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Ceramic Materials for Dental Implant and CAD-CAM Prostheses

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A special issue of Materials (ISSN 1996-1944). This special issue belongs to the section "Biomaterials".

Deadline for manuscript submissions: closed (20 June 2022) | Viewed by 34805

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Special Issue Editor

Prof. Dr. Jung-Suk Han

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Guest Editor

Department of Prosthodontics, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul 03080, Korea
Interests: ceramics; zirconia; digital dentistry; prosthodontics

Special Issue Information

Dear Colleagues,

The Special Issue “Ceramic materials for dental implant and CAD-CAM prostheses” mainly addresses the various physical and biological properties of ceramic materials, which are currently used as diverse dental restorations, including implant prosthetics. With the recent rapid development of materials science studies, the advantages of ceramic dental prosthetic materials have exceeded mere aesthetics for anterior restorations. Ceramic materials now have the physical and chemical durability that surpasses conventional metal materials for dental prostheses, making them the alternative choice even for posterior teeth. Furthermore, the application of the digital dentistry approach using CAD-CAM, which provides new paradigms and functions, from diagnosis and treatment plans to fabrication of definite prosthesis. It also improves the overall treatment experience, such as comfort for the patients, usability for practitioners, reduced treatment time, and enhanced overall precision. Also, when ceramic materials were used as implant components, the results showed excellent hard and soft tissue biocompatibility, which confirms their competence as long-lasting materials. The use of ceramic materials has expanded greatly to the point that they would potentially be used as titanium alternatives as implant fixtures. The up-to-date findings of ceramic materials in dentistry are in detail discussed in this Special Issue.

Prof. Dr. Jung-Suk Han
Guest Editor

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Keywords

digital dentistry
ceramic material
zirconia
titanium
CAD-CAM
soft tissue
implant fixture
prostheses
osteogenic enhancing materials
dental implant

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Published Papers (9 papers)

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Research

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10 pages, 2404 KiB

Open AccessArticle

Retention Forces of Monolithic CAD/CAM Crowns Adhesively Cemented to Titanium Base Abutments—Effect of Saliva Contamination Followed by Cleaning of the Titanium Bond Surface

by Felix Burkhardt, João Pitta, Vincent Fehmer, Philippe Mojon and Irena Sailer

Materials 2021, 14(12), 3375; https://doi.org/10.3390/ma14123375 - 18 Jun 2021

Cited by 12 | Viewed by 2187

Abstract

The aim of this study was to investigate the effects of saliva contamination and the cleaning of the bond surface of titanium base (ti-base) abutments on the bonding stability and retention force values. The bond surface of the ti-base abutments was treated with airborne-particle abrasion. After contamination, the ti-base abutments underwent different cleaning protocols: water spray (H₂O); alcohol (ALC); suspension of zirconium particles (SZP); reapplied airborne-particle abrasion (APA); and a control condition without contamination and cleaning (CTR). All lithium disilicate crowns were bonded to the ti-base abutments using a primer and a self-curing composite. Bonded specimens underwent thermo-mechanical aging. Bond failure analysis and pull-off testing were performed. Bond failure occurred more frequently in groups H₂O, ALC, SZP, and APA (p < 0.05). Significant differences in retention force values were only found between CTR and ALC (p < 0.05). Specimens which did not show bond failure after ageing had higher retention force values than the specimens that showed bond failure (p < 0.05). Saliva contamination with cleaning can degrade the bonding properties to titanium. For the retention force values, only the protocol with alcohol after contamination could not restore the values. Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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15 pages, 3281 KiB

Open AccessArticle

Influence of Preaging Temperature on the Indentation Strength of 3Y-TZP Aged in Ambient Atmosphere

by Ki-Won Jeong, Jung-Suk Han, Gi-Uk Yang and Dae-Joon Kim

Materials 2021, 14(11), 2767; https://doi.org/10.3390/ma14112767 - 23 May 2021

Cited by 18 | Viewed by 2505

Abstract

Yttria-stabilized zirconia (3Y-TZP) containing 0.25% Al₂O₃, which is resistant to low temperature degradation (LTD), was aged for 10 h at 130–220 °C in air. The aged specimens were subsequently indented at loads ranging from 9.8 to 490 N using a Vickers indenter. The influence of preaging temperature on the biaxial strength of the specimens was investigated to elucidate the relationship between the extent of LTD and the strength of zirconia restorations that underwent LTD. The indented strength of the specimens increased as the preaging temperature was increased higher than 160 °C, which was accompanied by extensive t-ZrO₂ (t) to m-ZrO₂ (m) and c-ZrO₂ (c) to r-ZrO₂ (r) phase transformations. The influence of preaging temperature on the indented strength was rationalized by the residual stresses raised by the t→m transformation and the reversal of tensile residual stress on the aged specimen surface due to the indentation. The results suggested that the longevity of restorations would not be deteriorated if the aged restorations retain compressive residual stress on the surface, which corresponds to the extent of t→m phase transformation less than 52% in ambient environment. Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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10 pages, 538 KiB

Open AccessArticle

Clinical Feasibility of Fully Sintered (Y, Nb)-TZP for CAD-CAM Single-Unit Restoration: A Pilot Study

by Ki-Won Jeong, Hyung-In Yoon, Jae-Hyun Lee, In-Sung Luke Yeo, Dae-Joon Kim and Jung-Suk Han

Materials 2021, 14(11), 2762; https://doi.org/10.3390/ma14112762 - 23 May 2021

Cited by 7 | Viewed by 2557

Abstract

Fifteen participants (9 male, 6 female) received a total of 15 monolithic single restorations made from fully sintered (Y, Nb)-TZP (tetragonal zirconia polycrystal) block. The restorations were clinically evaluated for survival, success rate, and periodontal probing depths 6 months after the insertion of the restorations. Esthetic, functional, and biological evaluations were also performed over a 6-month follow-up period. The survival and success rates of the single-unit restorations were 100%. The periodontal probing depth values ranged from 1 to 3 mm. No complications with regard to functional and biological properties were observed after 6 months. The postoperative sensitivity was only a transient phenomenon. The fully sintered (Y, Nb)-TZP single-unit restoration showed highly acceptable quality with successful clinical performance over 6 months. Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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11 pages, 29197 KiB

Open AccessArticle

Effects of Implant–Abutment Connection Type and Inter-Implant Distance on Inter-Implant Bone Stress and Microgap: Three-Dimensional Finite Element Analysis

by Takashi Matsuoka, Tamaki Nakano, Satoshi Yamaguchi, Shinji Ono, Shota Watanabe, Takumi Sato and Hirofumi Yatani

Materials 2021, 14(9), 2421; https://doi.org/10.3390/ma14092421 - 6 May 2021

Cited by 11 | Viewed by 3478

Abstract

The attainment of a good aesthetic outcome in dental implant treatment requires inter-implant papilla reconstruction, which is very difficult to perform. Maintenance of the inter-implant bone is essential for maintenance of the inter-implant papilla. The aim of this study was to investigate the mechanical influences of the implant–abutment connection type and inter-implant distance on the inter-implant bone by using three-dimensional finite element analysis. Three computer-aided design models of two-piece implants were designed: external connection (EC), internal connection (IC), and conical connection (CC). In each model, two identical implants were placed with inter-implant distances of 3.0, 2.5, and 2.0 mm. The maximum principal stress and microgap were evaluated. The stress values of the inter-implant bone decreased in the following order: IC, EC, and CC. The microgap decreased in the following order: EC, IC, and CC. Regardless of the type of implant–abutment connection, the stress of the inter-implant bone increased as the inter-implant distance decreased. The microgap barely changed as the inter-implant distance decreased. A CC implant is a mechanically advantageous implant–abutment connection type for maintenance of the inter-implant bone. With an inter-implant distance of less than 3.0 mm, use of a CC implant might suppress absorption of the inter-implant bone. Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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13 pages, 4290 KiB

Open AccessArticle

Effect of Fabrication Technique on the Microgap of CAD/CAM Cobalt–Chrome and Zirconia Abutments on a Conical Connection Implant: An In Vitro Study

by Pedro Molinero-Mourelle, Rocio Cascos-Sanchez, Burak Yilmaz, Walter Yu Hang Lam, Edmond Ho Nang Pow, Jaime Del Río Highsmith and Miguel Gómez-Polo

Materials 2021, 14(9), 2348; https://doi.org/10.3390/ma14092348 - 30 Apr 2021

Cited by 21 | Viewed by 3414

Abstract

The aim of this in vitro study was to investigate the microgaps at the implant–abutment interface when zirconia (Zr) and CAD/CAM or cast Co–Cr abutments were used. Methods: Sixty-four conical connection implants and their abutments were divided into four groups (Co–Cr (milled, laser-sintered and castable) and Zirconia (milled)). After chewing simulation (300,000 cycles, under 200 N loads at 2 Hz at a 30° angle) and thermocycling (10,000 cycles, 5 to 50 °C, dwelling time 55 s), the implant–abutment microgap was measured 14 times at each of the four anatomical aspects on each specimen by using a scanning electron microscope (SEM). Kruskal–Wallis and pair-wise comparison were used to analyze the data (α = 0.05). Results: The SEM analysis revealed smaller microgaps with Co–Cr milled abutments (0.69–8.39 μm) followed by Zr abutments (0.12–6.57 μm), Co–Cr sintered (7.31–25.7 μm) and cast Co–Cr (1.68–85.97 μm). Statistically significant differences were found between milled and cast Co–Cr, milled and laser-sintered Co–Cr, and between Zr and cast and laser-sintered Co–Cr (p < 0.05). Conclusions: The material and the abutment fabrication technique affected the implant–abutment microgap magnitude. The Zr and the milled Co–Cr presented smaller microgaps. Although the CAD/CAM abutments presented the most favorable values, all tested groups had microgaps within a range of 10 to 150 μm. Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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18 pages, 5786 KiB

Open AccessArticle

Effect of Air-Abraded Versus Laser-Fused Fluorapatite Glass-Ceramics on Shear Bond Strength of Repair Materials to Zirconia

by Alaaeldin Elraggal and Nikolaos Silikas

Materials 2021, 14(6), 1468; https://doi.org/10.3390/ma14061468 - 17 Mar 2021

Cited by 9 | Viewed by 3661

Abstract

Zirconia repair could be a feasible alternative option to total replacement in fractured zirconia-based restorations. Maximising the bond strength by enriching zirconia with fluorapatite glass-ceramics (FGC) powder has been addressed and compared to other surface treatments. Besides resin composite, other repair materials have been proposed and compared. Zirconia blocks received different surface treatments (A—sandblasting with tribochemical silica-coated alumina (CoJet). B—sandblasting with FGC powder (FGC), C—fluorapatite glass-ceramic coat+ neodymium-doped yttrium aluminum garnet laser irradiation (FGC + Nd: YAG), and D—no surface treatment). The surface roughness, topography, and crystallinity were investigated by a profilometer, scanning electron microscopy (SEM), and X-ray diffraction (XRD) analyses, respectively. For each surface treatment, three repair materials (feldspathic porcelain, lithium disilicate, and resin composite) were bonded to zirconia with 10, Methacryloyloxydecyl dihydrogen phosphate (MDP)–Monobond Plus/ Multilink Automix. Bonded specimens were thermocycled for 10,000 cycles and tested for shear bond strength (SBS) at a speed of 1 mm/min, followed by the analysis of the mode of failure. FGC + Nd: YAG laser group reported the highest surface roughness and monoclinic content compared to CoJet, FGC, and control groups. The highest mean SBS was found in FGC-blasted zirconia, followed by FGC + Nd: YAG laser and CoJet treated groups. However, the lowest SBS was found in control groups regardless of the repair material. Sandblasting zirconia with FGC powder increased SBS of resin to zirconia with lower monoclinic phase transformation compared to FGC + Nd: YAG or CoJet groups. Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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11 pages, 6808 KiB

Open AccessArticle

Fracture Load of Metal, Zirconia and Polyetheretherketone Posterior CAD-CAM Milled Fixed Partial Denture Frameworks

by Verónica Rodríguez, Celia Tobar, Carlos López-Suárez, Jesús Peláez and María J. Suárez

Materials 2021, 14(4), 959; https://doi.org/10.3390/ma14040959 - 18 Feb 2021

Cited by 23 | Viewed by 3508

Abstract

The aim of this study was to investigate the load to fracture and fracture pattern of prosthetic frameworks for tooth-supported fixed partial dentures (FPDs) fabricated with different subtractive computer-aided design and computer-aided manufacturing (CAD-CAM) materials. Materials and Methods: Thirty standardized specimens with two abutments were fabricated to receive three-unit posterior FDP frameworks with an intermediate pontic. Specimens were randomly divided into three groups (n = 10 each) according to the material: group 1 (MM)—milled metal; group 2 (L)—zirconia; and group 3 (P)—Polyetheretherketone (PEEK). The specimens were thermo-cycled and subjected to a three-point bending test until fracture using a universal testing machine (cross-head speed: 1 mm/min). Axial compressive loads were applied at the central fossa of the pontics. Data analysis was made using one-way analysis of variance, Tamhane post hoc test, and Weibull statistics (α = 0.05). Results: Significant differences were observed among the groups for the fracture load (p < 0.0001). MM frameworks showed the highest fracture load values. The PEEK group registered higher fracture load values than zirconia samples. The Weibull statistics corroborated these results. The fracture pattern was different among the groups. Conclusions: Milled metal provided the highest fracture load values, followed by PEEK, and zirconia. However, all tested groups demonstrated clinically acceptable fracture load values higher than 1000 N. PEEK might be considered a promising alternative for posterior FPDs. Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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Review

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14 pages, 1597 KiB

Open AccessReview

Adhesion to Zirconia: A Systematic Review of Surface Pretreatments and Resin Cements

by Rubén Comino-Garayoa, Jesús Peláez, Celia Tobar, Verónica Rodríguez and María Jesús Suárez

Materials 2021, 14(11), 2751; https://doi.org/10.3390/ma14112751 - 22 May 2021

Cited by 71 | Viewed by 6717

Abstract

This systematic review aims to evaluate the different pretreatments of the zirconia surface and resin cement in order to determine a valid operative protocol for adhesive cementation. Methodologies conducted for this study followed the Prisma (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. An electronic search was performed in four databases. The established focus question was: “What type of surface conditioning method is the one that obtains the best adhesion values to zirconia over time by applying a resin cement?” Forty-five relevant papers were found to qualify for final inclusion. In total, 260 different surface pretreatment methods, mainly combinations of air-abrasion protocols and adhesive promoters, were investigated. Altogether, the use of two artificial aging methods, three types of cement and four testing methods was reported. The results showed that mechanicochemical surface pretreatments offered the best adhesive results. Self-adhesive cement and those containing 10-MDP obtained the best results in adhesion to zirconia. Artificial aging reduced adhesion, so storage in water for 30 days or thermocycling for 5000 cycles is recommended. A standardized adhesive protocol has not been established due to a lack of evidence Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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20 pages, 2088 KiB

Open AccessReview

Clinical Performance of CAD/CAM All-Ceramic Tooth-Supported Fixed Dental Prostheses: A Systematic Review and Meta-Analysis

by Babak Saravi, Andreas Vollmer, Maja Hartmann, Gernot Lang, Ralf-Joachim Kohal, Martin Boeker and Sebastian B. M. Patzelt

Materials 2021, 14(10), 2672; https://doi.org/10.3390/ma14102672 - 20 May 2021

Cited by 33 | Viewed by 5244

Abstract

Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported zirconia- and lithium disilicate-based fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5-, and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates excluding failures, but including any other types of intervention were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication excluding failures but requiring intervention was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with seven studies associated with low risk of bias, eight studies with a moderate risk of bias, and three studies with serious risk of bias. The current meta-analysis on CAD/CAM-supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature. Full article

(This article belongs to the Special Issue Ceramic Materials for Dental Implant and CAD-CAM Prostheses)

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