title: Cyclic Loading Effect on Color Stability of Unshaded versus Shaded Zirconia.
abstract: BACKGROUND
  Shaded versions of dental zirconia may improve initial color matching to teeth, but might change color with cyclic mechanical loading.
  
  
  OBJECTIVE
  The purpose of this study was to measure the color of unshaded and shaded zirconia dental ceramic before and after cyclic mechanical loading and calculate color differences (ΔE).
  
  
  METHODS
  Disk-shaped specimens (N = 30, Nobel Procera, 0.8 mm thick, 12 mm diameter) of unshaded or shaded zirconia (intrinsically shaded by small oxide modifications) were fabricated by the Nobel Biocare using standard CAD-CAM processing. Milled surfaces were polished. CIE L*a*b* values were measured (Konica Minolta spectrophotometer) before and after mechanical cycling (custom modified Leinfelder test machine, biaxial flexure loading, load = 80 N × 500,000 cycles, dry), and L*a*b* individual differences and ΔE color differences were calculated and compared (ANOVA, p < 0.05).
  
  
  RESULTS
  Mean L*a*b* values for the unshaded group before (U1 = 86.165, -0.887, 0.372) and after (U2 = 84.860, -0.805, 0.097) cyclic loading were compared to the shaded group before (S1 = 75.281, -0.679, 23.251) and after (S2 = 74.961, -1.233, 22.439) cyclic loading. All color variables for both unshaded and shaded groups were significantly different between before and after cyclic loading (p < .004) except for the L* value of the shaded group. The ΔE for unshaded (1.441 ± 0.495) versus shaded (1.252 ± 0.363) were statistically different but clinically the change would not be detectable at this point.
  
  
  CONCLUSIONS
  The color of the unshaded and shaded zirconia specimens was influenced by cyclic loading (p < 0.05). Color changes were detectable but small at levels up to 500,000 cycles, and remained clinically acceptable at that point.
  
  
  CONCLUSIONS
  It is important to acknowledge any possible color changes that might occur in zirconia restorations, especially in the esthetic zone. Minor color changes that are individually imperceptible to the human eye within different restorative components may be compounded to produce clinically significant color change that is not aesthetically acceptable.
authors.affiliation: Department of Prosthodontics, The National and Kapodistrian University of Athens, School of Dentistry, 2 Thivon St, 115 27 Goudi, Athens, Greece.
authors.forename: Panagiota-Eirini
authors.initials: PE
authors.lastname: Spyropoulou
authors.affiliation: Department of Prosthodontics, The National and Kapodistrian University of Athens, School of Dentistry, 2 Thivon St, 115 27 Goudi, Athens, Greece.
authors.forename: Phophi
authors.initials: P
authors.lastname: Kamposiora
authors.affiliation: Department of Biomaterials, The National and Kapodistrian University of Athens, School of Dentistry, 2 Thivon St, 115 27 Goudi, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Eliades
authors.affiliation: Department of Prosthodontics, The National and Kapodistrian University of Athens, School of Dentistry, 2 Thivon St, 115 27 Goudi, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Papavasiliou
authors.affiliation: Department of Biologic and Materials Sciences, Division of Prosthodontics, The University of Michigan, School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Razzoog
authors.affiliation: Department of Cariology, Restorative Sciences and Endodontics, The University of Michigan, School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Bayne
mesh_terms: D002516:Ceramics; D003116:Color; D003764:Dental Materials; D015040:Zirconium
chemical_list: D003764:Dental Materials; D015040:Zirconium; C028541:zirconium oxide