Enhancing Resin Cement Adhesion to Zirconia by Oxygen Plasma-Aided Silicatization

Enhancing surface energy and characterizing optical properties of ultra-high translucency zirconia via an innovative heat treatment process

PURPOSE

Ultra-high translucency zirconia (UT-Zr) is known for its high esthetic quality; however, its inert surface results in low hydrophilicity and surface energy (SE). To address this limitation, this study proposes an innovative zirconia heat treatment process (ZHTP) and aims to evaluate the effects of ZHTP on the surface characteristics of UT-Zr, offering a novel and practical approach for surface pretreatment in dental practice.

MATERIAL AND METHODS

The plate-shaped UT-Zr samples were fabricated. After sintering, the samples without additional staining or polishing were divided into the following nine groups: NT (no additional pretreatment), AB (airborne-particle abrasion), PL (nonthermal plasma), PO (polishing), HPO (fine-polishing), NTH (treat with ZHTP), POPL (PL followed by PO), POH (ZHTP followed by PO), and HPOH (ZHTP followed by HPO). The surface roughness (Ra), microstructure, transmittance, glossiness, wettability, and SE of the samples (n = 10), and statistical analyses were conducted.

RESULTS

AB showed the highest Ra and lowest glossiness (P < 0.05), while HPO and HPOH yielded the smoothest surfaces, with HPOH achieving the highest glossiness (P < 0.05). Although the ZHTP approach slightly improved transmittance, it did not affect the microstructure. PO reduced hydrophilicity and SE (P < 0.05), and HPO slightly increased them. PL significantly enhanced both properties (P < 0.05), and ZHTP also increased them (P < 0.05) to levels similar to PL. Notably, hydrophilicity in nonthermal plasma and ZHTP-treated samples decreased similarly after 24 h.

CONCLUSIONS

The ZHTP approach enhances UT-Zr wettability and SE, with slight transmittance improvement. HPOH achieves hydrophilicity and SE comparable to PL, validating ZHTP as a promising strategy for UT-Zr surface optimization in dental applications.

Alternative Treatments for Zirconium Oxide to Compare Commonly Used Surface Treatments to Determine Which Has the Least Effect on the Phase Transformation

Traditional mechanical processing of zirconium leads to an unfavorable transformation, from a metastable tetragonal phase to a monoclinic phase (t→m), which weakens the structure of the material and subsequently leads to damage to the prosthetic restoration. The aim of this research is to compare commonly used surface treatments to determine which has the least effect on t→m. Thirty cylindrical samples made of sintered zirconium were divided into six groups based on the following treatments: polishing, grinding, sandblasting, chemical etching, laser structuring or dry plasma etching. After surface treatment, the samples were subjected to the following tests: X-Ray Diffraction, microscopic examination, surface wettability and surface roughness measurements. Chemical etching, laser structuring and plasma etching significantly reduce the content of the monoclinic phase. All surface treatments significantly reduced the final amount of the monoclinic phase. However, chemical etching did not provide sufficient surface roughness. Both laser and plasma processing offer the advantage of creating structural patterns on the surface of elements. However, as plasma etching requires a mask to obtain the appropriate pattern on the surface, it seems that laser processing offers more and varied structuring possibilities. Laser structuring is easier to control and more economical than the other methods.

Effects of plasma surface treatment on the bond strength of zirconia with an adhesive resin luting agent

The purpose of this study was to evaluate the effect of the atmospheric pressure plasma treatment as a surface treatment method on the contact angle and shear bond strength (SBS) of zirconia ceramics and the failure mode between the self-adhesive resin luting agent and zirconia. The zirconia specimens were divided into eight groups based on the surface treatment method: alumina blasting, air plasma, argon plasma (AP), Katana cleaner, ozonated water, ozonated water+AP, Katana cleaner+AP, and tap water+AP. The contact angles, SBS, and fracture modes were tested. AP treatment significantly reduced the contact angle (p<0.0001). The combination of AP and other cleaning methods showed a higher bond strength and more mixed fractures. Our findings indicate that using atmospheric pressure plasma with argon gas, combined with other cleaning methods, results in a stronger bond than when using alumina blasting alone.

Zirconia bond strength durability following artificial aging: A systematic review and meta-analysis of in vitro studies

The present study systematically reviewed the literature regarding the bond strength durability of zirconia ceramics to resin-based luting cements after application of different bonding protocols and aging conditions. Electronic searches in PubMed, Scopus, and Web of Science databases were performed for relevant literature published between January 1st 2015 and November 15th 2022. Ninety-three (93) English language in-vitro studies were included. The percentage of the mean bond strength change was recorded prior to and after artificial aging, and the weighted mean values and 95% confidence intervals were calculated. Bonding protocols were classified based on the combination of MDP/non-MDP containing cement/primer and surface pretreatment, as well as the level of artificial aging performed. Alumina sandblasting (SA) was identified as the most frequently used surface pre-treatment while an insufficient number of studies was identified for each category of alternative surface treatments. The combination of MDP cement with tribochemical silica coating (TSC) or SA yielded more durable results after aging, while the application of SA and TSC improved bond durability when a non-MDP cement and a non-MDP primer were used. TSC may lead to increased bond durability compared to SA, whereas MDP cements may act similarly when combined with SA or TSC.

Dental Luting Cements: An Updated Comprehensive Review

The cementation of indirect restoration is one of the most important steps in prosthetic and restorative dentistry. Cementation aims to bond the prosthetic restoration to the prepared enamel or enamel and dentine. Successful cementation protocols prevent biofilm formation at the margin between tooth and restoration and minimize mechanical and biological complications. With the advancements in dental cements, they have been modified to be versatile in terms of handling, curing, and bond strengths. This review presents updates on dental cements, focusing on the composition, properties, advantages, limitations, and indications of the various cements available. Currently, dental restorations are made from various biomaterials, and depending on each clinical case, an appropriate luting material will be selected. There is no luting material that can be universally used. Therefore, it is important to distinguish the physical, mechanical, and biological properties of luting materials in order to identify the best options for each case. Nowadays, the most commonly used dental cements are glass-ionomer and resin cement. The type, shade, thickness of resin cement and the shade of the ceramic, all together, have a tangible influence on the final restoration color. Surface treatments of the restoration increase the microtensile bond strength. Hence, the proper surface treatment protocol of both the substrate and restoration surfaces is needed before cementation. Additionally, the manufacturer's instructions for the thin cement-layer thickness are important for the long-term success of the restoration.

Zirconia Nanoparticles as Reinforcing Agents for Contemporary Dental Luting Cements: Physicochemical Properties and Shear Bond Strength to Monolithic Zirconia

Nanofillers in resin materials can improve their mechanical and physicochemical properties. The present work investigated the effects of zirconia nanoparticles (NPs) as fillers in commercial dental luting cements. Two dual-cured self-adhesive composites and one resin modified glass ionomer (RMGI) luting cement were employed. Film thickness (FT), flexural strength (FS), water sorption (W_sp), and shear bond strength (SBS) to monolithic zirconia were evaluated according to ISO 16506:2017 and ISO 9917-2:2017, whereas polymerization progress was evaluated with FTIR. Photopolymerization resulted in double the values of DC%. The addition of 1% wt NPs does not significantly influence polymerization, however, greater amounts do not promote crosslinking. The sorption behavior and the mechanical performance of the composites were not affected, while the film thickness increased in all luting agents, within the acceptable limits. Thermocycling (TC) resulted in a deteriorating effect on all composites. The addition of NPs significantly improved the mechanical properties of the RMGI cement only, without negatively affecting the other cements. Adhesive primer increased the initial SBS significantly, however after TC, its application was only beneficial for RMGI. The MDP containing luting cement showed higher SBS compared to the RMGI and 4-META luting agents. Future commercial adhesives containing zirconia nanoparticles could provide cements with improved mechanical properties.