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This review aimed to illustrate the utility of additive manufacturing technologies for the fabrication of polymer, metal, and ceramic components within the confines of their current and potential clinical applications in dentistry. The literature reviewed on five additive manufacturing technologies, namely, vat-polymerization, material jetting, material extrusion, powder-based fusion, and binder jetting, have been investigated in relevance to their dental applications. These technologies have the following existing or potential clinical applications: diagnostic and definitive casts, custom trays, positioning guides for custom abutments, tooth preparation guides, interim dental restorations, all-ceramic crowns, metal crowns and copings, silicone indices, occlusal devices, complete dentures, wax patterns for intra- and extra-coronal restorations, surgical guides, removable partial dentures, and tooth- or implant-supported frameworks. Vat-polymerization, material jetting, and powder-based fusion technologies have existing clinical applications utilizing mainly polymers and metals. Additive manufacturing technologies need further development to be used with ceramic materials for dental applications.

Objective The aims of this study were: 1) to evaluate the effect of sintering temperature on microstructure, density and flexural strength of a 3Y-TZP/TiO2 composite containing 12.5 wt% of TiO2 compared to 3Y-TZP specimens (control); 2) to compare 3Y-TZP with the experimental 3Y-TZP/TiO2 composite, both sintered at 1400 °C, with respect to the following parameters: optical properties, characteristic strength, Weibull modulus, fatigue behavior, induction of osteoblasts proliferation and differentiation (mineralization nodules formation). Methods The 3Y-TZP and 3Y-TZP/TiO2 powders were uniaxially pressed and sintered at 1200 °C, 1300 °C, 1400 °C or 1500 °C for one hour in a furnace. The microstructural analysis consisted of X-ray diffraction and scanning electron microscopy. The density was measured by the Archimedes' principle and the flexural strength was obtained by the biaxial flexure test. The optical properties were measured using a spectrophotometer operating in the visible light wavelength range. The step-stress accelerated life testing was performed by the pneumatic mechanical cycler and the biological behavior achieved by using osteoblast-like cells (Osteo-1 cell line). Results Tetragonal zirconia was identified in all groups and cubic zirconia was identified only at 3Y-TZP group. The addition of TiO2 decreased the values of density and flexural strength of the composite 3Y-TZP/TiO2 in relation to 3Y-TZP regardless of the sintering temperature. The color difference between the two materials was not significant regarding L*a*b* parameters. The composite showed higher probability of failure, and induced higher proliferation and differentiation than control. Significance The composite developed have good aesthetic and biologics properties. However, its microstructure and mechanical properties need to be improved for future dental implant applications.

A evolução dos sistemas informatizados para a produção de restaurações dentárias associadas ao desenvolvimento de novas microestruturas para materiais cerâmicos causou uma mudança importante no fluxo de trabalho clínico de dentistas e técnicos, bem como nas opções de tratamento oferecidas aos pacientes. Novas microestruturas também foram desenvolvidas pela indústria para oferecer materiais cerâmicos e compósitos com propriedades otimizadas, ou seja, boas propriedades mecânicas, comportamento adequado ao desgaste e características estéticas aceitáveis. O objetivo desta revisão de literatura é discutir as principais vantagens e desvantagens dos novos sistemas cerâmicos e métodos de processamento. O manuscrito está dividido em cinco partes: I) restaurações monolíticas de zircônia; II) próteses dentárias multicamadas; III) novas vitrocerâmicas; IV) cerâmica infiltrada por polímero; e V) novas tecnologias de processamento. As cerâmicas dentárias e as tecnologias de processamento evoluíram significativamente nos últimos dez anos, com a maior parte da evolução relacionada a novas microestruturas e métodos CAD-CAM. Além disso, uma tendência ao uso de restaurações monolíticas mudou a maneira como os médicos produzem próteses dentárias totalmente em cerâmica, uma vez que as restaurações mais estéticas em várias camadas, infelizmente, são mais propensas a lascar ou delaminar. Os materiais compósitos processados ​​via CAD-CAM tornaram-se uma opção interessante, pois possuem propriedades intermediárias entre cerâmica e polímeros e são mais facilmente fresados ​​e polidos.

The aims of this study were: 1) to evaluate the effect of sintering temperature on microstructure, density and flexural strength of a 3Y-TZP/TiOThe 3Y-TZP and 3Y-TZP/TiOTetragonal zirconia was identified in all groups and cubic zirconia was identified only at 3Y-TZP group. The addition of TiOThe composite developed have good aesthetic and biologics properties. However, its microstructure and mechanical properties need to be improved for future dental implant applications.

Objective To investigate the effect of titania addition (0, 10 and 30 mol%) on the microstructure, relative density, Young’s modulus (E), Poisson’s ratio (υ), mechanical properties (flexural strength, σf, and Weibull modulus, m) of a Y-TZP/TiO2 composite. The effect of the presence of a biomimetic coating on the microstructure and mechanical properties was also evaluated. Methods Y-TZP (3 mol% of yttria) and Y-TZP/TiO2 composite (10 or 30 mol% of titania) were synthesized by co-precipitation. The powders were pressed and sintered at 1400°C/2 h. The surfaces, with and without biomimetic coating, were characterized by X-ray diffraction analysis and scanning electron microscopy. The relative density was measured by the Archimedes’ principle. E and υ were measured by ultrasonic pulse-echo method. For the mechanical properties the specimens (n = 30 for each group) were tested in a universal testing machine. Results Titania addition increased the grain size of the composite and caused a significant decrease in the flexural strength (in MPa, control 815.4a; T10 455.7b and T30 336.0c), E (in GPa, control 213.4a; T10 155.8b and T30 134.0c) and relative density (control 99.0%a; T10 94.4%c and T30 96.3%b) of the Y-TZP/TiO2 composite. The presence of 30% titania caused substantial increase in m and υ. Biomimetic coating did not affect the mechanical properties of the composite. Significance The Y-TZP/TiO2 composite coated with a layer of CaP has great potential to be used as implant material. Although addition of titania affected the properties of the composite, the application of a biomimetic coating did not jeopardize its reliability.

Capítulo 1. A investigação teve como objetivo desenvolver filmes finos de sílica micropadronizada (FFSM) contendo micro-agregados de nanohidroxiapatita (nanoHA) que não ficassem totalmente cobertos pela sílica e assim pudessem interagir diretamente com as células vizinhas e o objetivo específico foi avaliar o efeito da presença de dois filmes (FFSM com ou sem a adição de nanohidroxiapatita) na resistência característica (?0) e no módulo de Weibull (m) de uma Y-TZP. Processamento sol-gel e litografia foram usados para aplicar o FFSM sobre os espécimes de Y-TZP. Três grupos experimentais foram produzidos: Y-TZP, Y-TZP+FFSM e Y-TZP+FFSM+nanoHA borrifada. Todas as superfícies foram caracterizadas por MEV/EDS e testadas em resistência à flexão em quatro pontos (n=30) em água a 37°C. A análise de Weibull foi usada para determinar ?0 e m (método de probabilidade máxima). A Y-TZP foi recoberta com êxito com o FFSM e FFSM+nanoHA. Micrografias indicaram que os micro-agregados de nanoHA não foram totalmente cobertos pela sílica. Não houve diferença estatisticamente significativa entre os grupos experimentais para ?0 e m. Essa investigação obteve sucesso em produzir filmes finos de sílica micropadronizada contendo micro-agregados de nanoHA que permaneceram expostos ao meio ambiente. Os filmes desenvolvidos não prejudicaram a confiabilidade estrutural da Y-TZP comercial, como confirmado pela estatística de Weibull. Capítulo 2. Objetivos: avaliar o efeito da concentração de vidro bioativo (VB), de zero e 10% em massa e da temperatura de sinterização (1.200°C e 1.300°C) na microestrutura, densidade relativa e resistência à flexão do compósito Y-TZP/VB. Material e métodos: os pós de Y-TZP e Y-TZP/VB foram prensados uniaxialmente e sinterizados a 1.200°C e 1.300°C por 1 hora. A microestrutura foi caracterizada pela análise de difração de raios X, microscopia eletrônica de varredura e espectroscopia de energia dispersiva (EDS). A densidade relativa foi calculada por meio dos valores de densidade obtidos pelo princípio de Archimedes. Para a resistência à flexão, espécimes (n=6) foram fraturados no teste de resistência à flexão biaxial usando um dispositivo de pistão sobre 3 esferas em uma máquina universal de ensaios. Resultados: a adição de VB diminuiu o tamanho de grão do compósito, aumentou as porosidades e causou uma diminuição significativa na densidade relativa (Y-TZP/1.300°C=97,7%a; Y-TZP/1.200°C=91,1%b; Y-TZP/VB/1.300°C 79,7%c e Y-TZP/VB/1.200°C 77,4%d) e diminuiu também significativamente a resistência à flexão (em MPa, Y-TZP/1.300°C=628,3a; Y-TZP/1.200°C=560,8b; Y-TZP/VB=1.300°C=189,1c e Y-TZP/VB/1.200°C=153,0c). As fases cristalinas de zircônia cúbica estabilizada por cálcio e silicato de sódio zircônio foram formadas após a adição de VB. Conclusão: a adição de vidro bioativo na Y-TZP aumentou a porosidade e resultou na formação de zircônia cúbica estabilizada com cálcio e silicato de sódio zircônio. A adição de vidro também resultou na diminuição do tamanho de grão, densidade e resistência à flexão. Os espécimes sinterizados a 1.300°C mostraram valores de densidade superior e grãos maiores quando comparados ao grupo sinterizado a 1.200°C. Chapter 1. This investigation aimed at developing micropatterned silica thin films (MSTF) containing nanoHA micro-aggregates that were not completely covered by silica so that they could directly interact with the surrounding cells and the specific objectives was to evaluate the effect of the presence of two films (MSTF with or without nanoHA addition) on the characteristic strength (?0) and Weibull modulus (m) of a Y-TZP. Sol-gel process and soft-lithography were used to apply the MSTF onto the Y-TZP specimens. Three experimental groups were produced: Y-TZP, Y-TZP+MSTF and Y-TZP+MSTF+sprayed nanoHA. All surfaces were characterized by SEM/EDS and tested for four-point flexural strength (n=30) in water at 37°C. Weibull analysis was used to determine m and ?0 (maximum likelihood method). Y-TZP was successfully coated with MSFT and MSFT+nanoHA. SEM micrographs indicated that the micro-aggregates of nanoHA were not entirely covered by the silica. There was no statistically significant difference among the experimental groups for ?0 and m. This investigation was successful in producing a micropatterned silica thin film containing nanoHA micro-aggregates that remained exposed to the environment. The developed films did not jeopardize the structural reliability of a commercial Y-TZP, as confirmed by the Weibull statistics. Chapter 2. Objectives: to evaluate the effect the bioactive glass (BG) concentration (0 and 10wt%) and the sintering temperature (1.200°C and 1.300°C) on the microstructure, relative density and flexural strength of the composite Y-TZP/BG. Methods: The Y-TZP and Y-TZP/BG powders were uniaxially pressed and sintered at 1.200°C or 1.300°C for 1 h. The microstructure was characterized by X-ray diffraction analysis, scanning electron microscopy and Energy Dispersive X-ray Spectroscopy. Relative density was calculated from density values obtained using the Archimedes\' principle. For the flexural strength, specimens (n=6) were fractured in a biaxial flexural setup using a piston-on-3-balls fixture in a universal testing machine. Results: BG addition decreased the grain size of the composite, increased porosity and caused a significant decrease in the relative density (Y-TZP/1.300°C=97.7%a; Y-TZP/1.200°C=91.1%b; Y-TZP/BG/1.300°C 79.7%c and Y-TZP/BG/1.200°C 77.4%d) and flexural strength (in MPa, Y-TZP/1.300°C=628.3a; Y-TZP/1.200°C=560.8b; Y-TZP/BG=1.300°C=189.1c and Y-TZP/BG/1.200°C=153.0c). The crystalline phases of calcium stabilized cubic zirconia and sodium zirconium silicate were formed after the addition of BG. Conclusion: Addition of bioactive glass to Y-TZP increased porosity and resulted in the formation of calcium stabilized cubic zirconia and sodium zirconium silicate. Also, glass addition resulted in decrease in grain size, density and flexural strength. Composite specimens sintered at 1.300°C showed the highest density values and larger grains compared to those sintered at 1.200°C

Aims To evaluate the effect of the processing method (conventional sintering, S, and heat-pressing, HP) and addition of potassium titanate fibers, PTF, on the microstructure, mechanical properties (flexural strength, σ f , and Weibull parameters, m and σ 5% ), slow crack growth parameters n (stress corrosion susceptibility coefficient), and optical properties (translucency parameter, TP, and opalescence index, OI) of a feldsphatic dental porcelain. Methods Disks ( n =240, O12×1 mm) of porcelain (Vintage-Halo, Shofu) were produced using S and HP methods with and without addition of 10 wt% (conventional sintering) or 5 wt% (heat-pressing) of PTF. For the S method, porcelain was sintered in a conventional furnace. In the HP technique, refractory molds were produced by lost wax technique. The porcelain slurry was dry-pressed (3 t/30 s) to form a cylinder with 12 mm (diameter) and 20 mm (height), which was heat-pressed for 5 min/3.5 bar into the mold. Specimens were tested for biaxial flexural strength in artificial saliva at 37 °C. Weibull analysis was used to determine m and σ 5% . Slow crack growth (SCG) parameters were determined by the dynamic fatigue test, and specimens were tested in biaxial flexure at five stress rates: 10 −2 , 10 −1 , 10 0 , 10 1 and 10 2 MPa/s ( n =10), immersed in artificial saliva at 37 °C. Parameter n was calculated and statistically analyzed according to ASTM F394-78. Optical properties were determined in a spectrophotometer in the diffuse reflectance mode. Results The highest n value was obtained by the combination of heat-pressing with fiber addition (37.1) and this value was significantly higher than those obtained by both sintered groups (26.2 for control group and 27.7 for sintered with fiber). Although heat-pressing alone also resulted in higher n values compared to the sintered groups, there were no significant differences among them. Fiber addition had no effect on mechanical strength, but it resulted in decreased TP values and increased OI values for both processing methods. Heat-pressing alone was able to reduce the porosity level of the porcelain. Conclusions Addition of PTF combined with heat-pressing can reduce strength degradation of a dental porcelain compared to sintered materials with or without fibers. Heat-pressing (HP) alone should be considered as a good alternative for clinical cases where high translucency is required.

To investigate the effect of titania addition (0, 10 and 30mol%) on the microstructure, relative density, Young's modulus (E), Poisson's ratio (υ), mechanical properties (flexural strength, σY-TZP (3mol% of yttria) and Y-TZP/TiOTitania addition increased the grain size of the composite and caused a significant decrease in the flexural strength (in MPa, control 815.4The Y-TZP/TiO

Os objetivos desse trabalho foram: 1) determinar o efeito do conteúdo de titânia em mol % (zero, 10 e 30) na área de superfície específica (SBET), no tamanho dos aglomerados e na intensidade dos picos correspondentes às fases cristalinas presentes no pó cerâmico de Y-TZP/TiO2; 2) determinar o efeito do conteúdo de titânia em mol % (zero, 10 e 30) na microestrutura, densidade, densidade relativa, módulo de elasticidade, coeficiente de Poisson, módulo de Weibull (m) e resistência à flexão (f) de pastilhas cerâmicas sinterizadas de Y-TZP/TiO2 e, 3) determinar o efeito do recobrimento biomimético no módulo de Weibull (m) e na resistência á flexão de pastilhas cerâmicas sinterizadas de Y-TZP/TiO2. Os pós foram produzidos por meio de uma rota de co-precipitação, obtendo-se três composições do compósito Y-TZP/TiO2, que foram de zero (T0), 10 (T10) e 30 (T30) % mol de titânia. O pó produzido foi prensado (50 MPa) para produzir pastilhas de 15 mm de diâmetro e sinterizado a 1400 °C por 2 horas. Após o polimento com solução diamantada de 45 m, as pastilhas (n=60 para cada grupo) ficaram com aproximadamente 12 mm de diâmetro e 1,0 mm de espessura. Metade das pastilhas foram submetidas ao recobrimento biomimético (sete dias em solução de silicato de sódio e sete dias em solução de 1,5 SBF-simulated body fluid). Os pós foram caracterizados por difração de raios-X (DRX), espalhamento a laser, adsorção gasosa e microscopia eletrônica de varredura (MEV). As pastilhas foram caracterizadas pelo método de Archimedes, pulso-eco ultra-ssônico, MEV, DRX e para a análise de Weibull, as pastilhas foram submetidas ao ensaio de resistência à flexão biaxial em saliva artificial a 37°C. Os resultados mostraram que todos os pós apresentaram zircônia monoclínica e tetragonal na sua composição e uma área de superfície específica superior a 42 m2/g. A adição de titânia favoreceu a formação de aglomerados maiores e com uma distribuição bimodal. Em todas as pastilhas foram detectadas zircônia monoclínica e tetragonal, enquanto no grupo T30 também foi detectada a fase de titanato de zircônia (ZrTiO4). O grupo T0 apresentou os maiores valores de densidade medida (6,05 g/cm3), densidade relativa (99,0%), módulo de elasticidade (213 GPa) e resistência à flexão (815 MPa). A adição de titânia reduziu significativamente a densidade medida (5,45 g/cm3 para T10 e 5,15 g/cm3 para T30) a densidade relativa (94,4% para T10 e 96,3% para o T30) o módulo de elasticidade (156 GPa para T10 e 134 GPa para o T30) e a resistência à flexão (455 MPa para o grupo T10 e 336 MPa para o grupo T30) do compósito Y-TZP/TiO2. O grupo T30 apresentou um módulo de Weibull (11,7) e um coeficiente de Poisson (0,34) significativamente superior ao grupo T0 (6,4 e 0,31, respectivamente). Foi observado que o recobrimento biomimético promoveu a formação de glóbulos de hidroxiapatita distribuídos de forma heterogênea na superfície do material e que esse tratamento não alterou significativamente a resistência à flexão e o módulo de Weibull do compósito Y-TZP/TiO2. Conclui-se que a adição de titânia afetou as propriedades estudas do pó e das pastilhas do compósito de Y-TZP/TiO2. Além disso, o compósito pode ser recoberto com uma camada hidroxiapatita sem ter sua confiabilidade estrutural afetada. The objectives of this study were: 1) to determine the effect of titania content in mol% (zero, 10 and 30) in the specific surface area (SBET), the size of the agglomerates and the intensity of the peaks corresponding to crystalline phase present in the ceramic powder of Y-TZP/TiO2; 2) to determine the effect of the content in mol% of titania (zero, 10 and 30) in the microstructure, density, relative density, modulus of elasticity, Poisson\'s ratio, Weibull modulus (m) and flexural strength (f) of ceramic discs sintered from Y-TZP/TiO2 and 3) to determine the effect of biomimetic coating on the Weibull modulus (m) and the flexural strength of the sintered ceramic discs of Y-TZP/TiO2. The powders were produced by a co-precipitation route, in order to obtain the composite Y-TZP/TiO2 with three compositions, containing zero (T0), 10 (T10) and 30 (T30) mol% titania. The produced powder was pressed (50 MPa) into discs of 15 mm diameter and sintered at 1400 °C for 2 hours. After polishing with diamond solution of 45 m, the discs (n = 60 for each group) were approximately 12 mm in diameter and 1.0 mm-thick. Half of the discs were subjected to biomimetic coating (seven days with sodium silicate solution and seven days in 1,5 SBF-simulated body fluid solution ). The powders were characterized by X-ray diffraction (XRD), laser scattering, gas adsorption and scanning electron microscopy (SEM). The discs were characterized by the Archimedes method, ultrasonic pulse-echo, SEM, XRD and for the Weibull analysis, the discs were subjected to the test of biaxial flexural strength in artificial saliva at 37 °C. The results showed that all powders had monoclinic and tetragonal zirconia in their composition, and a specific surface area greater than 42 m2/g. The titania addition favored the formation of larger agglomerates and a bimodal distribution. In all discs monoclinic and tetragonal zirconia were detected, while in the T30 group zirconium titanate (ZrTiO4) was also detected. T0 group had the highest measured density (6,05 g/cm3), relative density (99,0%), elasticity modulus (213 GPa) and flexural strength (815 MPa). The addition of titania significantly reduced the measured density (5,45 g/cm3 for T10 group and 5,15 g/cm3 for T30 group), the relative density (94,4% for T10 group and 96,3% for T30 group), elasticity modulus (156 GPa for T10 group and 134 GPa for T30 group) and flexural strength (455 MPa for T10 group and 336 MPa for T30 group) of the Y-TZP/TiO2 the composite. The T30 group showed a Weibull modulus (11,7) and Poisson\'s ratio (0,34) significantly higher than those of T0 group (6,4 and 0,31). It was observed that the biomimetic coating resulted in the formation of apatite globules heterogeneously distributed on the surface of the material and that this treatment did not significantly alter the flexural strength and Weibull modulus of the composite Y-TZP/TiO2. It is concluded that the addition of titania affects the studied properties of the powder and discs of the composite Y-TZP/TiO2. Also, the composite can be coated with a layer of calcium phosphate without affecting its structural reliability.