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  • 1.
    Papia, Evaggelia
    Malmö högskola, Faculty of Odontology (OD).
    Micromechanical retention and chemical bonding to polycrystalline dental ceramics: studies on aluminum oxide and stabilized zirconium dioxide2014Doctoral thesis, comprehensive summary (Other academic)
    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.

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