Zirconia fixed dental prostheses fabricated by 3D gel deposition show higher fracture strength than conventionally milled counterparts

Zirconia restorations, which are fabricated by additive 3D gel deposition and do not require glazing like con-ventional restorations, were introduced as self-glazed zirconia restorations into dentistry. This in vitro inves-tigation characterized the surface layer, microstructure and the fracture and aging behavior of self-glazed zirconia (Y-TZPSG) three-unit fixed dental prostheses (FDP) and compared them to conventionally CAD/CAM milled and glazed controls (Y-TZPC-FDPs). For this purpose, the FDPs were analyzed by (focused ion beam) scanning electron microscopy, laserscanning microscopy, energy dispersive X-ray spectroscopy, X-ray diffraction and a dynamic and static loading test. For the latter, half of the samples of each material group (n = 16) was subjected to 5 million cycles of thermocyclic loading (98N) in an aqueous environment in a chewing simulator. Afterwards, all FDPs were loaded to fracture. Y-TZPSG-FDPs demonstrated a comparable elemental composition but higher surface microstructural homogeneity and fracture strength compared to Y-TZPC-FDPs. Microstructural flaws within the FDPs' surfaces were identified as fracture origins. The high fracture strength of the Y-TZPSG- FDPs was attributed to a finer-grained microstructure with fewer surface flaws compared to the Y-TZPC-FDPs which showed numerous flaws in the glaze overlayer. A decrease in fracture strength after dynamic loading from 5165N to 4507N was observed for the Y-TZPSG-FDPs, however, fracture strength remained statistically signifi-cantly above the one measured for Y-TZPC-FDPs (before chewing simulation: 1923N; after: 2041N). Within the limits of this investigation, it can therefore be concluded that Y-TZPSG appears to be stable for clinical application suggesting further investigations to prove clinical applicability.

Automated summary

This study compared self-glazed zirconia restorations with conventionally CAD/CAM milled and glazed controls and found that self-glazed zirconia restorations have higher surface microstructural homogeneity and fracture strength. The fracture strength of self-glazed zirconia restorations decreased after dynamic loading but remained significantly higher than the conventionally glazed controls. Therefore, this study suggests that self-glazed zirconia restorations are stable for clinical application and further research is needed to prove their clinical applicability.