Dental zirconia: in-vitro comparison and outcome of methods for veneering, glazing, and chipping repairs
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OBJECTIVE: The purpose of this study is to evaluate the experimental properties of zirconia-based ceramics. METHODS: Zirconia bars were veneered to 2mm total thickness. Veneering-method groups included: 1.Hand-layered feldsparthic porcelain (VM=VitaVM9,Vident) and fluorapatite glass-ceramic (CR=IPSe.maxCeram,IvoclarVivadent); 2.Pressed feldspathic porcelain (PM=VitaPM9,Vident) and fluorapatite glass-ceramic (ZP=IPSe.maxZirPress,IvoclarVivadent); 3.CAD/CAM milled feldspathic ceramic (TF=VitablocsTriluxeForte,Vident) and lithium-disilicate glass-ceramic (CAD=IPSe.maxCAD,IvoclarVivadent). CAD/CAM veneers were either cemented with resin cements (P=Panavia21,KurarayDental), (R=RelyXUltimate,3M ESPE), (M=MultilinkAutomix,IvoclarVivadent) or fused with fusion glass-ceramic (C=CrystalConnect,IvoclarVivadent). A Three-point-bending test was performed. For group VM,PM,TF-M,TF-C,CAD-M,CAD-C, ten more bars were prepared and aged with cyclic loading and thermocycling before testing. Zirconia bars (PrettauZirconia,Zirkonzahn;inCorisTZI,Sirona;ZirluxFC,PentronCeramics) specimens were prepared and polished. The specimens were divided into 3 groups: control, self-glaze fired, and glazed groups. A Three-point bending test was performed. Veneered zirconia crowns were made. Feldspathic porcelain was applied to zirconia coping. Bevel cut on porcelain was made to simulate porcelain chipping. The crowns were then divided into 4 different groups according to repair materials including: 1.Conventional-resin composite (TetricEvoCeram,IvoclarVivadent) 2.Flowable-resin composite (G-aenialUniversalFlo,GCamerica) 3.Cemented CAD/CAM milled feldspathic ceramic (VitaTriluxForte,Vident) 4.Cemented CAD/CAM milled lithium-disilicate glass-ceramic (IPSe.maxCAD,IvoclarVivadent). Each crown underwent thermocycling. The test was performed by loading force on the center of repaired part to record load-to-failure. RESULTS: There were significant differences in the failure loads of non-aged bilayered veneer-zirconia bars. Aging experiment revealed a significant difference in failure load between non-aged and aged bars in groups VM and PM, but not in the groups with CAD/CAM milled veneers. There was significant influence of surface treatments on flexural strength of zirconia specimens. Post-hoc test showed that glazed group had significant lower flexural strength than other groups. Crowns repaired with CAD/CAM ceramics showed significant higher failure load than resin composite. Repairing with lithium-disilicate glass ceramic yielded the highest load-to-failure of the specimens. CONCLUSIONS: - Veneer materials, veneering methods, and cement materials have a significant effect on the failure load of bilayered veneer- zirconia. CAD/CAM veneer-zirconia is not susceptible to aging performed in this study. - Glazing decreased the flexural strength of high translucent zirconia. - Veneered zirconia crowns repaired with CAD/CAM ceramic materials have significantly higher load-to-failure than veneered crowns repaired with resin composite.