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OBJECTIVE: To evaluate the effect of the deterioration of computer aided design/computer aided manufacturing (CAD/CAM) burs during zirconia milling, on surface roughness, contact angle, and fibroblast viability. MATERIALS AND METHODS: Ceramic blocks were milled and 75 ceramic disks (8 × 1.5 mm) made and allocated into three groups (n = 25): G1-brand new 2L and 1L burs, G2-2L bur at the end of lifetime and brand new 1L bur and G3-both burs at the end of their lifetimes. Roughness (Ra, Rq, and Rz) was evaluated using a 3D optical profilometer, the contact angle by the sessile drop method and the cell viability of the mouse NIH/3T3 fibroblast, using the Alamar Blue assay at intervals of 24, 48, and 72 h (ISO 10993-5). Data were analyzed by one-way ANOVA and Kruskal-Wallis tests (p ≤ 0.05). RESULTS: Roughness increased as the burs deteriorated and G3 (0.27 ± 0.04) presented a higher value for Ra (p < 0.001). The highest contact angle was observed in G3 (86.2 ± 2.66) when compared with G1 (63.7 ± 12.49) and G2 (75.3 ± 6.36) (p < 0.001). Alamar Blue indicated an increase in cell proliferation, with no significant differences among the groups at 24 and 72 h (p > 0.05). CONCLUSIONS: The deterioration of the burs increased the surface roughness and decreased the wettability, but did not interfere in cell viability and proliferation. CLINICAL SIGNIFICANCE: The use of custom zirconia abutments represents an effective strategy for single crowns restorations. Our findings suggest that these abutments can be efficiently milled using CAD/CAM burs within their recommended lifetime.

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Objective: This in vitro study evaluates the shear bond strength (SBS) of yttria-stabilized tetragonal zirconia (Y-TZP) and resin cement after different surface treatments. Materials and methods: Forty-eight ceramic cubes were divided into four groups (n = 12): G1 (control) sandblasting with Al2O3; G2-sandblasting with silica-coated Al2O3 (Rocatec); G3-Rocatec + CO2 laser; and G4-CO2 laser + Rocatec. A metallic primer was applied to the pretreated ceramic. A rubber ring was adapted on the central area, and then, the resin cement was inserted into the matrix and photoactivated. The samples were evaluated regarding surface roughness (Ra), SBS, failure type, and qualitatively with scanning electron microscopy (SEM). The data were analyzed by one-way analysis of variance followed by Tukey's test (p < 0.05). Results: The mean values of Ra (µm) were as follows: G1-4.52a, G2-4.24a,b, G3-4.10a,b, and G4-2.90b and the mean values of SBS (MPa) were as follows: G1-7.84a , G2-4.41b , G3-4.61b and G4-6.14a,b. SEM analyses showed superficial irregularities for all groups, being more prominent for G1. The presence of silica deposits was observed for G2, G3, and G4, but in the last two groups there were some linear areas, promoted by the fusion of silica, due to the thermomechanical action of the CO2 laser. Conclusions: The surface treatment with CO2 laser + Rocatec, using one MDP-based cement, can be an alternative protocol for the adhesion cementation of Y-TZP ceramic since it was as effective as the conventional pretreatment with aluminum oxide sandblasting.

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Commercial Yttria-tetragonal zirconia polycrystalline (Y-TZP) was subjected to surface treatments, and the bond strength of dual resin cement to Y-TZP and failure modes were evaluated. Disks (12 mm × 2 mm), cylinders (7 mm × 3.3 mm), and bars (25 mm × 5 mm × 2 mm) were milled from Y-TZP CAD-CAM blocks, divided into seven groups, and subjected to different surface treatments; silicatization was used as control. On the basis of the literature, this study evaluated modifications with films containing SiO2 nanoparticles and silane; SiO2+ZrO2­SiO2 (50%) and ZrO2 (50%) nanoparticles, SiO2+ZrO2/Silane-SiO2 (50%) and ZrO2 (50%) nanoparticles, and silane. Specimens were analyzed by wettability (n = 3), surface free energy (n = 3), X-ray diffraction (n = 1), Fourier transform infrared spectroscopy (FTIR) (n = 1), roughness (n = 5), shear bond test (n = 10), and dynamic modulus (n = 3). Specimens treated with hydrofluoric acid­HF 40% presented significantly higher contact angle and lowest surface free energy (p < 0.05). The SiO2/Silane presented crystalline SiO2 on the surface. The surface roughness was significantly higher for groups treated with nanofilms (p < 0.05). Shear bond strength was significantly higher for silicatization, HF 40%/silicatization, SiO2/Silane, and SiO2+ZrO2/Silane groups. The proposed treatments with nanofilms had potentially good results without prejudice to the physicochemical characteristics of zirconia. Generally, groups that underwent silica surface deposition and silanization had better bond strength (p < 0.005).

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OBJECTIVES: This study aimed to evaluate the impact of mechanical fatigue cycling using the step-stress approach along with hydrothermaldegradation (134 ºC with a constant pressure of 2 bars for 20 h), and a novel intercalated hydrothermal/fatigue aging protocol on different aspects of the aging resistance of three generations of dental zirconias. METHODS: "Y"Z T (VITA), INCORIS "T"ZI (Dentsply Sirona) and "K"ATANA UTML (Noritake Kuraray) - 1st, 2nd and 3rd generation, respectively-, zirconia disks (N = 153), were divided into 6 groups (n = 3) for monotonic testing and 9 groups (n = 15) for mechanical fatigue testing, according to 3 proposed treatments for each zirconia: CF (control - only mechanical fatigue cycling); AF (aging in hydrothermal reactor at 134 °C for 20 h + mechanical fatigue cycling); AFA (Alternating protocol: 4 steps of 5 h of hydrothermal aging intercalated with mechanical fatigue cycling). Mechanical fatigue aging was performed according to the step-stress approach through biaxial flexural setup (piston-on-3-balls, initial strength: 100 MPa, step: 50 MPa/10,000, frequency: 20 Hz) until failure. Data were analyzed using Kaplan-Meier and Mantel-Cox test (α = 0.05), in addition to Weibull analysis. Fractured disks were analyzed in stereomicroscope, Scanning Electron Microscopy and X-Ray Diffraction. RESULTS: Continuous hydrothermal and mechanical fatigue cycling decreased the fatigue strength of YAF group (516 ± 38 MPa), while the alternating protocol increased it (730 ± 58 MPa). KATANA UTML showed no differences for both treatments and did not undergo t-m phase transformation. The TAF group showed the highest fatigue strength (810 ± 76 MPa) and cycles for failure (147,000.00 cycles). The fracture origin for all specimens was on the tensile side in pre-existing defects. SIGNIFICANCE: INCORIS TZI zirconia had higher fatigue strength and survival rates after hydrothermal and mechanical fatigue aging. Although less resistant, KATANA UTML did not suffer chemical degradation.

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OBJECTIVES: This study investigates the simulation of the mechanical behavior of a bioceramic composite based on (Ce,Y)-TZP reinforced with equiaxed Al2O3 and platelet-shaped hexaaluminate (H6A) grains using Finit Element Method (FEM). METHODS: A commercial (Ce, Y)-TZP/Al2O3 ceramic powder was compacted into disc-shaped specimens that were sintered at 1500 °C for 2 h. The sintered samples were further subjected to hydrothermal degradation in an autoclave at 134 °C, 0.2 MPa, for 10 h and characterized according to their phase composition, microstructure, and relative density. Their flexural strength values were determined by the piston-on-three-ball test, and Weibull statistics was used to evaluate the results. Their hardness, fracture toughness and elastic parameters were also measured. Numerical simulations of the biaxial strength test were performed using the ABAQUS finite element code. RESULTS: The sintered ceramic composite material presented relative density >99%, high resistance to hydrothermal degradation, average hardness of 1435 ± 35 HV, fracture toughness KIC of 9.7 ± 0.5 MPa m1/2, and average biaxial flexural strength of 952.6 ± 88 MPa. The numerical predictions of the biaxial flexural strength showed a consistently lower average biaxial flexural strength value of 880.9 MPa, ∼10% lower than the average experimental results. CONCLUSIONS: The differences observed are attributed to the complex coupled toughness mechanisms of this material, not included in the finite element simulations.

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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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ABSTRACT Introduction: Various surface pre-treatment methods have been adapted to optimize the bonding between the zirconia ceramics and the orthodontic brackets. Objective: This review is aimed at systematically analyzing the relevant data available in the literature, to find out the most effective and durable bonding protocol. Methods: Database search was conducted in PubMed, Scopus, and ScienceDirect, during September 2020. The review was conducted according to the PRISMA guidelines. Results: Based on the inclusion criteria, 19 articles were selected for qualitative analysis. Meta-analysis could not be performed due to the heterogeneity of the methodology among the studies. Most of the studies scored medium risk of bias. Compared to the untreated surface, surface pretreatments like sandblasting and lasers were advantageous. Primers and universal adhesive were mostly used as an adjunct to the mechanical pretreatment of the zirconia surface. In most studies, thermocycling seemed to lower the shear bond strength (SBS) of the orthodontic brackets. Conclusion: Based on this qualitative review, surface pretreatments with lasers and sandblasting can be suggested to optimize the bracket bond strength. To clarify this finding, meta-analysis is anticipated. Hence, high heterogeneity of the included studies demands standardization of the methodology.

RESUMO Introdução: Diferentes métodos de pré-tratamento da superfície foram adaptados para otimizar a colagem entre os braquetes ortodônticos e as cerâmicas de zircônia. Objetivo: A presente revisão teve como objetivo analisar, de forma sistemática, os dados relevantes na literatura, para buscar o protocolo de colagem mais efetivo e duradouro. Métodos: As buscas foram feitas em setembro de 2020, nas seguintes bases de dados: PubMed, Scopus e ScienceDirect. A revisão foi feita de acordo com as diretrizes do PRISMA. Resultados: Com base nos critérios de inclusão, 19 artigos foram selecionados para análise qualitativa. A metanálise não pôde ser feita, devido à heterogeneidade na metodologia dos estudos incluídos. A maior parte dos estudos apresentou risco de viés moderado. Comparadas às superfícies não tratadas, as superfícies com pré-tratamento usando jateamento ou laser apresentaram vantagem. Primers e adesivos universais foram mais usados como adjuntos ao pré-tratamento mecânico da superfície de zircônia. Na maioria dos estudos, a termociclagem parece ter reduzido a resistência ao cisalhamento dos braquetes ortodônticos. Conclusões: Com base nessa revisão qualitativa, os pré-tratamentos de superfície com laser e jateamento podem ser sugeridos para otimizar a resistência ao cisalhamento dos braquetes. Para esclarecer esse achado, uma metanálise é necessária. Para isso, faz-se necessária a padronização da metodologia, para lidar com a alta heterogeneidade dos estudos incluídos.

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O objetivo deste trabalho foi avaliar a resistência à fadiga e ciclos até a falha de 3 zircônias odontológicas após envelhecimento hidrotérmico isolado e um novo protocolo alternado. Discos de zircônia "Y"Z T (VITA), INCORIS "T"ZI (Dentsply Sirona) e "K"ATANA UTML (Noritake Kuraray) (N=135) ­ 1ª, 2ª e 3ª gerações, respectivamente ­, foram divididos em 9 grupos (n=15), com 3 tratamentos para cada zircônia: CF ­ Controle, somente com fadiga mecânica; EF ­ Envelhecido em reator hidrotérmico a 134 ºC por 20 h + Fadiga; EFA: 4 passos de envelhecimentos de 5h alternados com fadiga. O teste de fadiga em flexão biaxial foi realizado com configuração de pistão sob 3 esferas, utilizando o método step-stress (carga inicial: 100 Mpa, step: 50 MPa/10.000 ciclos, frequência: 20 Hz). Os dados foram analisados através de teste Kaplan-Meir e Mantel-Cox com α=0,05, além da análise de Weibull. Discos fraturados foram analisados em estereomicroscópio, Microscopia Eletrônica de Varredura (MEV) e Difratômetro de Raios-X (DRX). O envelhecimento isolado com fadiga aumentou a resistência do grupo TEF (810 ± 76 MPa), enquanto diminuiu a do YEF (516 ± 38 MPa), o protocolo alternado aumentou a resistência apenas para a YZ T (730 ± 59 MPa). A KATANA UMTL não apresentou diferenças para ambos os tratamentos. Igualmente, foi a única a não sofrer transformação de fase T-M. O grupo TEF apresentou maior taxa sobrevivência à fadiga (147,000.00 ciclos). A origem de fratura para todos os espécimes deu-se no lado de tração em defeitos pré-existentes. Zircônias de 2ª geração possuem melhor comportamento mecânico e longevidade pós-envelhecimento e fadiga. Embora seja menos resistente, a KATANA UTML não sofreu degradação

This study aimed to evaluate the fatigue strength and cycles for failure of 3 dental zirconias after isolated and a novel hydrothermal and mechanical fatigue cycling aging protocol. "Y"Z T (VITA), INCORIS "T"ZI (Dentsply Sirona) and "K"ATANA UTML (Noritake Kuraray) zirconia discs (N=135), were divided into 9 groups (n=15), according to 3 proposed treatments for each zirconia: CF (control ­ only mechanical fatigue cycling); AF (aging in hydrothermal reactor at 134°C for 20 h + mechanical fatigue cycling ); AFA (Alternating protocol: 4 steps of 5 h of hydrothermal aging intercalated with mechanical fatigue cycling). Mechanical fatigue aging was performed according to the step stress approach through biaxial flexural setup (piston-on-3-balls, initial strength: 100 MPa, step: 50 MPa/ci000, frequency: 20 Hz) until failure. Data were analyzed using KaplanMeier and Mantel-Cox test (α=0.05), in addition to Weibull analysis. Fractured discs were analyzed in stereomicroscope, Scanning Electron Microscopy and XRay Diffraction. Continuous hydrothermal and mechanical fatigue cycling decreased the fatigue strength of YAF group (516 ± 38 MPa), while the alternating protocol increased it (730 ± 59 MPa). KATANA UTML showed no differences for both treatments and did not undergo T-M phase transformation. The TAF group showed the highest fatigue strength (810 ± 76 MPa) and cycles for failure (147,000.00 cycles). The fracture origin for all specimens was on the tensile side in pre-existing defects. INCORIS TZI zirconia have higher fatigue strength after hydrothermal and mechanical fatigue aging. Although less resistant, KATANA UTML did not suffer chemical degradation

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OBJECTIVE: The aims of this study were: 1) to evaluate the effect of sintering temperature on microstructure, density and flexural strength of a 3Y-TZP/TiO2 composite containing 12.5 wt% of TiO2 compared to 3Y-TZP specimens (control); 2) to compare 3Y-TZP with the experimental 3Y-TZP/TiO2 composite, both sintered at 1400 °C, with respect to the following parameters: optical properties, characteristic strength, Weibull modulus, fatigue behavior, induction of osteoblasts proliferation and differentiation (mineralization nodules formation). METHODS: The 3Y-TZP and 3Y-TZP/TiO2 powders were uniaxially pressed and sintered at 1200 °C, 1300 °C, 1400 °C or 1500 °C for one hour in a furnace. The microstructural analysis consisted of X-ray diffraction and scanning electron microscopy. The density was measured by the Archimedes' principle and the flexural strength was obtained by the biaxial flexure test. The optical properties were measured using a spectrophotometer operating in the visible light wavelength range. The step-stress accelerated life testing was performed by the pneumatic mechanical cycler and the biological behavior achieved by using osteoblast-like cells (Osteo-1 cell line). RESULTS: Tetragonal zirconia was identified in all groups and cubic zirconia was identified only at 3Y-TZP group. The addition of TiO2 decreased the values of density and flexural strength of the composite 3Y-TZP/TiO2 in relation to 3Y-TZP regardless of the sintering temperature. The color difference between the two materials was not significant regarding L*a*b* parameters. The composite showed higher probability of failure, and induced higher proliferation and differentiation than control. SIGNIFICANCE: The composite developed have good aesthetic and biologics properties. However, its microstructure and mechanical properties need to be improved for future dental implant applications.

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Abstract Glaze application on monolithic zirconia (Y-TZP) can be a practical approach to improve the mechanical properties of this material. Objective Our study evaluated the effect of glazing side and mechanical cycling on the biaxial flexure strength (BFS) of a Y-TZP. Methodology Eighty sintered Y-TZP discs (Ø:12 mm; thickness: 1.2 mm - ISO 6872) were produced and randomly assigned into eight groups (n=10), according to the factors "glazing side" (control - no glazing; GT - glaze on tensile side; GC - glaze on compression side; GTC - glaze on both sides) and "mechanical aging" (non-aged and aged, A - mechanical cycling: 1.2×106, 84 N, 3 Hz, under water at 37°C). Specimens were subjected to BFS test (1 mm/min; 1,000 Kgf load cell) and fractured surfaces were analyzed by stereomicroscopy and SEM. Hsueh's rigorous solutions were used to estimate the stress at failure of glazed specimens. Two-way ANOVA, Tukey's test (5%), and Weibull analysis were performed. Results The "glazing side", "mechanical aging" and the interaction of the factors were significant (p<0.05). Groups GC (1157.9±146.9 MPa), GT (1156.1±195.3 MPa), GTC (986.0±187.4 MPa) and GTC-A (1131.9±128.9 MPa) presented higher BFS than control groups (Tukey, 5%). Hsueh's rigorous solutions showed that the maximum tensile stress was presented in the bottom of zirconia layer, at the zirconia/glaze interface. Weibull characteristic strength (σo) of the GC was higher than all groups (p<0.05), except to GT, GTC-A and GTC, which were similar among them. The fractography showed initiation of failures from zirconia the tensile side regardless of the side of glaze application and fatigue. Conclusion Glazing zirconia applied on both tensile and compression sides improves the flexural strength of Y-TZP, regardless the mechanical aging.

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Objetivo: Investigar o efeito de técnicas de acabamento/polimento, da espessura e do envelhecimento in situ na resistência à flexão, topografia superficial e adesão celular de uma zircônia ultratranslúcida. Metodologia: Duzentas e quarenta barras de zircônia (UT: Prettau Anterior/Ultratranslúcida, Zirkonzahn, Gais, Itália) foram cortadas, lixadas e sinterizadas, sendo metade (120) nas dimensões finais de 8 x 2 x 1mm e as demais nas dimensões de 8 x 2 x 0,5mm. As barras foram divididas em 16 grupos (n=15) de acordo com três fatores: "envelhecimento in situ" (E: com e sem), "espessura"(1: 1 mm ou 05: 0,5mm) e "Acabamento e Polimento" (C: Controle; B:borrachas DhPro, Paraná Brasil; P: Asperização com pontas diamantadas KG Sorensen 4135; PB: Asperização com pontas diamantadas + Pontas de borrachas ). Para os grupos experimentais submetidos ao envelhecimento in situ, foram selecionados 15 pacientes (comitê de ética - 3.133.187), as amostras foram incluídas nas próteses totais provisórias dos pacientes, que utilizaram as próteses com as barras durante 60 dias. As barras foram submetidas ao ensaio de mini flexão de três pontos (1mm/min, 100 kgf). Duas amostras de cada grupo foram preparadas para as análises topográficas em Microscopia Eletrônica de Varredura (MEV), Difração de raios X (DRX), Microscopia de Força Atômica (AFM) e rugosidade superficial. Para o ensaio de adesão celular, seis blocos de zircônia ultra translúcida (2,5 x 2,5 mm), de cada grupo, foram contaminadas com C. albicans (ATCC 90028) para contagem da unidade formadora de colônia (UFC/mL). Os dados do ensaio de mini flexão (MPa) foram analisados por meio de ANOVA (3 fatores) e Tukey (5%); e os dados do ensaio de adesão celular pelo teste Kruskal Wallis (5%). Resultados: ANOVA (3 fatores) revelou que apenas o fator "Acabamento e Polimento" foi estatisticamente significativo para a resistência à mini flexão (p=0,0001). O desgaste apenas com broca diamantada produziu valores de resistência à mini flexão (variando de 257,1 a 292,9MPa) estatisticamente inferiores em relação aos grupos polidos apenas com discos de borracha (variando de 449,8 a 513,5 MPa), para todas as condições experimentais. No que diz respeito à adesão celular, o teste de Kruskal wallis não revelou diferenças significativas entre os grupos experimentais (p=0,053), apesar da rugosidade ter sido estatisticamente significante por meio do ANOVA (p = 0,001) e diferente entre todos os grupos. Conclusão: O ajuste de peças monolíticas de zircônia ultratranslúcida deve ser realizado idealmente com discos de borracha de poliuretano impregnadas com diamantes. Para a adesão celular, os protocolos de acabamento e polimento não interferem na adesão fúngica, apenas na rugosidade superficial, sendo as amostras polidas com borrachas as de maior lisura (AU).

Introduction: The aim of this study was to investigate the influence of different protocols of finishing and polishing, thickness, and aging in situ on flexural strength and cell adhesion of ultratranslucent zirconia. Methodology: 240 zirconia bars (UT: Prettau Anterior/Ultratranslucent, zirkonzahn, Gais, Italy) were cut, polished and sintered, presenting final dimensions of 1,0 x 2 x 8mm, and 0,5 x 2 x 8mm. The bars were divided among 16 groups (n=15) in accordance to three factors "in situ aging"­ 2 levels (With and Withouth "E"), "thickness" ­ 2 levels (1- 1 mm or 05- 0,5mm) and "Finishing and Polishing" ­ 4 levels (CControl, B- Rubber polishing; P- grinding with burs; PB- grinding with burs + polishing). To the experimental groups submitted to in situ aging, 15 patients were selected (ethics commitee - 3.133.187), the samples were included on the temporary prothesis, and the patients used the prothesis with the bars during 60 days. The bars were submitted to mini flexure three points test (1mm/min, load cell 100 kgf). Two samples of each group were prepared to the topographical analysis on Scanning Electron Microscopy (SEM), X-ray Diffraction (XRD), Atomic Force Microscopy (AFM), and surface roughness. For the cell adhesion assay, six blocks of ultratranslucent zirconia (2.5 x 2.5 mm), of each group were contaminated with the C. albicans (ATCC 90028) for counting the colony forming units (CFU / mL). Results: The mechanical test results were analyzed using ANOVA (3 factors) and Tukey (5%); and the cell adhesion assay data by the Kruskal Wallis test (5%. Results: ANOVA (3 factors) revealed that only the "Finishing and Polishing" factor was statistically significant for mini-flexure strength (p = 0.0001). The finishing and polishing with rubber polishers produced mini-flexure resistance values (varying from 257,1 to 292,9 Mpa) statistically lower in relation to the groups polished only with rubber discs (varying from 449,8 to 513,5 Mpa) to all experimental conditions. Concerning to cell adhesion, Kruskal wallis test did not reveal any significant differences between the experimental groups (p=0,053), despite of the fact that, the surface roughness presented itself statistically significant through ANOVA (p = 0,001) and difference between all groups. Conclusion: The adjustment of ultratranslucent zirconia monolithic should preferably be performed with rubber polishers impregnated with polyurethan. Concerning to cell adhesion, the protocols of finishing and polishing do not interfer at fungal adhesion, only on surface roughness, when the samples are polished with the smoothest rubbers (AU).

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OBJECTIVE: To investigate the wear behavior of novel graded glass/zirconia materials and their abrasiveness to the antagonist relative to homogeneous zirconias (polished or glazed) and a glass-ceramic. METHODS: Graded glass/zirconia specimens were prepared by sintering with concurrent glass-infiltration of pre-sintered zirconia (3Y-TZP) with a polished or as-machined surface. Monolithic zirconia samples were sintered and their surfaces were polished or glazed (as-machined). Glass-ceramic samples were obtained and the surface polished. All specimens were subjected to chewing simulations with a steatite antagonist (r = 3 mm) and a cyclic load of 50 N. Quantitative measurements of wear and roughness were performed on ceramics and antagonists for prescribed number of cycles. Damage sustained in ceramics and antagonists was analyzed by SEM. RESULTS: The polished zirconia presented little to no variation in wear depth (2 µm) and roughness (0.06 µm). Graded and glazed zirconia experienced a rapid increase in wear depth while the superficial glass layer was present (until 1000 cycles), but showed little variations afterwards - at 450k cycles ∼15 µm for graded and 78 µm for glazed zirconia. The glass-ceramic presented the greatest wear depth (463 µm) and roughness (1.48 µm). Polished zirconia, polished graded zirconia and glazed zirconia yielded significantly lower volumetric wear (∼3 mm3) of the antagonist than as-machined graded zirconia and glass-ceramic (∼5 mm3). SIGNIFICANCE: Polished graded zirconia and polished zirconia presented little wear and roughness, as well as yielded reduced antagonist wear. Glassy materials are both more susceptible to wear and more abrasive to the antagonist relative to zirconia.

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The aim of this study was to develop and characterise a new plasma-enhanced chemical vapor deposition (PECVD) film for improving shear bond strength (SBS) between yttria-stabilised tetragonal zirconia (Y-TZP) and veneering ceramic. In total, 192 Y-TZP samples (13 × 5.4 × 5 mm) were divided into 6 groups: control - no treatment (C), airborne-particle abrasion with 27 µm aluminum oxide particles (Al27), 110 µm aluminum oxide particles (Al110), and 250 µm aluminum oxide particles (Al250), application of liner for zirconia (L) and the PECVD film application (P). The Y-TZP surface was characterised by means of Scanning Electronic Microscopy (SEM), Energy-dispersive Spectroscopy (EDS), atomic force microscopy (AFM), surface profilometry and surface-free energy (SFE). SBS between Y-TZP and veneering ceramic was tested before and after thermocycling (20,000 cycles of 5 and 55 °C), and failure mode was also evaluated. Data were analysed by ANOVA and Tukey's HSD test (α = 0.05). Data analysis showed that PECVD film had no effect on surface roughness of Y-TZP (p > 0.05 vs control), whilst the other groups presented higher roughness values (p < 0.05). All treatments increased SFE, except the Al27 group. The highest SBS was presented by the P group (p < 0.05), and values were similar to those of the Al27 group (p = 0.107). Mixed failures were prevalent in all groups, and premature failures were found only in Al groups after thermocycling. Whilst PECVD treatment did not affect Y-TZP surface roughness, high SBS between Y-TZP and the veneering layer was observed. Therefore, PECVD treatment is a promising alternative to improve the performance of bi-layer zirconia-based restorations.

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OBJECTIVE: To investigate the effect of titania addition (0, 10 and 30mol%) on the microstructure, relative density, Young's modulus (E), Poisson's ratio (υ), mechanical properties (flexural strength, σf, and Weibull modulus, m) of a Y-TZP/TiO2 composite. The effect of the presence of a biomimetic coating on the microstructure and mechanical properties was also evaluated. METHODS: Y-TZP (3mol% of yttria) and Y-TZP/TiO2 composite (10 or 30mol% of titania) were synthesized by co-precipitation. The powders were pressed and sintered at 1400°C/2h. The surfaces, with and without biomimetic coating, were characterized by X-ray diffraction analysis and scanning electron microscopy. The relative density was measured by the Archimedes' principle. E and υ were measured by ultrasonic pulse-echo method. For the mechanical properties the specimens (n=30 for each group) were tested in a universal testing machine. RESULTS: Titania addition increased the grain size of the composite and caused a significant decrease in the flexural strength (in MPa, control 815.4a; T10 455.7b and T30 336.0c), E (in GPa, control 213.4a; T10 155.8b and T30 134.0c) and relative density (control 99.0%a; T10 94.4%c and T30 96.3%b) of the Y-TZP/TiO2 composite. The presence of 30% titania caused substantial increase in m and υ. Biomimetic coating did not affect the mechanical properties of the composite. SIGNIFICANCE: The Y-TZP/TiO2 composite coated with a layer of CaP has great potential to be used as implant material. Although addition of titania affected the properties of the composite, the application of a biomimetic coating did not jeopardize its reliability.

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PURPOSE: The objective of this systematic review with meta-analysis was to evaluate surface treatment in yttria-stabilized tetragonal zirconia polycrystal ceramic (Y-TZP) on the shear bond strength (SBS) values between Y-TZP (core ceramic) and veneer ceramic, compared to untreated specimens. MATERIALS AND METHODS: This review was registered at PROSPERO platform under the number CRD42016036493. The systematic review of the extracted publications was performed to compare the effect of surface treatment on SBS between Y-TZP ceramic and veneering ceramic. A comprehensive review of the literature from the earliest available dates through January 2017 was performed in the PubMed/Medline, Embase, Scopus, and Cochrane Library databases. RESULTS: A total of 15 studies were identified for the inclusion of data, with only in vitro studies. A random-effect model found statistically significant differences between untreated and treated surfaces of Y-TZP (p < 0.00001; MD: 2.84; 95% CI: 2.19 to 3.49). In another analysis, a random-effect model found statistically significant differences between the groups that only performed the associations of treatments and control group (p < 0.00001; MD: 3.19; 95% CI: 2.11 to 4.28). CONCLUSIONS: Surface treatment in Y-TZP improved the values of SBS between the Y-TZP and veneer ceramic. The associations between two or more treatments also showed positive effect on the bond strength due the cumulative effect of the treatments.

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Introdução: As restaurações em zircônia monolítica podem exigir ajustes em sua estrutura antes da cimentação. Diversos métodos de acabamento e polimento são sugeridos na literatura, entretanto estes podem promover mudanças estruturais e na superfície da zircônia, o que pode afetar a resistência mecânica do material em longo prazo. Objetivo: Investigar in vitro o efeito de diferentes regimes de acabamento e polimento e da degradação em baixas temperaturas na resistência à flexão e topografia superficial em dois tipos de zircônia monolíticas. Metodologia: 300 barras de zircônia (Z: ice zirkon transluzent/Convencional e UT: Prettau Anterior/Ultratranslúcida, zirkonzahn, Gais, Itália) foram confeccionadas nas dimensões 2,1- 1,3x 2,5x10mm, lixadas e sinterizadas, apresentando dimensões finais de 1,7-1 x 2 x 8mm, divididas em 20 grupos (n=15) de acordo com três fatores: "Zircônia"-2 níveis (Z: Convencional; UT: Ultratranslúcida), "Acabamento e Polimento"- 5 níveis (C- Controle; BBorrachas; P- Asperização com pontas; PB- Asperização com pontas + Borrachas; PGAsperização com pontas + glaze) e "Degradação"- 2 níveis (COMD: autoclave à 127°C, 1,7 bar /24h; sem degradação). Foi realizado o ensaio de resistência à miniflexão (3 pontos), com v:1mm/min e células de carga 500N e 5000N. Duas amostras de cada grupo foram preparadas para microscopia eletrônica de varredura (MEV)/ Espectrometria por Energia Dispersiva de Raios-X (EDS) e microscopia de força atômica (MFA). A rugosidade média de cada grupo foi avaliada qualitativamente. Os dados foram analisados por ANOVA (3 fatores) e Tukey (5%). Resultados: Os fatores "Zircônia" (p=0,0000), "Acabamento e Polimento" (p=0,0000) e "Degradação" (p=0,01) e foram estatisticamente significantes, sendo as maiores médias encontradas nos grupos ZPBD (1670.2 ± 252.73)A , ZBD (1663.5 ± 216.80)A e ZB (1654.7 ± 367.79A ) e as menores na zircônia UT, destacando-se o grupo UTPG (372.1±56.295)G . No MEV pode-se observar que a camada de glaze não recobriu toda superfície da zircônia e as borrachas promoveram uma superfície mais uniforme. O EDS revelou maior quantidade de óxido de ítrio nas zircônias UT, já na MFA maior valor de Ra foi encontrado nos grupos asperizados, sendo UT>Z. Conclusão: O protocolo mais indicado para acabamento e polimento das restaurações em zircônia são o uso de borrachas diamantadas. A asperização seguida pelo glaze reduziu a resistência da zircônia e o uso das borrachas forneceram uma superfície mais uniforme em relação aos demais métodos (AU).

Background: The restorations in monolithic zirconia may require adjustments in their structure prior to cementation. Several methods of finishing and polishing are suggested in the literature, however they can promote structural and surface changes of the zirconia, which can affect the mechanical strength of the material in the long term. Aim: To investigate in vitro the effect of different finishing and polishing regimes and low temperature degradation on flexural strength and surface topography in two types of monolithic zirconia. Method: 300 zirconia bars (Z: ice zirkon transluzent / Conventional and UT: Prettau Anterior / Ultratransluzent, zirkonzahn, Gais, Italy) were made in sizes 2.1-1.3x 2.5x10mm, sanded and sintered, (Z: Conventional; UT: Ultratransluzent), "Finishing and Polishing" - 5 levels (C- Control, B- diamond polishers, Pgrinding with burs, PB- grinding with burs + diamond polishers, PG- grinding with burs + glaze) and "Degradation" - 2 levels (WithD: autoclave at 127 ° C, 1,7 bar / 24h, without degradation). The miniflexion resistance test (3 points) was performed, with v: 1mm / min and 500N and 5000N load cells. Two samples from each group were prepared for Scanning Electron Microscopy (SEM) / X-ray Dispersive Energy Spectrometry (EDS) and Atomic Force Microscopy (AFM). The mean roughness of each group was evaluated qualitatively. Data were analyzed by ANOVA (3 factors) and Tukey (5%). Results: The "Zirconia" (p = 0.0000), "Finishing and Polishing" (p = 0.0000) and "Degradation" factors (p = 0.01) were statistically significant, ZBD (1670.2 ± 252.73)A , ZBD (1663.5 ± 216.80)A and ZB (1654.7 ± 367.79A ) and the lowest in the UT zirconia, standing out the UTPG group (372.1 ± 56.295)G . In the SEM it can be observed that the glaze layer did not cover the whole surface of the zirconia and the diamond polishers promoted a more uniform surface. The EDS showed higher amount of yttrium oxide in the UT zirconia and the AFM showed the higher Ra value was found in the roughened groups, with UT> Z. Conclusion: The most suitable protocol for finishing and polishing restorations in zirconia is the use of diamond polishers. The grinding followed by glaze reduced zirconia resistance and the use of the diamond polishers provided a more uniform surface compared to the other methods (AU).

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Um dos maiores desafios atuais da ciência dos materiais dentários é a obtenção de união efetiva e durável às cerâmicas de alto conteúdo cristalino. O objetivo do presente estudo foi avaliar a resistência de união, energia de superfície e tipos de fratura de dois sistemas cerâmicos após diferentes formas de tratamento de superfície associada à aplicação do plasma em pressão atmosférica. Para o estudo foram obtidas quarenta placas de zircônia (12 mm x 5 mm x 1,5 mm) de dois tipos de cerâmicas zircônia (E.max ZirCad e Calypso), polidas e limpas por ultrassom durante 5 minutos. Divididas aleatoriamente em 2 grupos de acordo com o sistema cerâmico e 4 subgrupos (n=5) de acordo com o tratamento de superfície, (I) controle (primer), (II) jateamento com partículas micrométricas de alumina (Al2O3) + primer, (III) jateamento com partículas micrométricas de alumina (Al2O3) + plasma + primer, (IV) plasma + primer. Foram confeccionados cento e vinte cilindros de resina composta (Z100), utilizando matrizes cilíndricas (1,0 mm x 3,0 mm) cimentadas com cimento resinoso, Multilink N, sobre as placas de zircônia. Os espécimes foram armazenados em água destilada durante 24 horas a 37° C, depois testados para microcisalhamento em máquina de teste Shimadzu EZ a 1,0 mm/min. Os dados obtidos foram submetidos à análise estatística para comparação entre os grupos E.max e Calypso em relação à resistência à união (força/área ­ MPa), ângulo de contato e os tipos de fratura. Os dados foram analisados pelos testes ANOVA One-Way e Kruskal-Wallis para resistência de união (p=0,003) e (p=0,005) e ângulo de contato (p<0,001) e (p<0,001). Não houve diferença significativa para os dados de fratura (p=0,145), pelo teste quiquadrado, com predomínio de fraturas mistas. Os valores de resistência de união das cerâmicas Y-TZP apresentaram maiores valores quando o plasma foi associado ao jateamento com óxido de alumínio e/ou primer e a aplicação somente do plasma não superou os valores alcançados pelas outras formas de tratamento da superfície. Essa associação resultou em menores valores dos ângulos de contato. Houve maior frequência de fraturas mistas quando realizado somente o tratamento com óxido de alumínio e quando em associação com o plasma.(AU)

One of the major challenges today in the science of dental materials is the achievement of effective and durable bonding to ceramics with high crystalline content. The objective of the present study was to evaluate the efficacy of plasma at atmospheric pressure in the adhesion of ceramic zirconia through the bond strength, surface energy and type of fracture of two ceramic systems after different forms of surface treatment associated with the application of plasma at atmospheric pressure. For the study forty zirconia plates (12 mm x 5 mm x 1.5 mm) were obtained from two zirconia ceramics (E.max ZirCad and Calypso), polished and cleaned by ultrasound for 5 minutes. Randomly divided into 2 groups according to the ceramic system and 4 subgroups (n = 5) according to the surface treatment, control (primer), primer + blasting with micrometric alumina (Al2O3) particles, primer + blasting with micrometric particles of alumina (Al2O3) + plasma, primer + plasma. One hundred and twenty cylinders of composite resin (Z-100) were made using cylindrical matrices (1.0 mm x 3.0 mm) cemented on the zirconia plates. The specimens were stored in distilled water for 24 hours at 37°C, then tested for microshear on a Shimadzu EZ test machine at 0.5 mm / min. The obtained data were submitted to statistical analysis for comparison between the E.max and Calypso groups in relation to the bond strength (strength / area - Mpa), contact angle and fracture types. The data were analyzed by ANOVA One-Way and Kruskal-Wallis tests for bond strength (p=0.003) and (p=0.005) and contact angle (p<0.001) and (p<0.001). There was no significant difference for the fracture data (p = 0.145), by the chi-square test, with a predominance of mixed fractures. The bond strength values of the Y-TZP ceramics showed higher values when the plasma was associated with blasting with aluminum oxide and / or primer and the application of only the plasma did not exceed the values reached by the other forms of surface treatment. This association resulted in lower values of contact angles. It is a higher frequency of mixed fractures when only aluminum oxide treatment is performed and when it is associated with plasma.(AU)

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RESUMEN Objetivo: Analizar el efecto del microgranallado superficial como tratamiento experimental de regeneración, en la resistencia flexural y esfuerzos residuales de una Zirconia Y-TZP, una vez ha sido alterada con otros tratamientos mecánicos como microarenado y fresado. Métodos: Un total de 75 probetas de Zirconia Y-TZP fueron divididas en cinco grupos n=15 y sometidas a tratamientos de superficie así: fresado y microarenado (Grupos 2 y 4) microarenado + microgranallado y fresado + microgranallado (Grupos 3 y 5), y comparadas con un grupo control (Grupo 1), mediante Difracción de Rayos X (DRX), Microscopía electrónica de barrido (SEM), Microscopía confocal (CLSM) y sometida a falla en máquina universal de ensayos. Resultados: Los grupos de microgranallado y microarenado presentaron un aumento significativo de la resistencia flexural p=0.0082 con relación al grupo de fresado. Las mediciones mediante DRX no mostraron relación estadística con los cambios en la resistencia flexural. Significancia: Es posible que el microgranallado se considere un tratamiento para regenerar las propiedades mecánicas reducidas por fresado o arenado en la Zirconia Y-TZP.

ABSTRACT Objective: To analyze the effect of surface micro shot peening as an experimental regeneration treatment on the flexural strength and residual stresses of a Y-TZP Zirconia, once it has been altered with other mechanical treatments such as micro sandblasting and milling. Methods: A total of 75 Zirconia Y-TZP specimens were divided into five n = 15 groups and subjected to surface treatments such as: milling and micro sandblasting (Groups 2 and 4) micro sandblasting + micro shot peening; and milling + micro shot peening (Groups 3 and 5), compared to a control group (Group 1), by X-ray diffraction (XRD), scanning electron microscopy (SEM), confocal microscopy (CLSM) and subjected to failure in a universal testing machine. All the results were compared to find a statistical relationship between them using a mixed linear model and Tuckey. Results: The groups of micro shot peening and micro sandblasting presented a significant increase of the flexural strength p = 0.0082 vs the milling group. The XRD technique is not related to flexural strength measurements. Significance: It is possible that the micro shot peening be considered a treatment to regenerate the mechanical properties reduced by milling or sandblasting in Zirconia Y-TZP.

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The aim of the present study was to evaluate the influence of intra-oral aging on the tetragonal-to-monoclinic (t→m) phase transformation of two Y-TZP dental ceramics - Lava Frame (Frame) and Lava Plus (Plus) - and determine the impact of this response on their microstructures and mechanical properties: flexural strength, Young's modulus, microhardness and fracture toughness. Standardized ceramic specimens were analyzed by X-ray diffraction (XRD), scanning electron microscopy (SEM) and atomic force microscopy (AFM). After the baseline analysis, the specimens were attached to personalized intra-oral resin appliances and exposed to the oral cavity of 20 subjects for 60 days and then analyzed again. Specimens produced for mechanical properties evaluation were also analyzed before and after the 60-day intra-oral aging. The data were analyzed using two-way ANOVA and Tukey HSD's post hoc test (α=0.05). Weibull analysis was used to evaluate the strength reliability. Both Y-TZP ceramics suffered t→m phase transformation after 60-day intra-oral aging (Plus=4.7%/Frame=7.7%). SEM and AFM analyses showed dislodgement of ZrO2 grains and a significant increase in roughness after intra-oral aging for both ceramics. Both Y-TZP ceramics suffered a decrease on flexural strength, Young's modulus and fracture toughness after intra-oral aging (p<0.05). Only Plus presented a decrease of microhardness after intra-oral aging (p<0.05). Intra-oral aging for 60 days produced t→m phase transformation, changed the microstructure and decreased the mechanical properties of two Y-TZP dental ceramics.

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Abstract This study evaluated the effect of air-abrasion on t®m phase transformation, roughness, topography and the elemental composition of three Y-TZP (Yttria-stabilized tetragonal zirconia polycrystal) dental ceramics: two conventional (Lava Frame and IPS ZirCad) and one with high-translucency (Lava Plus). Plates obtained from sintered blocks of each ceramic were divided into four groups: AS (as-sintered); 30 (air-abrasion with 30 mm Si-coated Al2O3 particles); 50 (air-abrasion with 50 mm Al2O3 particles) and 150 (air-abrasion with 150 mm Al2O3 particles). After the treatments, the plates were submitted to X-ray diffractometry; 3-D profilometry and SEM/EDS. The AS surfaces were composed of Zr and t phases. All treatments produced t®m phase transformation in the ceramics. The diameter of air-abrasion particles influenced the roughness (150>50>30>AS) and the topography. SEM analysis showed that the three treatments produced groove-shaped microretentions on the ceramic surfaces, which increased with the diameter of air-abrasion particles. EDS showed a decrease in Zr content along with the emergence of O and Al elements after air-abrasion. Presence of Si was also detected on the plates air-abraded with 30 mm Si-coated Al2O3 particles. It was concluded that irrespective of the type and diameter of the particles, air-abrasion produced t®m phase transformation, increased the roughness and changed the elemental composition of the three Y-TZP dental ceramics. Lava Plus also behaved similarly to the conventional Y-TZP ceramics, indicating that this high translucency ceramic could be more suitable to build monolithic ceramic restorations in the aesthetic restorative dentistry field.

Resumo Este estudo avaliou o efeito da abrasão a ar na transformação de fase t®m, na rugosidade, topografia e composição elementar de três cerâmicas Y-TZP (Zircônia tetragonal policristalina estabilizada por ítrio): duas convencionais (Lava Frame e ZirCad) e uma de alta translucidez (Lava Plus). Placas obtidas de blocos sinterizados de cada cerâmica foram divididos em quatro grupos: AS (pré-sinterizado); 30 (jateamento com partículas de Al2O3 de 30 mm cobertas com Si); 50 (jateamento com partículas de Al2O3 de 50 mm) e 150 (jateamento com partículas de Al2O3 de 150 mm). Após os tratamentos, as placas foram submetidas à difratometria de Rx, perfilometria 3-D e microscopia eletrônica de varredura com espectroscopia de energia dispersiva de Rx (SEM/EDS). As superfícies pré-sinterizadas apresentaram predominantemente Zr e fase tetragonal. Todos os tratamentos superficiais produziram transformação t®m nas cerâmicas avaliadas. A topografia e a rugosidade foram influenciadas pelo diâmetro das partículas abrasivas (150>50>30>AS). A análise através de SEM mostrou que os três tratamentos produziram fendas retentivas nas superfícies das cerâmicas, por influência do tamanho das partículas. A análise através de EDS mostrou uma diminuição da concentração de Zr, paralela ao surgimento de O e Al, após o jateamento. No grupo tratado com partículas de Al2O3 de 30 mm cobertas com Si foi também observado um aumento de Si após o jateamento. Concluiu-se que, independente do tipo e do diâmetro das partículas, o jateamento produziu transformação t®m, aumentou a rugosidade e alterou a composição elementar das cerâmicas avaliadas. A Lava Plus apresentou comportamento semelhante às cerâmicas convencionais, indicando que esta cerâmica de alta translucidez pode ser mais adequada à confecção de restaurações monolíticas no campo da odontologia estética restauradora.

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