development of new synthesised multilayered bioceramics for dental crown restorations ali ...

351 Pages·2017·17.25 MB·English

DEVELOPMENT OF NEW SYNTHESISED
MULTILAYERED BIOCERAMICS FOR DENTAL CROWN

RESTORATIONS

ALI ABDULLAH ALWAN AL-MAQTARI

DEPARTMENT OF RESTORATIVE DENTISTRY
FACULTY OF DENTISTRY
UNIVERSITY OF MALAYA
KUALA LUMPUR

2017
DEVELOPMENT OF NEW SYNTHESISED
MULTILAYERED BIOCERAMICS FOR DENTAL
CROWN RESTORATIONS

ALI ABDULLAH ALWAN AL-MAQTARI

THESIS SUBMITTED IN FULFILMENT OF THE
REQUIREMENTS FOR THE DEGREE OF DOCTOR OF
PHILOSOPHY

DEPARTMENT OF RESTORATIVE DENTISTRY
FACULTY OF DENTISTRY
UNIVERSITY OF MALAYA
KUALA LUMPUR

2017
UNIVERSITY OF MALAYA
ORIGINAL LITERARY WORK DECLARATION

Name of Candidate: ALI ABDULLAH ALWAN AL-MAQTARI (I.C/Passport No:
03042002)
Registration/Matric No: DHA080003
Name of Degree: DOCTOR OF PHILOSOPHY
Title of Project Paper/Research Report/Dissertation/Thesis (“this Work”):
Development of New Synthesised Multilayered Bioceramics for Dental Crown
Restorations.
Field of Study: Dental All-Ceramic Restoration.
RESTORATIVE DENTISRTY
I do solemnly and sincerely declare that:
(1) I am the sole author/writer of this Work;
(2) This Work is original;
(3) Any use of any work in which copyright exists was done by way of fair dealing
and for permitted purposes and any excerpt or extract from, or reference to or
reproduction of any copyright work has been disclosed expressly and
sufficiently and the title of the Work and its authorship have been
acknowledged in this Work;
(4) I do not have any actual knowledge nor do I ought reasonably to know that the
making of this work constitutes an infringement of any copyright work;
(5) I hereby assign all and every rights in the copyright to this Work to the
University of Malaya (“UM”), who henceforth shall be owner of the copyright
in this Work and that any reproduction or use in any form or by any means
whatsoever is prohibited without the written consent of UM having been first
had and obtained;
(6) I am fully aware that if in the course of making this Work I have infringed any
copyright whether intentionally or otherwise, I may be subject to legal action
or any other action as may be determined by UM.

Candidate’s Signature Date:

Subscribed and solemnly declared before,

Witness’s Signature Date:

Name: Prof. Dato' Dr. Abdul Aziz Bin Abdul Razak
Designation:

ii
UNIVERSITI MALAYA
PERAKUAN KEASLIAN PENULISAN

Nama: ALI ABDULLAH ALWAN AL-MAQTARI (No. K.P/Pasport: 03042002)
No. Pendaftaran/Matrik: DHA080003
Nama Ijazah: DOKTOR FALSAFAH
Tajuk Kertas Projek/Laporan Penyelidikan/Disertasi/Tesis (“Hasil Kerja ini”):
Development of New Synthesised Multilayered Bioceramics for Dental Crown
Restorations.

Bidang Penyelidikan: Dental All-Ceramic Restoration.

Saya dengan sesungguhnya dan sebenarnya mengaku bahawa:
(1) Saya adalah satu-satunya pengarang/penulis Hasil Kerja ini;
(2) Hasil Kerja ini adalah asli;
(3) Apa-apa penggunaan mana-mana hasil kerja yang mengandungi hakcipta telah
dilakukan secara urusan yang wajar dan bagi maksud yang dibenarkan dan apa-
apa petikan, ekstrak, rujukan atau pengeluaran semula daripada atau kepada
mana-mana hasil kerja yang mengandungi hakcipta telah dinyatakan dengan
sejelasnya dan secukupnya dan satu pengiktirafan tajuk hasil kerja tersebut dan
pengarang/penulisnya telah dilakukan di dalam Hasil Kerja ini;
(4) Saya tidak mempunyai apa-apa pengetahuan sebenar atau patut
semunasabahnya tahu bahawa penghasilan Hasil Kerja ini melanggar suatu
hakcipta hasil kerja yang lain;
(5) Saya dengan ini menyerahkan kesemua dan tiap-tiap hak yang terkandung di
dalam hakcipta Hasil Kerja ini kepada Universiti Malaya (“UM”) yang
seterusnya mula dari sekarang adalah tuan punya kepada hakcipta di dalam
Hasil Kerja ini dan apa-apa pengeluaran semula atau penggunaan dalam apa
jua bentuk atau dengan apa juga cara sekalipun adalah dilarang tanpa terlebih
dahulu mendapat kebenaran bertulis dari UM;
(6) Saya sedar sepenuhnya sekiranya dalam masa penghasilan Hasil Kerja ini saya
telah melanggar suatu hakcipta hasil kerja yang lain sama ada dengan niat atau
sebaliknya, saya boleh dikenakan tindakan undang-undang atau apa-apa
tindakan lain sebagaimana yang diputuskan oleh UM.

Tandatangan Calon Tarikh:

Diperbuat dan sesungguhnya diakui di hadapan,

Tandatangan Saksi Tarikh:

Nama: Prof. Dato' Dr. Abdul Aziz Bin Abdul Razak
Jawatan:
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ABSTRACT
Objectives. This study aimed to investigate and establish the biomechanical behaviour
of functionally graded dental ceramic cores in simulated models of a maxillary second
premolar using 3D finite element analysis. It also aimed to synthesise and evaluate the
microstructural, physical, thermal, and mechanical properties of a new multilayered
bioceramic cores. The shear bond strength of the synthesised zirconia and alumina
ceramic core with/without infiltrated graded silica with their corresponding veneering
porcelains were also evaluated. Finally, cytotoxicity effects of the new synthesised dental
bioceramic core (powders and discs) were evaluated using human gingival fibroblast
(HGF-1) cells.
Materials and Methods. An intact maxillary premolar was digitized with a CT scanner.
Eight different models (Models A-H) were developed. A total of 243 images were
obtained, and the image data was saved as files in DICOM format. Mimics software was
used for reconstruction of the data converted to the DICOM file in the 3D FE model on
the computer. The 3D FE models were constructed meshed. The models were constrained
at the bottom boundaries. A static load (200 N) was applied in three different directions
(oblique, horizontal, and vertical) at three different areas on all models. All materials were
assumed to be isotropic and homogeneous. The von Mises stress distributions along the
veneer-core-cement-dentin interfaces and interface stresses between the crown and its
surrounding structures were investigated under oblique, vertical, and horizontal loadings.
Also, strain distribution at the veneer-core-cement-dentine interfaces was also
investigated. Samples containing 0, 20, 40, and 50 wt.% of Al O particles in the Y-ZrO
2 3 2
matrix were prepared by uniaxial pressing (200 MPa) and sintered in air at 1500 °C for
2h. The microstructure (FESEM, EDX, XRD), physical (density, porosity, shrinkage),
thermal (TMA), and mechanical (Vickers hardness, compressives strength, elastic
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modulus, and strain) were characterized and analyzed. The shear bond strength was
carried out. Subsequently, all specimens were subjected to a shear load in a universal
testing machine. Fractured specimens were evaluated microscopically (SEM, EDX) to
determine the failure mode. In vitro biocompatability evaluation of synthesised ceramic
powders and discs were tested and to determine the cytotoxic level of the synthesised
ZrO –Al O ceramic composites by using the resazurin proliferation assay with HGF-1
2 2 3
cells lines after 72 h. For ceramic discs, ANOVA was used to determine statistical
significant differences among the synthesised ceramic disc groups, and also Dunnett’s
test was used for multiple comparisons. For powders ceramics, two-way ANOVA was
employed to determine the interaction influence between synthesised ceramic powders
with five different concentrations. t-test was used to compare the mean between non-
sintered and sintered synthesised ceramics. The significant level was set at 0.05.
Results and conculsions. The results showed that functionally graded structured dental
ceramic cores models, B, C, D, E, F, and G, demonstrated desirable advantages in terms
of stress distribution compared to homogenous zirconia (model A) cores. Dental ceramic
crowns with bilayered structure cores dissipated the localized and interfacial stress and
strain efficiently. Functionally graded material approach can be used to design new dental
cores in order to reduce stress concentrations and interfacial stresses successfully in the
dental crown. Fully dense ceramic materials were obtained with a Vickers hardness test
ranging between 1292.8 VH and 1711.9 VH, depending on the amount of Al O in the
2 3
ZrO matrix. There was no significant influence from the infiltrated of graded silica
2
addition to the shear bond strength. The results indicated that the shear bond strength
between zirconia/alumina cores and veneering ceramics was not affected by infiltrated
graded silica. Also, the results indicated that powder form ceramic was cytotoxic to HGF-
1 cells at higher concentrations. However, at lower concentrations powder ceramics
showed minimal toxicity. Disc ceramics showed minimal toxicity on HGF-1 cells.
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ABSTRAK
Objektif. Kajian ini bertujuan untuk menyiasat dan mewujudkan tingkah laku
biomekanik teras seramik pergigian fungsi digred berstruktur dalam model simulasi gigi
premolar kedua dgn rahang menggunakan analisis 3D unsur. Ia juga adalah untuk
mengsintesis, menilai pencirian mikrostruktur, fizikal, haba, dan mekanik teras
bioceramic berbilang lapisan yang baru. Ia juga adalah untuk menilai kekuatan ikatan
ricih zirkonia dan alumina teras seramik disintesis dengan / tanpa silika bergred
menyusup dengan porselin veneering. Dan akhirnya, untuk menyiasat dan menentukan
kesan sitotoksik disintesis gigi teras bioceramic yang baru (serbuk dan cakera)
menggunakan sel fibroblast gingival manusia (HGF-1).
Bahan dan Kaedah. Gigi premolar dangan rahang utuh telah didigitalkan dengan
pengimbas CT. Lapan model yang berbeza (Model A-H) telah dibuat. Sebanyak 243 imej
yang telah diperolehi, dan data imej telah disimpan sebagai fail dalam format DICOM.
Perisian meniru telah digunakan untuk pembinaan semula data ditukar ke fail DICOM
dalam model 3D FE pada komputer. Model-model 3D FE yang dihancurkan telah dibina.
Model-model yang telah dikekang pada sempadan bawah. Satu beban statik (200 N) telah
digunakan dalam tiga arah yang berbeza (serong, mendatar, dan menegak) di tiga
kawasan yang berbeza untuk semua model dan diedarkan pada satu kawasan. Semua
bahan telah diandaikan sebagai isotropik dan seragam. von Mises taburan tekanan di
sepanjang muka venir-core-simen-dentin dan tekanan antara muka antara mahkota dan
struktur sekitarnya disiasat mengikut hala serong, menegak, dan beban mendatar. Juga,
agihan terikan antara muka venir-core-simen-dentin juga disiasat. Sampel yang
mengandungi 0, 20, 40, dan 50 wt.% zarah Al O dalam matriks Y-ZrO telah disediakan
2 3 2
oleh ekapaksi menekan (200 MPa) dan disinter di udara pada 1500 ° C untuk 2h.
Mikrostruktur (FESEM, EDX, XRD), fizikal (ketumpatan, keliangan, pengecutan), haba
(TMA), dan mekanikal (kekerasan Vickers, compressives kekuatan, modulus elastik,
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tekanan, ricih kekuatan ikatan) telah dikaji dan dianalisis. Kekuatan ikatan ricih telah
dijalankan. Selepas itu, semua spesimen tertakluk kepada beban ricih dalam mesin ujian
universal. spesimen patah dinilai secara mikroskopik (SEM, EDX) untuk menentukan
mod kegagalan. Dalam penilaian biocompatability vitro, serbuk seramik disintesis dan
cakera telah diuji dan untuk menentukan tahap sitotoksik bagi komposit seramik ZrO -
2
Al O disintesis dengan menggunakan percambahan assay resazurin dengan HGF-1 sel
2 3
garisan selepas 72 jam.
Keputusan dan kepentingan. Hasil kajian menunjukkan bahawa fungsi digred
berstruktur gigi teras seramik model, B, C, D, E, F dan G, menunjukkan kelebihan wajar
dari segi agihan tegasan berbanding zirkonia homogen (model A) teras. mahkota seramik
pergigian dengan bilayered teras struktur lesap tekanan dan ketegangan setempat dan
antara muka cekap. pendekatan bahan berfungsi digredkan boleh digunakan untuk
merekabentuk teras gigi baru untuk mengurangkan kepekatan tekanan dan tekanan antara
muka dengan jayanya dalam mahkota gigi. bahan-bahan seramik sepenuhnya padat
diperoleh dengan kekerasan Vickers yang terdiri antara 1292,8 VH dan 1711,9 VH,
bergantung kepada jumlah Al O dalam matriks ZrO itu. Tidak terdapat pengaruh
2 3 2
penting penambahan silika bergred pada kekuatan ikatan ricih. Keputusan menunjukkan
bahawa kekuatan ikatan ricih antara teras zirconia / alumina dan seramik veneering tidak
terjejas oleh silika bergred menyusup. Juga, keputusan menunjukkan bahawa bentuk
serbuk seramik adalah sitotoksik kepada HGF-1 sel-sel pada kepekatan yang lebih tinggi.
Walau bagaimanapun, pada kepekatan yang lebih rendah, seramik serbuk menunjukkan
ketoksikan minimum. seramik cakera menunjukkan ketoksikan minimum ke atas HGF-1
sel-sel.
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ACKNOWLEDGEMENTS
First of all, I would like to express my sincerest gratitude and thanks to Allah for his
help and support.
I would also like to express my sincere gratitude to my supervisors Prof. Dato’ Dr.
Abdul Aziz Bin Abdul Razak and Prof. Dr. Mohd Hamdi Bin Abdul Shokur, for their
continuous guidance, patience, help, and support during my whole PhD period. Also, their
profound and intuition have gradually led me towards becoming a creative researcher and
an innovative thinker. Their vast knowledge in materials and mechanics always made
difficult problems seemed simple. They are true scholars and excellent mentors.
I am indebted to my friends who have provided me with stimulating encouraguement
for the last few years.
I would like to express my appreciation to the University of Malaya Grant Program
for funding this research through Grant IPPP (PV020-2011B (IPPP) and RG512-13HTM
(UMR). Also, I would like to express my appreciation to the University of Thamar
(Yemen) for supporting me during my PhD study.
Finally, I would like to express my gratitude to my family (my lovely wife Arwa, my
sweet son Haitham and my sweet daughter Raghd). Without their support and love, I
would never have succeeded. Also, I want to express my sincerest thanks and deepest
gratitude to my parents and my sisters and my brothers, for their endless support and
motivation. I greatly appreciate their numerous sacrifices that they have made to provide
me with a good education. I dedicate this dissertation to them for all their love and
support.

viii
TABLE OF CONTENTS
Abstract ........................................................................................................................... iv
Abstrak ............................................................................................................................ vi
Acknowledgements ....................................................................................................... viii
Table of Contents ........................................................................................................... ix
List of Figures ............................................................................................................... xvi
List of Symbols and Abbreviations .......................................................................... xxvii
List of Appendices ...................................................................................................... xxix
CHAPTER 1: INTRODUCTION .................................................................................. 1
1.1 Introduction.............................................................................................................. 1
1.2 Rationale of Study ................................................................................................... 6
1.3 Statement of Problem .............................................................................................. 7
1.4 Thesis Layout........................................................................................................... 7
CHAPTER 2: LITERATURE REVIEW ...................................................................... 9
2.1 Bioceramic in Dentistry ........................................................................................... 9
2.1.1 Zirconia (zirconium oxide) (ZrO2) ........................................................................ 10
2.1.1.1 Yttrium-Tetragonal Zirconia Polycrystalline (Y-TZP) ............................ 12
2.1.1.2 Partially Stabilized Zirconia (Mg-PSZ).................................................... 14
2.1.1.3 Zirconia Toughened Alumina (ZTA) ....................................................... 15
2.1.2 Alumina (aluminum oxide) (Al2O3) ...................................................................... 19
2.1.3 Glass Ceramics ...................................................................................................... 22
2.2 Modern Dental All-Ceramics ................................................................................ 23
2.2.1 Classification of Modern Dental All-Ceramics Restorations ................................ 23
2.2.1.1 Fusion Temperature .................................................................................. 24
2.2.1.2 Applications .............................................................................................. 24
2.2.1.3 Fabrication Techniques ............................................................................ 24
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