Zirconia as a biomaterial for odontological applications : effects of composition and manufacturing processes on fracture resistance

Abstract: Background: Ceramics have long been amongst the most biocompatible materials known but their mechanical properties have limited their use. During the past few decades zirconia has aroused particular interest as a biomaterial because of its greater flexural strength, fracture resistance and toughness compared to other bioceramics. Technological inventions and developments have made the processing of zirconia-based ceramics possible and thus also the successful processing of dental restorations constructed from this type of material. The properties of zirconia-based ceramics can, however, be affected by, for example, shape, composition, manufacturing processes and subsequent handling. It was, therefore, of particular interest to study in what way recently introduced zirconia-based ceramics intended for odontological applications could be affected by the shape, manufacturing process, composition, grinding and veneering. Methods: By means of newly invented and developed CAM-Software systems with improvements in grinding technology and strategy and hardware technology, cores for single crowns, fixed partial denture (FPD) frameworks and implant-supported abutments and copies were manufactured from a hot isostatic-pressed (HIPed) yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) ceramic. In addition, zirconia-based ceramics intended for odontological applications but made from other compositions and/or using different manufacturing techniques were studied. The effects were determined of shape, composition, manufacturing process, heat treatment and veneering of the cores/frameworks on the fracture or bending resistance of various types of ceramic single crowns, FPD frameworks and implant-supported abutments and copies. Results: Different thicknesses in different parts of HIPed Y-TZP cores improved the fracture resistance compared with cores of a uniform thickness resulting in a thicker veneer layer. Machining, heat treatment and veneering affected the fracture resistance of the zirconia-based ceramics studied. In addition, the quality of sintering and composition and type of veneering porcelain used influenced the fracture resistance of zirconia-based ceramics. Conclusion: The results obtained indicate that zirconia-based ceramics have the potential for use as a material in odontological applications. The mechanical properties of zirconia ceramics are, however, affected by, among other things, the shape, composition, manufacturing processes and subsequent handling of the material. These findings have to be taken in consideration in the production processes of zirconia-based ceramic restorations. To further improve their function more studies are needed to elucidate the effects of various manufacturing and handling techniques on the properties of zirconia-based ceramics.