Biomaterials Translational ›› 2023, Vol. 4 ›› Issue (3): 151-165.doi: 10.12336/biomatertransl.2023.03.004
• REVIEW • Previous Articles Next Articles
Mugilan Thanigachalam*,#(
), Aezhisai Vallavi Muthusamy Subramanian#
Received:2023-06-30
Revised:2023-08-07
Accepted:2023-09-08
Online:2023-09-28
Published:2023-09-28
Contact:
*Mugilan Thanigachalam,
Thanigachalam, M.; Subramanian, A. V. M. Fabrication, microstructure and properties of advanced ceramic-reinforced composites for dental implants: a review. Biomater Transl. 2023, 4(3), 151-165.
Figure 1. Materials and factors considered in the design of dental implants. AZT: alumina–toughened zirconia; Y–TZP: yttria–stabilised tetragonal zirconia polycrystalline; ZrO2: zirconium dioxide; ZTA: zirconia–toughened alumina.
Figure 2. Ceramic matrix composite fabrication processes. CMCs: ceramic matrix composites; CVD: chemical vapour deposition; PVD: physical vapour deposition.
| Implant material | Product name | Manufacturer |
|---|---|---|
| Alumina–toughened zirconia | ZERAMEX (P)lus | Dental point AG, Spreitenbach, Switzerland |
| FairWhiteTM | Fair implant, Schleswig–Holstein, Germany | |
| SDS – Swiss Dental Solutions 1.0 DT | SDS Swiss Dental Solutions AG, Kreuzlingen, Switzerland | |
| Yttria–stabilised tetragonal zirconia polycrystalline | CeraRoot | CeraRoot S.L, Barcelona, Spain |
| Ceralog | Camlog System, Basel, Switzerland | |
| SDS 2.2 | SDS AG, Kreuzlingen, Switzerland | |
| ICX–White | MKI GmbH &Co.KG, Stuttgart, Germany | |
| REPLICATETM System | Natural Dental Implant AG, Berlin, Germany | |
| Zirconia oxide | Konus K3Pro ZirKon Implant system | Argon Medical Productions, Plano, TX, USA |
| Easy Kon | General Implants, Wurmlingen, Germany | |
| Whitesky | Bredent medical, Senden, Germany | |
| CeraRoot | ||
| (S)andard ZV3 | ZV3–ZirconVison GmbH, Munchen, Germany | |
| Ceramic implant | VITA Zahnfabrik, Wurttemberg, Germany |
Table 1. Implant manufacturers and zirconia implant materials
| Implant material | Product name | Manufacturer |
|---|---|---|
| Alumina–toughened zirconia | ZERAMEX (P)lus | Dental point AG, Spreitenbach, Switzerland |
| FairWhiteTM | Fair implant, Schleswig–Holstein, Germany | |
| SDS – Swiss Dental Solutions 1.0 DT | SDS Swiss Dental Solutions AG, Kreuzlingen, Switzerland | |
| Yttria–stabilised tetragonal zirconia polycrystalline | CeraRoot | CeraRoot S.L, Barcelona, Spain |
| Ceralog | Camlog System, Basel, Switzerland | |
| SDS 2.2 | SDS AG, Kreuzlingen, Switzerland | |
| ICX–White | MKI GmbH &Co.KG, Stuttgart, Germany | |
| REPLICATETM System | Natural Dental Implant AG, Berlin, Germany | |
| Zirconia oxide | Konus K3Pro ZirKon Implant system | Argon Medical Productions, Plano, TX, USA |
| Easy Kon | General Implants, Wurmlingen, Germany | |
| Whitesky | Bredent medical, Senden, Germany | |
| CeraRoot | ||
| (S)andard ZV3 | ZV3–ZirconVison GmbH, Munchen, Germany | |
| Ceramic implant | VITA Zahnfabrik, Wurttemberg, Germany |
Figure 3. Grain growth development by densification.
Figure 4. Appropriate fabrication techniques for various crystalline phases. 12Ce–TZP: 12 ceria stabilized tetragonal zirconia polycrystals; 3Y–TZP: 3 yttriastabilised tetragonal zirconia polycrystalline.
Figure 5. Classification of sintering processes.
| Sintering method | Sintering temperature (°C) | Holding time (minutes) | Relative density (%) | Grain size (nm) | Codesa | |
|---|---|---|---|---|---|---|
| Zirconia | Alumina | |||||
| Microwave sintering (MW) | 1200 | 10 | 98.5 | 210±64 | 270±84 | MW120010 |
| 1200 | 30 | 99 | 240±67 | 300±100 | MW120030 | |
| 1300 | 10 | 99.8 | 280±75 | 400±157 | MW130010 | |
| 1300 | 30 | 99.8 | 280±70 | 380±146 | MW130030 | |
| Conventional sintering (CS) | 1400 | 120 | 98.3 | 240±41 | 350±98 | CS1400120 |
| 1500 | 120 | 99.2 | 330±56 | 450±100 | CS1500120 | |
Table 2. Summary of the sintering process of alumina–toughened zirconia
| Sintering method | Sintering temperature (°C) | Holding time (minutes) | Relative density (%) | Grain size (nm) | Codesa | |
|---|---|---|---|---|---|---|
| Zirconia | Alumina | |||||
| Microwave sintering (MW) | 1200 | 10 | 98.5 | 210±64 | 270±84 | MW120010 |
| 1200 | 30 | 99 | 240±67 | 300±100 | MW120030 | |
| 1300 | 10 | 99.8 | 280±75 | 400±157 | MW130010 | |
| 1300 | 30 | 99.8 | 280±70 | 380±146 | MW130030 | |
| Conventional sintering (CS) | 1400 | 120 | 98.3 | 240±41 | 350±98 | CS1400120 |
| 1500 | 120 | 99.2 | 330±56 | 450±100 | CS1500120 | |
Figure 6. (A) Fracture surface, where three different regions are distinguished: notch (a), micro–cracked area (b), and regular fracture surface (c). (B) The cross–sectional view obtained by focused ion beam analysis of the fracture surface. Reprinted from Turon–Vinas and Anglada.38 Copyright 2018 The Academy of Dental Materials.
Figure 7. Fracture morphologies of porous Si3N4–Si3N4 composite ceramics as a function of deposition time: (A) 0, (B) 3, (C) 6, (D) 9, and (E) 12 hours. Scale bars: 30 μm. Si3N4: silicon nitride. Reprinted from Cheng et al.43
Figure 8. Scanning electron microscopic images of fracture surfaces. Scale bars: 100 μm (A), 10 μm (B, D), 50 μm (C). Reprinted from Liu et al.4 Copyright 2019 Elsevier Ltd and Techna Group S.r.l.
Figure 9. Effect of sintering temperature on Vickers hardness of alumina ceramics.
Figure 10. Effect of zirconia addition on elastic modulus and Vickers hardness at various sintering temperatures. ZrO2: zirconium dioxide.
Figure 11. Toughening mechanism in zirconia against crack propagation. ZrO2: zirconium dioxide.
Figure 12. Effect of ZrO2 content on fracture toughness at various grain sizes. ZrO2: zirconium dioxide.
Figure 13. Effect of ZrO2 content on flexural strength at various sintering temperatures. ZrO2: zirconium dioxide.
Figure 14. Mechanical properties of different implant materials. (A) Elastic modulus. (B) Vickers hardness. (C) Fracture toughness. (D) Flexural strength. Al2O3: aluminium dioxide; AZT: alumina toughened zirconia; TPZ: tetragonal phase zirconia; Y–TZP: Yttria–stabilised tetragonal zirconia polycrystalline; ZTA: zirconia toughened alumina.
| Studies | Ceramic composites | Method of mixing | Conditions for sintering | Results |
|---|---|---|---|---|
| Liu et al. | Al2O3–ZrB2–MgO/Al2O3–TiN–MgO | Planetary ball milling machine, alumina ball to powder ratio 1:3 | Hot pressed, vacuum at 1650°C, 60 minutes under 35 MPa. | Flexural strength = 654 ± 43 MPa, fracture toughness = 8.7 ± 0.2 MPa·m1/2, Vickers hardness = 20.1 ± 0.5 GPa, elastic modulus = 351 GPa |
| Tovar–Vargas et al. | Yttrium doped ZrO2–Al2O3 composite powders with partially stabilised ZrO2 (PSZ) | Wet ball milling | Pressing (370 MPa); Sintering (1600°C/5 hours) | Highest Kc ~8.40 ± 0.4 MPa and hardness ~16.31 ± 0.58 GPa were obtained for the 30 wt% PSZ–Al2O3 |
| Smirnov et al. | Hierarchical tantalum–graphene flakes reinforced zirconia | Ball milling | Spark plasma sintering (maximum temperatures of 1400 and 1500°C under vacuum at a heating rate of 100°C/min, and applied pressure of 80 MPa) | Flexural strength 30% increment and toughness 175% increase compared to monolithic Zr |
| Liu et al. | ρ–Al2O3 | Wet–milled with a rotating speed of 300 r/min for 3 hours | Compacted at 10 MPa, sintered at a heating rate of 5°C/min to 1600°C, 3 hours | Hot modulus of rupture = 6.26 MPa, thermal shock resistance = 2.53 |
| Yan et al. | ZrB2–SiC–Ni | Ball–milled for 12 hours | Spark plasma sintering | Fracture toughness = 8.3 MPa, |
| Smirnov et al. | 3Y–TZP/Ta | High–energy ball milling | spark plasma sintering, vacuum (≈ 1 × 102 Mbar) at 1400°C, 200°C/min | Flexural strength = 967 MPa, surface roughness Ra = 0.3 ± 0.1 |
| Prajzler et al. | Alumina based zirconia ceramics | Ball milling | Pressureless rapid rate sintering (100°C/min to 1500°C/min) | Nearly total density (> 95% TD) without forming cracks or other structural defects. |
| Ke et al. | WcoB–TiC | Planetary ball milling machine | Sintering at 1500°C, 60 minutes | Hardness = 91.6 HRA, transverse rapture strength = 1783 MPa. |
| Cheng et al. | Porous Si3N4–Si3N4 | Ball milling | Sintering and 3D printing combined with low–pressure chemical vapour infiltration | Density increased from 0.99 to 2.02 g/cm3 flexural strength of 47 ± 2 MPa |
| Manshor et al. | TiO2 (ZTA–TiO2) Cr2O3 | Ball milling | Sintering 1600°C for 1 hour with 5°C/min | Fracture toughness increased to 7.15 MPa·m1/2 by adding up to 0.6 wt% Cr2O3 |
| Zhu et al. | MgTiO3/CaO–B2O3–SiO2 | Ball milling with ethyl alcohol for 300 minutes | Sintered at 810°C, 120 minutes | Bulk density = 3.1270 g/cm3, flexural strength = 214.85 MPa |
| Wang et al. | Al2O3/TiC | Hybrid slurries form ball–milling for 60 hours | Hot–pressing sintering 1700–1750°C in a nitrogen atmosphere, 35 MPa | Fracture toughness = 97 MPa·m1/2, Vickers hardness = 37 GPa |
| Zhang et al. | SiAlON–Si3N4 | Ball milling | Reaction–bonded sintering, 4°C/min to 1500°C | Compressive strength = 185 MPa |
| Zhao et al. | ZrB2–SiC–Ni | Ball–milled for 12 hours using ZrO2 ball media | Spark plasma sintering, 1400°C for 1 minute, 200°C/min | Hardness = 20.2 GPa, elastic modulus of ZS =53.7 GPa |
| Li et al. | CM2A8 (CaMg2Al16O27) and C2M2A14 (Ca2Mg2Al28O46) | Calcinated at 900°C for 1 hour | Hot press sintering 1750°C, 15 MPa. | Vickers hardness = 12.95 GPa, fracture toughness = 2.17 MPa, flexural strength = 248 MPa |
Table 3. Systematic literature collection of results from recent research
| Studies | Ceramic composites | Method of mixing | Conditions for sintering | Results |
|---|---|---|---|---|
| Liu et al. | Al2O3–ZrB2–MgO/Al2O3–TiN–MgO | Planetary ball milling machine, alumina ball to powder ratio 1:3 | Hot pressed, vacuum at 1650°C, 60 minutes under 35 MPa. | Flexural strength = 654 ± 43 MPa, fracture toughness = 8.7 ± 0.2 MPa·m1/2, Vickers hardness = 20.1 ± 0.5 GPa, elastic modulus = 351 GPa |
| Tovar–Vargas et al. | Yttrium doped ZrO2–Al2O3 composite powders with partially stabilised ZrO2 (PSZ) | Wet ball milling | Pressing (370 MPa); Sintering (1600°C/5 hours) | Highest Kc ~8.40 ± 0.4 MPa and hardness ~16.31 ± 0.58 GPa were obtained for the 30 wt% PSZ–Al2O3 |
| Smirnov et al. | Hierarchical tantalum–graphene flakes reinforced zirconia | Ball milling | Spark plasma sintering (maximum temperatures of 1400 and 1500°C under vacuum at a heating rate of 100°C/min, and applied pressure of 80 MPa) | Flexural strength 30% increment and toughness 175% increase compared to monolithic Zr |
| Liu et al. | ρ–Al2O3 | Wet–milled with a rotating speed of 300 r/min for 3 hours | Compacted at 10 MPa, sintered at a heating rate of 5°C/min to 1600°C, 3 hours | Hot modulus of rupture = 6.26 MPa, thermal shock resistance = 2.53 |
| Yan et al. | ZrB2–SiC–Ni | Ball–milled for 12 hours | Spark plasma sintering | Fracture toughness = 8.3 MPa, |
| Smirnov et al. | 3Y–TZP/Ta | High–energy ball milling | spark plasma sintering, vacuum (≈ 1 × 102 Mbar) at 1400°C, 200°C/min | Flexural strength = 967 MPa, surface roughness Ra = 0.3 ± 0.1 |
| Prajzler et al. | Alumina based zirconia ceramics | Ball milling | Pressureless rapid rate sintering (100°C/min to 1500°C/min) | Nearly total density (> 95% TD) without forming cracks or other structural defects. |
| Ke et al. | WcoB–TiC | Planetary ball milling machine | Sintering at 1500°C, 60 minutes | Hardness = 91.6 HRA, transverse rapture strength = 1783 MPa. |
| Cheng et al. | Porous Si3N4–Si3N4 | Ball milling | Sintering and 3D printing combined with low–pressure chemical vapour infiltration | Density increased from 0.99 to 2.02 g/cm3 flexural strength of 47 ± 2 MPa |
| Manshor et al. | TiO2 (ZTA–TiO2) Cr2O3 | Ball milling | Sintering 1600°C for 1 hour with 5°C/min | Fracture toughness increased to 7.15 MPa·m1/2 by adding up to 0.6 wt% Cr2O3 |
| Zhu et al. | MgTiO3/CaO–B2O3–SiO2 | Ball milling with ethyl alcohol for 300 minutes | Sintered at 810°C, 120 minutes | Bulk density = 3.1270 g/cm3, flexural strength = 214.85 MPa |
| Wang et al. | Al2O3/TiC | Hybrid slurries form ball–milling for 60 hours | Hot–pressing sintering 1700–1750°C in a nitrogen atmosphere, 35 MPa | Fracture toughness = 97 MPa·m1/2, Vickers hardness = 37 GPa |
| Zhang et al. | SiAlON–Si3N4 | Ball milling | Reaction–bonded sintering, 4°C/min to 1500°C | Compressive strength = 185 MPa |
| Zhao et al. | ZrB2–SiC–Ni | Ball–milled for 12 hours using ZrO2 ball media | Spark plasma sintering, 1400°C for 1 minute, 200°C/min | Hardness = 20.2 GPa, elastic modulus of ZS =53.7 GPa |
| Li et al. | CM2A8 (CaMg2Al16O27) and C2M2A14 (Ca2Mg2Al28O46) | Calcinated at 900°C for 1 hour | Hot press sintering 1750°C, 15 MPa. | Vickers hardness = 12.95 GPa, fracture toughness = 2.17 MPa, flexural strength = 248 MPa |
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