The evaluation of prepared microstructure pattern by carbon-dioxide laser on zirconia-based ceramics for dental implant application: an in vitro study.

3 mol% yttria-stabilized zirconia ceramics have been gaining attention as promising restorative materials that are extensively used in dental implant applications. However, implant failure due to bacterial infection and its bioinert surface slow osseointegration in vivo, which are significant issues in clinical applications. In this work, surface modification was achieved using a continuous wave carbon dioxide laser at a wavelength of 10.6 µm in an air atmosphere. Changes in the surface characteristics were evaluated using X-ray diffraction (XRD), field-emission scanning electron microscopy (FESEM), atomic force microscopy (AFM), and 2D roughness and hardness tests. The bioactivity of the laser-treated samples was studied by examining their behavior when immersed in the SBF solution. The formation of the hydroxyapatite phase on the laser-treated sample was much more uniform than that of its untreated counterparts. The antibacterial properties of surface-treated zirconia ceramics against Streptococcus mutans and Escherichia coli bacteria were rigorously examined. These results indicate that the laser-induced nanoscale grooves significantly improved antibacterial activity by creating hydrophobic surfaces. The cellular response was evaluated for 7 days on microtextures on the zirconia surfaces and an untreated sample with MC3T3-E1 pre-osteoblast cell line cultured under basal conditions. Surface topography was revealed to improve the cellular response with increased metabolic activity compared to the untreated sample and showed modulation of cell morphology for the entire time. These results suggest that laser modification can be an appropriate non-contact method for designing nanoscale microtextures to improve the biological response and antibacterial behavior of zirconia ceramics in restorative dentistry.