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Micromechanical retention and chemical bonding to polycrystalline dental ceramics: studies on aluminum oxide and stabilized zirconium dioxide
Malmö högskola, Faculty of Odontology (OD).ORCID iD: 0000-0001-6260-473X
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [sv]

Det pågår en ständig utveckling av olika dentala material avsedda föratt ersätta förlorad tandsubstans. En materialgrupp som är särskiltintressant är höghållfasta keramiska material, oxidkeramer så somyttriumdioxidstabiliserad tetragonal polykristallin zirkoniumdioxid(Y-TZP). Förutom utveckling av material, är en av de störreutmaningarna att få tandersättningar att sitta fast i munnen på ettvävnadsbesparande sätt.Vid traditionell cementeringsteknik, fästs tandstödda ersättningarmed vattenbaserade cement, vars vidhäftning dels är beroendeav att tänderna slipas i syfte att skapa en geometrisk form för attåstadkomma makromekanisk retention och dels av ytstrukturenpå tand och tandersättning som skapas under processen och utgörmikromekanisk retention. I kliniska situationer med otillräckligmakromekanisk retention kan det vara nödvändigt att användaadhesiv cementeringsteknik. En förutsättning för en tillförlitligadhesiv bindning mellan tandersättning, cement och befintligtand är mikromekanisk retention och resinbaserade cement sommöjliggör en kemisk bindning. Det senare har visat sig vara svårtoch oförutsägbart att uppnå för oxidkeramer. Olika tekniker förmodifiering av oxidkeramers cementeringsyta har föreslagits för attmöjliggöra adhesiv cementeringsteknik.Övergripande mål med föreliggande avhandlingsarbete var attutveckla och utvärdera metoder för att modifiera polykristallinakeramers yta och därigenom möjliggöra kombinerad mekanisk ochkemisk bindning mellan oxidkeramer och adhesiva cementsystem. I delarbete I utvärderades bindningsstyrkan mellan olika adhesivacementsystem och en tätsintrad aluminiumoxidbaserad keram. Tvåav sex undersökta cementsystem uppvisade acceptabel bindning tillaluminiumoxid. Valet av ytbehandling på oxidkeramen bör baseraspå vilket cementsystem som ska användas.I delarbete II presenterades och utvärderades en ny framställningsteknikför ytmodifierad Y-TZP, lämpad för adhesivcementeringsteknik. Ytmodifieringen visade ökad mikrostruktur ochhögre bindningsstyrka jämfört med obehandlad Y-TZP. Uppföljninggjordes i delarbete IV med ytterligare ytanalyser och hållfasthetstest.En kemisk sammansättning med glas och monoklin fas identifieradesmed ökad ytråhet. Ytmodifieringen med glasmedium resulterade ilägre hållfasthet som dock ökade i samband med cementering.Delarbete III var en systematisk litteraturöversikt med syfteatt inventera olika metoder för ytbehandling/modifiering avoxidkeramer och utvärdera vilka av dessa som ger kliniskt relevantbindningsstyrka. Indelningen av de olika ytbehandlingarna var:fabriksproducerad, slipad/polerad, sandblästrad, ytmodifierad medolika typer av täckande lager, laser-, syra- och primerbehandlad.Sandblästring eller kiseltäckning av cementeringsytan kombineratmed primer utmärkte sig med högre värden på bindningsstyrkan,något som dock ännu inte blivit bekräftat i kliniska studier. Detfinns ingen universell ytbehandling. Valet av ytbehandlingar börbaseras på vilket material som ska användas.Sammanfattningsvis visar resultaten i avhandlingen att olikaytbehandlingar av oxidkeramer, i synnerlighet ytmodifieringmed glasmedium, kan öka bindningsstyrkan mellan keram ochadhesivt cementsystem. All ytbehandling påverkar dock materialetsegenskaper och slutligen tandersättningen. Valet av ytbehandlingbör göras utifrån specifika materialval, avseende både keram ochrespektive cementsystem.

Abstract [en]

Researchers are constantly developing new dental materials toreplace missing teeth. One material group receiving major focusis ceramic materials; more specifically, oxide ceramics; and, inparticular, yttrium dioxide-stabilized tetragonal polycrystallinezirconium dioxide (Y-TZP). In addition, one of the major challengesis to ensure retention of oxide ceramic-based restoration in themouth, in a tissue preserving way.Success in traditional cementation of dental restorations relies ona geometric form that establishes the macromechanical retention,the surface structure of the dental restoration, the tooth substance(micromechanical retention) and the cement itself. In clinicalsituations when macromechanical retention is insufficient, it maybe necessary to use an adhesive cementation technique. Reliableadhesive bonding between the restoration, the cement, and thetooth substance requires micromechanical retention and cementthat achieves chemical retention. In oxide ceramics, chemicalretention has been difficult to achieve and unpredictable. Varioustechniques have been proposed for modifying the surface of oxideceramic-based restorations making adhesive cementation techniquea possible treatment option.The overall aim of this thesis is to evaluate and develop techniquesfor modifying the surface of oxide ceramics that enable durablebonding between the restorations and adhesive cement systems.Additionally, the thesis will inventory existing methods for achievinga bondable surface on oxide ceramics and how these methods affectthe materials. Study I evaluated bond strength between several adhesive cementsystems and densely sintered aluminum oxide. Two of six of thecement systems studied showed acceptable bonding to denselysintered aluminum oxide. The choice of surface treatment for theoxide ceramic should be based on the cement system to be used.Study II described a modified-additive technique for producingbondable Y-TZP and evaluated the resulting surface structure andbond strength. Surface-modified Y-TZP showed a rougher surfacestructure and higher bond strength than unmodified Y-TZP. StudyIV extended these evaluations with additional surface analysisand flexural strength testing. The results showed increased surfaceroughness, with a chemical composition of glass and with a content ofmonoclinic phase. Compared to unmodified Y-TZP, glass-modifiedY-TZP showed lower flexural strength values that increased withthe use of cement.Study III was a systematic literature review to inventory existingmethods for achieving a bondable surface on oxide ceramics. Thisstudy also evaluated which methods provide clinically relevantbond strength and classified the various surface treatments intoseven main groups: as-produced, grinding/polishing, airborneparticle abrasion, surface coating, laser treatment, acid treatment,and primer treatment. Abrasive surface treatment, as well as silicacoatingtreatment, combined with the use of a primer treatment canresult in sufficient bond strength for the bonding of oxide ceramics.This conclusion, however, needs to be confirmed by clinical studies.There is no universal surface treatment; the choice should be basedon the specific materials. Together, the results of this thesis demonstrate that differentsurface treatments/modifications of oxide ceramics increase thebond strength between ceramics and adhesive cement systems.Surface modification with a glass medium was particularly effective.All surface treatment, however, affects the material properties andthe resulting dental restoration. Choice of surface treatment shouldbe made based on the restoration materials: the oxide ceramics andthe adhesive cement systems.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology , 2014. , p. 110
Series
Doctoral Dissertation in Odontology
Keywords [en]
alumina, aluminium oxide, bond strength, oxide ceramics, polycrystalline dental ceramics, stabilized zirconium dioxide, Y-TZP, zirconia, adhesive cements
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-7674Local ID: 16893ISBN: 978-91-7104-539-3 (print)ISBN: 978-91-7104-540-9 (print)OAI: oai:DiVA.org:mau-7674DiVA, id: diva2:1404614
Note

Note: The papers are not included in the fulltext online.

Paper IV in dissertation as manuscript.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-12Bibliographically approved
List of papers
1. Bond strength between different bonding systems and densely sintered alumina with sandblasted surfaces or as produced
Open this publication in new window or tab >>Bond strength between different bonding systems and densely sintered alumina with sandblasted surfaces or as produced
2008 (English)In: Swedish Dental Journal, ISSN 0347-9994, Vol. 32, no 1, p. 35-45Article in journal (Refereed)
Abstract [en]

The traditional zinc phosphate cementation technique for crowns and fixed partial dentures (FPDs) is based on mechanical retention where the geometry of the prepared tooth provides retention for the restoration. In clinical situations where mechanical retention is compromised or regarded insufficient, a bonding system can be used to provide retention. This study investigates whether bond strengths of different bonding systems to densely sintered high-strength alumina ceramics are sufficient. One hundred twenty pairs of industrially manufactured specimens--one block and one cylinder-shaped disc of densely sintered alumina--were used. The cementation surfaces of the blocks were sandblasted with 110-microm aluminium oxide while the cementation surfaces of the discs were left untreated, as produced. The pairs were then bonded with one of six different bonding systems. Each bonding group of 20 samples was randomly divided into thermocycled and non-thermocycled subgroups (n=10). Both subgroups were stored 1 week in distilled water (37 degrees C). During this week, the thermocycled subgroup underwent 5000 thermocycles (5 degrees C-55 degrees C). Following pre-treatment, the specimens were loaded until fracture in a universal testing machine to determine shear bond strength. Data were analysed using student's t-test and a one-way ANOVA. Fractured interfaces were examined under a light microscope to classify the failure mode of the debonded area as adhesive, cohesive, or a combination of the two. The highest bond strengths, achieved with two of the bonding systems, were significantly higher than the remaining bonding systems, irrespective of pretreatment--(p>0.001). The predominant failure mode for both treated and untreated surfaces was adhesive. Two of the six tested bonding systems achieved sufficient shear bond strength to densely sintered alumina. Furthermore, recommendations on whether to use surface-treated or as produced densely sintered alumina must be based on which bonding system is being used.

National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-6023 (URN)6939 (Local ID)6939 (Archive number)6939 (OAI)
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2022-06-27Bibliographically approved
2. Impaction-modified densely sintered yttria-stabilized tetragonal zirconium dioxide: methodology, surface structure, and bond strength
Open this publication in new window or tab >>Impaction-modified densely sintered yttria-stabilized tetragonal zirconium dioxide: methodology, surface structure, and bond strength
Show others...
2012 (English)In: Journal of Biomedical Materials Research. Part B - Applied biomaterials, ISSN 1552-4973, E-ISSN 1552-4981, Vol. 100, no 3, p. 677-684Article in journal (Refereed)
Abstract [en]

The objectives of the study were to describe a novel method for producing zirconium dioxide specimens with a cementation surface that allows adhesive cementation techniques, to describe the surface structure and to evaluate the bond strength. Forty-eight pairs of specimens were fabricated and adhesively luted together. Three different surfaces were tested: impaction-modified surfaces created by using glass granules (G), impaction-modified surfaces created by using polymer granules (P) and a nonmodified control surface (C). Two bonding systems were used, Variolink(®)II (VA) or Panavia™F 2.0 (PA). During the different fabrication steps, the surfaces were examined under light microscope and analyzed with an optical interferometer. All groups were thermocycled and subjected to shear bond strength test. The groups with modified cementation surfaces showed significantly higher shear bond strength: 34.9 MPa (VA-G), 30.9 MPa (VA-P), 29.6 MPa (PA-P), and 26.1 MPa (PA-G) compared with the relevant control group: 20.5 MPa (VA-C) and 17.8 MPa (PA-C). The groups with surface modification showed a rougher surface structure and significantly fewer fractures between the cement and the zirconium dioxide surfaces compared to the control groups where all failures were adhesive. Impaction modification with an impaction medium pressed into the cementation surface of zirconium dioxide-based reconstructions can be used in combination with an additive production technique to increase bond strength. Both modification techniques described in the study result in a rougher surface structure and higher shear bond strength compared to the control groups.

Place, publisher, year, edition, pages
John Wiley & Sons, 2012
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15862 (URN)10.1002/jbm.b.31992 (DOI)000300983700010 ()22278954 (PubMedID)2-s2.0-84858071492 (Scopus ID)14595 (Local ID)14595 (Archive number)14595 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
3. Bonding between oxide based ceramics and adhesive cement systems: a systematic review
Open this publication in new window or tab >>Bonding between oxide based ceramics and adhesive cement systems: a systematic review
2014 (English)In: Journal of Biomedical Materials Research. Part B - Applied biomaterials, ISSN 1552-4973, E-ISSN 1552-4981, Vol. 102, no 2, p. 395-413Article, review/survey (Refereed) Published
Abstract [en]

The following aims were set for this systematic literature review: (a) to make an inventory of existing methods to achieve bondable surfaces on oxide ceramics and (b) to evaluate which methods might provide sufficient bond strength. Current literature of in vitro studies regarding bond strength achieved using different surface treatments on oxide ceramics in combination with adhesive cement systems was selected from PubMed and systematically analyzed and completed with reference tracking. The total number of publications included for aim a was 127 studies, 23 of which were used for aim b. The surface treatments are divided into seven main groups: as-produced, grinding/polishing, airborne particle abrasion, surface coating, laser treatment, acid treatment, and primer treatment. There are large variations, making comparison of the studies difficult. An as-produced surface of oxide ceramic needs to be surface treated to achieve durable bond strength. Abrasive surface treatment and/or silica-coating treatment with the use of primer treatment can provide sufficient bond strength for bonding oxide ceramics. This conclusion, however, needs to be confirmed by clinical studies. There is no universal surface treatment. Consideration should be given to the specific materials to be cemented and to the adhesive cement system to be used.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
adhesive cements, alumina, bond strength, oxide ceramics, zirconia
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-16241 (URN)10.1002/jbm.b.33013 (DOI)000330639400022 ()24123837 (PubMedID)2-s2.0-84892433820 (Scopus ID)16693 (Local ID)16693 (Archive number)16693 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved
4. Surface structure and mechanical properties of impaction-modified Y-TZP
Open this publication in new window or tab >>Surface structure and mechanical properties of impaction-modified Y-TZP
Show others...
2014 (English)In: Dental Materials, ISSN 0109-5641, E-ISSN 1879-0097, Vol. 30, no 8, p. 808-816Article in journal (Refereed)
Abstract [en]

Objectives The objectives of the study were to describe the surface structure and the chemical surface composition of Y-TZP ceramics produced by using the modified additive technique and to evaluate the flexural strength of Y-TZP with or without surface modification and with different pretreatments: etching before or after sintering combined with or without an adhesive cement system. Methods Y-TZP discs were used for surface analysis (n = 48) and for biaxial flexural strength testing (n = 200). The specimens were divided into groups depending on the cementation surface of Y-TZP: unmodified, sandblasted or glass-modified Y-TZP surfaces, and according to the production process: etching before or after sintering. Results The surface structure and the chemical composition of glass-modified Y-TZP differ; a rougher surface and phase transformation was identified compared to unmodified Y-TZP. The unmodified Y-TZP groups showed significantly higher flexural strength compared to the glass-modified groups (p < 0.001) and showed increased flexural strength after sandblasting (p < 0.001). Furthermore, by adding cement to the surface, the value increased even further in comparison with the sandblasted non-cemented specimens (p < 0.01). After thermocycling, however, the cement layer on the unmodified and the sandblasted surfaces had air pockets and regions with loose cement. Significance A rougher surface structure, superficial glass remnants and a higher content of m-phase was present in the cementation surface of glass-modified Y-TZP. The glass modification creates a bondable cementation surface that is durable. By etching the glass-modified Y-TZP before sintering, a more homogenous surface is created compared to one that is etched after sintering.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
compressive strength, dental bonding, dental ceramics, dental cements, material testing, yttria-stabilized tetragonal zirconia, Y-TZP
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-15313 (URN)10.1016/j.dental.2014.05.002 (DOI)000339998500006 ()24962988 (PubMedID)2-s2.0-84905083332 (Scopus ID)18148 (Local ID)18148 (Archive number)18148 (OAI)
Available from: 2020-03-30 Created: 2020-03-30 Last updated: 2024-02-05Bibliographically approved

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