Effect of pigmentation techniques on the fatigue mechanical behavior of a translucent zirconia for monolithic restorations.

This study aims to characterize the effect of pre- and/or post-sintering pigmentation techniques on the fatigue behavior of a 4YSZ ceramic (4 mol% yttrium stabilized zirconia). First, 4YSZ ceramic discs (IPS e.max ZirCAD, 15 mm diameter, and 1.2 mm thickness) were obtained and allocated according to the 'pigmentation technique' factor into 5 groups: Ctrl - unshaded ceramic disc (IPS e.max ZirCAD BL); Manuf - ceramic discs shaded by the manufacturer at block formation (IPS e.max ZirCAD MT A2); Brush - unshaded ceramic disc pigmented in the pre-sintered stage using a brush; Stain - unshaded ceramic disc pigmented in the post-sintering stage using a stain glaze (shade A2); Brush + Stain - combination of Brush and Stain techniques. The specimens were sintered and analyzed by a spectrophotometer (VITA Easyshade) for color differences (ΔE calculated according to CIEDE, 2000) to ensure that they present the same perceived color (ΔE ≤ 1.77, acceptability threshold). The specimens (n = 15) were submitted to biaxial flexural fatigue testing using a cyclic fatigue method (frequency of 20 Hz; 10,000 cycles per step; initial stress of 200 MPa; and step-size of 25 MPa) until specimen fracture. Fatigue strength (FS) and number of cycles until failure (CFF) were recorded with statistical purposes. Fractographic, complementary topography, elemental and roughness analyses were performed. The Ctrl shown the highest FS, CFF, and survival rates compared to the other conditions (p < 0.05), being only statistically similar to Brush. Stain showed the lowest FS, CFF and survival rates (p < 0.05). The Manuf and Brush + Stain shown intermediary performance. In regards of Weibull moduli, Brush shown the lowest values (lowest structural reliability), for both FS and CFF, being only statistically similar to Manuf. Topography analysis shown a uniform size of zirconia crystals in Ctrl, Manuf and Brush. In addition, a smooth glassy surface with some spots of impregnated pigment was observed in the groups where glaze was applied (Stain and Brush + Stain). This finding was corroborated by elemental analysis. Despite that, Stain and Brush + Stain presented the roughest surface (p < 0.05). In summary, the pigmentation techniques used to provide a Vita classical A2 color shade have a detrimental effect on the mechanical fatigue properties of a 4YSZ ceramic, except for the technique performed with the brush in the block pre-sintering stage. Despite this, the brush technique presents great variability in mechanical performance, resulting in lower structural reliability.