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BACKGROUND: Effects of the aging process on the flexural strength of Y-TZP and different Y-PSZ ceramics of different thicknesses were investigated. METHODS: 300 disc-shaped samples (12 mm diameter, 0.8 and 1.5 mm thicknesses) were made from 5 different zirconia materials 3Y-TZP LA, 4Y-PSZ, 5Y-PSZ, 3 + 5Y-PSZ and 4 + 5Y-PSZ. Experimental groups were artificially aged in an autoclave at 134 °C, 2 bar pressure for 1 and 5 h; control groups were not subjected to any treatment. Microstructural analysis was conducted using Scanning Electron Microscopy, and X-Ray Diffraction analysis determined the crystalline phase content. The impact of aging on flexural strength was investigated with the use of the biaxial flexural strength test. Data were analyzed using three-way ANOVA tests with a significance level of p < 0.05, applying Bonferroni correction for multiple comparisons. RESULTS: Statistically significant differences in flexural strength were observed among the materials and the material thicknesses (p < 0.05), while there were no significant differences among the aging times (p > 0.05). The highest mean flexural strength values were recorded in the case of the 3 Y-TZP-1.5 mm-5 h group (744.1 ± 61.2 MPa), which was attributed to phase-transformation toughening. The lowest values were observed in the case of the 5 Y-PSZ-1.5 mm-5 h (338.3 ± 34.8 MPa) group. CONCLUSIONS: Both material type and thickness significantly affect the flexural strength of zirconia ceramics, whereas aging time does not; thus, material selection and thickness are crucial considerations for clinicians.

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Objectives: Porcelain chipping and delamination are among the shortcomings of all-ceramic restorations. This study aimed to assess the effect of laser irradiation and sandblasting on shear bond strength (SBS) of zirconia to veneering porcelain. Materials and Methods: In this in vitro, experimental study, 60 zirconia blocks were randomly divided into three groups (n=20) for surface treatment with Er:YAG laser, sandblasting, and no surface treatment (control). Each group was randomly divided into two subgroups (n=10) for porcelain application by the layering or the pressing technique. The surface roughness, SBS, and failure mode were determined and analyzed using two-way ANOVA, Tukey's HSD test, Chi-square test, and Pearson's correlation test (alpha=0.05). Results: The mean SBS was 8.16±3.66 MPa, 9.32±2.7 MPa, and 11.85±3.06 MPa in the control, laser, and sandblasting groups, respectively. The SBS was significantly different among the three groups (P=0.002). The failure mode of the three groups was not significantly different (P>0.05). The sandblasted group showed significantly higher surface roughness than the control and laser groups (P<0.001). Conclusion: Sandblasting yielded higher SBS particularly when the porcelain was applied by the layering technique. Although laser irradiation increased the SBS, the difference with the control group was not statistically significant.

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Objective: The goal of this systematic review and meta-analysis was to assess whether there were clinically relevant differences in the treatment of edentulous areas comparing zirconia (Zr) and titanium (Ti) dental implants. The null hypothesis is that no differences can be observed in terms of the clinical parameters; the positive hypothesis I is that Zr implants have generally better results compared to Ti implants; and the positive hypothesis II is that Ti implants have a generally superior result than Zr implants. Methods: This review work was registered on the PROSPERO platform, and its development was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The electronic search process was conducted on three databases (PubMed/Scopus/Web of Science), including randomized controlled trials (RCTs) from the past 10 years (up to April 2024). Identified articles were analyzed and included/excluded based on pre-defined selection and exclusion criteria. The quality assessment and risk of bias were evaluated using a Cochrane risk-of-bias assessment tool specifically designed for randomized trials (RoB2). A meta-analysis was conducted to correlate different treatment options based on the described outcomes; a random-effects model was used in the analysis of the variables. The analysis of heterogeneity was conducted by means of Cochran's Q-test and Higgins' I2 statistic. Results: Six RCTs were enrolled; 152 patients (90 males and 62 females) and 448 implants (267 Zr and 181 Ti) were included. Dental implant placement involved both the maxillary and mandibular arches. The implant sites showed heterogeneity in receiving Zr and Ti dental implants; in particular, 22 dental implants were placed in the mid-palatal region and 426 dental implants in the alveolar region (255 were in Zr and 171 in Ti). Regarding the success rate, it was better for Zr but with no statistical difference (p > 0.05); bleeding on probing had slight differences between Ti with 0.34% ± 0.42 and Zr with 0.26% ± 0.36 (p > 0.05); plaque score showed 0.46 ± 0.47 for Ti compared to 0.44 ± 0.49 for Zr (p > 0.05); no statistically significant difference was observed for pink esthetic score (PES). Statistically significant results were found for survival rate, which favored Ti implants (77.6%) compared to Zr (70.3%) (p < 0.05), and for marginal bone loss, which showed less loss in Ti implants (0.18 mm ± 0.47) compared to 0.42 mm ± 0.40 in Zr at 12 months (p < 0.001). Conclusions: The present systematic review and meta-analysis identified the positive hypothesis I and rejected the null and positive hypothesis II; it was possible to conclude that Ti dental implants have a better survival rate and less marginal bone loss than Zr dental implants after 1-year follow-up.

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This in vitro study was to evaluate the effect of different non-thermal atmospheric pressure plasma (NTP) on shear bond strength (SBS) between yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) and self-adhesive resin cement. In this study, The Y-TZP specimens were divided into 4 groups according to the surface treatment methods as follows: Control (no surface treatment), Sb (Sandblasting), AP(argon NTP), and CP(20 % oxygen and 80 % argon combination NTP). Y-TZP specimens were randomly selected from each group to observe and test the following indexes: scanning electron microscope to observe the surface morphology; atomic force microscope to detect the surface roughness; contact angle detector to detect the surface contact angle; energy spectrometer to analyze the surface elements. Then, resin cement (Rely X-U200) was bonded to human isolated teeth with Y-TZP specimens to measure SBS. The results showed that for the SE test, the NTP group was significantly higher than the control group (p < 0.05). The results of the SBS test showed that the SBS values of the NTP group were significantly higher than those of the other groups, regardless of the plasma treatment (p < 0.05). However, there was no significant difference between groups AP and CP in a test of SBS (p > 0.05). This study shows that non-thermal atmospheric pressure plasma can improve the shear bond strength of Y-TZP by increasing the surface energy. The addition of oxygen ratio to argon is more favorable to increase the shear bond strength and is worth further investigation.

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OBJECTIVE: To design a patient-specific subperiosteal implant for a severely atrophic maxillary ridge using yttria-stabilized additively manufactured zirconia (3YSZ) and evaluate its material properties by applying topology optimization (TO) to replace bulk material with a lattice structure. MATERIALS: A contrast-based segmented skull model from anonymized computed tomography data of a patient was used for the initial anatomical design of the implant for the atrophic maxillary ridge. The implant underwent finite element analysis (FEA) and TO under different occlusal load-bearing conditions. The resulting implant designs, in bulk material and lattice, were evaluated via in-silico tensile tests and 3D printed. RESULTS: The workflow produced two patient-specific subperiosteal designs: a) an anatomically precise bulk implant, b) a TO lattice implant. In-silico tensile tests revealed that the Young's modulus of yttria-stabilized zirconia is 205 GPa for the bulk material and 83.3 GPa for the lattice. Maximum principal stresses in the implant were 61.14 MPa in bulk material and 278.63 MPa in lattice, both tolerable, indicating the redesigned implant can withstand occlusal forces of 125-250 N per abutment. Furthermore, TO achieved a 13.10 % mass reduction and 208.71 % increased surface area, suggesting improved osteointegration potential. SIGNIFICANCE: The study demonstrates the planning and optimization of ceramic implant topology. A further iteration of the implant was successfully implanted in a patient-named use case, employing the same fabrication process and parameters.

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PURPOSE: The objective of this study was to compare the shear bond strengths of orthodontic brackets bonded to translucent dental zirconia samples which are anatomically accurate and treated with various surface treatments. METHODS: This in vitro study included 156 samples from 3 brands of high-translucent zirconia split into a control group and 4 surface treatment groups: 9.6% hydrofluoric acid etching, 50-micron aluminium oxide particle air abrasion, and 30-micron tribochemical silica coating (TBS) particle air abrasion with and without silane application. After surface treatment, all groups were primed with a 10-MDP primer and bonded to metal orthodontic brackets. Shear bond strength (SBS) was tested and results were compared between all groups. Data analysis consisted of a balanced two-factor factorial ANOVA, a Shapiro-Wilks test, and a non-parametric permutation test. The significance level was set at 0.05. RESULTS: Among all surface treatments, aluminium oxide particle abrasion produced significantly higher SBS (P≤0.002). Lava™ Plus zirconia samples had significantly higher SBS than Cercon® samples (P<0.0001). TBS surface treatment produced significantly higher SBS on Lava™ Plus samples than it did on the other zirconia brands (P=0.032). CONCLUSIONS: This study indicated that mechanical abrasion using aluminium oxide in combination with a 10-MDP primer creates a higher SBS to high-translucent zirconia than the bond created by tribochemical silica coating. Also, there was no significant difference in ARI regardless of zirconia brand or surface preparation.

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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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OBJECTIVES: For the present review, the following focused question was addressed: In patients with root-analog dental implants, what is the effect of implants made of other materials than titanium (alloy) on implant survival, marginal bone loss (MBL), and technical and biological complications after at least 5 years. MATERIALS AND METHODS: An electronic (Medline, Embase, Web of Science) search was performed to identify observational clinical studies published from January 2000 investigating a minimum of 20 commercially available zirconia implants with a mean follow-up of at least 60 months. Primary outcome was implant survival, secondary outcomes included peri-implant MBL, probing depths (PDs), and technical and biological complications. Meta-analyses were performed to evaluate implant survival, MBL, and PD. RESULTS: From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 4 prospective and 2 retrospective observational clinical cohort studies were included for data extraction. Meta-analyses estimated after 5 years of loading mean values of 97.2% (95% CI 94.7-99.1) for survival (277 implants, 221 patients), 1.1 mm (95% CI: 0.9-1.3) for MBL (229 implants, 173 patients), and 3.0 mm (95% CI 2.5-3.4) for PDs (231 implants, 175 patients). CONCLUSIONS: After 5 years, commercially available zirconia implants showed reliable clinical performance based on survival rates, MBL, and PD values. However, more well-designed prospective clinical studies and randomized clinical trials investigating titanium and zirconia implants are needed to confirm the presently evaluated promising outcomes.

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OBJECTIVES: In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the surrounding peri-implant tissues after at least 1 year? MATERIALS AND METHODS: This systematic review included eligible randomized controlled trials identified through an electronic search (Medline, Embase and Web of Science) comparing alternative abutment materials versus titanium (alloy) abutments with a minimum follow-up of 1 year and including at least 10 patients/group. Primary outcomes were peri-implant marginal bone level (MBL) and probing depth (PD), these were evaluated based on meta-analyses. Abutment survival, biological and technical complications and aesthetic outcomes were the secondary outcomes. The risk of bias was assessed with the RoB2-tool. This review is registered in PROSPERO with the number (CRD42022376487). RESULTS: From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 12 articles could be included. Concerning the primary outcomes (MBL and PD), no differences could be seen between titanium abutment and zirconia or alumina abutments, not after 1 year (MBL: zirconia: MD = -0.24, 95% CI: -0.65 to 0.16, alumina: MD = -0.06, 95% CI: -0.29 to 0.17) (PD: zirconia: MD = -0.06, 95% CI: -0.41 to 0.30, alumina: MD = -0.29, 95% CI: -0.96 to 0.38), nor after 5 years. Additionally, no differences were found concerning the biological complications and aesthetic outcomes. The most important technical finding was abutment fracture in the ceramic group and chipping of the veneering material. CONCLUSIONS: Biologically, titanium and zirconia abutments seem to function equally up to 5 years after placement.

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The aim of this study was to evaluate the effect of different surface treatments on the shear bond strength (SBS) between metal orthodontic brackets and monolithic zirconia surfaces bonded with resin composite. Fifty monolithic zirconia (4Y-TZP) disks were sintered and glazed. Specimens were divided into five groups (n = 10) for different surface treatments: control, nano second fiber laser, sandblasting, grinding and tribochemical coating (CoJet Sand 30-µm). Metal orthodontic brackets were bonded to monolithic zirconia surface by two-component orthodontic adhesive. After 500 cycles of thermocycling, shear bond strength values were measured by a universal testing machine at a cross head speed of 0.5 mm/min. The data was recorded as MPa and statistically analyzed with One-way ANOVA, Levene's LSD tests with Bonferroni corrections. The significance level was α = 0.05. The surface topography of one specimen of each group was evaluated by scanning electron microscopy (SEM). Statistically significant difference was observed among study groups (p = 0.018). The lowest shear bond strength was observed in the control group (3.92 ± 1.9). Tribochemical coating showed the highest bond strength (7.44 ± 2.9), which was statistically different from the control and nano second laser (4.3 ± 1.4) groups but not statistically different from grinding (6.15 ± 3.1) or sandblasting (6.47 ± 3.3). SEM images showed comprehensive results of each surface treatment on monolithic zirconia. All failure modes were recorded as adhesive between the composite resin and monolithic zirconia. Based on the findings of this study, it can be concluded that grinding, sandblasting and tribochemical coating techniques showed clinically acceptable bond strength within the range of 6-8 MPa. These surface treatments can be considered suitable for achieving a durable bond between metal orthodontic brackets and monolithic 4Y-TZP ceramic surfaces.

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Y-TZP/MWCNT-SiO2 nanocomposite was synthesized by co-precipitation and hydrothermal treatment methods. After the characterization of the MWCNT-SiO2 powder, specimens were obtained from the synthesized material Y-TZP/MWCNT-SiO2 by uniaxial pressing for a second characterization and later comparison of its optical and mechanical properties with the conventional Y-TZP. The MWCNT-SiO2 was presented in bundles of carbon nanotubes coated by silica (mean length: 5.10 ± 1.34 µm /D90: 6.9 µm). The composite manufactured was opaque (contrast ratio: 0.9929 ± 0.0012) and had a white color with a slightly difference from the conventional Y-TZP (ΔE00: 4.4 ± 2.2) color. The mechanical properties of Y-TZP/MWCNT-SiO2: vickers hardness (10.14 ± 1.27 GPa; p = 0.25) and fracture toughness (4.98 ± 0.30 MPa m1/2; p = 0.39), showed no significant difference from the conventional Y-TZP (hardness: 8.87 ± 0.89; fracture toughness: 4.98 ± 0.30 MPa m1/2). However, for flexural strength (p = 0.003), a lower value was obtained for Y-TZP/MWCNT-SiO2 (299.4 ± 30.5 MPa) when compared to the control Y-TZP (623.7 ± 108.8 MPa). The manufactured Y-TZP/MWCNT-SiO2 composite presented satisfactory optical properties, however the co-precipitation and hydrothermal treatment methods need to be optimized to avoid the formation of porosities and strong agglomerates, both from Y-TZP particles and MWCNT-SiO2 bundles, which lead to a significant decrease in the material flexural strength.

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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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Aim: The purpose of the present study was to examine the optical properties, chemical composition, and grain size (GS) of monolithic zirconia (MZ) ceramic at different thicknesses sintered using different procedures after hydrothermal aging. Settings and Design: An in vitro study. Materials and Methods: Forty MZ discs (0.5-mm thickness [Group-0.5] and 1-mm thickness [Group-1]; 12 mm diameter) were milled and divided according to standard (Group-ST) and speed (Group-SP) sintering procedures. All specimens were hydrothermally aged at 134°C after sintering. Translucency (TP), opalescence (OP), and fluorescence (ΔEabFNx01-FL) parameters were calculated using the color coordinates (LFNx01, aFNx01, bFNx01, respectively) of the discs. The chemical composition and the GS of the specimens were characterized using X-ray fluorescence spectroscopy and a scanning electron microscopy, respectively. Statistical Analysis Used: TPs and ΔEabFNx01-FLs were analyzed using independent samples t-tests and Mann-Whitney U-tests while a two-way analysis of variance (ANOVA) was used for OPs. Results: Group-1 showed significantly lower TP than Group-0.5 (P < 0.001) but a significantly higher OP (P = 0.014). Group-SP showed significantly higher OP (P = 0.00003) and ΔEabFNx01-FL (P = 0.0026) values than Group-ST without considering the thickness. Group-SP (0.29 ± 0.119 µm) had a smaller GS than Group-ST (0.306 ± 0.142 µm). Compared to Group-ST, Group-SP had a lower percentage of Y2O3 and a higher percentage of Al2O3. Conclusion: The effect of the sintering procedure on TP and OP of MZ was not perceived by the naked eye. The speed sintering procedure may increase Δ EFNx01ab-FL of MZ to higher values than natural teeth when compared with standard sintering. The speed sintering may cause minor changes in GS and the chemical composition of MZ.

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Aim: The aim of the study is to systematically assess the impact of low-temperature degradation (LTD) simulation in an autoclave on mechanical and microstructural properties of infiltrated monolithic zirconia compared to the noninfiltrated zirconia. Settings and Design: Systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. Materials and Methods: An electronic search was done within these databases: PubMed, Scopus, and Web of Science, Science Direct, Embase, Wiley, Google Scholar for articles published between 2000 and March 2021. Search results that met eligibility criteria were categorized into two groups based on properties assessed of infiltrated monolithic zirconia exposed to LTD (also called aging simulation) - (a) mechanical (flexural strength and fracture toughness) and (b) microstructural properties (phase transformation rate and m content). Statistical Analysis Used: Qualitative analysis. Results: The search identified 272 preliminary results. After discarding duplicates, and screening of titles, abstracts, and full texts, 10 articles finally met inclusion criteria. Data were collected on author's details and their countries, journal and year of publication, type and percentage of infiltration, aging protocol (duration and temperature), mechanical, and microstructural properties. All the included studies invariably revealed better aging resistance without a change in mechanical properties for infiltrated monolithic zirconia as compared to noninfiltrated species. Conclusion: Infiltration within monolithic zirconia can reduce degradation and simultaneously maintain their mechanical properties by preventing water entry into grain contours. The final m content was less for infiltrated Zirconium, indicating a lesser phase transformation and better aging resistance. Other Information: Systematic review protocol registered at PROSPERO CRD42021248153.

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Precise fit of a crown and accurate reproduction of the digital design are paramount for successful treatment outcomes and preservation of clinician and technician time. The study aimed to compare the internal fit, marginal adaptation, precision, and trueness of 3D-printed zirconia crowns compared to their milled counterpart. A total of 20 monolithic 3 mol% yttria stabilized-zirconia crowns (n = 10) were made using computer-assisted design (CAD) followed by additive (3D-printed) and subtractive (milled) manufacturing. Digital scanning of the master die with and without a fit checker followed by image superimposition, and analysis was performed to evaluate internal and marginal adaptation in four areas (occlusal, axial, marginal, and overall). ISO 12836:2015 standard was followed for precision and trueness evaluation. Statistical analysis was achieved using a t-test at α = 0.05. Internal fit and marginal adaptation revealed no significant difference between the two test groups (p > 0.05). The significant difference in trueness (p < 0.05) was found between the two groups in three areas (occlusal, axial, and internal). The best and worst trueness values were seen with 3D-printed crowns at occlusal (8.77 ± 0.89 µm) and Intaglio (23.90 ± 1.60 µm), respectively. The overall precision was statistically better (p < 0.05) in the 3D-printed crowns (9.59 ± 0.75 µm) than the milled (17.31 ± 3.39 µm). 3D-printed and milled zirconia crowns were comparable to each other in terms of internal fit and marginal adaptation. The trueness of the occlusal and axial surfaces of 3D-printed crowns was better, whereas the trueness of fitting surface of milled crowns was better. 3D-printed crowns provided a higher level of precision than milled crowns. Although the internal and marginal fit of both production techniques were comparable, 3D printing of zirconia produced more precise crowns.

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Background: The main drawbacks of zirconia are its high refractive index and opacity. This study aimed to assess the effect of sintering temperature on the translucency of Ivoclar e. max ZirCAD (IEZ), and White Peaks Symphony (WPS) zirconia blocks. Materials and Methods: In this in vitro experimental study, 30 IEZ and 30 WPS zirconia blocks measuring 10 mm × 10 mm × 1 mm were prepared and underwent sintering in three subgroups at 1440°C, 1500°C, and 1530°C. The specimens were then photographed against a black and a white background with a standard digital camera. The L*, a*, and b* color parameters were measured using Adobe Photoshop software, and translucency was calculated. Data were analyzed using one-way ANOVA and Tukey's test (P < 0.05). Results: In both the IEZ and WPS groups, the maximum and minimum translucency parameters were recorded in 1530°C and 1440°C subgroups, respectively. The difference in the mean translucency was significant among the three subgroups of each zirconia group (P < 0.001). The mean translucency of WPS zirconia was significantly higher than that of IEZ zirconia (P < 0.01), and maximum difference was noted at 1500°C sintering temperature. Conclusion: Increasing the sintering temperature from 1440°C to 1530°C can significantly increase the translucency of IEZ and WPS zirconia blocks, and can be considered to improve the quality of zirconia restorations.

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This study investigated the two-body wear resistance of a first generation 3 mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP), a second generation 3Y-TZP, a third generation 4 mol% yttria partially stabilized zirconia (4Y-PSZ), a 5 mol% yttria partially stabilized zirconia (5Y-PSZ), and a type III gold alloy (Aurocast 8), performed using opposing antagonistic cusps made out of the same material. Eight cylindrical specimens were prepared for each material (n = 8) for a total of forty specimens (N = 40). Conical cusps were fabricated for each material. Each cylinder−cusp pair was arranged inside a two-axis chewing simulator over up to 360,000 loading cycles. The wear resistance was analyzed by measuring the vertical substance loss (mm) and the volume loss (mm3). The antagonist wear (mm) was recorded before and after the wear test to evaluate the linear difference. Statistical analysis was performed using one-way analysis of variance (ANOVA); multiple comparisons were performed according to Tukey's method. No statistically significant differences (p > 0.05) among the first generation 3Y-TZP, second generation 3Y-TZP, and 4Y-PSZ wear were found. 5Y-PSZ showed statistically significant higher wear compared to other the zirconias. Aurocast 8 displayed the highest values in terms of vertical wear, antagonist cusp wear, and volumetric loss. Although still not statistically comparable, the wear behavior of the latest 5Y-PSZ was the closest to the widely recognized gold standard represented by the type III gold alloy.

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The objective of this study is to examine the physiomechanical and surface properties of 3D-printed zirconia in comparison to milled zirconia. A total of 80 disc-shaped (14 × 1.5 ± 0.2 mm) specimens (20 milled and 60 3D-printed (at three different orientations; horizontal, vertical, and tilted)) were manufactured from 3-mol% yttria-stabilized tetragonal zirconia. Five specimens per group were evaluated for crystalline phase, grain size, density, porosity, surface roughness, wettability, microhardness, and SEM analysis of the surface. Biaxial flexural strength (BFS) was measured (n = 15) followed by Weibull analysis and SEM of fractured surfaces. Statistical analysis was performed using one-way ANOVA and Tukey's post hoc test at α = 0.05. All groups showed a predominant tetragonal phase, with a 450 nm average grain size. There was no significant difference between groups with regards to density, porosity, and microhardness (p > 0.05). The tilted group had the highest surface roughness (0.688 ± 0.080 µm), significantly different from the milled (p = 0.012). The horizontal group presented the highest contact angle (89.11 ± 5.22°), significantly different from the milled and tilted (p > 0.05). The BFS of the milled group (1507.27 ± 340.10 MPa) was significantly higher than all other groups (p < 0.01), while vertical and tilted had a similar BFS that was significantly lower than horizontal (p < 0.005). The highest and lowest Weibull modulus were seen with tilted and milled, respectively. Physical properties of all groups were comparable. The surface roughness of the tilted group was higher than milled. The horizontal group had the highest hydrophobicity. Printing orientations influenced the flexural strength of 3D-printed zirconia. Clinical implications: This study demonstrates how the printing orientation affects the physiomechanical characteristics of printed zirconia.

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OBJECTIVES: Information regarding the effects of orthodontic bracket debonding on zirconia restorations, and the preferred method for residual adhesive removal from the zirconia restoration surface is lacking. Thus, this study aimed to assess the effects of different methods of residual adhesive removal after orthodontic bracket debonding on flexural strength, surface roughness, and phase transformation of high-translucent (HT) zirconia. MATERIALS AND METHODS: This in vitro study evaluated 72 bar-shaped HT zirconia specimens; 18 specimens were assigned to the control group. Metal brackets were bonded to the remaining specimens by resin cement. After bracket debonding, the residual adhesive on the surface of specimens was removed by three methods (n=18): a 30-flute tungsten-carbide (TC) bur at low speed, an ultrafine diamond bur at high speed, and Er:YAG laser irradiation. The surface roughness (Ra and Rz) was measured. X-ray diffraction (XRD) analysis was carried out, and the flexural strength was measured as well. Data were statistically analyzed (α=0.05). RESULTS: Before polishing, all methods increased the Ra and Rz values (P<0.05) except for the diamond bur yielding a Rz value comparable to that of the control group. The Ra values of the test groups were comparable after polishing, and still higher than that of the control group (P<0.05). The flexural strength of all three test groups was comparable (P>0.05), and significantly lower than that of the control group (P<0.001). The monoclinic phase was not observed in any group. CONCLUSIONS: Orthodontic bracket debonding adversely affects the surface roughness and flexural strength of zirconia despite polishing.

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AIM: The aim of this study was to evaluate the effect of combination of surface treatment using laser along with other modalities of surface treatment on shear bond strength of zirconia to veneering ceramic. MATERIALS AND METHODS: Milled and sintered zirconia cylinders (n = 150) were used in the study which were divided into six groups that were subjected to various surface treatments. Samples in group I were subjected to sandblasting. In group II Laser (Er: YAG) surface treatment was performed. Samples in group III were subjected to sandblasting followed by laser ablation. In group IV laser ablation was carried out followed by liner application, and samples in group V were subjected to laser ablation followed by argon plasma treatment. Instron machine was used to test the shear bond strength (SBS). One-way ANOVA and Bonferroni test were used for statistical analysis. RESULT: Samples in group III showed highest values for SBS followed by groups I, IV, and V with less SBS value for group II. CONCLUSION: Thus, the results conclude the use of combination of surface treatment using laser to be an effective modality to enhance the shear bond strength of zirconia. CLINICAL SIGNIFICANCE: Synergistic surface treatment using laser increases the bond strength of zirconia prosthesis to veneering ceramic improving its clinical longevity.

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