In this prospective clinical trial we observed the 2-year clinical performance of posterior tooth-supported multi-unit fixed dental prostheses (FDP) fabricated from zirconia with monolithic occlusal surfaces. Fifty multi-unit FDPs were inserted in 50 patients. After two years of clinical service, 43 restorations were reexamined as one patient had died and six patients were not available for recall. Two biological (root canal treatment: 12 and 14 months) and one technical (debonding: 12 months) complications occurred. According to the Kaplan–Meier analysis, the success rate was 93.7%, and the survival rate was 100%. The six patients who were not available for regular 2-year follow-up were examined after the official 2-year recall interval, and none of the FDPs presented complications or failures. Within the limitations of the current study, the use of multi-unit FDPs with monolithic occlusal surfaces fabricated from zirconia can be recommended for short-term use in the posterior area.

[EN] Zirconia has become a widely utilized structural ceramic material with important applications in dentistry due to its superb mechanical properties, biocompatibility, aesthetic characteristics and durability. Zirconia needs to be stabilized in the t-phase to obtain improved mechanical properties such as hardness and fracture toughness. Fully dense yttria-stabilized tetragonal zirconia polycrystalline (Y-TZP) materials are normally consolidated through the energy-intensive processing of powders at very high temperatures (>1000 °C). Innovative non-conventional approaches are being developed to reduce time and energy consumption and, consequently, environmental impact in ceramic powder processing. Microwave sintering is one such approach aimed at fully-densifying ceramics by using a different heating mechanism based on the material's inherent dielectric properties. The main purpose of this work is to obtain highly dense Y-TZP dental materials from commercial and lab-prepared sources via microwave sintering with mechanical and microstructural qualities that are similar or even improved with respect to their conventionally sintered counterparts. Therefore, its effect on important aspects related to dental applications has been studied. First, Y-TZP ceramics have been characterized upon sintering to determine whether the resulting properties meet the minimum mechanical requirements for structural dental applications. Second, the influence of microwave sintering on hydrothermal degradation, a spontaneous ageing phenomenon that affects zirconia materials in wet conditions, has been investigated. And third, the behavior under fretting wear conditions of microwave and conventionally sintered materials has been assessed to evaluate their durability and performance. The main conclusions indicate that microwave sintering allows proper consolidation of dental Y-TZP materials resulting in a finer microstructure due to shorter processing time and mechanical properties comparable, and in some cases enhanced, to those obtained in conventional sintered materials at lower dwell temperatures. Additionally, a higher resistance to hydrothermal degradation has been determined for microwave sintered materials due to a finer grain size and lower sintering temperatures that reduce the presence of cubic phase, which is responsible for destabilizing neighboring tetragonal phase grains. Finally, a similar wear rate has been obtained between microwave and conventional sintering of zirconia materials under fretting wear conditions. In addition, humidity can reduce the wear volume loss due to the lubricative effect of water and wear of degraded materials might increase the resistance due to the formation of a protective debris layer. In general, microwave sintering can be an interesting alternative for obtaining fully-densified Y-TZP dental materials providing certain advantages over conventional methods. Nonetheless, more studies are still necessary to have a better understanding of the advantages and disadvantages of microwave sintering of zirconia ceramics. / [ES] La circona es un material ampliamente utilizado como cerámica estructural con aplicaciones en el ámbito dental debido a sus propiedades mecánicas, biocompatibilidad, características estéticas y durabilidad. Para poder aprovechar las altas propiedades mecánicas de la circona, es necesario estabilizarla en su fase tetragonal. Los materiales de circona policristalina estabilizada con itria (Y-TZP) se consolidan normalmente a través de polvos mediante procesos energéticamente intensivos a altas temperaturas (>1000 °C). Actualmente, se están desarrollando técnicas basadas en métodos no convencionales para reducir el tiempo y el consumo energético en el procesado de polvos cerámicos. La sinterización por microondas tiene por objetivo la densificación completa mediante la utilización de mecanismos de calentamiento basados en las propiedades dieléctricas del material. El objetivo principal es la obtención de materiales dentales de Y-TZP altamente densos mediante la sinterización por microondas con propiedades mecánicas y microestructurales similares, o incluso por encima de las obtenidas por el método convencional. Para ello, se estudian aspectos relevantes al ámbito dental. En primer lugar, los materiales son caracterizados con el fin de determinar si las propiedades finales cumplen con los requisitos mecánicos para aplicaciones dentales. Además, se ha investigado la influencia de la sinterización por microondas en la degradación hidrotérmica, un fenómeno espontáneo de envejecimiento que afecta a los materiales de circona en condiciones de humedad. Finalmente, se ha evaluado el comportamiento en condiciones de desgaste fretting de los materiales sinterizados para determinar su durabilidad. Las conclusiones principales indican que la sinterización por microondas permite la consolidación adecuada de estos materiales, resultando en una microestructura más fina debido a los tiempos más cortos de procesado y en propiedades mecánicas comparables a las de materiales obtenidos mediante el método convencional, incluso a temperaturas más bajas. Una mayor resistencia a la degradación hidrotérmica se ha determinado en materiales sinterizados por microondas. Al emplear temperaturas más bajas se reduce la presencia de fase cúbica, la cual es responsable por la desestabilización de granos adyacentes de fase tetragonal. Tasas de desgaste similares han sido observadas entre materiales sinterizados por microondas y convencionalmente bajo condiciones de desgaste fretting. Adicionalmente, la humedad puede reducir sustancialmente la pérdida de volumen de desgaste debido al efecto lubricante del agua y los materiales degradados pueden aumentar la resistencia a este tipo de desgaste como consecuencia de la formación de una capa protectora de material que se desprende más fácil. En general, la sinterización por microondas es una alternativa interesante para obtener materiales dentales de Y-TZP altamente densos con ciertas ventajas sobre los métodos convencionales pero deben considerarse también las desventajas de esta técnica. / [CA] La circona és un material àmpliament utilitzat com a ceràmica estructural amb aplicacions en l'àmbit dental a causa de les seues propietats mecàniques, biocompatibilidad, característiques estètiques i durabilitat. Per a poder aprofitar les altes propietats mecàniques de la circona, és necessari estabilitzar-la en la seua fase tetragonal. Els materials de circona policristalina estabilitzada amb itria (Y-TZP) es consoliden normalment mitjançant processos energèticament intensius a altes temperatures (>1000 °C). Actualment, s'estan desenvolupant tècniques basades en mètodes no convencionals per a reduir el temps i el consum energètic en el processament de la pols ceràmicas. La sinterització per microones té per objectiu la densificació completa mitjançant la utilització de mecanismes d'escalfament basats en les propietats dielèctriques del material. L'objectiu principal d'aquesta tesi és l'obtenció de materials dentals de Y-TZP altament densos mitjançant la sinterització per microones amb propietats mecàniques i microestructurals superiors a les obtingudes per mètodes convencionals. En primer lloc, els materials seràn caracteritzats per a determinar si les propietats finals compleixen amb els requisits mecànics per a aplicacions dentals. En segon lloc, s'investigarà la influència de la sinterització per microones en la degradació hidrotèrmica, un fenomen espontani d'envelliment que afecta als materials de circona en condicions d'humitat. I en tercer lloc, s'avaluarà el comportament en condicions de desgast fretting dels materials sinteritzats per a determinar la seua durabilitat. Les conclusions principals indiquen que la sinterització per microones permet la consolidació adequada i millorada de materials de Y-TZP, amb una microestructura més fina a causa dels temps més curts de processament i propietats mecàniques comparables a les de materials obtinguts mitjançant el mètode convencional, fins i tot a temperatures més baixes. Un factor positiu ha sigut la major resistència a la degradació hidrotèrmica en materials sinteritzats per microones. A més, al emprar temperatures més baixes es redueix la presència de fase cúbica, la qual és la responsable de la desestabilització de grans adjacents de fase tetragonal. Finalment, sota condicions de desgast fretting, s'han observat taxes de desgast similars entre materials sinteritzats per microones i via convencional. Addicionalment, en condicions de 100% d'humitat es pot reduir substancialment la pèrdua de volum de desgast a causa de l'efecte lubrificant de l'aigua i materials degradats, els quals poden augmentar la resistència a aquest tipus de desgast com a conseqüència de la formació d'una capa protectora de material que es desprèn amb més facilitat. En general, la sinterització per microones és una alternativa molt interessant per a obtindre materials dentals Y-TZP òptims i amb certes avantatges sobre els mètodes convencionals, però han de considerar-se també algunes desavantatges d'aquesta tècnica. / Presenda Barrera, Á. (2016). ADVANCED CERAMIC MATERIALS FOR DENTAL APPLICATIONS SINTERED BY MICROWAVE HEATING [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/68510

Un four micro-ondes à cavité monomode a été développé afin d'étudier le frittage de poudres céramiques et métalliques. Dans cette cavité TE10p, la distribution du champ électromagnétique est maîtrisée et les matériaux peuvent être chauffés en champ soit électrique soit magnétique prépondérant. Le chauffage micro-onde peut être direct ou hybride (avec suscepteur). La température est mesurée par une caméra infrarouge. Un pilotage en température original a été mis au point. Des études comparatives entre les frittages micro-ondes et conventionnel ont porté sur une poudre céramique et une poudre métallique. Pour la zircone yttriée avec une vitesse de chauffage de 25°C/min, le chauffage micro-ondes décale d'une centaine de degrés les courbes de densification, accélère les cinétiques pendant les premiers stades et permet de limiter la croissance granulaire. Pour une poudre de nickel submicronique un frittage n'a été observé qu'en champ électrique dominant et en présence d'un plasma.

This in vitro study was conducted to evaluate the influence of surface treatments on the bond strength between an yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic and resin cement. For this purpose, 120 Y-TZP blocks (IPS e.max® ZirCAD in inLab®) were randomly distributed into 12 experimental groups (n = 10), according to six surface treatment strategies and two storage conditions (24 hours post cementation and after 60 days in water and 10,000 thermocicles): AS (as sintered, no treatment); TBS (tribochemical silica coating followed by silanization); AAP (particle abrasion with 50 μm aluminum oxide followed by application of Monobond®Plus); FS (fusion sputtering); SN (5 nm SiO2 nanofilm deposition and silanization) and FSSN (FS + SN). The Y-TZP blocks were embedded in acrylic resin and cylinders of resin cement (Ø=0.96 mm x 1 mm in height) (RelyX ARC) were built up on the ceramic surface. After the storage, the specimens were submitted to microshear test (μSBS) (1 mm/min) in a universal testing machine. After testing, the surfaces were analyzed with a stereomicroscope and scanning electron microscope (SEM) in order to categorize the failure modes. One additional specimen per surface treatment strategy was analyzed by X-ray diffraction, for phases content, and by SEM for micromorphology observation. Bond strength values were statistically analyzed by Kruskal-Wallis and Mann Whitney tests for surface treatments (p <0.001) and aging factor (p <0.05). In both storage conditions, TBS and AAP provided higher bond strength values, followed by FSSN, FS and SN groups. The aging negatively influenced the results, with one exception for the FS. An increase in the amount of monoclinic phase was observed in the abraded groups. Sandblasting of alumina particles followed by application of a primer with MPA is as effective as the tribochemical treatment combined with silane for pretreatment of the Y-TZP surface, with respect to the bond strength to the composite. / No presente trabalho objetivou-se avaliar, in vitro, o efeito de diferentes tratamentos de superfície na resistência de união de uma cerâmica à base de zircônia policristalina tetragonal estabilizada por ítria (Y-TZP) a um cimento resinoso. Para tanto, 120 blocos de Y-TZP (IPS e.max® ZirCAD for inLab®, Ivoclar-Vivadent, Schaan, Liechtenstein) foram distribuídos randomicamente em 12 grupos experimentais (n=10), conforme 6 estratégias de tratamento de superfície e 2 condições de envelhecimento (24 horas e após o envelhecimento em água e termociclagem): AS (sem tratamento); TBS (jateamento de partículas de alumina revestidas por sílica e silanização); AAP (abrasão com partículas de alumina seguida da aplicação de primer universal); FS (pulverização de micropartículas de zircônia na superfície livre da Y-TZP e após, fusão por sinterização); SN (deposição de nanofilme de sílica com 5 nm) e FSSN (FS seguido de SN). Os blocos de Y-TZP foram embutidos em resina acrílica e microcilindros de cimento resinoso (0,96 mm de diâmetro; 1 mm de altura) (RelyX ARC) foram confeccionados na superfície cerâmica. Após o armazenamento, os testes de microcisalhamento foram conduzidos a uma velocidade de 1 mm/min, em máquina de ensaios universal. Após o teste, as superfícies foram analisadas com estereomicroscópio e microscópio eletrônico de varredura (MEV) para caracterização das falhas. Em um espécime adicional, também foi conduzida análise de fases do material por difração de raios-X e caracterização da micromorfologia de superfície em MEV. Os valores de resistência de união foram submetidos aos testes estatísticos Kruskal-Wallis e Mann Whitney para os tratamentos testados (p<0.001) e para o fator envelhecimento (p<0.05). Em ambas as condições de envelhecimento, TBS e AAP proporcionaram os maiores valores de resistência adesiva, seguidos dos grupos FSSN, FS e SN. O envelhecimento influenciou negativamente os resultados, com única exceção para o FS. A difractometria revelou aumento de conteúdo monoclínico nos grupos jateados. FS não alterou a percentagem de fase monoclínica. O jateamento de partículas de alumina seguido da aplicação de um primer com MPA apresentou-se tão efetivo quanto o tratamento triboquímico aliado ao silano, para o pré-tratamento da superfície da Y-TZP, no que diz respeito à resistência de união ao compósito.

This thesis deals with a CAD programmed construction design of dental prosthetics and its subsequent production by means of a five axis machine tool. In the theoretical part of the thesis one can find characteristics and analysis of materials designed for a production of dental prosthetics constructions. Among other things, the practical part of the thesis follows up digitization of a patient´s oral cavity part with the use of Trios intraoral scanner representing the latest scanning technology. The obtained data created a basis for a design of the respective dental prosthetics construction using the shape dental system programme called DentalDesigner 2015. Furthermore, the paper deals with a production of a dental prosthetics construction by means of a five axis machine tool and pursues completion works which resulted in the prosthetics final shape. The paper is concluded with discussion comprising a summary of results acquired in the practical part beginning from dental implant introduction to insertion of the made prosthetics construction into the patient´s oral cavity.

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.