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      Monolithic Zirconia: An Update to Current Knowledge. Optical Properties, Wear, and Clinical Performance

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          Abstract

          The purpose of this paper was to update the knowledge concerning the wear, translucency, as well as clinical performance of monolithic zirconia ceramics, aiming at highlighting their advantages and weaknesses through data presented in recent literature. New ultra-translucent and multicolor monolithic zirconia ceramics present considerably improved aesthetics and translucency, which, according to the literature reviewed, is similar to those of the more translucent lithium disilicate ceramics. A profound advantage is their high strength at thin geometries preserving their mechanical integrity. Based on the reviewed articles, monolithic zirconia ceramics cause minimal wear of antagonists, especially if appropriately polished, although no evidence still exists regarding the ultra-translucent compositions. Concerning the survival of monolithic zirconia restorations, the present review demonstrates the findings of the existing short-term studies, which reveal promising results after evaluating their performance for up to 5 or 7 years. Although a significant increase in translucency has been achieved, new translucent monolithic zirconia ceramics have to be further evaluated both in vitro and in vivo for their long-term potential to preserve their outstanding properties. Due to limited studies evaluating the wear properties of ultra-translucent material, no sound conclusions can be made, whereas well-designed clinical studies are urgently needed to enlighten issues of prognosis and long-term survival.

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          Most cited references142

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          Making yttria-stabilized tetragonal zirconia translucent.

          Yu Zhang (2014)
          The aim of this study was to provide a design guideline for developing tetragonal yttria-stabilized zirconia with improved translucency.
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            A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns

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              Wear characteristics of current aesthetic dental restorative CAD/CAM materials: two-body wear, gloss retention, roughness and Martens hardness.

              This study determined the two-body wear and toothbrushing wear parameters, including gloss and roughness measurements and additionally Martens hardness, of nine aesthetic CAD/CAM materials, one direct resin-based nanocomposite plus that of human enamel as a control group. Two-body wear was investigated in a computer-controlled chewing simulator (1.2 million loadings, 49N at 1.7Hz; 3000 thermocycles 5/50°C). Each of the 11 groups consisted of 12 specimens and 12 enamel antagonists. Quantitative analysis of wear was carried out with a 3D-surface analyser. Gloss and roughness measurements were evaluated using a glossmeter and an inductive surface profilometer before and after abrasive toothbrushing of machine-polished specimens. Additionally Martens hardness was measured. Statistically significant differences were calculated with one-way ANOVA (analysis of variance). Statistically significant differences were found for two-body wear, gloss, surface roughness and hardness. Zirconium dioxide ceramics showed no material wear and low wear of the enamel antagonist. Two-body wear of CAD/CAM-silicate and -lithium disilicate ceramics, -hybrid ceramics and -nanocomposite as well as direct nanocomposite did not differ significantly from that of human enamel. Temporary polymers showed significantly higher material wear than permanent materials. Abrasive toothbrushing significantly reduced gloss and increased roughness of all materials except zirconium dioxide ceramics. Gloss retention was highest with zirconium dioxide ceramics, silicate ceramics, hybrid ceramics and nanocomposites. Temporary polymers showed least gloss retention. Martens hardness differed significantly among ceramics, between ceramics and composites, and between resin composites and acrylic block materials as well. All permanent aesthetic CAD/CAM block materials tested behave similarly or better with respect to two-body wear and toothbrushing wear than human enamel, which is not true for temporary polymer CAD/CAM block materials. Ceramics show the best gloss retention compared to hybrid ceramics, composites and acrylic polymers. Copyright © 2013 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Dent J (Basel)
                Dent J (Basel)
                dentistry
                Dentistry Journal
                MDPI
                2304-6767
                02 September 2019
                September 2019
                : 7
                : 3
                : 90
                Affiliations
                [1 ]Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
                [2 ]Private Practice, Cambridge CB1 3NU, UK
                [3 ]Private Practice, Limassol 3061, Cyprus
                [4 ]Private Practice, 55131 Thessaloniki, Greece
                Author notes
                [* ]Correspondence: kont@ 123456dent.auth.gr
                Author information
                https://orcid.org/0000-0003-1477-2549
                Article
                dentistry-07-00090
                10.3390/dj7030090
                6784470
                31480688
                d46b49bb-0ced-4ca9-8989-895438e0498a
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 10 June 2019
                : 20 August 2019
                Categories
                Review

                monolithic zirconia,translucency,wear,clinical performance

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