Hyung-In Yoon

Effect of surface treatment and liner material on the adhesion between veneering ceramic and zirconia

Fully sintered zirconia blocks, each with one polished surface, were treated with one of the followings: 1) no treatment, 2) airborne-particle abrasion with 50μm alumina, and 3) airborne-particle abrasion with 125μm alumina. Before veneering with glass ceramic, either liner Α or liner B were applied on the treated surfaces. All veneered blocks were subjected to shear force in a universal testing machine. For the groups with liner A, irrespective of the particle size, air abrasion on Y-TZP surfaces provided greater bond strength than polishing. Application of liner B on an abraded zirconia surface yielded no significant influence on the adhesion. In addition, specimens with liner A showed higher bond strength than those with liner B, if applied on roughened surfaces. Fractured surfaces were observed as mixed patterns in all groups. For the liner A, surface treatment was helpful in bonding with veneering ceramic, while it was ineffective for the liner B.

Effect of a macroscopic groove on bone response and implant stability.

OBJECTIVES The aim of this study was to investigate the effect of a macroscopic groove on bone response and implant stability during the early stages of healing using a rabbit tibia model. MATERIALS AND METHODS Anodized titanium implants with (n=24) and without (n=24) macroscopic grooves were prepared. A total of 12 rabbits were used and each received four implants: six rabbits with implants with macroscopic grooves (test group) and six rabbits with implants without macroscopic groves (control group). Histomorphometry, resonance frequency, and removal torque value were evaluated 2 and 6 weeks post-implant-insertion. RESULTS At 2 and 6 weeks, there was no significant difference between the two groups in the percentage of bone-to-implant contact (P>0.05). At 6 weeks, the test group had significantly higher implant stability quotient values than the control group (P<0.05). At 2 and 6 weeks, implants with grooves showed a significantly greater resistance to reverse torque than control implants (P<0.05). CONCLUSION The groove on the oxidized titanium surface may increase both resistance to shear load and adhesion at the bone-implant interface. A geometric feature such as a macroscopic groove may facilitate osseointegration and increase implant stability in various clinical conditions. Further studies are required to confirm whether the improvement in implant stability will enhance treatment success in humans.

Prosthetic rehabilitation with an implant-supported fixed prosthesis using computer-aided design and computer-aided manufacturing dental technology for a patient with a mandibulectomy: A clinical report

The fabrication of dental prostheses with computer-aided design and computer-aided manufacturing shows acceptable marginal fits and favorable treatment outcomes. This clinical report describes the management of a patient who had undergone a mandibulectomy and received an implant-supported fixed prosthesis by using additive manufacturing for the framework and subtractive manufacturing for the monolithic zirconia restorations.

Porcelain repair - Influence of different systems and surface treatments on resin bond strength.

PURPOSE The purpose of this study was to evaluate the bond strength of composite resin on the fracture surface of metal-ceramic depending on the repair systems and surface roughening methods. MATERIALS AND METHODS A total of 30 disk specimens were fabricated, 15 of each were made from feldspathic porcelain and nickel-chromium base metal alloy. Each substrate was divided into three groups according to the repair method: a) application of repair system I (Intraoral Repair Kit) with diamond bur roughening (Group DP and DM), b) application of repair system I with airborne-particle abrasion (Group SP and SM), and c) application of repair system II (CoJet Intraoral Repair System, Group CP and CM). All specimens were thermocycled, and the shear bond strength was measured. The data were analyzed using the Kruskal-Wallis analysis and the Mann-Whitney test with a significance level of 0.05. RESULTS For the porcelain specimens, group SP showed the highest shear bond strength (25.85 ± 3.51 MPa) and group DP and CP were not significantly different. In metal specimens, group CM showed superior values of bond strength (13.81 ± 3.45 MPa) compared to groups DM or SM. CONCLUSION Airborne-particle abrasion and application of repair system I can be recommended in the case of a fracture localized to the porcelain. If the fracture extends to metal surface, the repair system II is worthy of consideration.

Effect of various intermediate ceramic layers on the interfacial stability of zirconia core and veneering ceramics.

Abstract Objectives. The purposes of this study were to evaluate the effects of intermediate ceramics on the adhesion between the zirconia core and veneer ceramics. Materials and methods. The polished surfaces of fully sintered Y-TZP blocks received three different treatments: (1) connector (C), (2) liner (L) or (3) wash layer (W). All the treated zirconia blocks were veneered with either (a) fluorapatite glass-ceramic (E) or (b) feldspathic porcelain (V) and divided into four groups (CE, CV, LE and WV). For the control group, the testing surfaces of metal blocks were veneered with feldspathic porcelain (VM). A half of the samples in each group (n = 21) were exposed to thermocycling, while the other half of the specimens were stored at room temperature under dry conditions. All specimens were subjected to the shear test and the failed surfaces were microscopically examined. The elemental distribution at the zirconia core/veneer interface was analyzed. Results. The specimens in Groups CE and CV exhibited significantly greater mean bond strength values than those in Groups LE and WV, respectively (p < 0.05). However, the mean bond strengths significantly decreased in the connector groups (CE and CV) after thermal cycling (p < 0.05). The elemental analysis suggested diffusion of ceramic substances into the zirconia surface. Conclusions: A glass–ceramic based connector is significantly more favorable to core/veneer adhesion than the other intermediate ceramics evaluated in the study. However, thermal cycling affected the bond strength at the core/veneer interface differently according to the intermediate ceramics.

Comparison of the Osteogenic Potential of Titanium and Modified Zirconia-Based Bioceramics

Zirconia is now favored over titanium for use in dental implant materials because of its superior aesthetic qualities. However, zirconia is susceptible to degradation at lower temperatures. In order to address this issue, we have developed modified zirconia implants that contain tantalum oxide or niobium oxide. Cells attached as efficiently to the zirconia implants as to titanium-based materials, irrespective of surface roughness. Cell proliferation on the polished surface was higher than that on the rough surfaces, but the converse was true for the osteogenic response. Cells on yttrium oxide (Y2O3)/tantalum oxide (Ta2O5)- and yttrium oxide (Y2O3)/niobium oxide (Nb2O5)-containing tetragonal zirconia polycrystals (TZP) discs ((Y, Ta)-TZP and (Y, Nb)-TZP, respectively) had a similar proliferative potential as those grown on anodized titanium. The osteogenic potential of MC3T3-E1 pre-osteoblast cells on (Y, Ta)-TZP and (Y, Nb)-TZP was similar to that of cells grown on rough-surface titanium. These data demonstrate that improved zirconia implants, which are resistant to temperature-induced degradation, retain the desirable clinical properties of structural stability and support of an osteogenic response.

Characterization of Human Gingival Fibroblasts on Zirconia Surfaces Containing Niobium Oxide

It was indicated that tetragonal zirconia polycrystal (TZP) containing yttria (Y2O3) and niobium oxide (Nb2O5) ((Y,Nb)-TZP) could be an adequate dental material to be used at esthetically important sites. The (Y,Nb)-TZP was also proved to possess its osteogenic potential comparable with those conventional dental implant material, titanium (Ti). The objective of the current study was to characterize cellular response of human gingival fibroblasts (HGFs) to smooth and rough surfaces of the (Y,Nb)-TZP disc, which were obtained by polishing and sandblasting, respectively. Various microscopic, biochemical, and molecular techniques were used to investigate the disc surfaces and cellular responses for the experimental (Y,Nb)-TZP and the comparing Ti groups. Sandblasted rough (Y,Nb)-TZP (Zir-R) discs had the highest surface roughness. HGFs cultured on polished (Y,Nb)-TZP (Zir) showed a rounded cell morphology and light spreading at 6 h after seeding and its proliferation rate significantly increased during seven days of culture compared to other surfaces. The mRNA expressions of type I collagen, integrin α2 and β1 were significantly stimulated for the Zir group at 24 h after seeding. The current findings, combined with the previous results, indicate that (Y,Nb)-TZP provides appropriate surface condition for osseointegration at the fixture level and for peri-implant mucosal sealing at the abutment level producing a suitable candidate for dental implantation with an expected favorable clinical outcome.

Spatial variation of bone biomechanical properties around a dental implant using nanoindentation: a case study

The aim of the study was to evaluate the spatial variations in the biomechanical properties of the bone around the implants retrieved from human subjects due to fixture head fracture after almost 20 years of loading. The implant-in-bone specimens were prepared for the histomorphometry and nanoindentation test to measure the bone-to-implant contact ratio (BIC ratio) and elastic modulus (E) of peri-implant bone. The indentations were performed in the up, center, down, and away regions of the bone tissues within all the thread spaces. The BIC ratios were 91.0% for Patient #1 and 95.8% for Patient #2. The E values assessed from the up region within the thread spaces were significantly higher than those measured from the center region. The elastic properties assessed from center and down regions within the thread spaces were similar to those assessed from the away region. The representative E values showed no significant thread-dependent linear trend. Within the limitation of this study, the peri-implant bone tissue showed spatial variation of its elastic modulus after long-term functioning.

Fracture Resistance of CAD/CAM-Fabricated Lithium Disilicate MOD Inlays and Onlays with Various Cavity Preparation Designs: Fracture Resistance of CAD/CAM Lithium Disilicate

PURPOSE To examine the fracture resistance of premolars restored with CAD/CAM lithium disilicate mesio-occlusal-distal (MOD) inlays and onlays of different cavity designs. MATERIALS AND METHODS Two widths of occlusal isthmus (75%, 100% of intercuspal distance) and three designs of cuspal coverage (none, palatal, complete) were used for the preparation of MOD inlays and onlays in the extracted maxillary premolars. Sixty lithium disilicate restorations were milled and bonded into the cavities. After 24 hours of water storage, the specimens were loaded until fracture, and the fracture loads (N) were measured. Any evidence of cracks and fractures on the tested specimens were examined to classify failure patterns. RESULTS Mean fracture load values for the tested groups were as follows: 664.4 ± 214.7 N (group A), 659.3 ± 391.2 N (B), 681.9 ± 258.1 N (C), 938.1 ± 862.0 N (D), 841.7 ± 375.4 N (E), and 994.2 ± 486.3 N (F). The width of occlusal isthmus did not significantly affect the fracture loads among all the groups. Within groups with identical isthmus width, the fracture loads showed no significant difference depending on the designs of cuspal coverage. The majority of specimens showed either type III or IV fracture mode. CONCLUSIONS Within limitations of this study, the bonded restorations of premolars with CAD/CAM-generated lithium disilicate were reliable, regardless of cavity preparation design.

A Study on Possibility of Clinical Application for Color Measurements of Shade Guides Using an Intraoral Digital Scanner

PURPOSE To assess if color measurement with intraoral scanner correlates with digital colorimeter and to evaluate the possibility of application of a digital scanner for shade selection. MATERIALS AND METHODS The L*a*b* values of the five shade tabs (A1, A2, A3, A3.5, and A4) were obtained with an intraoral scanner (TRIOS Pod) and a colorimeter (ShadeEye). Both devices were calibrated according to the manufacturers instructions before measurements. Color measurement values were compared with paired t-test, and a Pearsons correlation analysis was performed to evaluate the relationship of two methods. RESULTS The L*a*b* values of the colorimeter were significantly different from those of the digital scanner (p < 0.001). The L* and b* values of both methods were strongly correlated with each other (both p < 0.05). The device repeatability in both methods were reported to be excellent (p < 0.05). Within the limitations of this study, color measurements with digital intraoral scanners and computer-assisted image analysis were in accordance with those of the colorimeter with respect to L* and b* values; however, all the coordinates of shade tabs were significantly different between two methods. CONCLUSIONS The digital intraoral scanner may not be used as the primary method of color selection in clinical practices, considering significant differences in color parameters with colorimeter. The scanners capability in shade selection should be further evaluated.