Showing papers by "Bart Van Meerbeek published in 2021"

Impact of sandblasting on the flexural strength of highly translucent zirconia.

Abstract: The objective of this study was to assess the influence of alumina sandblasting on the flexural strength of the latest generation of highly translucent yttria partially stabilized dental zirconia (Y-PSZ). Fully-sintered zirconia disk-shaped specimens (14.5-mm diameter; 1.2-mm thickness) of four Y-PSZ zirconia grades (KATANA HT, KATANA STML, KATANA UTML, all Kuraray Noritake; and Zpex Smile, Tosoh) were sandblasted at 0.2 MPa with 50-μm alumina (Al2O3) sand (Kulzer) or left as-sintered (control). For each zirconia grade, the yttria (Y2O3) content was determined using X-ray fluorescence (XRF). Surface roughness was assessed using 3D confocal laser microscopy. Micro-Raman spectroscopy (μ-Raman) and X-ray diffraction (XRD) were used to assess potentially induced residual stresses. Biaxial flexural strength (n = 20) was statistically compared by Weibull analysis. Focused ion beam - scanning electron microscopy (FIB/SEM) was used to observe the subsurface microstructure. Fracture surfaces after biaxial flexural strength testing were observed by SEM. KATANA UTML had the highest Y2O3 content (6 mol%), followed by KATANA STML and Zpex Smile (5 mol%), and KATANA HT (4 mol%). Al2O3-sandblasting significantly increased surface roughness of KATANA UTML and Zpex Smile. μRaman and XRD revealed the presence of residual compressive stress on all Al2O3-sandblasted surfaces. FIB/SEM revealed several sub-surface microcracks in the sandblasted specimens. Weibull analysis revealed that Al2O3-sandblasting increased the characteristic strength of KATANA HT, KATANA STML, whereas it decreased the strength of KATANA UTML. The strength enhancement after Al2O3-sandblasting of KATANA HT was the highest, followed by KATANA STML. For Zpex Smile, the influence was statistically insignificant. The impact of Al2O3-sandblasting on the Weibull modulus was controversial. The strength of zirconia after Al2O3-sandblasting is determined by the balance between microcrack formation (decreased strength) and surface compressive stress build-up (increased strength).

Additively Manufactured Zirconia for Dental Applications.

Abstract: We aimed to assess the crystallography, microstructure and flexural strength of zirconia-based ceramics made by stereolithography (SLA). Two additively manufactured 3 mol% yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP: LithaCon 3Y 230, Lithoz; 3D Mix zirconia, 3DCeram Sinto) and one alumina-toughened zirconia (ATZ: 3D Mix ATZ, 3DCeram Sinto) were compared to subtractively manufactured 3Y-TZP (control: LAVA Plus, 3M Oral Care). Crystallographic analysis was conducted by X-ray diffraction. Top surfaces and cross-sections of the subsurface microstructure were characterized using scanning electron microscopy (SEM). Biaxial flexural strength was statistically compared using Weibull analysis. The additively and subtractively manufactured zirconia grades revealed a similar phase composition. The residual porosity of the SLA 3Y-TZPs and ATZ was comparable to that of subtractively manufactured 3Y-TZP. Weibull analysis revealed that the additively manufactured LithaCon 3Y 230 (Lithoz) had a significantly lower biaxial flexural strength than 3D Mix ATZ (3D Ceram Sinto). The biaxial flexural strength of the subtractively manufactured LAVA Plus (3M Oral Care) was in between those of the additively manufactured 3Y-TZPs, with the additively manufactured ATZ significantly outperforming the subtractively manufactured 3Y-TZP. Additively manufactured 3Y-TZP showed comparable crystallography, microstructure and flexural strength as the subtractively manufactured zirconia, thus potentially being a good option for dental implants.

Back to the multi-step adhesive system: A next-generation two-step system with hydrophobic bonding agent improves bonding effectiveness.

Abstract: This study evaluated the bonding effectiveness of a newly developed two-step hydrophobic bonding material. Three groups using different bonding systems were compared: BZF group, using the new bonding system (BZF-29; GC, Tokyo, Japan); GPB group, using a one-step bonding system (G-Premio Bond; GC); and SE2 group, using a two-step bonding system (CLEARFIL SE Bond 2; Kuraray Noritake Dental, Tokyo, Japan). Microtensile bond strength (µTBS) was measured after storage in water for 24 h, 3 months and 6 months (n=25/group). Fracture surfaces were observed under scanning electron microscopy. The BZF group showed significantly higher µTBS than the other groups (p<0.001). Dominant failure patterns were cohesive failure for the BZF group (48-84%), mixed failure for the SE2 group (48-60%) and interface failure between adhesive and resin composite for the GPB group (48-52%). The hydrophobicity of the BZF-29 bonding system improves the long-term bonding effectiveness between adhesive and resin composite.

Alumina toughened zirconia reinforced with equiaxed and elongated lanthanum hexa-aluminate precipitates

Abstract: Three different alumina sources (boehmite, aluminium nitrate and α-alumina particles) and 12Ce-TZP powder containing 1 wt% lanthanum oxide were used to prepare 12Ce-TZP-based alumina-toughened-zirconia (ATZ) composites. The obtained ATZs had similar density and phase composition, whereas the microstructures were significantly different. Alumina-particle addition gave rise to a typical ATZ microstructure consisting of equiaxial sub-micrometer zirconia and alumina phases, while the lanthanum hexa-aluminate phase was formed in large and non-homogenously distributed precipitates (∼3.5 μm in length). The boehmite and aluminium nitrate-based composites contained not only sub-micrometer equiaxial alumina and zirconia grains but also small-sized lanthanum hexa-aluminate precipitates (∼1.2 μm in length) that were inter- and transgranularly positioned in the zirconia matrix and effectively promoted crack deflection and toughening. In combination with a higher t-ZrO2 transformability, the boehmite-based composites had a higher indentation fracture resistance, strength and reliability compared to the aluminium-nitrate and alumina-particle based equivalents.

Antibacterial Effect of Amino Acid-Silver Complex Loaded Montmorillonite Incorporated in Dental Acrylic Resin

Abstract: Several dental materials contain silver for antibacterial effect, however the effect is relatively low. The reason for the lower antibacterial efficacy of silver is considered to be the fact that silver ions bind to chloride ions in saliva. To develop new effective silver antibacterial agents that can be useful in the mouth, we synthesized two novel amino acid (methionine or histidine)-silver complexes (Met or His-Ag) loaded with montmorillonite (Mont) and analyzed their antibacterial efficacy. At first the complexes were characterized using nuclear magnetic resonance (NMR), and amino acid-Ag complex-loaded Mont (amino acid-Ag-Mont) were characterized using X-ray diffraction (XRD) and scanning electron microscopy (SEM). The antibacterial efficacy of these materials in dental acrylic resin was then investigated by bacterial growth measurement using a spectrophotometer. As controls, commercially available silver-loaded zeolite and silver-zirconium phosphate were also tested. Dental acrylic resin incorporating His-Ag-Mont strongly inhibited Streptococcus mutans growth. This was explained by the fact that His-Ag complex revealed the highest amounts of silver ions in the presence of chloride. The structure of the amino acid-Ag complexes affected the silver ion presence in chloride and the antibacterial efficacy. His-Ag-Mont might be used as antibacterial agents for dental materials.

Effective Protocol for Daily High-quality Direct Posterior Composite Restorations. The Interdental Anatomy of the Class-2 Composite Restoration.

Abstract: The importance of the interdental anatomy of a class-2 direct composite restoration is one of the most underestimated topics in direct posterior composite restorations. The proximal emergence profile of the restoration and the contact area should be designed to maximize arch continuity and to minimize food impaction. Other restorative criteria that must be fulfilled are marginal adaptation compatible with the dental and periodontal integrity, and geometry of the marginal ridge compatible with the mechanical integrity of the restoration under load. Shortcomings will result in masticatory discomfort, caries, periodontal problems and undesired movement of teeth. In vitro and in vivo studies showed that the use a contoured sectional metal matrix band with a separation clamp results in the tightest contact point. However, this matrix system also has shortcomings and does not give the expected result in all class-2 cavities. The variation in depth, width of the box, distance between the cervical cavity margin and the adjacent tooth requires customization of the interproximal space. In order to realize this, sectional matrix bands with several profiles of curvature, variation of wedges and separation clamps, and the use of teflon tape are required. In addition, dentists should follow a protocol allowing them to build a proximal composite surface that fulfills the required restorative criteria. Pre-wedging, space evaluation, interproximal clearance, correct selection, positioning and stabilization of the matrix band are important steps in this protocol.

Mini-iFT Confirms Superior Adhesive Luting Performance using Light-curing Restorative Composites.

Abstract: Purpose To validate the rationale of using a conventional light-cur ing resin-based composite (RBC) to lute thick indirect restorations by measuring mini-interfacial fracture toughness (mini-iFT). Materials and methods Freshly exposed dentin of extracted third molars (n = 64) was immediately sealed with a thin layer of an experimental RBC with a 50 wt% or 75 wt% (IDS) filler load. Two- or 6-mm -thick CAD/CAM composite block s were luted onto IDS using either pre-heated light-cure or dual-cure luting RBC , with the latter having served as control. Samples were cut into sticks, upon which a notch was prepared at the interface between IDS and luting RBC , prior to being submitted to a 4-point bending test to determine mini-iFT. The results were analyzed using a mixed linear model (LME). Failure mode at the fractured interface was determined using scanning electron microscopy (SEM). Results LME revealed that mini-iFT was not significantly affected by the composite block thickness (p = 0.39) , but by the luting RBC (p Conclusion This work provides the proof of concept that 2- and 6-mm -thick indirect restorations can safely be adhesively luted with pre-heated conventional light-cure RBC under controlled light-irradiation conditions. This strategy even seems beneficial in terms of mini-iFT compared to using a dual-cure luting RBC. IDS with lower filler content also appeared more favo rable.