Search Results (243)

Background/Objectives: Formation of tight contacts between oral soft tissue and dental implants is a significant challenge in contemporary implantology. An essential role in this process is played by oral epithelial cells. In the present study, we investigated how titanium and zirconia surfaces with different roughness influence various parameters of oral epithelial cells in vitro. Methods: We used the human oral squamous carcinoma Ca9-22 cell line and cultured them on the following surfaces: machined smooth titanium (TiM) and zirconia (ZrM) surfaces, as well as sandblasted and acid-etched titanium moderately rough (SLA) and zirconia (ZLA) surfaces. Cell proliferation/viability was measured by CCK-8 assay, and cell morphology was analyzed by fluorescent microscopy. The gene expression of interleukin (IL)-8, intercellular adhesion molecule (ICAM)-1, E-cadherin, integrin (ITG)-α6, and ITG-β4 was measured by qPCR, and the content of IL-8 in conditioned media by ELISA. Results: At the initial culture phase, cell proliferation was promoted by rougher surfaces. Differences in cell attachment were observed between machined and moderately rough surfaces. Machined surfaces were associated with slightly higher IL-8 levels (p < 0.05). Furthermore, both ZLA and SLA surfaces promoted the expression of (ITG)-α, ITG-β4, and ICAM-1 in Ca9-22 cells (p < 0.05). Surface material had no impact on the investigated parameters. Conclusions: Under the limitations of this in vitro study, some properties of oral epithelial cells, particularly the immunological and barrier function, are moderately modified by roughness but not by material. Hence, the roughness of the implant surface might play a role in the quality of the peri-implant epithelium. Full article

This in vitro investigation evaluated the marginal fit of three pressable glass-ceramic onlay materials: a conventional monolithic lithium disilicate (IPS e.max Press, EM, ivoclar vivadent AG, Schaan, Liechtenstein) and two zirconia-reinforced glass-ceramics (Vita Ambria, VA, VITA Zahnfabrik, Bad Säckingen, Germany; Celtra Press, CP, Sirona Dentsply, Milford, CT, USA). A typodont maxillary first premolar was prepared for an intensive onlay design by a single operator using a milling surveyor. The master die was duplicated with silicone impressions to create 72 identical epoxy resin dies. Seventy-two onlays (n = 24 per material) were fabricated and adhesively cemented to their respective dies. Vertical marginal gaps were recorded under a stereo-electron microscope before and after thermomechanical loading (TML) in a chewing simulator. Data were analyzed with one-way ANOVA and Tukey’s post hoc tests for intergroup comparisons and paired t-tests for pre- versus post-TML values. All groups showed a significant increase in marginal gap following TML. VA exhibited mean gaps of 46.41 µm before and 57.28 µm after loading (p = 0.001). EM demonstrated 41.16 µm before and 46.63 µm after TML (p = 0.002). CP showed 45.70 µm before and 55.99 µm after TML (p = 0.003). Among the three materials, EM maintained the most accurate marginal adaptation both before and after simulated chewing. Despite the increases, all post-loading values remained within the clinically acceptable threshold for marginal discrepancy. These findings indicated that thermomechanical fatigue adversely affected the marginal integrity of pressable glass-ceramic onlays, including zirconia-reinforced formulations. Nevertheless, zirconia-reinforced ceramics (VA and CP) achieved marginal gaps comparable to conventional lithium disilicate and remained within acceptable clinical limits. IPS e.max Press provided the best overall fit, suggesting it may offer superior long-term marginal stability for onlay restorations. Full article

Reliable bonding between zirconia and PEEK surfaces is crucial for ensuring the long-term success of hybrid prosthetic restorations. This study aimed to evaluate the tensile bond strength of zirconia–PEEK specimens prepared using different primer strategies to determine the most effective adhesive protocol. One hundred bonded specimens were divided into four groups (n = 25): control (no primer), zirconia primer (MKZ Primer), PEEK primer (Visio.link), and dual primer application. Specimens underwent sandblasting with 110 µm Al₂O₃ particles at 2 bar pressure for 15 s, and the PEEK primer was light-cured using a Valo Grand LED curing unit (1000 mW/cm², 90 s). All samples were bonded using the same universal adhesive and resin cement, and tensile bond strength was measured with a micro-tensile testing device. Data were analyzed using one-way ANOVA and Tukey’s HSD test (α = 0.05). The mean bond strengths were 12.83 MPa (control), 15.05 MPa (zirconia primer), 90.50 MPa (PEEK primer), and 102.09 MPa (dual primer). Application of PEEK primer significantly enhanced adhesion compared to zirconia primer or control (p < 0.001), while dual primer use yielded the highest values, indicating a synergistic effect. These findings suggest that surface-specific priming of both zirconia and PEEK surfaces effectively improves polymer–ceramic bonding performance and may contribute to the clinical durability of hybrid prosthetic restorations. Full article

Natural fiber-based composites are gaining attention as sustainable alternatives to synthetic fiber-reinforced materials. Herein, styrene-free unsaturated polyester (UPe) nanocomposites and flax-fabric laminates reinforced with vinyl-triethoxy-silane (VTES) functionalized zirconia nanoparticles (ZrO₂-VS) were studied. Nanoparticles were dispersed by high-shear mixing, and ZrO₂-VS was benchmarked against unmodified ZrO₂ and neat UPe. Fourier-transform infrared spectroscopy (FTIR) tracked cure conversion; scanning electron microscopy (SEM/EDS), tensile testing, and dynamic mechanical analysis (DMA) evaluated structure-property relationships. ZrO₂-VS improved dispersion and interfacial adhesion, yielding higher tensile strength and storage modulus compared with unmodified ZrO₂. In flax-fabric laminates, ZrO₂-VS/UPe achieved a tensile strength of 72.2 ± 3.6 MPa, exceeding both unmodified ZrO₂/UPe and neat UPe controls. DMA showed pronounced increases in storage modulus across temperature with small, non-significant changes in Tg. These results highlight a low-styrene-hazard UPe matrix and natural fiber reinforcement pathway to improved mechanical performance via silane-mediated nanoparticle-matrix-fiber bridging. Full article

The application of bioinspired nanocomposites in orthopedic implants marks a significant innovation in biomedical engineering, aimed at overcoming long-standing limitations of conventional implant materials. Traditional implants frequently suffer from poor osseointegration, mechanical mismatch with bone, and vulnerability to infection. Bioinspired nanocomposites, modeled after the hierarchical structures found in natural tissues such as bone and nacre, offer the potential to enhance mechanical performance, biological compatibility, and implant functionality. This study reviews and synthesizes current advancements in the design, fabrication, and functionalization of bioinspired nanocomposite materials for orthopedic use. Emphasis is placed on the integration of nanocrystalline hydroxyapatite (nHA), carbon nanotubes (CNTs), titanium dioxide (TiO₂) nanotubes, and other nanostructured coatings that mimic the extracellular matrix. Methods include comparative evaluations of mechanical properties, surface modifications for biocompatibility, and analyses of antibacterial efficacy through nano-topographical features. Bioinspired nanocomposites have been shown to improve osteoblast adhesion, proliferation, and differentiation, thereby enhancing osseointegration. Nanostructured coatings such as TiO₂ nanotubes increase surface hydrophilicity and corrosion resistance, supporting long-term implant stability. Mechanically, these composites offer high stiffness, superior wear resistance, and improved strength-to-weight ratios. Biomimetic combinations of hydroxyapatite, zirconia, and biopolymers have demonstrated effective load transfer and reduced stress shielding. Additionally, antibacterial functionality has been achieved via nanostructured surfaces that deter bacterial adhesion while remaining cytocompatible with host tissues. The integration of bioinspired nanocomposites into orthopedic implants provides a multifunctional platform for enhancing clinical outcomes. These materials not only replicate the mechanical and biological properties of native bone but also introduce new capabilities such as infection resistance and stimuli-responsive behavior. Despite these advancements, challenges including manufacturing scalability, long-term durability, and regulatory compliance remain. Continued interdisciplinary research is essential for translating these innovations from laboratory to clinical practice. Full article

Background/Objectives: This systematic review aimed to evaluate and summarize the available evidence on the effects of light-based applications, including laser irradiation on fibroblast responses to zirconia surfaces. Methods: A comprehensive electronic search was performed in PubMed, Scopus, Web of Science, Embase, and WorldCat databases. After duplicate removal and eligibility screening, 17 studies met the inclusion criteria. Only in vitro and animal studies assessing fibroblast behavior on zirconia after light- or laser-based surface irradiation were included. Due to heterogeneity in study designs and parameters, data were qualitatively synthesized. Results: All included studies confirmed the biocompatibility of laser-modified zirconia surfaces. Various laser systems—including Er:YAG, Er,Cr:YSGG, Nd:YAG, diode, excimer, and femtosecond lasers—were investigated. Most studies reported enhanced fibroblast adhesion, proliferation, and cytoskeletal organization compared with untreated controls. Two of the included studies demonstrated an antibacterial effect of erbium lasers treatment on zirconia surfaces. However, outcomes varied depending on the laser parameters, irradiation energy, and zirconia type used. Conclusions: Laser-based surface modification of zirconia appears safe and biocompatible, with evidence indicating favorable effects on fibroblast adhesion, proliferation, and organization. While these findings are promising for optimizing soft-tissue integration around zirconia implant abutments, further standardized and long-term studies are necessary to determine optimal laser settings and confirm clinical applicability. Full article

Ceramic materials have gained outstanding popularity in restorative and prosthetic dentistry due to their combination of high biocompatibility, mechanical durability, and natural esthetics. Among the most important developments in this field are the use of zirconia- and glass-based ceramics for various applications. Zirconia ceramics, especially yttria-stabilized tetragonal zirconia polycrystals (Y-TZP), are famous for their high mechanical strength, transformation toughening, chemical stability, and great biocompatibility. Newer generations like 4Y/5Y-PSZ zirconia have addressed the demand for higher translucency, meeting esthetic requirements. Glass–ceramics, including lithium disilicate and leucite-reinforced systems, are preferred for their optical properties, etchability, and strong adhesive bonding. Their microstructure provides a balance between strength and esthetics, supporting minimally invasive restorations with long-term clinical success. Both zirconia and glass–ceramics exhibit favorable biological responses, including low plaque accumulation and soft tissue compatibility. The goal of ongoing research is to overcome limitations, such as low-temperature degradation, bonding limitations, and surface durability. Also, to improve mechanical performance and functional integration, new approaches include 3D printing, graded materials, nanostructuring, and bioactive coatings. This review aims to provide a comprehensive overview of the composition, properties, clinical applications, current limitations, and future perspectives of zirconia- and glass-based ceramics in restorative dentistry. Full article

Background/Objectives: Zirconia-reinforced lithium silicate (ZLS) is a glass–ceramic that combines the translucency of lithium disilicate with the enhanced strength provided by dispersed zirconia crystals. Evidence on the mechanical behavior of ZLS implant-supported crowns remains limited. This study evaluated the fracture resistance of posterior monolithic ZLS crowns and analyzed the influence of cement type and artificial aging. Methods: Forty ZLS crowns (Celtra™ Duo) were fabricated, cemented onto straight titanium abutments and assigned to four groups (n = 10) according to cement type (adhesive or self-adhesive) and aging (500,000 cycles at 150 N). Specimens underwent axial load-to-fracture testing using a universal testing machine. Data were analyzed with Student’s t-tests and Kruskal–Wallis tests (α = 0.05). Results: Mean fracture resistance was 1625.46 ± 340.02 N. Although adhesive cement showed higher mean values than self-adhesive cement, no statistically significant differences were found (p = 0.102). Artificial aging also produced no significant reduction in fracture resistance (p = 0.674). All groups exceeded the physiological posterior occlusal forces. Conclusions: Monolithic ZLS crowns cemented onto titanium abutments demonstrated high fracture resistance under axial loading. Within the limitations of this in vitro design, neither cement type nor mechanical aging significantly affected performance. These findings support the mechanical feasibility of ZLS for posterior implant-supported single crowns, although further studies including thermomechanical aging and oblique loading are required. Full article

Background: This study evaluated the influence of various decontamination protocols after salivary contamination on the micro-shear bond strength (µSBS) between monolithic high-translucency zirconia and resin cement. Methods: A total of 81 multilayer (ML) monolithic–translucent zirconia discs of 10 mm diameter and 2 mm thickness (DD cubeX2 ML, Dental Direkt) were fabricated, sintered, and polished using silicon–carbide papers. The bonding surfaces were treated with 50-μm Al₂O₃ using a Renfert sandblaster at 0.3 MPa for 20 s. Fifty samples were randomly assigned to five groups (n = 10). A control group consisted of clean, uncontaminated samples, while the other four groups were contaminated and cleaned using water, sodium hypochlorite, phosphoric acid + ethanol, or Ivoclean, respectively. Resin cement cylinders (Panavia V5, Kuraray Noritake) were bonded onto the zirconia surfaces. The µSBS was evaluated after simulated ageing using a universal testing machine. Failure modes were analysed by light microscopy. Surface morphology was evaluated using a field emission scanning electron microscope (SEM), and the chemical surface was assessed with X-ray photoelectron spectroscopy (XPS) and Fourier Transform Infrared (FTIR) Spectroscopy. Surface wettability was assessed through contact angle measurements. One-way ANOVA with Tukey’s HSD was used to compare µSBS between groups. Results: Among the tested groups, the control group exhibited the highest µSBS value (59.5 ± 4.2 MPa), followed by Ivoclean (56.7 ± 4.8 MPa), phosphoric acid + ethanol (46.8 ± 4.7 MPa), and sodium hypochlorite (41.1 ± 5.7 MPa), with the lowest value observed with water (33.5 ± 6.3 MPa). All groups exhibited adhesive failure, with no sign of cohesive or mixed failures. SEM analysis showed no effect on zirconia crystallinity or sandblasting, while Ivoclean left residual zirconium oxide particles. Furthermore, XPS and FTIR analysis revealed favourable chemical changes after Ivoclean treatment, correlating with improved bonding performance. Contact angle measurements confirmed greater surface wettability in the Ivoclean group, resulting in strong bond strength. Conclusions: Ivoclean significantly increased the resin–zirconia bond strength after saliva contamination, showing more reliable results compared to others. Phosphoric acid + ethanol showed the second-highest mean strength, while water showed the least effectiveness. Full article

The purpose of this study was to evaluate the effect of different framework materials and thermal aging on the shear bond strength (SBS) of gingiva-colored composites used in fixed dental restorations. A total of 270 samples (10 × 10 × 2 mm³) were prepared using titanium, zirconia, and modified polyetheretherketone (modified PEEK). Three gingiva-colored composites (Gradia Gum, Anaxgum, Nexco) were applied after surface polishing and sandblasting. All specimens were stored in water at 37 °C for 24 h, then half of each group was subjected to thermal aging consisting of 10,000 cycles at temperatures between 5 and 55 °C. SBS testing was performed using a universal testing machine with a crosshead speed of 1 mm/min. Bonding failures were analyzed under a stereomicroscope, and one sample from each group was examined using a scanning electron microscope. SBS data were analyzed using three-way ANOVA with composite type, framework material, and thermal aging as factors, followed by pairwise comparisons (SPSS 23.0; p < 0.05). The highest SBS was recorded for the zirconia framework combined with Gradia Gum, specifically in the group without thermal aging (p < 0.05), while the lowest was observed for zirconia combined with Nexco after thermal aging (p < 0.05). Adhesive failures were predominant in the modified PEEK groups, whereas mixed failures occurred more frequently in titanium and zirconia groups. Both composite type and framework material significantly influenced SBS values, with thermal aging having a detrimental effect across all groups. This study demonstrates that both framework material and composite type affect bond strength, with specimens not subjected to thermal aging maintaining better adhesion. Thermal cycling reduced SBS in all groups, although the extent varied by material combination. Full article

Ions of Gd³⁺ and Yb³⁺ have radii similar to those of Zr⁴⁺, enabling them to form limited solid solutions in the ZrO₂ lattice through substitution. After solid solution formation, oxygen vacancy defects and complex defect aggregates are generated, which are crucial for stabilizing the high-temperature phase structure and reducing thermal conductivity. Therefore, in this study, 8 wt% Y₂O₃ and 5 wt% Yb₂O₃ were doped with 5 wt%, 10 wt%, and 15 wt% Gd₂O₃, respectively, to stabilize zirconia powders. GYYZO thermal barrier coatings (TBCs) were fabricated via atmospheric plasma spraying (APS). Subsequently, the GYYZO coatings with different Gd₂O₃ addition amounts were subjected to continuous thermal shock cycling at 1100 °C for 10, 30, 60, 90, and 150 cycles. The results indicate that the incorporation of Gd₂O₃, Yb₂O₃, and Y₂O₃ leads to the formation of stable tetragonal ZrO₂ phase in the GYYZO coatings. Although increasing the Gd₂O₃ addition amount reduces the thermal conductivity of the coatings, excessive Gd₂O₃ addition causes coating spallation. The GYYZO coating with 10 wt% Gd₂O₃ exhibits the lowest thermal conductivity of 0.59 W/(m·K). Additionally, the GYYZO coating with 10 wt% Gd₂O₃ can withstand thermal cycling for 150 cycles, while the one with 5 wt% Gd₂O₃ can endure 90 of thermal cycles. In contrast, the 8YSZ coating cracks and spalls after 60 thermal cycles. These findings demonstrate that doping ZrO₂ with Gd₂O₃, Yb₂O₃, and Y₂O₃ can enhance the thermal cycling resistance of the coatings and effectively reduce their thermal conductivity, but excessive Gd₂O₃ addition will decrease the coating adhesion strength. Full article

Background/Objectives: Achieving durable intraoral repairs of fractured metal and zirconia restorations requires optimal adhesion. This in vitro study evaluated the effects of mechanical surface treatments and commercial repair systems on the shear bond strength (SBS) of composite resin to nickel–chromium (Ni-Cr) alloy and zirconia, including the influence of thermocycling aging. Methods: In this study, 144 Ni-Cr and zirconia discs (12 × 12 × 2 mm) were randomly assigned to three surface treatments: untreated control, airborne particle abrasion (50 µm Al₂O₃), and medium grit diamond bur grinding. Each group was further subdivided to assess two intraoral repair kits (GC Corp (Tokyo, Japan). and Bisco Inc. (Schaumburg, IL, USA)). Composite resin cylinders were bonded following the manufacturer’s instructions. Half of the specimens (n = 12/subgroup) underwent 5000 thermocycles (5–55 °C). Micro-shear bond strength testing was performed, and failure modes were analyzed. Data were analyzed using three-way ANOVA and post hoc tests (p < 0.05). Results: Air abrasion significantly increased SBS compared to control and bur grinding for metal (p < 0.001). For zirconia, both air abrasion and bur grinding yielded similarly improved SBS over the control (p < 0.001). The GC repair kit demonstrated significantly superior bond stability after thermocycling across both substrates. Aging significantly reduced SBS in all groups (p < 0.001), with the most substantial reductions observed in untreated controls and groups repaired with the Bisco system. Conclusions: Airborne particle abrasion combined with a HEMA-free, 10-MDP-containing universal adhesive achieved the strongest and most durable resin bonds to both metal and zirconia, supporting its clinical use for the intraoral repair of ceramic and metal restorations. Full article

Objective: The aim of this study was to evaluate surface roughness (R_a) and microbial adhesion on four provisional prosthodontic materials in comparison to zirconium oxide. Methods: Four provisional prosthodontic restorative materials were evaluated in this study: poly methyl methacrylate (PMMA) acrylic resin (ALIKE; GC America Inc., Alsip, IL, USA), dimethacrylate (Bis-acryl) resin (Integrity; Dentsply Sirona, Charlotte, NC, USA), 3D-printed temporary crown and bridge resin (Formlabs Inc., Somerville, MA, USA), prepolymerized poly methyl methacrylate (milled PMMA) (Harvest Dental Laboratory Products, Brea, CA, USA), and zirconium oxide (Ivoclar Vivadent AG, Liechtenstein, Germany). A total of 90 samples were prepared and divided into two groups per material (treated and untreated). Provisional material samples were prepared per manufacturer’s instructions, polished with the same sequence using acrylic burs followed by Acrylipro silicone polishers (Brasseler, Savannah, GA, USA), and pumice with a goat brush. Zirconia was polished with a green grinding stone (ZR Grinders; Brassseler, Savannah, GA, USA), followed by a feather lite (Dialite ZR polisher; Brasseler, Savannah, GA, USA). The Ra of all samples was measured using a digital profilometer. Sterilized samples were incubated in Todd Hewitt yeast extract (THY) broth containing Candida albicans SC5314 and Streptococcus mutans BM71 at 37 °C under anaerobic conditions for 72 h. Subsequently, the number of colony-forming units (CFU) adhered to each sample was determined by serial dilution plating. Normality and homoscedasticity were assessed prior to statistical analysis. Welch’s ANOVA was then performed to evaluate differences among all samples, followed by Games–Howell post hoc tests for pairwise comparisons. A p < 0.05 was considered significant in all experiments. Results: Zirconia demonstrated the lowest surface roughness and significantly reduced adhesion of S. mutans and C. albicans compared to all other materials (p < 0.001). Milled PMMA exhibited significantly lower roughness and microbial adhesion than conventional PMMA (p < 0.001), with no significant difference from Printed PMMA in microbial adhesion. Additional pairwise differences were observed between Bis-acryl and PMMA (p = 0.0425), Milled and Printed PMMA (p < 0.0001), and Bis-acryl and Printed PMMA (p < 0.0001). Conclusions: Zirconia and milled PMMA showed superior surface properties and reduced microbial adhesion, supporting their use in long-term provisional restorations. Materials with higher microbial retention, such as self-curing PMMA, bis-acryl, and 3D-printed resins, may be less suitable for extended use. These findings guide material selection to improve clinical outcomes and highlight the need for further in vivo research. Full article

Surface treatments play a crucial role in modifying the surface properties and biological performance of dental ceramics. This study investigated the effects of surface conditions on the wettability, cytocompatibility, and bacterial resistance of 4 mol% Y₂O₃-stabilized tetragonal zirconia polycrystal (4Y–TZP) and two lithium disilicate (Li₂Si₂O₅) glass ceramics (Amber^® Mill (AM) and Amber^® Mill Abut-Crown (AC)). Human gingival fibroblast (HGF-1) responses and biofilm formation on the machined, polished, and glazed samples were evaluated. The polished 4Y–TZP sample exhibited the highest water contact angle (WCA; 71.3°), while that of the AC samples decreased as the sample was machined (58.4°), polished (46.8°), and glazed (14.0°). The wettability, cytocompatibility, and bacterial resistance of the dental ceramics were significantly influenced by material type and surface condition. Among the surface-treated samples, the glazed specimens exhibited the lowest WCA and bulk density; thus, wettability is an important factor for cell proliferation and bacterial resistance. Among all samples, HGF-1 cells adhered well to the glazed ceramics and significantly proliferated over time. Particularly, the 4Y–TZP and AC glazed samples exhibited the lowest biomass and strong resistance to biofilm formation and bacterial adhesion. Thus, the glaze dramatically affected HGF-1 cell growth and antibiofilm formation. Full article

(1) Background: Zirconia (ZrO₂) is increasingly used in dental implantology due to its biocompatibility and favorable mechanical and biological properties. While subtractive and stereolithographic additive manufacturing techniques are well established, the application of Fused Filament Fabrication (FFF) for zirconia-based dental implants remains largely unexplored. (2) Methods: Cylindrical ZrO₂ specimens were fabricated using three different manufacturing techniques: milling (MIL), Digital Light Processing (DLP), and FFF. Surface topography was analyzed via white-light interferometry. Human fetal osteoblasts (hFOBs 1.19) were cultured on the specimens to evaluate cell adhesion after 4 and 24 h, proliferation for 4 days, cell surface coverage after 4 and 24 h, and osteogenic gene expression (RUNX2, ALPL, and BGLAP) after 24 h, 48 h, 7 days, and 14 days. (3) Results: The FFF samples exhibited significantly higher surface roughness than the MIL and DLP specimens. After 24 h, enhanced cell adhesion and the highest proliferation rates were observed on FFF surfaces. At 14 days, gene expression analysis revealed elevated expression of BGLAP on FFF surfaces, suggesting advanced osteogenic differentiation compared to MIL and DLP. (4) Conclusions: The inherent surface roughness of FFF-printed zirconia appears to promote osteogenic activity without additional surface treatment. These findings suggest that FFF may constitute a viable manufacturing method for the fabrication of customized zirconia components in dental implantology, warranting further investigations, particularly regarding their mechanical performance. Full article