Zirconia-based restorations are widely used in prosthetic dentistry; however, their susceptibility to hydrothermal degradation remains elusive. We hypothesized that CAD/CAM machining and subsequent surface treatments, i.e., grinding and/or grit-blasting, have marked effects on the hydrothermal degradation behavior of Y-TZP. CAD/CAM-machined Y-TZP plates (0.5 mm thick), both with and without subsequent grinding with various grit sizes or grit-blasting with airborne alumina particles, were subjected to accelerated aging tests in a steam autoclave. Results showed that the CAD/CAM-machined surfaces initially exhibited superior hydrothermal degradation resistance, but deteriorated at a faster rate upon prolonged autoclave treatment compared with ground and grit-blasted surfaces. The accelerated hydrothermal degradation of CAD/CAM surfaces is attributed to the CAD/CAM machining damage and the absence of surface compressive stresses in the fully sintered material. Clinical relevance for surface treatments of zirconia frameworks in terms of hydrothermal and structural stabilities is addressed.

Zirconia-based restorations are widely used in prosthetic dentistry, but their susceptibility to postsintering cementation surface treatments remains controversial. We hypothesized that grinding (600-grit) and alumina abrasion (50 µm, 5 sec, 0.5 MPa) affect the damage modes and reliability of zirconia core material. Monolithic CAD/CAM-machined and sintered Y-TZP plates (0.5 mm thickness) were adhesively cemented to dentin-like composite substrates. Uni-axial mouth-motion cyclic contact was applied through a tungsten carbide spherical indenter (r = 3.18 mm). Results showed that zirconia core ceramic is vulnerable to lower surface radial fracture after grinding or alumina abrasion, while the as-received control chiefly fractured from load-application surface cone fracture. Significantly lower reliability of ground and alumina-abraded compared with the as-received zirconia core ceramic can be attributed to damage induced on the cementation surface. Clinical relevance concerning surface treatment protocols for zirconia framework materials prior to cementation is addressed.

Failures of zirconia-based all-ceramic restorations appear to be predominantly chips and fractures in the porcelain veneer, from occlusally induced sliding contact damage. We hypothesized that such failure may be substantially mitigated by controlled grading of the elastic modulus at the ceramic surface. In this study, we fabricated graded structures by infiltrating glass into zirconia plates, resulting in improved aesthetics and diminished modulus at the surfaces. Individual plates were then embedded in epoxy or cemented to dental composites and subjected to single- or multi-cycle sliding contact. Plates of porcelain-veneered zirconia and monolithic zirconia served as controls. Graded zirconia-glass structures exhibited over 3 times better resistance to single-cycle sliding damage than monolithic zirconia and 25 times better than veneered zirconia, and had a fatigue sliding damage resistance comparable with that of monolithic zirconia. These zirconia-glass materials can be engineered in shades from white to yellow, and have potentially better cementation properties than homogeneous zirconia.