Indiana University-Purdue University Indianapolis (IUPUI) / Statement of problem: Yttria-partially stabilized tetragonal zirconia polycrystal (Y-TZP) all-ceramic restorations have been reported to suffer from chipping or cracking of the veneering porcelain (VP) as the most common complication. There is little information in the literature regarding the influence of surface treatment on VP shear bond strength to Y-TZP after cyclic loading. Purpose of this study: The goals of this study were (1) to investigate the influence of zirconia surface treatments on veneering porcelain shear bond strength and (2) to investigate the influence of cyclic loading on the shear bond strength between VP and Y-TZP. Materials and Methods: 48 cylinder–shaped specimens (6mm in diameter and 4mm in height) were divided into 4 groups containing 12 specimens each according to the surface treatment. As a control group (C), no further treatment was applied to the specimens after grinding. Group H was heat-treated as a pretreatment according to the manufacturer’s recommendations. Group S was airborne-particle abraded with 50 µm alumina (Al2O3) particles under a pressure of 0.4 MPa for 10 seconds. In the group SH, the heat-treatment was performed after the airborne-particle abrasion. A VP cylinder (2.4 mm in diameter and 2 mm in height) was applied and fired on the prepared Y-TZP specimens. The shear bond strength was tested using a universal testing machine. Six specimens from each group were subjected to fatigue (10,000cycles, 1.5Hz, 10N load) before testing. Results: The 3-way ANOVA showed no statistically significant effect of surface treatment and cyclic loading on shear bond strength. The highest mean shear bond strength was recorded for the air-particle abrasion group without cyclic loading (34.1 + 10 MPa). The lowest mean shear bond strength was the air-particle abrasion group with cyclic loading (10.7 ± 15.4 MPa). Sidak multiple comparisons procedure demonstrated cyclic loading specimens had significantly lower shear bond strength than non-cyclic loading specimens after air-particle abrasion without heat treatment (p=0.0126) Conclusion: Within the limitations of this study, (1) Shear bond strength between Y-TZP and VP is not affected statistically by surface treatment using heat treatment, airborne-particle abrasion, and heat treatment after airborne-particle abrasion. (2) There is significant difference in shear bond strength with air-particle abrasion between with and without cyclic loading groups. This difference suggested that air-particle abrasion should be avoided in clinical situations as a surface treatment without heat treatment.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: New glass ceramics and Computer-Aided Design/Computer Assisted Manufacture (CAD/CAM) have become common aspects of modern dentistry. The use of posterior ceramic crowns with a high level of esthetics, fabricated using the CAD/CAM technology is a current treatment modality. Several materials have been used to fabricate these crowns, including lithium disilicate glass-ceramics, which have not been fully investigated in the literature. Objective: to investigate the load to fracture of lithium disilicate glass ceramic posterior crowns fabricated by CAD/CAM technology with different material thicknesses adhesively cemented on epoxy resin. Methods: Four groups of different ceramic thicknesses (0.5 mm, 1 mm, 1.5 mm, and 2 mm) were fabricated by milling CAD/CAM lithium disilicate IPS emax CAD blocks. A total of 68 posterior crowns were surface treated and luted with a resin adhesive cement on an epoxy resin model. Samples were fatigued then loaded to fracture using a universal testing machine to test the fracture strength. Statistical comparisons between various crown thicknesses were performed using one-way ANOVA followed by Fisher's Protected Least Significant Differences. Results: There was a significant difference in the load-to-fracture (N) value for all comparisons of the four thickness groups (p < 0.0001), except 2 mm vs. 1.5 mm (p = 0.325). The mean load-to-fracture (N) was significantly higher for 2 mm than for 1 mm or 0.5 mm. Additionally, the mean load-to-fracture was significantly higher for 1.5 mm than for 1 mm or 0.5 mm. Furthermore, the mean load-to-fracture was significantly higher for 1 mm than for 0.5 mm. Conclusion: Within the limitation of this study, it is advisable for clinical applications to consider a crown thickness of 1.5 mm or greater of milled lithium disilicate for posterior single teeth.

Indiana University-Purdue University Indianapolis (IUPUI) / The use of yttria-stabilized tetragonal zirconia polycrystal (Y-TZP), normally employed as a framework for all-ceramic restorations, has now started to be used without any veneering ceramics in patients with parafunctional activities. The aims of this study were to evaluate the influence of Y-TZP surface roughness on the wear behavior (volume/height loss) against glass-based ceramics (i.e., IPS Empress CAD and IPS e.max CAD, Ivoclar-Vivadent). Thirty-two Y-TZP full-contour zirconia (Ardent®) sliders (ϕ=2 mm, 1.5 mm in height) were milled in a CAD/CAM unit and sintered according to the manufacturer instructions. Sliders were embedded in brass holders using acrylic resin and then randomly allocated into 2 groups according to the surface treatment (n=16): G1-as-machined and G2-glazed (Diazir®). Empress and e.max antagonists were cut into tabs (13×13×2 mm) wet-finished and also embedded in brass holders. Two-body pin-on-disc wear testing was performed at 1.2 Hz for 25,000 cycles under a 3-kg load. Non-contact profilometry was used to measure antagonist height (μm) and volume loss (mm3). Qualitative data of the testing surfaces and wear tracks were obtained using SEM. Statistics were performed using one- and two-way ANOVAs (α=0.05). The results indicated that G1 yielded significantly higher mean roughness values (Ra=0.83 μm, Rq=1.09 μm) than G2 (Ra=0.53 μm, Rq=0.78 μm). Regarding antagonist loss, G1 caused significantly less antagonist mean height and volume loss (68.4 μm, 7.6 mm3) for Empress than G2 (84.9 μm, 9.9 mm3) while no significant differences were found for e.max. Moreover, Empress significantly showed lower mean height and volume loss than e.max (p<0.0001). SEM data revealed morphological differences on wear characteristics between the two ceramics against Y-TZP. Within the limitations of this study, e.max wear was not affected by Y-TZP surface roughness. However, Empress wear was greater when opposing glazed Y-TZP. Overall, based on our findings, surface glazing on full-contour Y-TZP did not minimize glass-ceramic antagonist wear when compared with as-machined group.

Indiana University-Purdue University Indianapolis (IUPUI) / Background: Elucidating the lithium disilicate system like the popular IPS e.max® CAD (LS2), made specifically for Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM), as a function of temperature unravels new ways to enhance material properties and performance. Objective: To study the effect of various thermal processing on the crystallization kinetics, crystallite microstructure, and strength of LS2. Methods: The control group of the LS2 samples was heated using the standard manufacturer heating-schedule. Two experimental groups were tested: (1) an extended temperature range (750-840 °C vs. 820-840 °C) at the segment of 30 °C/min heating rate, and (2) a protracted holding time (14 min vs. 7 min) at the isothermal temperature of 840 °C. Five other groups of different heating schedules with lower-targeted temperatures were evaluated to investigate the microstructural changes. For each group, the crystalline phases and morphologies were measured by X-ray diffraction (XRD) and scanning electron microscope (SEM) respectively. Differential scanning calorimeter (DSC) was used to determine the activation energy of LS2 under non-isothermal conditions. A MTS universal testing machine was used to measure 3-point flexural strength and fracture toughness, and elastic modulus and hardness were measured by the MTS Nanoindenter® XP. A one-way ANOVA/Tukey was performed per property (alpha = 0.05). Results: DSC, XRD, and SEM revealed three distinct microstructures during LS2 crystallization. Significant differences were found between the control group, the two aforementioned experimental groups, and the five lower-targeted-temperature groups per property (p<0.05). The activation energy for lithium disilicate growth was 667.45 (± 28.97) KJ/mole. Conclusions: Groups with the extended temperature range (750-840 °C) and protracted holding time (820-840 °C H14) produced significantly higher elastic-modulus and hardness properties than the control group but showed similar significant flexural-strength and fracture-toughness properties with the control group. In general, explosive growth of lithium disilicates occurred only when maximum formation of lithium metasilicates had ended.