title: Assessing the feasibility of yttria-stabilized zirconia in novel designs as mandibular anterior fixed lingual retention after orthodontic treatment.
abstract: BACKGROUND
  The purpose of this study is to explore the feasibility of yttria-stabilized zirconia (Y-TZP) in fixed lingual retention as an alternative to stainless steel.
  
  
  METHODS
  Exploratory Y-TZP specimens were milled to establish design parameters. Next, the specimens were milled according to ASTM standard C1161-13 and subjected to 4-point flexural tests to determine material properties. Finite element analysis was used to evaluate 9 novel cross-sectional designs, which were compared with stainless steel wire. Each design was analyzed under loading conditions to determine von Mises and bond stresses. The most promising design was fabricated to assess the accuracy and precision of current CAD/CAM milling technology.
  
  
  RESULTS
  The superior design had a 1.0 × 0.5 mm semielliptical cross-section and was shown to be fabricated reliably. Overall, the milling indicated a maximum percent standard deviation of 9.3 and maximum percent error of 13.5 with a cost of $30 per specimen.
  
  
  CONCLUSIONS
  Y-TZP can be reliably milled to dimensions comparable with currently available metallic retainer wires. Further research is necessary to determine the success of the bonding protocol and the clinical longevity of Y-TZP fixed retainers. Advanced technology is necessary to connect the intraoral scan to an esthetic and patient-specific Y-TZP fixed retainer.
authors.affiliation: Department of Orthodontics, University of Washington, Seattle, Wash.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Stout
authors.affiliation: Materials Science and Engineering, University of Washington, Seattle, Wash.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Cook
authors.affiliation: Materials Science and Engineering, University of Washington, Seattle, Wash.
authors.forename: Dwayne D
authors.initials: DD
authors.lastname: Arola
authors.affiliation: Materials Science and Engineering, University of Washington, Seattle, Wash.
authors.forename: Hanson
authors.initials: H
authors.lastname: Fong
authors.affiliation: Restorative Dentistry, University of Washington, Seattle, Wash.
authors.forename: Ariel J
authors.initials: AJ
authors.lastname: Raigrodski
authors.affiliation: Department of Orthodontics, University of Washington, Seattle, Wash. Electronic address: mine@uw.edu.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Bollen
mesh_terms: D017076:Computer-Aided Design; D005240:Feasibility Studies; D006801:Humans; D016382:Orthodontic Appliance Design; D018704:Orthodontic Retainers; D013193:Stainless Steel; D015019:Yttrium / Q000627:therapeutic use*; D015040:Zirconium / Q000627:therapeutic use*
chemical_list: C499362:yttria stabilized tetragonal zirconia; D013193:Stainless Steel; D015019:Yttrium; D015040:Zirconium