Score/White Esthetic Score (PES/WES) of single tooth-supported prostheses in the maxillary esthetic zone (13-23). MATERIALS AND METHODS Forty-five patients were randomly assigned to one of the three treatment options (15 patients per group) receiving each one a different crown type: Porcelain fused to metal (PFM), monolithic zirconia, and lithium disilicate. Eight observers from each of four different specialties (Prosthodontists, Orthodontists, Periodontists, and Oral Surgeons) were recruited and assessed twice and four weeks apart (i.e., T1 and T2) 45 photographs of the single tooth-supported prosthesis using PES/WES and compared them with contralateral teeth. RESULTS According to the ANOVA and post hoc tests, the zirconia crown type obtained the highest mean score by all observers, with a mean value of 16.70 ± 2.94. The prosthodontists and oral surgeons assigned the lowest mean score to PFM crowns, 13.03 ± 3.47 and 13.80 ± 3.17, respectively. Notably, the prosthodontists awarded the highest scores, specifically 17.50 ± 2.81 for the zirconia crowns. Intraobserver agreement was calculated utilizing the paired t-test. Pairwise comparisons between observers of different specialties revealed significant intraobserver agreement. Interclass correlation coefficient (ICC) scores were statistically significant among four specialties. No difference was detected concerning the interobserver agreement. CONCLUSIONS The PES/WES index remains consistent across various observers from different specializations, yielding uniform results in the overall esthetic evaluation. Consequently, in light of the presented preliminary positive results, its use might also be considered for the esthetic assessment of single-tooth-supported prostheses. CLINICAL SIGNIFICANCE The PES/WES index may be employed clinically to evaluate single tooth-supported prostheses as it emerged as a reproducible esthetic scoring system.
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Affiliation(s)
- Sreeprada Dash
- Department of Prosthodontics, Institute of Dental Sciences, Bhubaneswar, India
| | - Gunjan Srivastava
- Department of Prosthodontics, Institute of Dental Sciences, Bhubaneswar, India
| | - Subrat Kumar Padhiary
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Bhubaneswar, India
| | - Monika Samal
- Department of Prosthodontics, Institute of Dental Sciences, Bhubaneswar, India
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
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Yousry M, Hammad I, El Halawani M, Aboushelib M. Randomized clinical trial of zirconia laminate veneers sintered by using conventional versus speed process: 1-year follow-up. J Prosthet Dent 2024:S0022-3913(24)00352-4. [PMID: 38824110 DOI: 10.1016/j.prosdent.2024.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 06/03/2024]
Abstract
STATEMENT OF PROBLEM The application of highly translucent multilayered zirconia ceramic in minimally invasive esthetic dentistry allows the achievement of both esthetics and strength with minimal thickness. Clinical studies that have assessed the performance of zirconia ultrathin veneers sintered with the conventional and speed procedure are lacking. PURPOSE The purpose of this clinical study was to evaluate the effect of speed sintering processes on the translucency and clinical performance of zirconia laminate veneers. MATERIAL AND METHODS Four participants had their teeth restored with 32 ultratranslucent zirconia laminate veneers. Based on the zirconia sintering procedure, the participants were randomly allocated into 2 groups. The teeth were prepared by selective reduction over trial restorations. Zirconia veneers were milled from multilayer zirconia blanks and sintered either by speed sintering or conventional sintering as specified by the manufacturer's recommendations. The intaglio surface of the veneers were airborne-particle abraded with 50-μm aluminum-oxide, and the veneers were then adhesively bonded to the teeth with translucent light-polymerizing resin cement. The modified California Dental Association (CDA)/Ryge criteria were used to assess participants at baseline and every 3 months for 12 months. The translucency and the color difference of the tooth before and after veneer restoration were evaluated. For statistical analysis, the Pearson chi squared test, independent t test, and paired t test were used (α=.05). RESULTS Translucency and color differences were significantly higher in the conventionally sintered group (P<.05). No restorations were lost. No significant differences were found between the 2 groups in the CDA/Ryge criteria or color parameter after follow-up intervals (P>.05). The primary qualitative changes observed at the final recall were marginal integrity and marginal discoloration. The color match and zirconia surface were rated Alfa. CONCLUSIONS After 1 year of follow-up, both conventional and speed sintered ultrathin zirconia laminates showed satisfactory functional, esthetic, and color stability outcomes.
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Affiliation(s)
- Mahinour Yousry
- PhD Researcher, Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ihab Hammad
- Professor, Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed El Halawani
- Lecturer, Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Moustafa Aboushelib
- Professor, Department of Dental Materials Science, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Juntavee N, Juntavee A, Jaralpong C. Flexural Strength of Two Multilayered and Monochromatic High Yttria Containing Zirconia Materials Following Different Sintering Parameters. Eur J Dent 2024; 18:551-562. [PMID: 37729931 PMCID: PMC11132776 DOI: 10.1055/s-0043-1772569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES Sintering parameters influence the properties of zirconia. This study examined the effect of altering sintering temperature and time of monochrome and multilayer 5 mol% yttria-partially stabilized zirconia (5Y-PSZ) on flexural strength. MATERIALS AND METHODS Three hundred specimens (width × length × thickness = 10 × 20 × 2 mm) were prepared from monolayer (ZX) and multilayer (ZM) 5Y-PSZ and randomly sintered at decreasing (TD: 1,450°C), regular (TR: 1,500°C), and increasing (TI: 1,550°C) sintering temperature, with extremely short (HE: 10 minutes), ultrashort (HU: 15 minutes), short (HS: 30 minutes), and regular (HR: 135 minutes) sintering time (n = 15/group). The precrack was induced on the tension side before testing for flexural strength (σ). STATISTICAL ANALYSIS Analysis of variance and Tukey's test were used for significant differences of σ at p < 0.05. The microstructure and crystalline (monoclinic; m, tetragonal; t, cubic; c) phase were evaluated by scanning electron microscope (SEM) and X-ray diffractometer (XRD). RESULTS ZXTIHS indicated the highest σ for ZX (315.81 ± 18.91 MPa), whereas ZMTIHS indicated the highest σ for ZM (335.21 ± 36.18 MPa). There was no significant difference for σ between ZX and ZM (p > 0.05). Sintering zirconia at TI or HR indicated significantly higher σ than sintering at TD or TR or with HS, HE, or HU for both ZX and ZM (p < 0.05). There was no significant difference for σ between TRHR and TIHS, TIHU, and TIHE (p > 0.05). SEM indicated intergranular and transgranular fractures. XRD revealed predominately c- and t-phases and minor amounts of m-phase. CONCLUSION Increasing sintered temperature with decreasing time offers acceptable strength to regular sintering. Raising sintering temperature with decreasing time is suggested to facilitate chairside restorative reconstruction.
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Affiliation(s)
- Niwut Juntavee
- Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Apa Juntavee
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Chutikarn Jaralpong
- Division of Biomaterials and Prosthodontics Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Alshahrani AM, Lim CH, Wolff MS, Janal MN, Zhang Y. Current speed sintering and high-speed sintering protocols compromise the translucency but not strength of yttria-stabilized zirconia. Dent Mater 2024; 40:664-673. [PMID: 38378371 PMCID: PMC11015968 DOI: 10.1016/j.dental.2024.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/05/2024] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVES To investigate the impacts of speed and high-speed sintering on the densification, microstructure, phase composition, translucency, and flexural strength of yttria-stabilized zirconia (YSZ). METHODS A total of 162 disc-shaped specimens (n = 18) were cold-isostatically pressed from 3YSZ (Zpex), 4YSZ (Zpex 4), and 5YSZ (Zpex Smile) powders (Tosoh Corporation) and sintered according to the following protocols: conventional (control, ∼12 h), speed (∼28 min for 3YSZ; ∼60 min for 4YSZ and 5YSZ), and high-speed (∼18 min) sintering. Dimensions of zirconia specimens after sintering and polishing (1-μm diamond grit finish) were Ø13.75 × 1 mm. Density, microstructure, phase content, translucency parameter, and biaxial flexural strength were evaluated using Archimedes', SEM, XRD, spectrophotometric, and piston-on-3-ball methods, respectively. Data were analyzed with either one-way ANOVA and Tukey's test or Kruskal-Wallis with Dunn's test (α = 0.05). RESULTS For all YSZ compositions, conventional sintering yielded the highest density followed by speed then high-speed sintering. All sintering protocols resulted in similar strength values; however, speed and high-speed sintering protocols afforded significantly lower translucency relative to conventional sintering. XRD analysis revealed similar spectra for YSZs sintered by various protocols. The speed sintered specimens had the smallest grain size whereas the high-speed sintered 5YSZ possessed the largest grain size among all groups. SEM examination of all YSZ compositions revealed that the average pore size was an order of magnitude smaller than the average grain size. SIGNIFICANCE Speed and high-speed sintering of YSZs yield similar strength but diminished density and translucency relative to their conventionally sintered counterparts.
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Affiliation(s)
- Abdulaziz M Alshahrani
- Laboratories for Microstructure Physics & Mechanics of Materials, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Chek Hai Lim
- Laboratories for Microstructure Physics & Mechanics of Materials, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Mark S Wolff
- Morton Amsterdam Dean, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Malvin N Janal
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, NY 10010, USA
| | - Yu Zhang
- Laboratories for Microstructure Physics & Mechanics of Materials, Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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14
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Yousry M, Hammad I, Halawani ME, Aboushelib M. Translucency of recent zirconia materials and material-related variables affecting their translucency: a systematic review and meta-analysis. BMC Oral Health 2024; 24:309. [PMID: 38443872 PMCID: PMC10913643 DOI: 10.1186/s12903-024-04070-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 02/25/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Recent forms of translucent zirconia material have been developed, offering a wide range of options and varieties for enhancing aesthetics, making it a preferred choice in the field of prosthetic dentistry. However, there is insufficient understanding regarding the recent types of zirconia materials and their optical behavior. Understanding the variables that influence the translucency of zirconia and identifying strategies to enhance its esthetics are crucial. PURPOSE The current systemic review highlights a comprehensive understanding of different zirconia generations in relation to their optical characteristics and evaluates material-related variables affecting their translucency. METHODS The present review studied in-vitro studies that evaluated the optical characteristics of different yttria content of yttria stabilized materials. The topics explored were: (1) the different zirconia material generations and their optical behavior; (2) material-related factors that affect their translucency. The research was restricted to online publication in the English language from July 1, 2010, to July 31, 2023, using PubMed, Scopus, and Science Direct resources. The search key terms and their combinations were "zirconia," "translucent zirconia," "cubic zirconia," "highly translucent zirconia," "yttria partially stabilized zirconia," "monolithic zirconia," "translucency," "optical properties," and "light transmission." RESULTS The data obtained from fifty-three studies addressed the optical characteristics of various zirconia generations. They reported that changing yttria content had a significant impact on translucency. Different kinds of zirconia ceramics of the same generation have varying translucencies. Achieving optimum aesthetics with monolithic zirconia is challenging due to factors related to material aspects such as the presence of additives, point defects, microstructure, thickness, phase distribution, and sintering conditions. CONCLUSIONS Newly developed monolithic dental zirconia ceramics have improved aesthetics and translucency. However, additional research is necessary to evaluate their performance and long-term durability. TRIAL REGISTRATION This systematic review was registered in PROSPERO, under number CRD42023474482.
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Affiliation(s)
- Mahinour Yousry
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ihab Hammad
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed El Halawani
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Moustafa Aboushelib
- Department of Dental Materials Science, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Stevens CD, Renné WG, Vág J. Translucency of chairside monolithic zirconias using different sintering ovens: An in vitro investigation. J Dent 2024; 142:104839. [PMID: 38216029 DOI: 10.1016/j.jdent.2024.104839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/13/2023] [Accepted: 01/09/2024] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE To evaluate the translucency of several monolithic zirconias (MZ) processed in various sintering ovens designed for single-visit, chairside use. METHODS Discs (n = 40) from zirconia blocks were fabricated for each MZ at manufacturer-recommended minimal thicknesses, as provided in each material's instructions for use: IPS e.max ZirCAD LT (ZLT); CEREC Zirconia+ (CZ+); 3M Chairside (3M); KATANA Zirconia (KT). Groups (n = 10) were sintered following manufacturer instructions for each oven: CEREC SpeedFire, Ivoclar CS4, Ivoclar CS6, and Ivoclar S2 (laboratory furnace control). Specimens were highly polished on one side and glazed on the other. Each side was measured with a spectrophotometer against white and black backgrounds to determine translucency parameter (TP) and contrast ratio (CR) values. Results for TP and CR for each material and oven combination were compared with a linear mixed model. Oven precision was evaluated using the Kruskall-Wallis test. RESULTS Glazed specimens were more translucent than polished ones (p < 0.001). ZLT and CZ+ were more translucent than 3M and KT regardless of the sintering oven (p < 0.01). Several oven/material combinations reached or exceeded the S2 oven TP: CS4 with CZ+ and 3M; CS6 with ZLT and KT (p < 0.01). SpeedFire was significantly less precise (p < 0.05) and produced lower TP values for ZLT, CZ+, and KT (p < 0.01). Results for TP and CR were highly correlated. CONCLUSIONS MZ surface finish, material thickness, and oven used all had a significant effect on translucency. Some chairside-oriented solutions produced results with translucency equal to conventionally processed zirconia. CLINICAL SIGNIFICANCE The translucency of a ceramic restoration is an important factor in determining its esthetics. Clinicians desiring the most esthetic outcomes with monolithic zirconia should be aware of the significant effects that surface finishing, material thickness, and the sintering oven used can have on restoration translucency.
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Affiliation(s)
| | | | - János Vág
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary.
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16
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Kyung KY, Park JM, Heo SJ, Koak JY, Kim SK, Ahn JS, Yi Y. Comparative analysis of flexural strength of 3D printed and milled 4Y-TZP and 3Y-TZP zirconia. J Prosthet Dent 2024; 131:529.e1-529.e9. [PMID: 38212154 DOI: 10.1016/j.prosdent.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/20/2023] [Accepted: 12/20/2023] [Indexed: 01/13/2024]
Abstract
STATEMENT OF PROBLEM The mechanical properties of 3 dimensionally (3D) printed zirconia have been reported to be comparable with those of milled zirconia, except for the flexural strength. However, most previous studies tested 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP), making it necessary to study 3D printed zirconia with 4 mol% yttria content (4Y-TZP). PURPOSE The purpose of this in vitro study was to compare the flexural strength of 3D printed 4Y-TZP with 3Y-TZP materials and milled 4Y-TZP. MATERIAL AND METHODS A total of 80 disk specimens (Ø15×1.5 mm) were fabricated and divided into 4 groups (n=20) using the fabrication method and yttria content: milled 3Y-TZP (Katana HT; Kuraray Noritake), 3D printed 3Y-TZP (TZ-3Y-E; Tosoh), milled 4Y-TZP (Katana STML; Kuraray Noritake), and 3D printed 4Y-TZP (3DMAT; Genoss). The biaxial flexural strength was determined with a piston-on-3-ball test (n=15). The flexural strength of each specimen was measured, and the Weibull modulus (m) and characteristic strength (σ0) were estimated from the fracture load distribution. Two intact and fractured specimens were examined with scanning electron microscopy (SEM). The crystalline phase of the specimens in each group was identified through X-ray diffraction (XRD) analysis (n=5). A 1-way ANOVA was used to compare the flexural strength among different groups. Subsequently, pairwise comparisons were conducted with the Tukey post hoc method (α=.05). RESULTS The flexural strength of 3D printed 4Y-TZP was significantly higher than that of milled 4Y-TZP (P<.001). In contrast, the flexural strength of 3D printed 3Y-TZP was significantly lower than that of milled 3Y-TZP (P<.001). X-ray diffraction (XRD) analysis revealed that the tetragonal phase was the dominant phase in all groups, with the identification of some cubic phase peaks. CONCLUSIONS Three dimensionally printed 4Y-TZP showed significantly higher flexural strength than milled 4Y-TZP and exhibited a clinically acceptable flexural strength exceeding 800 MPa.
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Affiliation(s)
- Kyu-Young Kyung
- PhD Candidate, Department of Prosthodontics & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Republic of Korea
| | - Ji-Man Park
- Associate Professor, Department of Prosthodontics & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
| | - Seong-Joo Heo
- Professor, Department of Prosthodontics & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jai-Young Koak
- Professor, Department of Prosthodontics & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Seong-Kyun Kim
- Professor, Department of Prosthodontics & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jin-Soo Ahn
- Professor, Department of Dental Biomaterials Science & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yuseung Yi
- Assistant Professor, Department of Prosthodontics & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Olcay EO, Diken Turksayar AA, Demirel M, Donmez MB, Şahmalı SM. Effect of partially stabilized zirconia thickness on the translucency and microhardness of resin cement. J Prosthet Dent 2024; 131:94-99. [PMID: 35256184 DOI: 10.1016/j.prosdent.2022.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Partially stabilized zirconia has been introduced as a more translucent iteration. However, knowledge of the effect of the thickness of partially stabilized zirconia on the microhardness of resin cement is sparse. PURPOSE The purpose of this in vitro study was to evaluate the effect of thickness and material type on the translucency of partially stabilized zirconia and the microhardness of the resin cement polymerized beneath. MATERIAL AND METHODS Specimens were prepared from 2 translucent zirconias with different yttrium content (Ceramil Zolid HT+ [HT] and Ceramil Zolid FX [SHT]) and a lithium disilicate glass-ceramic (e.max CAD [EX]) of different thicknesses (0.5, 1, 1.5, and 2 mm) (n=10). Color coordinates were recorded by using a spectrophotometer, and the relative translucency parameter (RTP) was calculated by using the CIEDE2000 formula. The microhardness of the resin cement polymerized under ceramic specimens was measured. Two-way analysis of variance, the Tukey honestly significant difference, and independent samples t tests were used to analyze the data (α=.05). RESULTS Material type (P<.001), thickness (P<.001), and their interaction significantly affected the RTP (P=.001) and hardness values (P<.001). Regardless of the thickness, EX had the highest RTP (P≤.027), and the resin cements polymerized under EX showed the highest microhardness (P≤.002). However, the difference between HT and SHT for RTP (P≥.082) and resin cement hardness (P≥.984) was not significant. Specimens of 0.5 mm resulted in higher RTP (P≤.001) and resin cement hardness (P≤.006) than the 1.5- and 2-mm specimens of each ceramic. CONCLUSIONS Increasing material thickness reduced the translucency of the partially stabilized zirconia and the hardness of the resin cements polymerized beneath.
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Affiliation(s)
- Emin Orkun Olcay
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey.
| | - Almira Ada Diken Turksayar
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Munir Demirel
- PhD student, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Mustafa Borga Donmez
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey; Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Univeristy of Bern, Bern, Switzerland
| | - Sevil Meral Şahmalı
- Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
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Sulaiman TA, Suliman AA, Abdulmajeed AA, Zhang Y. Zirconia restoration types, properties, tooth preparation design, and bonding. A narrative review. J ESTHET RESTOR DENT 2024; 36:78-84. [PMID: 37840220 PMCID: PMC10842315 DOI: 10.1111/jerd.13151] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE The purpose of this review was to provide dental professionals with information regarding the various types of zirconia restorations, their mechanical and optical properties, tooth preparation design, and bonding protocol in an effort to enhance the longevity and durability of zirconia restorations. OVERVIEW The yttria content of zirconia ceramics determines their classification. The mechanical and optical properties of each type are discussed, with an emphasis on the effect of yttria concentration on the properties of zirconia. The processing and sintering methods are also discussed as they have a direct impact on the properties of zirconia. The design of tooth preparation, specifically occlusal reduction, varies depending on the type of zirconia used in each case. Finally, a protocol for zirconia restoration bonding is described to ensure optimal bonding to the tooth structure. CONCLUSION Not all zirconia restorations are the same. The selection of zirconia type based on yttria concentration, processing and sintering methods, tooth preparation design, and adherence to the bonding protocol are all critical to the success and longevity of zirconia restorations. CLINICAL SIGNIFICANCE Zirconia restorations are the most commonly used indirect restorative material. The selection of the most appropriate zirconia type based on its yttria content, which determines its strength and translucency, is critical to the success and the longevity of the restoration. Tooth preparation design also influences the strength and translucency of the zirconia. Air-borne particle abrasion, followed by a ceramic primer and resin cement, can ensure a durable bond to the tooth structure.
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Affiliation(s)
- Taiseer A Sulaiman
- Division of Comprehensive Oral Health, University of North Carolina, Adams School of Dentistry, Chapel Hill, North Carolina, USA
| | - Abdulhaq A Suliman
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE
| | - Aous A Abdulmajeed
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Yu Zhang
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Edelhoff D, Schubert O, Stimmelmayr M, Schweiger J. CAD/CAM full-mouth rehabilitation of an elderly patient: One-piece digital complete denture meets multilayered zirconia with gradient technology. J ESTHET RESTOR DENT 2024; 36:174-185. [PMID: 36866726 DOI: 10.1111/jerd.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/02/2023] [Accepted: 02/11/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE This article highlights a CAD/CAM complete-mouth rehabilitation in an 82-year-old patient by means of a complete maxillary prosthesis and mandibular implant- and tooth-supported fixed restorations made from multilayered zirconia. CLINICAL CONSIDERATIONS Comprehensive complete-mouth rehabilitations in elderly patients with adaptation of the occlusal vertical dimension (OVD) often present particular challenges. This applies especially when exacting functional and esthetic requirements are to be met and the treatment should not cause the patient too much effort, still ensuring the highest level of quality and efficiency and a low intervention rate. CONCLUSION The digital approach used for the present patient allowed for an efficient treatment procedure, facilitated virtual evaluations using a face-scan, and enhanced the predictability of the prosthodontic outcome. The approach enabled some steps required in the conventional protocol to be omitted, resulting in a straightforward clinical treatment with minimal strain on the patient. CLINICAL SIGNIFICANCE Because of the comprehensive recording of extraoral and intraoral data, for example with a facial scanner, it was possible to transfer a digital replica of the patient to the dental laboratory technician. With this protocol, many steps can be performed in the absence of the real patient.
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Affiliation(s)
- Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
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Unnadkat A, Kirby L, Kulanthaivel S, Rysavy O, Tsujimoto A, Song X, Teixeira EC. The Effect of Sintering on Zirconia Manufactured via Suspension-Enclosing Projection Stereolithography for Dental Applications: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 17:14. [PMID: 38203868 PMCID: PMC10779720 DOI: 10.3390/ma17010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Zirconia is a widely used material in the dental industry due to its excellent mechanical and aesthetic properties. Recently, a new 3D printing process called suspension-enclosing projection stereolithography (SEPS) was introduced to fabricate zirconia dental restorations. However, the effect of the sintering time and temperature on the properties of zirconia produced via SEPS has not been fully investigated. METHODS Zirconia slurries were prepared with varying percentages of zirconia powders and 3D printing resins, and 5Y-TZP (5 mol% yttria-stabilized zirconia) (n = 40) and 3Y-TZP (3 mol% yttria-stabilized zirconia) (n = 40) bar specimens were fabricated via SEPS manufacturing. The specimens were sintered at different temperatures and dwell times, and their flexural strength, density, and phase composition were measured. The viscosity of the slurries was also measured. Statistical analysis was performed using Welch's ANOVA and Kruskal-Wallis tests to evaluate the impact of the sintering conditions. RESULTS Significant differences in flexural strength (p < 0.01) were observed between the 5Y-TZP samples, with those sintered at 1530 °C for 120 min showing an average strength of 268.34 ± 44.66 MPa, compared to 174.16 ± 42.29 MPa for those sintered at 1450 °C for 120 min. In terms of density, significant differences (p < 0.01) were noted for the 3Y-TZP specimens, with an average density of 6.66 ± 0.49 g/cm3 for samples sintered at 1530 °C for 120 min, versus 5.75 ± 0.55 g/cm3 for those sintered at 1530 °C for 10 min. X-ray diffraction confirmed the presence of a predominantly tetragonal phase in both materials. CONCLUSIONS Zirconia printed via SEPS manufacturing can be sintered at a higher temperature with shorter dwell times, thereby producing high density samples. Different sintering conditions can be used to fully sinter 3D-printed zirconia for potential dental applications.
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Affiliation(s)
- Amit Unnadkat
- Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Levi Kirby
- Department of Industrial and Systems Engineering, The University of Iowa College of Engineering, Iowa City, IA 52242, USA
| | - Senthilguru Kulanthaivel
- Department of Operative Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA; (S.K.); (A.T.)
| | - Oscar Rysavy
- Division of Biostatistics and Computational Biology, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA
- Department of Biostatistics, The University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA; (S.K.); (A.T.)
- Department of Operative Dentistry, Aichi Gakuin University School of Dentistry, Chikusa-ku, Nagoya 464-8651, Aichi, Japan
- Department of General Dentistry, Creighton University School of Dentistry, Omaha, NE 68102, USA
| | - Xuan Song
- Department of Industrial and Systems Engineering, The University of Iowa College of Engineering, Iowa City, IA 52242, USA
| | - Erica C. Teixeira
- Department of Operative Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA 52242, USA; (S.K.); (A.T.)
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Liu H, Inokoshi M, Xu K, Tonprasong W, Minakuchi S, Van Meerbeek B, Vleugels J, Zhang F. Does speed-sintering affect the optical and mechanical properties of yttria-stabilized zirconia? A systematic review and meta-analysis of in-vitro studies. JAPANESE DENTAL SCIENCE REVIEW 2023; 59:312-328. [PMID: 37705876 PMCID: PMC10495607 DOI: 10.1016/j.jdsr.2023.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 08/02/2023] [Accepted: 08/22/2023] [Indexed: 09/15/2023] Open
Abstract
Zirconia restorations are increasingly popular in dental treatment. Yttria-stabilized zirconia (YSZ) needs to be sintered for clinical applications and novel speed-sintering protocols are being developed for chairside treatments. Whether the properties of speed-sintered YSZ meet clinical requirements, however, remains unclear. Therefore, we conducted a systematic review and meta-analysis on the influence of speed-sintering on the optical and mechanical properties of dental YSZ according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. A literature search was conducted using PubMed, Embase, and Web of Science databases for relevant articles published between January 1, 2010 and February 28, 2022 in English, Chinese, or Japanese. After full-text evaluation and quality assessment, 26 articles were selected. Meta-analysis revealed that speed-sintering does not significantly affect the CIEDE2000-based translucency parameter, contrast ratio, three-point flexural strength, biaxial flexural strength, or fracture toughness of YSZ (p < 0.01) compared to conventional sintering. However, the CIELab-based translucency parameter of conventionally sintered YSZ is higher than that of speed-sintered YSZ. The descriptive analysis indicated that speed-sintering does not affect the hardness of YSZ compared to that of conventionally sintered YSZ. The results indicate that speed-sintering is suitable for preparing YSZ for dental restorations.
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Affiliation(s)
- Hengyi Liu
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Masanao Inokoshi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Kaiqi Xu
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Watcharapong Tonprasong
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Shunsuke Minakuchi
- Department of Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Bart Van Meerbeek
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 blok a, B-3000 Leuven, Belgium
| | - Jef Vleugels
- KU Leuven (University of Leuven), Department of Materials Engineering, Kasteelpark Arenberg 44, BE-3001 Leuven, Belgium
| | - Fei Zhang
- KU Leuven (University of Leuven), Department of Oral Health Sciences, BIOMAT & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 blok a, B-3000 Leuven, Belgium
- KU Leuven (University of Leuven), Department of Materials Engineering, Kasteelpark Arenberg 44, BE-3001 Leuven, Belgium
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22
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Attia MA, Radwan M, Blunt L, Bills P, Tawfik A, Arafa AM. Effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia fixed partial dentures: An in vitro study. J Prosthet Dent 2023; 130:908.e1-908.e8. [PMID: 37802734 DOI: 10.1016/j.prosdent.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 10/08/2023]
Abstract
STATEMENT OF PROBLEM Strength-gradient zirconia combining 3 zirconia formulations with different flexural strengths has been reported to have outstanding mechanical properties. However, data concerning the effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia fixed partial dentures (FPDs) are sparse. PURPOSE The purpose of this in vitro study was to test the effect of different sintering protocols on the fracture strength of 3-unit monolithic gradient zirconia FPDs. MATERIAL AND METHODS Two custom-made stainless-steel master dies were designed to replicate a mandibular right second premolar and second molar prepared to receive a 3-unit monolithic zirconia FPD. Thirty monolithic zirconia FPDs were milled from gradient zirconia blanks and allocated to 3 groups (n=10) according to the sintering protocols: high-speed sintering, speed sintering, and conventional sintering. The FPDs were cemented onto the corresponding dies with traditional glass ionomer cement. All FPDs were cyclic loaded (600 000 cycles/49 N/1.7 Hz) in a mastication simulator. Fracture load measurements for each FPD were determined by using a universal testing machine. Scanning electron microscopy (SEM) at ×80 magnification was used to examine a fractured FPD from each group. A representative specimen from each group was examined with SEM at ×30 000 magnification to determine the grain size. One-way ANOVA, pair-wise Tukey honestly significant difference (HSD), and Pearson correlation tests were used for statistical analysis of the data (α=.05). RESULTS The high-speed sintered FPDs recorded the highest statistically significant fracture load mean ±standard deviation value (2526 ±300 N), followed by the speed sintered FPDs (2136 ±127 N), while the lowest statistically significant fracture load mean value was recorded with the conventionally sintered FPDs (1361 ±181 N) (P<.001). In addition, the mean ±standard deviation grain size values were 488 ±272 nm for the high-speed sintered specimen, 578 ±409 nm for the speed sintered specimen, and 832 ±551 nm for the conventionally sintered specimen (P<.001). A significant negative correlation was found between fracture strength and grain size among the 3 groups. CONCLUSIONS The fracture strength of 3-unit monolithic gradient zirconia FPDs sintered by using a high-speed protocol was significantly higher than that of speed and conventionally sintered FPDs (P<.001). The high-speed sintering protocol reduced the mean grain size of gradient zirconia FPDs compared with that of both speed and conventional sintering protocols.
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Affiliation(s)
- Mazen A Attia
- Associate Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt.
| | - Mohamed Radwan
- Lecturer, Department of Fixed Prosthodontics, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt
| | - Liam Blunt
- Professor, Engineering and Physical Sciences Research Council (EPSRC) Future Advanced Metrology Hub, University of Huddersfield, Huddersfield, England, United Kingdom
| | - Paul Bills
- Professor, Engineering and Physical Sciences Research Council (EPSRC) Future Advanced Metrology Hub, University of Huddersfield, Huddersfield, England, United Kingdom
| | - Ahmed Tawfik
- PhD Researcher, Engineering and Physical Sciences Research Council (EPSRC) Future Advanced Metrology Hub, University of Huddersfield, Huddersfield, England, United Kingdom
| | - Ahmed M Arafa
- Lecturer, Department of Fixed Prosthodontics, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt
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23
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Yousry MA, Hammad IA, El Halawani MT, Aboushelib MN. Effect of sintering time on microstructure and optical properties of yttria-partially stabilized monolithic zirconia. Dent Mater 2023; 39:1169-1179. [PMID: 37845165 DOI: 10.1016/j.dental.2023.10.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 09/12/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To evaluate the impact of speed sintering on the microstructure and optical properties of 3 and 5 mol% yttria-partially stabilized monolithic zirconias. METHODS 120 plate-shaped zirconia specimens (10x10x 0.4 mm) were prepared from three commercial 5 mol% yttria-partially stabilized zirconia blocks (5Y-PSZs); Katana UTML (Kuraray Noritake), Cercon xtML (Dentsply Sirona), and Zolid FX white (Amann Girrbach), and two commercial 3 mol% yttria-partially stabilized zirconia blocks (3Y-PSZs); Lava Plus (3 M ESPE) and InCoris (Sirona, GmbH). Specimens were either conventional sintered (CS) using a 7-hour program or speed sintered (SS) using a quick 90-minute program. The microstructure was inspected with a scanning electron microscope (SEM), and phase fractions were detected using x-ray diffraction analysis (XRD). Translucency (TP00), and contrast ratio (CR) were obtained using a spectrophotometer (VITA Easyshade V). Color difference (ΔE00) between both sintering processes was calculated with the CIEDE2000 formula. ΔE00 up to 1.8 was set as the acceptability threshold. Data were analyzed using two-way ANOVA, Krusakll-Wallis, and Mann-Whitney U tests. (n = 12, α = .05). RESULTS Grain size was significantly decreased after SS for all tested materials (P < .0001). The average grain sizes of 5Y-PSZs were significantly larger than those of 3Y-PSZs. The atomic structure, microstructure, and transparency of CS and SS were all affected by the amount of yttria, the size of the crystals, and tetragonality. SS significantly reduced TP00 (F = 7135.95, P < 0.0001) and increased CR (F = 453.21, P < 0.0001). The CS Katana presented the highest TP00 and lowest CR value. ΔE00 between the CS and SS groups were clinically acceptable except for Lava, which had values above the set threshold (1.89). SIGNIFICANCE SS altered the grain size and internal structure of the tested materials, which was reflected in translucency.
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Affiliation(s)
- Mahinour A Yousry
- Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Ihab A Hammad
- Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed T El Halawani
- Division of Fixed Prosthodontics, Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Moustafa N Aboushelib
- Department of Dental Materials Science, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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24
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Kui A, Manziuc M, Petruțiu A, Buduru S, Labuneț A, Negucioiu M, Chisnoiu A. Translucent Zirconia in Fixed Prosthodontics-An Integrative Overview. Biomedicines 2023; 11:3116. [PMID: 38137337 PMCID: PMC10740999 DOI: 10.3390/biomedicines11123116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
Over the past two decades, dental ceramics have experienced rapid advances in science and technology, becoming the fastest-growing field of dental materials. This review emphasizes the significant impact of translucent zirconia in fixed prosthodontics, merging aesthetics with strength, and highlights its versatility from single crowns to complex bridgework facilitated by digital manufacturing advancements. The unique light-conducting properties of translucent zirconia offer a natural dental appearance, though with considerations regarding strength trade-offs compared to its traditional, opaque counterpart. The analysis extends to the mechanical attributes of the material, noting its commendable fracture resistance and durability, even under simulated physiological conditions. Various zirconia types (3Y-TZP, 4Y-TZP, 5Y-TZP) display a range of strengths influenced by factors like yttria content and manufacturing processes. The study also explores adhesive strategies, underlining the importance of surface treatments and modern adhesives in achieving long-lasting bonds. In the realm of implant-supported restorations, translucent zirconia stands out for its precision, reliability, and aesthetic adaptability, proving suitable for comprehensive dental restorations. Despite its established benefits, the review calls for ongoing research to further refine the material's properties and adhesive protocols and to solidify its applicability through long-term clinical evaluations, ensuring its sustainable future in dental restorative applications.
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Affiliation(s)
- Andreea Kui
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Manuela Manziuc
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Adrian Petruțiu
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, 13 Victor Babes Street, 400008 Cluj-Napoca, Romania
| | - Smaranda Buduru
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Anca Labuneț
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Marius Negucioiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Andrea Chisnoiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
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25
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Lubauer J, Schuenemann FH, Belli R, Lohbauer U. Speed-sintering and the mechanical properties of 3-5 mol% Y 2O 3-stabilized zirconias. Odontology 2023; 111:883-890. [PMID: 36859729 PMCID: PMC10492746 DOI: 10.1007/s10266-023-00796-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 02/15/2023] [Indexed: 03/03/2023]
Abstract
Ever faster workflows for the fabrication of all-ceramic restorations are of high economic interest. For that purpose, sintering protocols have been optimized for use in modern sintering furnaces, the so-called speed-sintering. However, conventional furnaces are still the most widely used equipment to sinter zirconia restorations. In this in-vitro study, we evaluated the feasibility of a speed-sintering protocol using a conventional sintering furnace to sinter different dental zirconias (stabilized with 3 mol% up to 5.4 mol% Y2O3) in comparison to a conventional sintering program. The properties evaluated were Young's modulus, Poisson's ratio, density, biaxial flexural strength, and fracture toughness. We show here that despite differences being dependent on material, the physical and mechanical properties of speed-sintered zirconia are comparable to those obtained by the conventional sintering.
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Affiliation(s)
- Julia Lubauer
- Zahnklinik 1-Zahnerhaltung und Parodontologie, Forschungslabor für dentale Biomaterialien, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstraße 11, 91054, Erlangen, Germany
| | - Fernanda Haverroth Schuenemann
- Zahnklinik 1-Zahnerhaltung und Parodontologie, Forschungslabor für dentale Biomaterialien, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstraße 11, 91054, Erlangen, Germany
| | - Renan Belli
- Zahnklinik 1-Zahnerhaltung und Parodontologie, Forschungslabor für dentale Biomaterialien, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstraße 11, 91054, Erlangen, Germany.
| | - Ulrich Lohbauer
- Zahnklinik 1-Zahnerhaltung und Parodontologie, Forschungslabor für dentale Biomaterialien, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glueckstraße 11, 91054, Erlangen, Germany
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26
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Antón X, Liebermann A, Hampe R, Joda T, Stawarczyk B. Impact of high-speed sintering and choice of preshaded monochrome or multilayered blanks on fatigue behavior of 4 mol% yttria-stabilized tetragonal zirconia polycrystal. J Prosthet Dent 2023; 130:639-645. [PMID: 34930599 DOI: 10.1016/j.prosdent.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 10/31/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM High-speed sintering allows the rapid fabrication of esthetic restorations with adequate flexural strength. However, data on the fatigue behavior of high-speed sintered 4 mol% yttria-stabilized tetragonal zirconia polycrystal (4Y-TZP) are lacking. PURPOSE The purpose of this in vitro study was to examine the effect of high-speed sintering and the preshading of blanks (monochrome versus multilayer) on the fatigue behavior of 4Y-TZP ceramics. MATERIAL AND METHODS Four-point flexural strength specimens (N=405) were fabricated from high-speed sintered multilayer 4Y-TZP (Zolid DRS) processed at 1580 °C for about 20 minutes and conventionally sintered at 1450 °C for about 10 hours, multilayer 4Y-TZP (Zolid Gen-x), and monochrome 4Y-TZP (Ceramill Zolid HT+PS), the control group. The specimens were loaded under 5 different dynamic test conditions for fatigue testing (P1-P5). Three were step-stress protocols (P1: 50 N for 5000 cycles; P2: 10 N for 1000 cycles, P3: 5% for 5000 cycles), 1 was tested with a constant force of 720 N (P4), and 1 was tested for different constant load levels (P5). For analysis of P1-P3, the Kaplan-Meier test and Mantel Cox test were performed (α=.05). P4 was analyzed with the Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests, and P5 by creating a load-cycle diagram. A fracture analysis was performed. RESULTS ZMLC showed better fatigue behavior than ZMLH (P≤.006) and ZMOC (P≤.002) in all 3 step-stress protocols (P1-P3). ZMLH showed results comparable with those for ZMOC (P≥.285). In P4 and P5, all materials showed comparable values (P=.163 for P4). CONCLUSIONS The multilayer technique showed a positive effect on the fatigue behavior of 4Y-TZP. In contrast, high-speed sintering negatively influenced the fatigue behavior of multilayer 4Y-TZP. The high-speed sintered material showed no deterioration compared with the conventional sintered monochrome material.
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Affiliation(s)
- Xenia Antón
- Doctoral student, Dental Materials Unit, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany.
| | - Anja Liebermann
- Assistant Professor, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Rüdiger Hampe
- Guest Researcher, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Tim Joda
- Professor, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Bogna Stawarczyk
- Scientific Head, Dental Materials Unit, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
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Attia MA, Shokry TE. Effect of dynamic loading on fracture resistance of gradient zirconia fixed partial denture frameworks. J Prosthet Dent 2023; 130:242-249. [PMID: 34740458 DOI: 10.1016/j.prosdent.2021.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 10/19/2022]
Abstract
STATEMENT OF PROBLEM The new strength-gradient zirconia composed of 3-mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) and 5-mol% yttria-stabilized tetragonal zirconia polycrystal (5Y-TZP) has been claimed to have superior mechanical properties. However, data on the fracture resistance of 3-unit gradient 5Y-TZP and 3Y-TZP fixed partial denture frameworks are lacking. PURPOSE The purpose of this in vitro study was to evaluate the effect of dynamic loading on the fracture resistance of gradient zirconia fixed partial denture frameworks. MATERIAL AND METHODS Two standardized stainless-steel master dies were designed to simulate a mandibular left second premolar and second molar prepared to receive zirconia frameworks. The frameworks were designed with a 0.6-mm uniform wall thickness. The mesiodistal width of the connectors was 3 ±0.02 mm, and the occlusogingival height was 3 ±0.02 mm. Forty zirconia frameworks were fabricated and divided into 2 groups according to the tested materials (n=20): 3Y-TZP and gradient 5Y-TZP and 3Y-TZP. The frameworks were cemented onto their corresponding dies with a conventional glass ionomer cement. Half of the cemented frameworks in each group underwent 600 000 cycles of dynamic loading in a mastication simulator (n=10). The other half was fractured without dynamic loading (n=10). Fracture resistance measurements (N) for each framework were recorded by using a universal testing machine at a crosshead speed of 1 mm/min. A fractured framework from each group was examined by using a scanning electron microscope (SEM) at ×100 magnification. The data obtained were statistically analyzed by using 2-way ANOVA, the pairwise Tukey honestly significant difference (HSD), and simple main effect tests to detect the difference between group mean values (α=.05). RESULTS The mean ±standard deviation of fracture load value before dynamic loading was 1919 ±193 N for the 3Y-TZP group and 908 ±99 N for the gradient 5Y-TZP and 3Y-TZP group. In addition, the mean fracture load value after dynamic loading was 1418 ±163 N for the 3Y-TZP group and 716 ±85 N for the gradient 5Y-TZP and 3Y-TZP group. The interaction between the effects of the zirconia material and dynamic loading on the fracture resistance was statistically significant (P=.002). The 3Y-TZP group had a statistically significant, higher fracture load mean value the gradient 5Y-TZP and 3Y-TZP group before and after dynamic loading (P<.001). CONCLUSIONS The fracture resistance of 3Y-TZP frameworks was significantly higher than that of gradient 5Y-TZP and 3Y-TZP frameworks before and after dynamic loading. Dynamic loading significantly reduced the fracture resistance of 3Y-TZP and gradient 5Y-TZP and 3Y-TZP frameworks.
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Affiliation(s)
- Mazen A Attia
- Associate Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Beni-Suef University, Beni-Suef, Egypt.
| | - Tamer E Shokry
- Professor, Department of Fixed Prosthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt
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Shin HJ, Kwon YH, Seol HJ. Effect of superspeed sintering on translucency, opalescence, microstructure, and phase fraction of multilayered 4 mol% yttria-stabilized tetragonal zirconia polycrystal and 6 mol% yttria-stabilized partially stabilized zirconia ceramics. J Prosthet Dent 2023; 130:254.e1-254.e10. [PMID: 37357086 DOI: 10.1016/j.prosdent.2023.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/27/2023]
Abstract
STATEMENT OF PROBLEM The optical properties of recently developed multilayer zirconia have mainly been studied for the effects of conventional sintering and speed sintering but not as much for the effect of superspeed sintering. As superspeed sintering protocols typically require a higher sintering temperature and higher heating and cooling rates than speed- and conventional sintering protocols, the optical properties of superspeed sintered zirconia may be affected differently. PURPOSE The purpose of this in vitro study was to investigate the effect of superspeed sintering on the optical properties, microstructure, and phase fraction of multilayered 4 mol% yttria-stabilized (4Y-) and 6 mol% yttria-stabilized (6Y-) zirconia. MATERIAL AND METHODS Multilayered 4Y- and 6Y-zirconia were sectioned. After conventional and superspeed sintering, the translucency parameter (TP), and opalescence parameter (OP) were measured with a spectrophotometer (n=10). To obtain the grain sizes from the field emission scanning electron microscopy (FE-SEM) images for each layer (n=2), more than 500 (6Y-zirconia) and 800 grains (4Y-zirconia) were measured by linear intercept methods. The phase fractions were obtained through X-ray diffraction (XRD) analysis by using the Rietveld method (n=1). The results were analyzed by 3-way ANOVA and post hoc Tukey honest significant difference tests (TP and OP) and by 3-way ANOVA and post hoc Scheffé tests (grain size) (α=.05). RESULTS No layers exhibited a significant difference in TP after superspeed sintering, except the dentin layer (DL) and transition layer 2 (T2) of 4Y- and 6Y-zirconia, respectively. The TP increased (P<.05) in DL for superspeed sintered 4Y-zirconia and decreased (P<.05) in T2 for the superspeed sintered 6Y-zirconia. However, the difference in TP by superspeed sintering was lower than the perceptibility thresholds of 50:50%. The OP decreased (P<.05) in the DL and T2 of 4Y-zirconia after superspeed sintering. For 6Y-zirconia, the OP decreased (P<.05) in all layers except for the transition layer 1 (T1) after superspeed sintering. However, the difference in OP values was minimal, with only a 1.1 difference observed for Zolid Gen-X (4Y) and a range of 1.22 to 1.62 for Katana UTML (6Y) when using superspeed sintering. No significant change was found in the grain size after superspeed sintering of either zirconia. Regardless of the sintering speed, the average grain size of the 6Y-zirconia (conventional: 2.09 to 2.21 μm; superspeed: 2.11 to 2.20 μm) was larger than that of the 4Y-zirconia (conventional: 0.50 to 0.52 μm; superspeed: 0.52 to 0.54 μm). Owing to superspeed sintering, the metastable tetragonal (T') phase content increased while the tetragonal (T) phase decreased in 4Y-zirconia; in 6Y-zirconia, the cubic (C) phase content increased, while the T'-phase content decreased. CONCLUSIONS Superspeed sintering did not result in any clinically significant changes in the translucency and opalescence of 4Y- or 6Y-zirconia.
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Affiliation(s)
- Hye-Jeong Shin
- Post-Doctoral Researcher, Department of Dental Materials, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea
| | - Yong-Hoon Kwon
- Professor, Department of Dental Materials, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea
| | - Hyo-Joung Seol
- Professor, Department of Dental Materials, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Gyeongsangnam-do, Republic of Korea.
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Reslan MR, Sayed M, Rayyan MM, Farouk H. Effect of Cement Type on Fracture Resistance and Mode of Failure of Monolith vs Bilayered Zirconia Single Crowns. J Contemp Dent Pract 2023; 24:576-581. [PMID: 38193181 DOI: 10.5005/jp-journals-10024-3546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
AIM To compare the fracture resistance and the mode of failure between monolith second-generation zirconia and bilayered first-generation zirconia single crowns cemented by resin cement and glass ionomer cement (GIC). MATERIALS AND METHODS A total of 36 maxillary first premolar crowns (5 mm in length × 4 mm in cervical diameter, with a base of 6 mm) were computer-aided design-computer-aided manufacturing (CAD-CAM) milled. They were divided into the following two groups (n = 18) according to the fabrication techniques: Group M - monolith zirconia crown (1-mm axial thickness and 2-mm occlusal thickness) and group B - bilayer zirconia crown (0.5-mm axial thickness and 1-mm occlusal thickness). Each group was further subdivided into the following two subgroups (n = 9) according to the cement used: Subgroup G - cemented using GIC; subgroup R - cemented using resin cement. All crowns were cemented to their corresponding resin dies and stored in distilled water for 72 hours. Each specimen was mounted to the lower member of the universal testing machine with a load cell of 5 kN and a crosshead speed of 0.5 mm/minute. Failure modes were analyzed for fractured parts using scanning electron microscopy (SEM). RESULTS Subgroup MR recorded the highest fracture resistance mean value (3616 ± 347.2 N) while the BG subgroup recorded the statistically significant lowest fracture resistance mean value (1728.7 ± 115.3 N). One-way analysis of variance (ANOVA) followed by pairwise Tukey's post hoc tests revealed a statistically significant difference (p = 0.0001) between groups M and B. One-way ANOVA followed by pairwise Tukey's post hoc tests also showed a statistically significant difference (p = 0.0297) between the types of cement used (subgroups G and R). CONCLUSION Monolith zirconia crowns had better mean fracture resistance than bilayered zirconia crowns. Resin cement improved the fracture resistance compared to GIC. Monolith zirconia crowns showed bulk fracture while bilayered zirconia crowns showed chipping fracture. CLINICAL SIGNIFICANCE Monolith zirconia crowns present a good prosthetic alternative overcoming the veneer chipping drawback of bilayered zirconia crowns. In addition, resin cement could increase the fracture resistance of zirconia crowns.
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Affiliation(s)
- Maria Rafaat Reslan
- Department of Oral Rehabilitation Sciences, Faculty of Dentistry, Beirut Arab University, Beirut, Lebanon
| | - Mohamed Sayed
- Department of Fixed Prosthodontics, Faculty of Dentistry, Sinai University, Kantara Campus, Sinai, Egypt, Phone: +20 1288670943, e-mail:
| | - Mohammad Mostafa Rayyan
- Department of Fixed Prosthodontics, Faculty of Dentistry, Sinai University, Kantara Campus, Sinai, Egypt
| | - Hadeel Farouk
- Department of Conservative Dentistry, Faculty of Dentistry, Sinai University, Kantara Campus, Sinai, Egypt
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Salah K, Sherif AH, Mandour MH, Nossair SA. Optical effect of rapid sintering protocols on different types of zirconia. J Prosthet Dent 2023; 130:253.e1-253.e7. [PMID: 37330359 DOI: 10.1016/j.prosdent.2023.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 06/19/2023]
Abstract
STATEMENT OF PROBLEM Rapid sintering protocols are available for the fabrication of zirconia restorations, but whether rapid sintering influences color or translucency is unclear. PURPOSE The purpose of this in vitro study was to investigate the effect of different rapid sintering protocols on the color and translucency of cubic and tetragonal zirconias. MATERIAL AND METHODS Sixty disk-shaped specimens of 1-mm-thick cubic (DD CubeX2) and tetragonal (DD Bio ZX2) zirconia were investigated. Specimens of each type of zirconia were divided into three groups: conventional, speed, and superspeed sintering protocols. The conventional group of each zirconia type served as the control for calculating color differences. Translucency for each group was assessed by the translucency parameter and contrast ratio. Two-way analysis of variance was used for statistical analysis of the data (α=.05). RESULTS The translucency of cubic and tetragonal zirconia decreased after speed and superspeed sintering (P<.001). Superspeed sintering resulted in a greater color change than speed sintering (P<.001). CONCLUSIONS Rapid sintering protocols produced a significant effect on the color and translucency of cubic and tetragonal zirconias.
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Affiliation(s)
- Kerolos Salah
- Former Postgraduate student, Department of Fixed Prosthodontics, Faculty of Oral and Dental Medicine, Future University, New Cairo, Egypt.
| | - Ashraf Hussein Sherif
- Professor, Department of Fixed Prosthodontics, Faculty of Oral and Dental Medicine, Future University, New Cairo, Egypt
| | - Mona H Mandour
- Professor, Department of Crown and Bridge, Faculty of Dental Medicine, Al-Azhar University, Girls' Branch, Cairo, Egypt
| | - Shereen Ahmed Nossair
- Assistant Professor, Department of Fixed Prosthodontics, Faculty of Oral and Dental Medicine, Future University, New Cairo, Egypt
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Alshahrani AM, Lim CH, Kim J, Zhang Y. Transient thermal stresses developed during speed sintering of 3 mol% yttria-stabilized tetragonal zirconia polycrystals. Dent Mater 2023; 39:522-528. [PMID: 37045719 PMCID: PMC10168597 DOI: 10.1016/j.dental.2023.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/05/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES To investigate transient thermal stresses that developed in 3Y-TZP green compacts during speed sintering. METHODS A total of 312 disc-shaped green compacts (Ø17.1 ×1, 1.5, 2, 2.5, 3 mm) were cold-isostatically pressed from 3Y-TZP powder (Zpex, Tosoh Corp.) for speed sintering studies as well as compositional analysis and biaxial flexural strength measurements (both at room temperature and following heating at 90 °C/min to 500 °C). Flexural strength was determined using the piston-on-3-ball method. Phase assemblies were analyzed using the X-ray diffraction method. Effects of heating/cooling rates on transient stresses were investigated by conducting definitive sintering studies to determine the threshold for fracture. Finite element analysis (FEA) was used to validate the experimental findings using measured thermomechanical properties. RESULTS The bulk and relative density of the green compact were 2.95 ± 0.03 g/cm3 and 48.52% ± 0.45%. The flexural strength was drastically decreased from 10.3 ± 0.4 MPa to 1.09 ± 0.07 MPa following heating at 90 °C/min to 500 °C. The monoclinic and tetragonal contents were 54.9% and 45.1%, respectively. The threshold for fracture was located at 500 °C during the first heating stage with a 90 °C/min heating rate in specimens of 2.5 mm thickness or greater. No fractures occurred in the second heating stage and cooling phase. The FEA estimated that the principal transient tensile stress was ∼1.14 MPa at 500 °C during the heating phase, which exceeded the corresponding flexural strength (1.09 ± 0.07 MPa). SIGNIFICANCE Advanced FEA methods are an accurate and efficient tool to analyze the history of transient stresses during sintering of ceramic dental restorations.
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Affiliation(s)
- Abdulaziz M Alshahrani
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Chek Hai Lim
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Jeongho Kim
- Department of Civil and Environmental Engineering, University of Connecticut, 261 Glenbrook Rd, U-3037, Storrs, CT 06269, USA
| | - Yu Zhang
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Nonaka K, Teramae M, Pezzotti G. Effect of Ga 2O 3 Dopant on High Speed Sintered 5 mol% Y 2O 3 Stabilized Dental Zirconia. MATERIALS (BASEL, SWITZERLAND) 2023; 16:714. [PMID: 36676451 PMCID: PMC9866617 DOI: 10.3390/ma16020714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
The high-speed sintering of zirconia has become essential for ceramic dental prosthesis treatment in a single visit. Previous studies have shown that 5 mol% yttria-stabilized zirconia (5Y zirconia), with the exception of some types, loses strength and translucency with high-speed sintering. In this study, 0.15-0.92 wt% Ga2O3, which is expected to promote the sintering of zirconia, was added to improve the properties of 5Y zirconia high-speed sintered bodies, and the effect of its addition was evaluated. The specimens were characterized by density and translucency measurements, a three-point bending test, X-ray diffraction (XRD), scanning electron microscopy (SEM), and shrinkage measurement. The addition of Ga2O3 improved both translucency and flexural strength of 5Y zirconia high-speed sintered bodies. XRD and SEM observations revealed that this improvement in properties was due to the change in the crystal phase composition and the decrease in the amount and size of pores due to the addition of Ga2O3. Shrinkage measurements also revealed that the addition of Ga2O3 changed the sintering behavior of 5Y zirconia, suggesting that this change led to a reduction in porosity. From the above results, it was concluded that Ga2O3 addition is effective in improving the properties of 5Y zirconia high-speed sintered bodies.
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Affiliation(s)
- Kazumichi Nonaka
- Department of Research and Development, SHOFU INC., Higashiyama-ku, Kyoto 605-0983, Japan
| | - Mitsuji Teramae
- Department of Research and Development, SHOFU INC., Higashiyama-ku, Kyoto 605-0983, Japan
| | - Giuseppe Pezzotti
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan
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State of the Art of Different Zirconia Materials and Their Indications According to Evidence-Based Clinical Performance: A Narrative Review. Dent J (Basel) 2023; 11:dj11010018. [PMID: 36661555 PMCID: PMC9857458 DOI: 10.3390/dj11010018] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
The aim of this study was to perform a narrative review to identify the modifications applied to the chemical structure of third- and fourth-generation zirconia ceramics and to determine the influence of these changes on the mechanical and optical properties. A bibliographical search using relevant keywords was conducted in the PubMed® and EBSCO databases. The abstracts and full texts of the resulting articles were reviewed for final inclusion. Fifty-four articles were included in this review. The analyzed topics were: (1) the composition of first- and second-generation zirconia materials (Y-TZP), (2) the behavior of the studied generations in relation to mechanical and optical properties, and (3) the modifications that were carried out on third-generation (5Y-TZP) and fourth-generation (4Y-TZP) zirconia materials. However, studies focusing on these specific characteristics in third- and fourth-generation zirconia materials are scarce. The review shows that there is a lack of sufficient knowledge about the chemical modifications of zirconia in the new generations.
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Roulet JF, Sinhoreti MAC, Pontes S, Rocha MG. Two-body wear resistance and fatigue survival of new Y-TZP and ATZ ceramics made with a new slip-casting method. J Mech Behav Biomed Mater 2022; 136:105535. [PMID: 36302274 DOI: 10.1016/j.jmbbm.2022.105535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Dental zirconium oxide restorations are milled from pre-sintered blocks or disks which are produced either with high isostatic pressure (HIP) or, simpler, a slurry technique. The objective was to perform a fatigue test and an in vitro wear simulation of two ceramics, yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) ceramic and a hybrid zirconium oxide-aluminum oxide ceramic, (ATZ) both produced either the classical way using high isostatic pressure (HIP, control) or with a slurry technique. MATERIALS AND METHODS Ten discs/group were subjected to a cyclic biaxial fatigue test using a staircase approach under water at 37 °C in a dynamic universal testing machine. The 2-body wear test was performed on eight lapped 12 mm thick cylindrical samples subjected to spherical (ø 6 mm) leucite ceramic antagonists in a CS-4 chewing simulator at 49 N force and 0.7 mm lateral movement for 600 k cycles and 4167 thermal cycles (5-55 °C). Volumetric wear was calculated based on laser-scanned surfaces. Selected samples of both tests were viewed in SEM. RESULTS All the ceramic specimens produced using the HIP method survived up to 1.2 M cycles with the maximum load of the equipment (1000 N) loading the specimens up to 1527 MPa. The fatigue limit stress at 1.2 M cycles for the Slurry ATZ samples was 946 MPa. For the Slurry Y-TZP samples the fatigue limit stress at 1.2 M cycles was 658 MPa. At 600 k cycles, all zirconium oxide ceramics showed no measurable wear and had a highly polished appearance. The leucite ceramic antagonists wear developed in a linear way. There was no difference between the materials produced with the slurry and the HIP process. ATZ ceramic produced significantly more wear than 3Y- TZP ceramic. CONCLUSIONS The HIP method provided higher fatigue strength than the Slurry manufacturing method. All HIP ceramics surpassed the limit threshold (1527 MPa) of the testing machine. The tested ceramics did not show any measurable wear but had worn the leucite reinforced glass ceramic antagonists for a considerable amount.
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Affiliation(s)
- Jean-François Roulet
- Center of Dental Biomaterials, Department of Restorative Dental Science, College of Dentistry, University of Florida, Gainesville, FL, USA.
| | - Mario Alexandre Coelho Sinhoreti
- Center of Dental Biomaterials, Department of Restorative Dental Science, College of Dentistry, University of Florida, Gainesville, FL, USA; Dental Materials Division, Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Stefany Pontes
- Center of Dental Biomaterials, Department of Restorative Dental Science, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Mateus Garcia Rocha
- Center of Dental Biomaterials, Department of Restorative Dental Science, College of Dentistry, University of Florida, Gainesville, FL, USA
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Miura S, Shinya A, Koizumi H, Fujisawa M. Effect of speed sintering of monolithic zirconia with different yttria contents on color and crystal phase. Eur J Oral Sci 2022; 130:e12898. [PMID: 36335285 DOI: 10.1111/eos.12898] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/28/2022] [Indexed: 11/09/2022]
Abstract
This study evaluated the color and microstructure of monolithic zirconia crowns with different yttrium oxide (Y2 O3 ) contents treated by conventional or speed sintering. Four types of zirconia ceramics were assessed: two monolayer zirconia, and two multilayer zirconia. The monolithic zirconia crowns were fabricated using a dental computer-aided design/computer-aided manufacturing (CAD/CAM) system and in two shades (A2 and BL). After milling, the zirconia crowns were sintered using either speed sintering or conventional sintering. For each combination of zirconia (4), shade (2), and sintering condition (2), the color parameters were determined at three positions of each of nine crowns using a non-contact dental spectrophotometer. In addition, the zirconia phases in the specimens were quantified using X-ray diffractometry. Significant differences in the ΔE00 values at different measurement positions were observed for the Multi2 crown of the BL shade group. The color difference resulting from conventional and speed sintering programs was not affected by the difference in yttria content of Mono1, Mono2, and Multi1. However, in Multi2, containing 3Y-TZP and 5Y-PSZ, a color change was caused by the use of speed sintering. Therefore, when performing speed sintering with Multi2, it is necessary to select the color in consideration of these results or take measures for staining.
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Affiliation(s)
- Shoko Miura
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Saitama, Japan
| | - Akikazu Shinya
- Department of Dental Materials Sciences, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan.,Department of Prosthetic Dentistry and Biomaterials Science, Institute of Dentistry, University of Turku, Turku, Finland
| | - Hiroyasu Koizumi
- Department of Dental Materials, Nihon University School of Dentistry, Tokyo, Japan
| | - Masanori Fujisawa
- Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Saitama, Japan
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Effect of sintering time on the marginal and internal fit of monolithic zirconia crowns containing 3–4 mol% Y2O3. BMC Oral Health 2022; 22:493. [PMID: 36380324 PMCID: PMC9664799 DOI: 10.1186/s12903-022-02563-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
Background Short-term sintering may offer advantages including saving time and energy but there is limited evidence on the effect that altering sintering time has on the accuracy of monolithic zirconia crowns. The purpose of this in vitro study was to investigate the effect of shortened sintering time on the marginal and internal fit of 3Y-TZP and 4Y-TZP monolithic crowns. Methods Sixty monolithic zirconia crowns were fabricated for the maxillary first molar tooth on the prefabricated implant abutment. Groups were created according to the material composition: 3Y-TZP Generation 1, 3Y-TZP Generation 2 and 4Y-TZP. Two different sintering protocols were performed: same final sintering temperature (1500 °C) and various rates of heating (10 °C/min and 40 °C/min), cooling down speed (− 10 °C/min and − 40 °C/min), holding time (45 and 120 minutes), and total sintering time (approximately 2 and 7 hours, respectively). The marginal and internal fit of the crowns were determined using the silicone replica technique. Comparisons between groups were analyzed using two-way ANOVA. Pairwise multiple comparisons were performed using t-test (p < 0.05). Results The mean marginal gap values of 4Y-TZP zirconia revealed statistically significant increase for the short-term sintering protocol (p < 0.0001), while no difference was observed between the sintering protocols for the mean marginal gap values of 3Y-TZP groups. Although all groups showed clinically acceptable gap values, altering the sintering time had an effect on marginal fit of the crowns manufactured from 4Y-TZP zirconia. Conclusions Shortening the sintering time may lead to differences within clinically acceptable limits. The manufacturer’s recommendations according to material composition should be implemented with care.
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Abstract
Resin-bonded ceramic restorations are common treatment options. Clinical longevity of resin-bonded ceramic restorations depends on the quality and durability of the resin-ceramic bond. The type and composition of the specific ceramic determines the selection of the most effective bonding protocol. Such protocol typically includes a surface pretreatment step followed by application of a priming agent. Understanding of fundamental ceramic properties and chemical compositions enables the clinician to make proper material selection decisions for clinically successful and long-lasting restorations. Based on research accrued over the past decades, this article reviews and discusses current resin-bonding protocols to most commonly used dental ceramics.
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Affiliation(s)
- Markus B Blatz
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA.
| | - Julian Conejo
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
| | - Amirah Alammar
- Sijam Medical Center, Northern Ring Road, Alghadeer District, Riyadh, Saudi Arabia
| | - Jose Ayub
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
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Restoring Teeth with an Advanced Lithium Disilicate Ceramic: A Case Report and 1-Year Follow-Up. Case Rep Dent 2022; 2022:6872542. [PMID: 36157203 PMCID: PMC9507783 DOI: 10.1155/2022/6872542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 11/17/2022] Open
Abstract
Advancements in materials science and bonding protocols as well as new manufacturing methods foster the development of novel ceramic materials to meet the increased demands for highly aesthetic, biocompatible, and long-lasting restorations in fixed prosthodontics. This case report highlights the minimally invasive rehabilitation with a new advanced lithium disilicate (ALD) ceramic block. It is reinforced with virgilite crystals in managing esthetic demand of patient besides having a high flexural strength. According to the manufacturer, the material provides a biaxial strength measured at >700 MPa and improved optical properties. The remarkable speed sintering time of approx. 4.5 minutes makes processing very fast. Time efficiency, predictability, and economically interesting treatment options are of great importance in current dentistry and can be well implemented in CAD/CAM dentistry. The newly introduced ALD ceramic for the “Chairside Economical Restoration of Esthetic Ceramics”/“CEramic REConstruction” (CEREC) system produces an esthetically pleasing and clinically excellent restoration. The shorter processing time combined with high flexural strength will optimize the chairside workflow. New treatment indication options for lithium disilicate ceramics will expand. Although more evidence from long-term clinical studies is needed to verify the clinical performance and manufacturer recommendations regarding indication, preparation and cementation must be followed very strictly. In the present case report, restorations were indicated for seven posterior teeth, which were prepared, scanned, designed with CEREC-Primescan SW 5.1.3, and fabricated with MCX5. The monolithic restorations were placed adhesively. The rehabilitation with the ALD blocks resulted in an aesthetically pleasing, functional outcome that improved overall treatment time and increased patient and practitioner satisfaction, which remained stable over a one-year follow-up period.
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Conventional, Speed Sintering and High-Speed Sintering of Zirconia: A Systematic Review of the Current Status of Applications in Dentistry with a Focus on Precision, Mechanical and Optical Parameters. J Clin Med 2022; 11:jcm11164892. [PMID: 36013131 PMCID: PMC9409711 DOI: 10.3390/jcm11164892] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 01/17/2023] Open
Abstract
The aim of this systematic review was to provide an overview of the technical and clinical outcomes of conventional, speed sintering and high-speed sintering protocols of zirconia in the dental field. Data on precision, mechanical and optical parameters were evaluated and related to the clinical performance of zirconia ceramic. The PICOS search strategy was applied using MEDLINE to search for in vitro and in vivo studies using MeSH Terms by two reviewers. Of 66 potentially relevant studies, 5 full text articles were selected and 10 were further retrieved through a manual search. All 15 studies included in the systematic review were in vitro studies. Mechanical, precision and optical properties (marginal and internal fit, fracture strength and modulus, wear, translucency and opalescence, aging resistance/hydrothermal aging) were evaluated regarding 3-, 4- and 5-YTZP zirconia material and conventional, high- and high-speed sintering protocols. Mechanical and precision results were similar or better when speed or high-speed sintering methods were used for 3-, 4- and 5-YTZP zirconia. Translucency is usually reduced when 3 Y-TZP is used with speed sintering methods. All types of zirconia using the sintering procedures performed mechanically better compared to lithium disilicate glass ceramics but glass ceramics showed better results regarding translucency.
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Nonaka K, Teramae M, Pezzotti G. Evaluation of the Effect of High-Speed Sintering and Specimen Thickness on the Properties of 5 mol% Yttria-Stabilized Dental Zirconia Sintered Bodies. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5685. [PMID: 36013827 PMCID: PMC9412651 DOI: 10.3390/ma15165685] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/08/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
High-speed sintering of zirconia has become essential to single-visit dental prosthetic treatments. This important prosthetic dentistry technique demands a translucent material tougher than porcelain. Previous studies on high-speed sintered zirconia did not take heat and material thickness into consideration. We evaluated pre-sintered specimen thickness and the effect of high-speed sintering on the properties of 5 mol% Y2O3-stabilized zirconia (5Y zirconia). High-speed sintered bodies of 5Y zirconia were evaluated by density measurements, translucency measurements, three-point flexural and fracture toughness tests, X-ray diffraction (XRD), and scanning electron microscopy (SEM). High-speed sintering reduced the translucency and mechanical properties of 5Y zirconia. XRD and SEM observation results clarified that these reductions were due to the change in crystal phase composition and to the increase in residual pores, respectively, both resulting from high-speed sintering. Moreover, in high-speed sintering, as the thickness of the specimen increased, the number and size of internal pores increased, and the translucency and strength decreased. The threshold value for avoiding a reduction in translucency and mechanical properties was found to lie at ~4.4 mm. From the above results, it was concluded that 5Y zirconia is not suitable for high-speed sintering applications.
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Affiliation(s)
- Kazumichi Nonaka
- Department of Research and Development, SHOFU INC, Higashiyama-ku, Kyoto 605-0983, Japan
| | - Mitsuji Teramae
- Department of Research and Development, SHOFU INC, Higashiyama-ku, Kyoto 605-0983, Japan
| | - Giuseppe Pezzotti
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Matsugasaki, Sakyo-ku, Kyoto 606-8585, Japan
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Mayinger F, Buser R, Laier M, Schönhoff LM, Kelch M, Hampe R, Stawarczyk B. Impact of the material and sintering protocol, layer thickness, and thermomechanical aging on the two-body wear and fracture load of 4Y-TZP crowns. Clin Oral Investig 2022; 26:6617-6628. [PMID: 35840737 DOI: 10.1007/s00784-022-04616-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/04/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of this study is to investigate the influence of the material and corresponding sintering protocol, layer thickness, and aging on the two-body wear (2BW) and fracture load (FL) of 4Y-TZP crowns. MATERIALS AND METHODS Multi-layer 4Y-TZP crowns in three thicknesses (0.5 mm/1.0 mm/1.5 mm) were sintered by high-speed (Zolid RS) or conventional (Zolid Gen-X) sintering. 2BW of ceramic and enamel antagonist after aging (1,200,000 mechanical-, 6000 thermal-cycles) was determined by 3D-scanning before and after aging and subsequent matching to determine volume and height loss (6 subgroups, n = 16/subgroup). FL was examined initially and after aging (12 subgroups, n = 16/subgroup). Fractographic analyses were performed using light-microscope imaging. Global univariate analysis of variance, one-way ANOVA, linear regression, Spearman's correlation, Kolgomorov-Smirnov, Mann-Whitney U, and t test were computed (alpha = 0.05). Weibull moduli were determined. Fracture types were analyzed using Ciba Geigy table. RESULTS Material/sintering protocol did not influence 2BW (crowns: p = 0.908, antagonists: p = 0.059). High-speed sintered Zolid RS presented similar (p = 0.325-0.633) or reduced (p < 0.001-0.047) FL as Zolid Gen-X. Both 4Y-TZPs showed an increased FL with an increasing thickness (0.5(797.3-1429 N) < 1.0(2087-2634 N) < 1.5(2683-3715 N)mm; p < 0.001). For most groups, aging negatively impacted FL (p < 0.001-0.002). Five 0.5 mm specimens fractured, four showed cracks during and after aging. CONCLUSIONS High-speed sintered crowns with a minimum thickness of 1.0 mm showed sufficient mechanical properties to withstand masticatory forces, even after a simulated aging period of 5 years. CLINICAL RELEVANCE Despite the manufacturer indicating a thickness of 0.5 mm to be suitable for single crowns, a minimum thickness of 1.0 mm should be used to ensure long-term satisfactory results.
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Affiliation(s)
- Felicitas Mayinger
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany.
| | - Ramona Buser
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany.,Department of Reconstructive Dentistry and Gerodontology, University of Bern, Freiburgstrasse 7, 3007, Bern, Switzerland
| | - Maximilian Laier
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Lisa Marie Schönhoff
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Matthias Kelch
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Rüdiger Hampe
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, Dental School, LMU Munich, Goethestraße 70, 80336, Munich, Germany
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Jeong JI, Shin HJ, Kwon YH, Seol HJ. Effect of Cooling Rate on Mechanical Properties, Translucency, Opalescence, and Light Transmission Properties of Monolithic 4Y-TZP during Glazing. MATERIALS 2022; 15:ma15124357. [PMID: 35744423 PMCID: PMC9228759 DOI: 10.3390/ma15124357] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/10/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022]
Abstract
A standard cooling rate has not been established for glazing; therefore, the effects of the cooling rate on the properties of zirconia need to be evaluated to predict outcomes in clinical practice. 4Y-TZP glazed at three different cooling rates was analyzed to estimate the effect of cooling rate during glazing on the mechanical and optical properties. Hardness tests, field-emission scanning electron microscopy analysis, X-ray diffraction analysis, flexural strength measurement, and optical property evaluations were performed. When 4Y-TZP was glazed at a higher cooling rate (Cooling-1) than the normal cooling rate (Cooling-2), there was no significant difference in grain size, flexural strength, average transmittance, and translucency parameters. The hardness was slightly reduced. The opalescence parameter was reduced for the 2.03 mm thick specimens. When 4Y-TZP was glazed at a lower cooling rate (Cooling-3) than the normal cooling rate, there was no significant difference in hardness, grain size, flexural strength, and translucency parameters. In addition, the average transmittance and opalescence parameters were slightly reduced for the 0.52 and 2.03 mm specimens, respectively. The effects of the cooling rate during glazing on the mechanical and optical properties of 4Y-TZP appear to be minimal and clinically insignificant. Therefore, even if the cooling rate cannot be strictly controlled during glazing, the clinical outcomes will not be significantly affected.
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Kim YK, Yoon HI, Kim DJ, Han JS. Comparative analysis on intaglio surface trueness, wear volume loss of antagonist, and fracture resistance of full-contour monolithic zirconia crown for single-visit dentistry under simulated mastication. J Adv Prosthodont 2022; 14:173-181. [PMID: 35855321 PMCID: PMC9259349 DOI: 10.4047/jap.2022.14.3.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE This analysis aimed to evaluate the intaglio surface trueness, antagonist’s wear volume loss, and fracture resistance of full-contour crowns of (Y, Nb)-stabilized fully-sintered zirconia (FSZ), 4 mol% or 5 mol% yttria-stabilized partially sintered zirconia (4YZ or 5YZ) with high-speed sintering. MATERIALS AND METHODS A total of 42 zirconia crowns were separated into three groups: FSZ, 4YZ, and 5YZ (n = 14). The intaglio surface trueness of the crowns was evaluated at the inner surface, occlusal, margin, and axial areas and reported as root-mean-square, positive and negative average deviation. Half of the specimens were aged for 120,000 cycles in the chewing simulator, and the wear volume loss of antagonist was measured. Before and after chewing, the fracture load was measured for each group. The trueness values were analyzed with Welch's ANOVA, and the wear volume loss with the Kruskal-Wallis tests. Effect of the zirconia type and aging on fracture resistance of crowns was tested using two-way ANOVA. RESULTS The intaglio surface trueness measured at four different areas of the crown was less than 50 µm, regardless of the type of zirconia. No significant P in wear volume loss of antagonists were detected among the groups (P > .05). Both the type of zirconia and aging showed statistically significant effects on fracture resistance (P < .05). CONCLUSION The full-contour crowns of FSZ as well as 4YZ or 5YZ with high-speed sintering were clinically acceptable, in terms of intaglio surface trueness, antagonist’s wear volume loss, and fracture resistance after simulated mastication.
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Affiliation(s)
- Yong-Kyu Kim
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Dae-Joon Kim
- Department of Dentistry, VASIC Research Center, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Jung-Suk Han
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Multilayer Super-Translucent Zirconia for Chairside Fabrication of a Monolithic Posterior Crown. Case Rep Dent 2022; 2022:4474227. [PMID: 35371572 PMCID: PMC8967591 DOI: 10.1155/2022/4474227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/07/2022] [Indexed: 11/17/2022] Open
Abstract
This case report describes the chairside fabrication of a monolithic posterior crown using a multilayer super-translucent zirconia material. According to the manufacturer’s information, the newly introduced multilayer zirconia (4-YTZP) offers a unique combination of fracture strength (>850 MPa with speed-sintering) and improved optical properties, thus allowing a reduced minimum material thickness and optional temporary luting. By using up-to-date components of the CEREC system, including superfast dry-milling and a speed-sintering process, the fabrication of a monolithic zirconia crown is possible within an acceptable timeframe for the chairside workflow (60-75 min). The usage of a multilayer super-translucent material allows for the individualization of the restoration, typically in a single combined stain and glaze firing. However, it should be noted that clinical data for this type of restoration are still sparse. Therefore, manufacturer recommendations regarding indication, preparation, and cementation must be followed very strictly.
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Evaluation of Er,Cr:YSGG laser irradiation for debonding of zirconia hybrid abutment crowns from titanium bases. Lasers Med Sci 2022; 37:2675-2685. [DOI: 10.1007/s10103-022-03539-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/28/2022] [Indexed: 10/18/2022]
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New generation CAD-CAM materials for implant-supported definitive frameworks fabricated by using subtractive technologies. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3074182. [PMID: 35281596 PMCID: PMC8906986 DOI: 10.1155/2022/3074182] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/05/2022] [Accepted: 02/02/2022] [Indexed: 12/31/2022]
Abstract
Innovations in digital manufacturing enabled the fabrication of implant-supported fixed dental prostheses (ISFDPs) in a wide variety of recently introduced materials. Computer-aided design and computer-aided manufacturing (CAD-CAM) milling allows the fabrication of ISFDPs with high accuracy by reducing the fabrication steps of large-span frameworks. The longevity of ISFDPs depends on the overall mechanical properties of the framework material including its fit, and the physical properties of the veneering material and its bond with the framework. This comprehensive review summarizes the recent information on millable CAD-CAM framework materials such as pre-sintered soft alloys, fiber-reinforced composite resins, PEEK, and PEKK in high-performance polymer family, and 4Y-TZP. Even though promising results have been obtained with the use of new generation millable CAD-CAM materials for ISFDPs, clinical studies are lacking and future research should focus on the overall performance of these millable materials in both static and dynamic conditions.
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Yılmaz Savaş T, Akın C. Effects of sintering protocol and dipping time on the optical properties of monolithic zirconia. J Prosthet Dent 2022; 127:801.e1-801.e8. [DOI: 10.1016/j.prosdent.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
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Alammar A, Blatz MB. The resin bond to high‐translucent zirconia—A systematic review. J ESTHET RESTOR DENT 2022; 34:117-135. [DOI: 10.1111/jerd.12876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 02/01/2023]
Affiliation(s)
- Amirah Alammar
- Sijam Medical Center, Private Practice Riyadh Saudi Arabia
| | - Markus B. Blatz
- School of Dental Medicine, Department of Preventive and Restorative Sciences University of Pennsylvania Philadelphia Pennsylvania USA
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Liu YC, Lin TH, Lin YY, Hu SW, Liu JF, Yang CC, Yan M. Optical properties evaluation of rapid sintered translucent zirconia with two dental colorimeters. J Dent Sci 2022; 17:155-161. [PMID: 35028033 PMCID: PMC8740431 DOI: 10.1016/j.jds.2021.05.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/16/2022] Open
Abstract
Background/purpose The efficient rapid sintering technique has employed to dental zirconia ceramics for shortening the fabrication time of zirconia restorations. The purpose was to compare the optical properties of two generations of rapid sintered translucent zirconia using two dental colorimeters. Materials and methods Two generations of translucent zirconia ceramics, 3 mol% yttria-tetragonal zirconia polycrystal (3Y-TZP): Copran Zr-i Ultra-T (UT) and Cercon HT (HT), and 5 mol% yttria-tetragonal zirconia polycrystal (5Y-TZP): Cercon xt (XT), of different thicknesses (0.5, 0.8, and 1.2 mm; n = 5) underwent rapid sintering (RS) or conventional sintering (CS). The CIELAB values were measured on the white and black backgrounds, respectively, by digital colorimeters, shadepilot, DeguDent (DD) and Easyshade V, Vita (Vita). Translucency parameter (TP), color difference (ΔE), surface morphology, and surface roughness were evaluated. Results RS resulted in reduced lightness, except in the XT group. The chromaticity increased slightly after RS. Translucency decreased with increasing material thickness. ΔE values differed between both sintering processes but were clinically acceptable (ΔE < 5). Grain size of XT decreased after RS. RS did not affect the surface roughness. Conclusion RS is a feasible method for shortening the manufacturing time of zirconia restorations. A significant difference in TP value was only in the XT group between both sintering methods as measured on DD. Color differences in rapid sintered translucent zirconia materials are imperceptible and acceptable. The specimen thickness affected more in the TP values of Vita than DD. DD has higher sensitivity to translucency and color compared with Vita.
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Affiliation(s)
- Yu-Ching Liu
- Dental Laboratory, Department of Prosthodontics, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Dental Technology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Tzu-Hao Lin
- Department of Oral Hygiene and Healthcare, Cardinal Tien Junior College of Healthcare and Management, New Taipei City, Taiwan
| | - Yuh-Yih Lin
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Dentistry, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung, Taiwan
| | - Suh-Woan Hu
- Department of Dentistry, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung, Taiwan.,Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Jeng-Fen Liu
- Department of Pediatric and Physically Disabled Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chun-Chuan Yang
- Department of Dental Technology, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.,Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
| | - Min Yan
- Department of Dentistry, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung, Taiwan.,Institute of Oral Sciences, Chung Shan Medical University, Taichung, Taiwan
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Arcila LVC, Ramos NDC, Campos TMB, Dapieve KS, Valandro LF, de Melo RM, Bottino MA. Mechanical behavior and microstructural characterization of different zirconia polycrystals in different thicknesses. J Adv Prosthodont 2022; 13:385-395. [PMID: 35003554 PMCID: PMC8712112 DOI: 10.4047/jap.2021.13.6.385] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/02/2021] [Accepted: 12/10/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To characterize the microstructure of three yttria partially stabilized zirconia ceramics and to compare their hardness, indentation fracture resistance (IFR), biaxial flexural strength (BFS), and fatigue flexural strength. MATERIALS AND METHODS Disc-shaped specimens were obtained from 3Y-TZP (Vita YZ HT), 4Y-PSZ (Vita YZ ST) and 5Y-PSZ (Vita YZ XT), following the ISO 6872/2015 guidelines for BFS testing (final dimensions of 12 mm in diameter, 0.7 and 1.2 ± 0.1 mm in thicknesses). Energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD) and scanning electron microscopy (SEM) analyses were performed, and mechanical properties were assessed by Vickers hardness, IFR, quasi-static BFS and fatigue tests. RESULTS All ceramics showed similar chemical compositions, but mainly differed in the amount of yttria, which was higher as the amount of cubic phase in the diffractogram (5Y-PSZ > 4Y-PSZ > 3Y-TZP). The 4Y- and 5Y-PSZ specimens showed surface defects under SEM, while 3Y-TZP exhibited greater grain uniformity on the surface. 5Y-PSZ and 3Y-TZP presented the highest hardness values, while 3Y-TZP was higher than 4Y- and 5Y-PSZ with regard to the IFR. The 5Y-PSZ specimen (0.7 and 1.2 mm) showed the worst mechanical performance (fatigue BFS and cycles until failure), while 3Y-TZP and 4Y-PSZ presented statistically similar values, higher than 5Y-PSZ for both thicknesses (0.7 and 1.2 mm). Moreover, 3Y-TZP showed the highest (1.2 mm group) and the lowest (0.7 mm group) degradation percentage, and 5Y-PSZ had higher strength degradation than 4Y-PSZ group. CONCLUSION Despite the microstructural differences, 4Y-PSZ and 3Y-TZP had similar fatigue behavior regardless of thickness. 5Y-PSZ had the lowest mechanical performance.
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Affiliation(s)
- Laura Viviana Calvache Arcila
- Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Institute of Science and Technology, São José Dos Campos, Brazil
| | - Nathália de Carvalho Ramos
- Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Institute of Science and Technology, São José Dos Campos, Brazil.,College of Dentistry, University of Taubaté (Unitau), Taubaté, Brazil
| | | | | | - Luiz Felipe Valandro
- College of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Renata Marques de Melo
- Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Institute of Science and Technology, São José Dos Campos, Brazil
| | - Marco Antonio Bottino
- Department of Dental Materials and Prosthodontics, São Paulo State University (UNESP), Institute of Science and Technology, São José Dos Campos, Brazil
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