Objectives: To fully realize the range of indication and clinical advantages of the new multilayered zirconias, a comprehensive understanding of their chemical composition, microstructure, low temperature degradation (LTD) resistance, and translucency properties is paramount.Methods: A zirconia system (Katana, Kuraray Noritake), including 3 distinct grades of multilayered zirconias, was selected for study: Ultra Translucent Multi-layered zirconia (UTML), Super Translucent Multi-layered zirconia (STML), and Multi-layered zirconia (ML). For different materials and their individual layers, the chemical composition, zirconia phase fractions, and microstructure were determined by x-ray fluorescence (XRF), x-ray diffraction (XRD), and field emission scanning electron microscopy (FE-SEM). Also, their resistance to LTD and translucency properties were characterized.Results: Our findings revealed no major differences amongst layers, but the 3 materials were very distinct-UTML: 5Y-PSZ (5 mol% yttria-partially-stabilized zirconia) with ~75 wt% cubic content and a 4.05 (±0.85) μm average grain size, STML: 4Y-PSZ with ~65 wt% cubic content and a 2.81 (±0.17) μm average grain size, and ML: 3Y-PSZ with <50 wt% cubic content and a 0.63 (±0.03) μm average grain size. After water aging at 120°C for 12 h, greater monoclinic content was found in ML. UTML and STML did not show detectable monoclinic phase. The translucency was similar among layers, and also between UTML and STML, which were superior to ML.Significance: For each multi-layered zirconia grades, the layers are only differed in pigment types and contents, which yield remarkably natural shade gradients. Also, despite the significant compositional difference between STML and UTML, both materials showed similar translucencies.

Developing yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) with high strength and translucency could significantly widen the clinical indications of monolithic zirconia restorations. This study investigates the mechanical and optical properties of three Y-TZP ceramics: High-Translucency, High-Strength and High-Surface Area. The four-point bending strengths (mean ± standard error) for the three Y-TZP ceramics (n = 10) were 990 ± 39, 1416 ± 33 and 1076 ± 32 MPa for High-Translucency, High-Strength and High-Surface Area, respectively. The fracture toughness values (mean ± standard error) for the three zirconias (n = 10) were 3.24 ± 0.10, 3.63 ± 0.12 and 3.21 ± 0.14 MPa m1/2 for High-Translucency, High-Strength and High-Surface Area, respectively. Both strength and toughness values of High-Strength zirconia were significantly higher than High-Surface Area and High-Translucency zirconias. Translucency parameter values of High-Translucency zirconia were considerably higher than High-Strength and High-Surface Area zirconias. However, all three zirconias became essentially opaque when their thickness reached 1 mm or greater. Our findings suggest that there exists a delicate balance between mechanical and optical properties of the current commercial Y-TZP ceramics.

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The fabrication of zirconia dental restorations is a time-consuming process due to traditional slow sintering schemes; zirconia (Y-TZP) produced by these conventional routes are predominantly opaque. Novel speed sintering protocols have been developed to meet the demand for time and cost effective chairside CAD/CAM-produced restorations, as well as to control ceramic microstructures for better translucency. Although the speed sintering protocols have already been used to densify dental Y-TZP, the wear properties of these restorations remain elusive. Fast heating and cooling rates, as well as shorter sintering dwell times are known to affect the microstructure and properties of zirconia. Thus, we hypothesize that speed sintered zirconia dental restorations possess distinct wear and physical characteristics relative to their conventionally sintered counterparts. Glazed monolithic molar crowns of translucent Y-TZP (inCoris TZI, Sirona) were fabricated using three distinct sintering profiles: Super-speed (SS, 1580 °C, dwell time 10 min), Speed (S, 1510 °C, dwell time 25 min), and Long-term (LT, 1510 °C, dwell time 120 min). Microstructural, optical and wear properties were investigated. Crowns that were super-speed sintered possessed higher translucency. Areas of mild and severe wear were observed on the zirconia surface in all groups. Micropits in the wear crater were less frequent for the LT group. Groups S and SS exhibited more surface pits, which caused a scratched steatite surface that is associated with a greater volume loss. Tetragonal to monoclinic phase transformation, resulting from the sliding wear process, was present in all three groups. Although all test groups had withstood thermo-mechanical challenges, the presence of hairline cracks emanating from the occlusal wear facets and extending deep into the restoration indicates their susceptibility to fatigue sliding contact fracture.

Ultra-translucent zirconias are drawing immense attention due to their fascinating esthetic appearance. However, the high translucency came at the expense of diminishing strength along with the reduced ability of transformation toughening due to the increased cubic zirconia content. We aim to address these issues by infiltrating glass on the surface of an ultra-translucent zirconia (5Y-PSZ). Glasses of different shades can be used and the resulting graded glass/zirconia layer is expected to improve the material's flexural strength without compromising its esthetics. We also aim to elucidate how clinically relevant surface treatments-namely, air abrasion, glazing, or polishing-affect the fracture resistance of these zirconias with a high cubic content. All surface treatments were performed on bar-shaped (2 × 3 × 25 mm) and plate-shaped (12 × 12 × 1 mm) specimens, which were then subjected to a 4-point bending test and translucency measurements, respectively. 5Y-PSZ proved to be significantly more translucent than 3Y-TZP but also much weaker. Our hypothesis was accepted, as the strength of the glass-infiltrated ultra-translucent 5Y-PSZ (582 ± 20 MPa) is over 70% higher than its uninfiltrated counterpart (324 ± 57 MPa). Its strength is also over 25% higher than the highly polished 5Y-PSZ (467 ± 38 MPa). In addition, the translucency of 5Y-PSZ (translucency parameter [ TP] = 34, contrast ratio [ CR] = 0.31) is not affected by glass infiltration ( TP = 34, CR = 0.32) when the residual surface glass is removed by gentle polishing using 6- and then 3-µm diamond grits. Finally, both air abrasion and the presence of a glaze layer on the tensile surface decreased flexural strength significantly, being 274 ± 55 and 211 ± 21 MPa, respectively. With a combined high strength and translucency, the newly developed glass-infiltrated 5Y-PSZ may be considered a suitable material for next-generation, damage-resistant, and esthetic dental restorations.

Objective To investigate fatigue fracture resistance and wear behavior of a polymer infiltrated ceramic network (PICN) material (ENAMIC, Vita Zahnfabrik). Methods Anatomically shaped ENAMIC monolithic crowns were milled using a CAD/CAM system. The crowns were cemented on aged dentin-like composite abutments (Z100, 3M ESPE) with resin-based cement (Vita DUO Cement, Vita). The specimens were subjected to 2 types of fatigue and wear tests: (1) accelerated sliding-contact mouth-motion step-stress fatigue test (n = 24) in water; and (2) long-term sliding-contact mouth-motion fatigue/wear test using a clinically relevant load (P = 200 N, n = 8) in water. Failure was designated as chip-off or bulk fracture. Optical and scanning electron microscopes were used to examine the occlusal surface and subsurface damage, as well as to reveal the material’s microstructure. In addition, wear volume and depth were measured by x-ray micro-computed tomography. Results For accelerated mouth-motion step-stress fatigue testing, 3 out of the 24 ENAMIC crowns fractured following cyclic loading up to 1700 N. Minor occlusal damage and contact-induced cone cracks were observed in all surviving specimens, but no flexural radial cracks were seen. For long-term mouth-motion fatigue/wear testing under a 200 N load in water, a small wear scar without significant cracks was observed in all 8 tested ENAMIC crowns. Significance Monolithic CAD/CAM ENAMIC crowns showed superior resistance to sliding-contact fatigue fracture and wear.

Objective To demonstrate the fatigue behavior of CAD/CAM resin composite molar crowns using a mouth-motion step-stress fatigue test. Monolithic leucite-reinforced glass-ceramic crowns were used as a reference. Methods Fully anatomically shaped monolithic resin composite molar crowns (Lava Ultimate, n = 24) and leucite reinforced glass-ceramic crowns (IPS Empress CAD, n = 24) were fabricated using CAD/CAM systems. Crowns were cemented on aged dentin-like resin composite tooth replicas (Filtek Z100) with resin-based cements (RelyX Ultimate for Lava Ultimate or Multilink Automix for IPS Empress). Three step-stress profiles (aggressive, moderate and mild) were employed for the accelerated sliding-contact mouth-motion fatigue test. Twenty one crowns from each group were randomly distributed among these three profiles (1:2:4). Failure was designated as chip-off or bulk fracture. Optical and electronic microscopes were used to examine the occlusal surface and subsurface damages, as well as the material microstructures. Results The resin composite crowns showed only minor occlusal damage during mouth-motion step-stress fatigue loading up to 1700 N. Cross-sectional views revealed contact-induced cone cracks in all specimens, and flexural radial cracks in 2 crowns. Both cone and radial cracks were relatively small compared to the crown thickness. Extending these cracks to the threshold for catastrophic failure would require much higher indentation loads or more loading cycles. In contrast, all of the glass-ceramic crowns fractured, starting at loads of approximately 450 N. Significance Monolithic CAD/CAM resin composite crowns endure, with only superficial damage, fatigue loads 3 – 4 times higher than those causing catastrophic failure in glass-ceramic CAD crowns.