Ag/Zn/Zeolite-Modified Glaze for Lithium Disilicate Ceramics: Comprehensive Evaluation of Antibacterial, Mechanical, and Optical Properties

Ag/Zn/Zeolite-Modified Glaze for Lithium Disilicate Ceramics: Comprehensive Evaluation of Antibacterial, Mechanical, and Optical Properties | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Ag/Zn/Zeolite-Modified Glaze for Lithium Disilicate Ceramics: Comprehensive Evaluation of Antibacterial, Mechanical, and Optical Properties Hüseyin Alperen SELVI, Zeynep BASAGAOGLU DEMIREKIN, Umran AYDEMIR SEZER, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8064545/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Objectives This study aimed to evaluate the antibacterial, mechanical, and optical properties of lithium disilicate ceramics after the addition of Ag/Zn/Zeolite at 0%, 1%, and 2% concentrations to the glaze layer. Methods IPS™ e.max Press samples were glazed with 0%, 1%, or 2% Ag/Zn/Zeolite. Surface roughness (n = 5), Vickers hardness (n = 10), and flexural strength (n = 10) were tested. Optical analysis included color change due to additive content and color stability after 7-day immersion in (Coca-Cola, Lipton Yellow Label Tea, Nescafe Gold) both assessed by ΔE₀₀ values (n = 5). Antibacterial activity against Streptococcus mutans was evaluated using the Direct Contact Test (n = 3 per time point), and biofilm formation was observed via SEM. Data were analyzed using ANOVA and Tukey’s post hoc test. Results Surface roughness significantly decreased in experimental groups (P 0.05). All groups showed significant color differences (P < 0.001), with the greatest between control and 2%. Discoloration after beverage immersion was higher in experimental groups but remained below perceptibility thresholds. Antibacterial activity increased with Ag/Zn/Zeolite concentration. SEM images confirmed reduced biofilm formation over 30 days in zeolite-containing samples. Conclusions The addition of Ag/Zn/Zeolite improved the antibacterial properties while maintaining acceptable mechanical and optical performance in lithium disilicate ceramics. Dental Ceramics Glaze Lithium Disilicate Streptococcus mutans Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 1. INTRODUCTION All-ceramic dental ceramics are among the most successful materials in dentistry due to their exceptional aesthetic properties, biocompatibility, and chemical inertness [ 1 ]. Recent advancements in material science and production techniques have significantly enhanced dental ceramics. Notably, glass ceramics like the IPS™ e.max series offer an ideal combination of aesthetic and mechanical properties, making them a preferred choice for dental restorations [ 2 ]. The longevity of a restoration is closely linked to its surface topology and roughness. Higher surface roughness can promote the formation of superficial cracks, compromising the restoration's strength over time [ 3 ]. Glazing is a routine finishing technique applied to dental ceramic restorations to create smooth, glass-coated surfaces that enhance both aesthetics and hygiene [ 4 , 5 ]. This process not only strengthens brittle ceramics by reducing surface defects but also helps seal cracks, thereby reinforcing the material's structural integrity [ 6 ]. Glazed surfaces also show reduced plaque accumulation, limiting the ceramic’s exposure to the oral cavity while maintaining the necessary smoothness [ 5 – 7 ]. Plaque and biofilms on dental materials form complex micro-ecosystems of oral microorganisms surrounded by an extracellular matrix of proteins and polysaccharides [ 8 ]. These biofilms contribute to dental caries, periodontal diseases, peri-implantitis, and plaque formation, ultimately leading to enamel demineralization. Biofilms adhere readily to both biotic and abiotic surfaces, including prostheses, implants, and tooth-restoration interfaces [ 9 – 11 ]. Reducing microbial colonization on dental materials is essential for improving treatment outcomes [ 12 ]. Zeolite, a crystalline aluminosilicate with a tetrahedral structure, has diverse applications, including potential use in dentistry as an antimicrobial agent. Ion-embedded zeolites can inactivate key microbial enzymes, disrupt DNA replication, and impair respiration, thereby inhibiting the growth of pathogenic microorganisms [ 13 – 15 ]. However, the addition of zeolite to dental materials necessitates careful evaluation of its mechanical impact. Properties like flexural strength, bond strength, compressive strength, setting time, and surface microhardness are critical to the long-term performance of dental restorations [ 16 ]. Studies indicate that adding ion-loaded zeolite in concentrations of 0.2% to 2% by weight is generally optimal, as higher concentrations may compromise the mechanical properties of materials like MTA and acrylic resin [ 17 ]. Hypothesis (H₀): The addition of Ag/Zn/Zeolite to the glaze layer of IPS™ e.max Press is hypothesized to enhance the antibacterial properties of restorations while maintaining or improving their mechanical and optical properties. 2. MATERIALS & METHODS 2.1. Preparation of Samples Lithium disilicate (IPS™ e.Max Press, Ivoclar Vivadent) samples were fabricated using the lost wax technique. The material was pressed in a Programat EP 5010 porcelain furnace (Ivoclar Vivadent, Schaan, Liechtenstein) at 920˚C under a pressure of 5 bar, following the manufacturer's guidelines. To ensure clean surfaces, the samples were immersed in a 1% solution of hydrofluoric and phosphoric acid (IPS™ e.max Press Invex Liquid, Schaan, Liechtenstein) for 10 minutes. They were then rinsed with distilled water, dried, and sandblasted using aluminum oxide (type 100) at a pressure of 1 bar. Surface smoothing was achieved with a diamond bur (grain size: 15–20 µm) followed by polishing with silicon carbide discs (White Dove Abrasives Co., Ltd., China) in successive grids (600, 800, and 1200) using a Metkon FORCIPOL 1V polisher (Metkon, Turkey). 2.2. Preparation of Zeolite and Glaze Porcelain Content Zeolite A crystals with a gel formulation of 11.25SiO₂:1.8Al₂O₃:13.4(TMA)₂O:0.6Na₂O:700H₂O were synthesized via an 18-hour aging process followed by an 8-hour hydrothermal reaction. After synthesis, the zeolite crystals were washed three times with distilled water, centrifuged, and dried in an oven at 60°C. The resulting crystals were characterized using Scanning Electron Microscopy (SEM) and X-Ray Diffraction (XRD). An aqueous solution containing 0.247 g of silver nitrate (AgNO₃) and 3.83 g of zinc sulfate heptahydrate (ZnSO₄·6H₂O) in 300 mL of distilled water was prepared to introduce antibacterial properties to the zeolite structure. Three grams of zeolite A were added to the solution for ion exchange. The mixture was stirred magnetically in the dark for 24 hours at room temperature, then centrifuged and washed three times with deionized water. The samples were dried at 45°C for 24 hours. To convert the ions in the zeolite into nanoparticles, a chemical reduction reaction was performed using an aqueous solution of sodium borohydride (NaBH₄). Three grams of ion-exchanged zeolite A were added to 375 mL of distilled water containing three grams of dissolved NaBH₄. After centrifuging and washing the zeolite crystals three times with distilled water, the samples were dried at 45°C for 24 hours. The chemical composition of Ag/Zn/Zeolite was analyzed using inductively coupled plasma optical emission spectrometry (ICP-OES). Reagents used included tetramethylammonium hydroxide solution (TMAOH, 25 wt.% in H₂O), aluminum isopropoxide (≥ 98%), sodium hydroxide (NaOH) from Sigma-Aldrich, and tetraethyl orthosilicate (TEOS) from Merck. A Milli-Q water purification system was employed to distill deionized water from tap water. For the glaze porcelain preparation, Ips™ Ivocolor glaze porcelain powder was mixed homogeneously with 1% or 2% (by weight) zeolite powder containing Ag and Zn. Clean brushes were used for each sample to apply equal volumes of the glaze mixture. The samples were baked at 770°C in a Programat P300 porcelain furnace (Ivoclar Vivadent, Schaan, Liechtenstein) according to the manufacturer’s instructions. 2.3. Characterization of Zeolite and Ag/Zn/Zeolite The morphology of the synthesized zeolite A crystals was analyzed using a field-emission scanning electron microscope (FE-SEM, FEI Quanta 400). Phase identification of the zeolite A crystals was performed through X-ray powder diffraction (XRD) with a Rigaku-Ultima IV. The chemical composition and ion exchange properties of the zeolite A crystals were evaluated using inductively coupled plasma optical emission spectrometry (ICP-OES, Perkin Elmer Optima 4300DV). 2.4. Measurement of Surface Roughness of Samples Five samples (2 mm thick and 10 mm in diameter) were prepared for each of the three groups containing different ratios of zeolite (0%, 1%, and 2%). Surface roughness measurements were performed using a profilometer (Surftest SJ-210 Mitutoyo, Tokyo, Japan) with a tip diameter of 5 µm. The device was calibrated as per the manufacturer’s instructions using a calibration plate. Each sample was placed sequentially on the device’s standard measuring table, maintaining a 90° contact angle between the profilometer’s reader tip and the sample disc. Measurements were conducted at 4 mm intervals with a measurement speed of 2 mm/sec and a cut-off value of 0.8 mm. Each sample was measured in three different regions (center and sides), and the mean of these values represented the surface roughness (Ra) for that sample. The instrument was recalibrated after every five measurements. To stabilize the samples during measurement, Patafix (UHU GmbH & Co. KG), an elastic and reusable adhesive, was used. 2.5. Measurement of Surface Hardness Degrees of Samples Ten samples (2 mm thick and 10 mm in diameter) were prepared for each of the three groups containing varying zeolite ratios (0%, 1%, and 2%). Surface hardness was measured using a Vickers microhardness tester in accordance with the ASTM E384-11 standard. A diamond pyramid-shaped indenter was applied with a load of 200 gf for a dwell time of 10 seconds. The Vickers Hardness (HV) value was calculated using the formula: HV = 1.8544 × (P/d²) where HV is the hardness value, P represents the applied load, and d is the diagonal length of the indentation. 2.6. Measurement of Flexural Strength of Samples Flexural strength was measured using a three-point bending test in accordance with ISO 6872:2008 standards. Thirty rectangular prism specimens were prepared for each of the three groups, with dimensions specified as 1.6 × 4 × 20 mm, as required for the three-point bending test of Type 1 ceramics. The test was performed using a computer-assisted universal testing machine (Shimadzu AGS-X, Japan) with a power capacity of 10 kN. The specimens were positioned parallel to each other on abutments spaced 16 mm apart. The testing device applied force at a speed of 1 mm/min until the specimens fractured. The maximum load (in Newtons, N) exerted on each specimen at the point of fracture was recorded. Flexural strength values were calculated in Megapascals (MPa) using Trapezium X data processing software connected to the testing machine. 2.7. Color Measurement Test to Investigate the Effect of Zeolite on the Colors of the Samples Fifteen samples (2 mm thick and 10 mm in diameter) were prepared for the color measurement test. Measurements were conducted using a VITA Easyshade Compact V device (VITA Zahnfabrik, Bad Säckingen, Germany). The device was calibrated prior to each measurement using D65 light on a white background. Samples were immersed in distilled water at 37 ºC for 24 hours and dried before measurement. During each measurement, the device’s fiber optic tip was placed perpendicular to the sample surface and parallel to the ground. For each sample in the control and experimental groups, color measurements were repeated three times, and the average was recorded. The color difference (ΔE₀₀) was calculated using the CIEDE2000 formula: ΔE₀₀ = √[(ΔL*/(kL*SL))² + (ΔC*/(kC*SC))² + (ΔH*/(kH*SH))² + RT(ΔC*/(kC*SC))(ΔH*/(kH*SH))]. 2.8. Application of Coloration Tests Five samples(2 mm thick and 10 mm in diameter) from each group (control, 1% Ag/Zn/Zeolite, and 2% Ag/Zn/Zeolite) were immersed in 15 mL of test solutions for 7 days at a controlled temperature of 37 ± 1°C in a dark environment. The test solutions included Coca-Cola, tea (Lipton Yellow Label Tea), and coffee (Nescafe Gold). Tea and coffee were prepared according to the manufacturer’s instructions, refreshed daily, and stirred every 12 hours to ensure solution homogeneity. After 7 days, the samples were removed, rinsed with distilled water, and dried using tissue paper. The color of each sample was measured three times both before and after immersion, with the averages recorded. The color difference (ΔE₀₀) was calculated using the CIEDE2000 color difference formula: ΔE₀₀ = √[(ΔL*/(kL*SL))² + (ΔC*/(kC*SC))² + (ΔH*/(kH*SH))² + RT(ΔC*/(kC*SC))(ΔH*/(kH*SH))]. 2.9. Preparation of the Bacterial Suspension The standard strain of Streptococcus mutans (ATCC 25175), registered in the American Type Culture Collection (ATCC), was used in this study. The strain was thawed from − 80°C to room temperature and rehydrated with approximately 0.5 mL of brain heart infusion (BHI broth). It was streaked onto a BHI agar plate and incubated at 35 ± 2°C in a CO₂ incubator (Nüve, Turkey) for 48–72 hours. The resulting bacterial colonies were re-streaked on fresh BHI agar plates and incubated under the same conditions for another 48–72 hours. Following the second passage, 2–4 bacterial colonies were selected using a sterile loop and suspended in 4 mL of saline solution. The absorbance of the suspension was measured spectrophotometrically using a McFarland device (PhoenixSpec, BD, NJ, USA). The bacterial suspension was adjusted to a 0.5 McFarland standard, equivalent to 1 × 10⁸ CFU/mL. 2.10. Application of the Direct Contact Test Method Three discs from each group (0%, 1%, and 2% Ag/Zn/Zeolite) were sterilized with ethylene oxide and placed into individual wells of a microplate. To each well, 10 µL of bacterial suspension (0.5 McFarland S. mutans ) was added. The plate was incubated at 35 ± 2°C in a CO₂ incubator, and colony counts (CFU/mL) were determined at 12, 24, and 48 hours. Three discs were used per group for each time point. At 6, 12, 24, and 48 hours, one control disc, one 1% Ag/Zn/Zeolite disc, and one 2% Ag/Zn/Zeolite disc were vortexed in 300 µL of BHI broth to produce the initial bacterial suspension for each group. Simultaneously, 90 µL of BHI broth was dispensed into 18 wells (six wells per group). For ten-fold serial dilutions, 10 µL of the bacterial suspensions were transferred to the wells containing 90 µL of BHI broth and mixed thoroughly. The plates were incubated for 6, 12, 24, and 48 hours. At each time point, 10 µL was taken from each well and inoculated onto BHI agar plates divided into four quadrants. Colony counts from six serial dilutions were used for analysis. The bacterial count was multiplied by the dilution factor to calculate CFU/mL. 2.11. Evaluation of Biofilm Formation by Scanning Electron Microscopy (SEM) Biofilm formation was evaluated for control samples and those containing 1% and 2% Ag/Zn/Zeolite following prolonged exposure to S. mutans . Each test disc was placed in a microcentrifuge tube and immersed in 300 µL of a S. mutans suspension prepared at a concentration equivalent to a 0.5 McFarland standard (approximately 1.5 × 10⁸ CFU/mL) in BHI medium supplemented with 1% sucrose. The samples were incubated at 37°C in a 5% CO₂ incubator for 24 hours, 7 days, and 30 days. After incubation, the samples were washed with sterile saline for 1 minute to remove planktonic bacteria. To assess biofilm formation, the samples were fixed in 10% formalin for one week, then dehydrated sequentially using ethanol solutions of increasing concentration (75%, 90%, and 100%). The processed samples were subsequently analyzed by Scanning Electron Microscopy (SEM). 2.12. Statistical Analyses The data were analyzed using SPSS 20.0 (Statistical Package for Social Sciences). Descriptive statistics, including the mean ± standard deviation, were calculated at a 95% confidence interval. For variables with parametric distribution, the median, minimum, and maximum values were determined, while categorical variables were summarized using numbers and percentages. To compare the means of groups containing more than two groups, a One-Way Analysis of Variance (ANOVA) test was performed. Groups showing statistically significant differences were further analyzed using the post hoc Least Significant Difference (LSD) test. Statistical significance was defined as P < 0.05. 3. RESULTS The FE-SEM images and X-ray diffraction (XRD) patterns of the synthesized zeolite crystals are shown in Fig. 1 . As seen in Fig. 1 A, the synthesized zeolite A crystals were uniform and nano-sized with a ball-like morphology. The XRD pattern (Fig. 1 B) matched well with reference patterns from the literature, with no additional peaks observed, confirming the successful synthesis of zeolite A crystals [ 18 ]. Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) analysis determined the concentration of Ag and Zn in the zeolite framework. The ion-exchange process resulted in metal concentrations of 2.17 ± 0.01 for silver and 11.8 ± 0.09 for zinc. The roughness values for the samples were significantly affected by the addition of Ag/Zn/Zeolite. The control group (0% Ag/Zn/Zeolite) displayed significantly higher surface roughness compared to the samples with 1% and 2% Ag/Zn/Zeolite (P 0.05). The highest flexural strength was measured in the samples containing 2% Ag/Zn/Zeolite, while the lowest was observed in the control group (Fig. 2 B). Despite these variations, the differences in flexural strength between the groups were not statistically significant (P > 0.05). Significant differences in surface hardness were observed across all groups (P < 0.05, Fig. 2 A). The control group (0% Ag/Zn/Zeolite) exhibited the highest surface hardness, while the samples with 2% Ag/Zn/Zeolite demonstrated the lowest hardness. When comparing color differences (ΔE₀₀) between groups, all pairs showed statistically significant differences (P < 0.001). The smallest color difference was noted between the 1% and 2% Ag/Zn/Zeolite groups, while the largest difference occurred between the control and the 2% Ag/Zn/Zeolite group (Fig. 3 B). The color stability of the samples after immersion in Coca-Cola revealed significant group differences (P < 0.05). The 2% Ag/Zn/Zeolite samples exhibited the highest color change, while the control samples showed the lowest (Fig. 3 A). For samples immersed in coffee or tea, no significant difference in color change was observed between the 1% and 2% Ag/Zn/Zeolite groups, though the control samples displayed significantly lower color change compared to both experimental groups. The results of the direct contact test demonstrated that colony counts were similar across all samples after 6 hours of contact (Fig. 4 ). However, after 12 hours, bacterial colony counts were reduced by a factor of 5 in the samples containing 1% Ag/Zn/Zeolite and by a factor of 33 in those containing 2% Ag/Zn/Zeolite compared to the control group. At the 24-hour mark, colony counts were 100 times lower in the 1% Ag/Zn/Zeolite samples and 1250 times lower in the 2% Ag/Zn/Zeolite samples relative to the control. After 48 hours of contact, no bacterial colonies were observed in either of the experimental groups, indicating complete bacterial inhibition (Fig. 4 ). Long-term biofilm formation was evaluated via SEM imaging on days 1, 7, and 30 (Fig. 5 ). These images revealed notable differences in biofilm coverage between the control group and the experimental groups. Samples containing 1% and 2% Ag/Zn/Zeolite exhibited significantly less biofilm formation than the control group, with the 2% Ag/Zn/Zeolite samples showing the greatest antibacterial effect over the 30-day period. 4. DISCUSSIONS The findings from this study indicate that surface roughness decreased with increasing concentrations of Ag/Zn/Zeolite in the glaze layer. This suggests that the addition of ion-loaded zeolite improves the smoothness of the material, which can positively influence its mechanical properties. Although no direct comparisons could be made with studies examining the effect of ion-loaded zeolite in the glaze layer of dental ceramics, our results align with similar findings reported for ion-loaded zeolite in PMMA resin [ 19 ]. In contrast, surface hardness decreased as the ratio of Ag/Zn/Zeolite in the glaze layer increased. The control sample (0% Ag/Zn/Zeolite) had an average surface hardness of 6.3 ± 0.09 GPa, while samples containing 1% and 2% Ag/Zn/Zeolite exhibited surface hardness values of 5.9 ± 0.07 GPa and 5.6 ± 0.17 GPa, respectively. Despite this reduction, the surface hardness values for all samples remained within acceptable limits, as outlined by the scientific documentation for IPS™ e.max ceramics [ 20 ]. The flexural strength of the samples increased with higher Ag/Zn/Zeolite concentrations, although the differences were not statistically significant. Control samples had an average flexural strength of 296 ± 49 MPa, while samples with 1% and 2% Ag/Zn/Zeolite exhibited values of 315 ± 46 MPa and 324 ± 25 MPa, respectively. These values surpass those reported in earlier studies (239–281 MPa) [ 21 – 25 ] and are consistent with the flexural strength range of 300–400 MPa reported in other investigations [ 26 – 29 ]. Variations in test design may account for discrepancies in reported values across studies [ 29 ]. Paravina et al. and de Oliveira et al. emphasized the importance of visual thresholds in interpreting numerical color differences. A ΔE 00 value of ≤ 0.8, referred to as the detection threshold, means 50% of observers perceive a color difference between two objects, while the other 50% do not. Similarly, a ΔE 00 value between 0.8 and 1.8(the acceptability threshold) indicates that 50% of observers find the color difference acceptable, while the other 50% may consider it to require correction [ 30 – 32 ]. Silver-containing materials are often associated with poor color stability [ 33 ]. However, no prior research has investigated how the incorporation of Ag/Zn/Zeolite into the glaze layer of dental ceramics affects color stability. In this study, we observed that adding Ag/Zn/Zeolite at 1% and 2% by weight caused concentration-dependent color changes. Despite these changes, the ΔE 00 values for all samples remained below the acceptable threshold of ≤ 1.8. Specifically, the ΔE 00 value was 1.126 between the control and 1% Ag/Zn/Zeolite samples, and 1.318 between the control and 2% Ag/Zn/Zeolite samples. The literature on dental materials highlights coffee as the most frequently used staining solution for evaluating color stability, followed by tea and Coca-Cola. In vitro, a one-week immersion period is considered to simulate the consumption of one cup of coffee or Coca-Cola daily for approximately seven months [ 34 – 40 ]. In this study, samples immersed in Coca-Cola for 7 days exhibited significant differences in color change depending on the concentration of zeolite added (P < 0.05). The highest color change was observed in the 2% Ag/Zn/Zeolite samples (ΔE 00 = 0.559), while the control samples displayed the lowest color change (ΔE 00 = 0.435). For samples immersed in coffee or tea, no significant difference in color change was detected between the 1% and 2% Ag/Zn/Zeolite groups after 7 days. However, the control group exhibited significantly lower color changes than both experimental groups. The 2% Ag/Zn/Zeolite samples had the highest color change (ΔE 00 = 0.769 and 0.643 for coffee and tea, respectively), while the control group showed the lowest values (ΔE 00 = 0.727 and 0.598 for coffee and tea, respectively). Although the addition of Ag/Zn/Zeolite increased discoloration, the highest recorded ΔE 00 value of 0.769 (2% Ag/Zn/Zeolite samples immersed in coffee) remained below the perceptibility threshold of ΔE 00 ≤ 0.8. S. mutans is a dominant microorganism in dental plaques and oral biofilm, making it a relevant choice for this study. This species is known to follow a bi-species biofilm pattern, colonizing supragingival biofilms early often within the first 8 hours. Additionally, S. mutans is a major acid producer implicated in dental caries formation [ 41 , 42 ]. However, true oral biofilms are highly heterogeneous, involving a range of attachment modes and interspecies interactions that were beyond the scope of this study [ 43 – 45 ]. The Direct Contact Test results demonstrated significant antimicrobial activity against S. mutans in samples containing 1% and 2% Ag/Zn/Zeolite. The activity was both time- and concentration-dependent. These findings are consistent with previous studies that highlighted the antibacterial properties of ion-loaded zeolite in various materials [ 46 – 50 ]. The antibacterial mechanism likely stems from the controlled, sustained release of silver and zinc ions with antimicrobial properties into the surrounding environment, as supported by earlier research [ 46 – 50 ]. Long-term exposure to S. mutans inoculum resulted in biofilm formation in all sample groups. However, SEM analysis showed that biofilm formation was significantly reduced in samples containing 1% and 2% Ag/Zn/Zeolite compared to the control group. Furthermore, the antimicrobial activity of these samples persisted over 30 days, with the 2% Ag/Zn/Zeolite samples demonstrating the highest level of inhibition against biofilm formation. Future studies, including clinical trials, are recommended to further validate these findings to assess the effects of incorporating Ag/Zn/Zeolite into the glaze layer of lithium disilicate restorations. Such studies would help clarify the long-term clinical implications of the antimicrobial and mechanical properties observed in this in vitro investigation. 5. CONCLUSIONS This study investigated the effects of incorporating zeolite containing 0%, 1%, and 2% silver and zinc into the glaze layer of a widely used dental ceramic material (IPS™ e.max Press). The mechanical, optical, and antimicrobial properties of the resulting glaze porcelain were evaluated following the firing process. The key findings of the study are as follows : Surface roughness decreased in samples containing 1% and 2% Ag/Zn/Zeolite compared to the control group, indicating improved smoothness. Flexural strength increased in the experimental groups (1% and 2% Ag/Zn/Zeolite) compared to the control group, although this increase was not statistically significant. Surface hardness decreased in the 1% and 2% Ag/Zn/Zeolite groups but remained above the minimum acceptable value specified by the manufacturer, consistent with previous studies. Color differences (ΔE₀₀) increased with higher concentrations of Ag/Zn/Zeolite, but all values were within the acceptable range for dental restorations. Discoloration caused by cola, coffee, and tea immersion was higher in the 1% and 2% Ag/Zn/Zeolite samples compared to the control group. However, the observed changes remained below the perceptibility threshold. Antibacterial activity was significantly higher in the 1% and 2% Ag/Zn/Zeolite samples, with the greatest effect observed in the 2% group. Declarations Conflict of Interest The authors have no conflicts of interest to declare. Ethical approval Not applicable. Author Contribution HAS conceptualized the study, performed data curation, formal analysis, investigation, and visualization, developed the methodology and software, acquired funding, and drafted the original manuscript.ZBD contributed to conceptualization, data curation, methodology, and supervision; acquired funding and resources; and participated in project administration, validation, and writing, review, and editing.UAS contributed to conceptualization, investigation, methodology, resources, and supervision, and was involved in project administration, validation, and writing, review, and editing.MIB and BA provided resources and supervision.ESC and TA contributed to the investigation and methodology.All authors reviewed and approved the final version of the manuscript. Acknowledgments This research is supported by the Suleyman Demirel University Scientific Research Projects Coordination Unit with the project number TDH-2021-8298. Data Availability All data generated or analyzed during this study, including antibacterial, mechanical, and optical test results, are available from the corresponding author upon reasonable request. References Pilathadka S, Vahalova D. Contemporary all-ceramic materials, part-1. Acta Medica (Hradec Kralove). 2007;50(2):101–4. 10.14712/18059694.2017.63 . Willard A, Gabriel Chu TM. The science and application of IPS e.Max dental ceramic. Kaohsiung J Med Sci. 2018;34(4):238–42. 10.1016/j.kjms.2018.01.012 . Flury S, Peutzfeldt A, Lussi A. Influence of surface roughness on mechanical properties of two computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic materials. Oper Dent. 2012;37(6):617–24. 10.2341/11-391-L . Albakry M, Guazzato M, Swain MV. Effect of sandblasting, grinding, polishing and glazing on the flexural strength of two pressable all-ceramic dental materials. J Dent. 2004;32(2):91–9. 10.1016/j.jdent.2003.08.006 . Aksoy G, Polat H, Polat M, Coskun G. Effect of various treatment and glazing (coating) techniques on the roughness and wettability of ceramic dental restorative surfaces. Colloids Surf B Biointerfaces. 2006;53(2):254–9. 10.1016/j.colsurfb.2006.09.016 . Fairhurst CW, Lockwood PE, Ringle RD, Thompson WO. The effect of glaze on porcelain strength. Dent Mater. 1992;8(3):203–7. 10.1016/0109-5641(92)90084-p . al-Wahadni A, Martin DM. Glazing and finishing dental porcelain: a literature review. J Can Dent Assoc. 1998;64(8):580–3. PMID: 9785688. Kolenbrander PE, Palmer RJ Jr, Periasamy S, Jakubovics NS. Oral multispecies biofilm development and the key role of cell-cell distance. Nat Rev Microbiol. 2010;8(7):471–80. 10.1038/nrmicro2381 . Ammons MC, Tripet BP, Carlson RP, et al. Quantitative NMR metabolite profiling of methicillin-resistant and methicillin-susceptible Staphylococcus aureus discriminates between biofilm and planktonic phenotypes. J Proteome Res. 2014;13(6):2973–85. 10.1021/pr500120c . Vo DT, Arola D, Romberg E, Driscoll CF, Jabra-Rizk MA, Masri R. Adherence of Streptococcus mutans on lithium disilicate porcelain specimens. J Prosthet Dent. 2015;114(5):696–701. 10.1016/j.prosdent.2015.06.017 . Dal Piva A, Contreras L, Ribeiro FC, et al. Monolithic Ceramics: Effect of Finishing Techniques on Surface Properties, Bacterial Adhesion and Cell Viability. Oper Dent. 2018;43(3):315–25. 10.2341/17-011-L . Bowen WH, Burne RA, Wu H, Koo H. Oral Biofilms: Pathogens, Matrix, and Polymicrobial Interactions in Microenvironments. Trends Microbiol. 2018;26(3):229–42. 10.1016/j.tim.2017.09.008 . Kraljević Pavelić S, Simović Medica J, Gumbarević D, Filošević A, Pržulj N, Pavelić K. Critical Review on Zeolite Clinoptilolite Safety and Medical Applications in vivo . Front Pharmacol. 2018;9:1350. 10.3389/fphar.2018.01350 . Published 2018 Nov 27. Derakhshankhah H, Jafari S, Sarvari S, et al. Biomedical Applications of Zeolitic Nanoparticles, with an Emphasis on Medical Interventions. Int J Nanomed. 2020;15:363–86. 10.2147/IJN.S234573 . Published 2020 Jan 21. Sivakumar I, Arunachalam KS, Sajjan S, Ramaraju AV, Rao B, Kamaraj B. Incorporation of antimicrobial macromolecules in acrylic denture base resins: a research composition and update. J Prosthodont. 2014;23(4):284–90. 10.1111/jopr.12105 . Wang L, D'Alpino PH, Lopes LG, Pereira JC. Mechanical properties of dental restorative materials: relative contribution of laboratory tests. J Appl Oral Sci. 2003;11(3):162–7. 10.1590/s1678-77572003000300002 . Hao J, Lang S, Mante F, Pavelić K, Ozer F. Antimicrobial and Mechanical Effects of Zeolite Use in Dental Materials: A Systematic Review. Acta Stomatol Croat. 2021;55(1):76–89. 10.15644/asc55/1/9 . Fan W, Meneau F, Bras W, Ogura M, Sankar G, Okubo T. Effects of silicon sources on the formation of nanosized LTA: An in situ small angle X-ray scattering and wide angle X-ray scattering study. Microporous Mesoporous Mater. 2007;101:134–41. 10.1016/j.micromeso.2006.10.007 . Esmaeilzadeh M, Divband B, Ranjkesh B, et al. Antimicrobial and Mechanical Properties of Orthodontic Acrylic Resin Containing Zinc Oxide and Titanium Dioxide Nanoparticles Supported on 4A Zeolite. Int J Dent. 2022;2022:8155971. 10.1155/2022/8155971 . Published 2022 Jul 14. Bühler-Zemp P, Völkel T, Fischer K. Scientific Documentation IPS e.Max Press. Schaan, Liechtenstein: Ivoclar Vivadent; 2011. Chung KH, Liao JH, Duh JG, Chan DC. The effects of repeated heat-pressing on properties of pressable glass-ceramics. J Oral Rehabil. 2009;36(2):132–41. 10.1111/j.1365-2842.2008.01909.x . Gorman CM, Horgan K, Dollard RP, Stanton KT. Effects of repeated processing on the strength and microstructure of a heat-pressed dental ceramic. J Prosthet Dent. 2014;112(6):1370–6. 10.1016/j.prosdent.2014.06.015 . Della Bona A, Mecholsky JJ Jr, Anusavice KJ. Fracture behavior of lithia disilicate- and leucite-based ceramics. Dent Mater. 2004;20(10):956–62. 10.1016/j.dental.2004.02.004 . Guazzato M, Albakry M, Ringer SP, Swain MV. Strength, fracture toughness and microstructure of a selection of all-ceramic materials. Part I. Pressable and alumina glass-infiltrated ceramics. Dent Mater. 2004;20(5):441–8. 10.1016/j.dental.2003.05.003 . Al-Thobity AM, Alsalman A. Flexural properties of three lithium disilicate materials: An in vitro evaluation. Saudi Dent J. 2021;33(7):620–7. 10.1016/j.sdentj.2020.07.004 . Albakry M, Guazzato M, Swain MV. Biaxial flexural strength and microstructure changes of two recycled pressable glass ceramics. J Prosthodont. 2004;13(3):141–9. 10.1111/j.1532-849X.2004.04025.x . Tang X, Tang C, Su H, Luo H, Nakamura T, Yatani H. The effects of repeated heat-pressing on the mechanical properties and microstructure of IPS e.max Press. J Mech Behav Biomed Mater. 2014;40:390–6. 10.1016/j.jmbbm.2014.09.016 . Fabian Fonzar R, Carrabba M, Sedda M, Ferrari M, Goracci C, Vichi A. Flexural resistance of heat-pressed and CAD-CAM lithium disilicate with different translucencies. Dent Mater. 2017;33(1):63–70. 10.1016/j.dental.2016.10.005 . Albakry M, Guazzato M, Swain MV. Biaxial flexural strength, elastic moduli, and x-ray diffraction characterization of three pressable all-ceramic materials. J Prosthet Dent. 2003;89(4):374–80. 10.1067/mpr.2003.42 . de Oliveira DC, Ayres AP, Rocha MG, et al. Effect of Different In Vitro Aging Methods on Color Stability of a Dental Resin-Based Composite Using CIELAB and CIEDE2000 Color-Difference Formulas. J Esthet Restor Dent. 2015;27(5):322–30. 10.1111/jerd.12155 . Paravina RD, Pérez MM, Ghinea R. Acceptability and perceptibility thresholds in dentistry: A comprehensive review of clinical and research applications. J Esthet Restor Dent. 2019;31(2):103–12. 10.1111/jerd.12465 . Paravina RD. Critical appraisal. Color in dentistry: match me, match me not [published correction appears in J Esthet Restor Dent. 2009;21(3):142]. J Esthet Restor Dent . 2009;21(2):133–139. 10.1111/j.1708-8240.2009.00246.x Imazato S. Antibacterial properties of resin composites and dentin bonding systems. Dent Mater. 2003;19(6):449–57. 10.1016/s0109-5641(02)00102-1 . Al Ben Ali A, Kang K, Finkelman MD, Zandparsa R, Hirayama H. The effect of variations in translucency and background on color differences in CAD/CAM lithium disilicate glass ceramics. J Prosthodont. 2014;23(3):213–20. 10.1111/jopr.12080 . Guler AU, Kurt S, Kulunk T. Effects of various finishing procedures on the staining of provisional restorative materials. J Prosthet Dent. 2005;93(5):453–8. 10.1016/j.prosdent.2005.02.001 . Ragain JC Jr, Johnston WM. Minimum color differences for discriminating mismatch between composite and tooth color. J Esthet Restor Dent. 2001;13(1):41–8. 10.1111/j.1708-8240.2001.tb00250.x . Raimondo RL Jr, Richardson JT, Wiedner B. Polished versus autoglazed dental porcelain. J Prosthet Dent. 1990;64(5):553–7. 10.1016/0022-3913(90)90126-w . Goldstein GR, Barnhard BR, Penugonda B. Profilometer, SEM, and visual assessment of porcelain polishing methods. J Prosthet Dent. 1991;65(5):627–34. 10.1016/0022-3913(91)90196-4 . Atay A, Karayazgan B, Ozkan Y, Akyil MS. Effect of colored beverages on the color stability of feldspathic porcelain subjected to various surface treatments. Quintessence Int . 2009;40(7):e41-e48. PMID: 19626223. Kursoglu P, Karagoz Motro PF, Kazazoglu E. Correlation of surface texture with the stainability of ceramics. J Prosthet Dent. 2014;112(2):306–13. 10.1016/j.prosdent.2013.09.028 . Zhu B, Macleod LC, Kitten T, Xu P. Streptococcus sanguinis biofilm formation & interaction with oral pathogens. Future Microbiol. 2018;13(8):915–32. 10.2217/fmb-2018-0043 . Afonso Camargo SE, Mohiuddeen AS, Fares C, et al. Anti-Bacterial Properties and Biocompatibility of Novel SiC Coating for Dental Ceramic. J Funct Biomater. 2020;11(2):33. 10.3390/jfb11020033 . Published 2020 May 20. Hojo K, Nagaoka S, Ohshima T, Maeda N. Bacterial interactions in dental biofilm development. J Dent Res. 2009;88(11):982–90. 10.1177/0022034509346811 . Jenkinson HF. Beyond the oral microbiome. Environ Microbiol. 2011;13(12):3077–87. 10.1111/j.1462-2920.2011.02573.x . Kuramitsu HK, He X, Lux R, Anderson MH, Shi W. Interspecies interactions within oral microbial communities. Microbiol Mol Biol Rev. 2007;71(4):653–70. 10.1128/MMBR.00024-07 . Casemiro LA, Gomes Martins CH, Pires-de-Souza Fde C, Panzeri H. Antimicrobial and mechanical properties of acrylic resins with incorporated silver-zinc zeolite - part I. Gerodontology. 2008;25(3):187–94. 10.1111/j.1741-2358.2007.00198.x . Li W, Qi M, Sun X, Chi M, Wan Y, Zheng X, et al. Novel dental adhesive containing silver exchanged EMT zeolites against cariogenic biofilms to combat dental caries. Microporous Mesoporous Mater. 2020;299:110113. 10.1016/j.micromeso.2020.110113 . Saengmee-Anupharb S, Srikhirin T, Thaweboon B, et al. Antimicrobial effects of silver zeolite, silver zirconium phosphate silicate and silver zirconium phosphate against oral microorganisms. Asian Pac J Trop Biomed. 2013;3(1):47–52. 10.1016/S2221-1691(13)60022-2 . Kawahara K, Tsuruda K, Morishita M, Uchida M. Antibacterial effect of silver-zeolite on oral bacteria under anaerobic conditions. Dent Mater. 2000;16(6):452–5. 10.1016/s0109-5641(00)00050-6 . Hotta M, Nakajima H, Yamamoto K, Aono M. Antibacterial temporary filling materials: the effect of adding various ratios of Ag-Zn-Zeolite. J Oral Rehabil. 1998;25(7):485–9. 10.1046/j.1365-2842.1998.00265.x . Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 17 Dec, 2025 Reviewers agreed at journal 17 Dec, 2025 Reviewers invited by journal 05 Dec, 2025 Editor invited by journal 11 Nov, 2025 Editor assigned by journal 11 Nov, 2025 Submission checks completed at journal 11 Nov, 2025 First submitted to journal 08 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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15:38:02","extension":"html","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":132561,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8064545/v1/549ff34d6df8011ceb52c814.html"},{"id":97721139,"identity":"38256745-f30c-46cf-9689-e913c22efe1b","added_by":"auto","created_at":"2025-12-08 15:38:02","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":90402,"visible":true,"origin":"","legend":"\u003cp\u003eFE-SEM image (A) and XRD pattern (B) of as-synthesized zeolite crystals.\u003c/p\u003e","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8064545/v1/33bcac2ad53b2c881261e542.png"},{"id":97721137,"identity":"37205443-d608-4a2d-b628-2fcf06a21b12","added_by":"auto","created_at":"2025-12-08 15:38:01","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":19216,"visible":true,"origin":"","legend":"\u003cp\u003eGraphs of (A) Surface Hardness, (B) Flexural Strength and (C) Surface Roughness of the Zeolite Containing Samples\u003c/p\u003e","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8064545/v1/a93028e0576d072af1b1a51d.png"},{"id":97895585,"identity":"d2f5433c-e287-4392-a38f-7a672c7522ad","added_by":"auto","created_at":"2025-12-10 15:34:30","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":14248,"visible":true,"origin":"","legend":"\u003cp\u003eGraphs of (A) Coloration Test Measurements to Investigate the Effect of Zeolite on the Coloration of the Samples (ΔE\u003csub\u003e00\u003c/sub\u003e) and (B) Color Measurement Test to Investigate the Effect of Zeolite on the Colors of the Samples(ΔE\u003csub\u003e00\u003c/sub\u003e) \u003csub\u003e\u0026nbsp;\u003c/sub\u003e\u003c/p\u003e","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8064545/v1/c0a24124def18754d9e4df64.png"},{"id":97721141,"identity":"fa447bb4-01de-430c-85be-7caae733bd63","added_by":"auto","created_at":"2025-12-08 15:38:02","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":7040,"visible":true,"origin":"","legend":"\u003cp\u003eGraph of the Direct Contact Test CFU Measurement Results\u003c/p\u003e","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-8064545/v1/9bc326f4fcb38c2a816c8f78.png"},{"id":97721148,"identity":"72f71a4d-30d1-4820-8999-f8502e44faa2","added_by":"auto","created_at":"2025-12-08 15:38:02","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":479779,"visible":true,"origin":"","legend":"\u003cp\u003eSEM Image of Biofilm formation of the Control and zeolite-containing Samples\u003c/p\u003e","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-8064545/v1/c95ac5ae292b6695b3a80019.png"},{"id":97902547,"identity":"afe8ff4e-24ae-4fca-ace2-ca2e5b7b7b82","added_by":"auto","created_at":"2025-12-10 15:52:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1706830,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8064545/v1/99225443-95dc-4043-9fe0-2133bc952b9f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Ag/Zn/Zeolite-Modified Glaze for Lithium Disilicate Ceramics: Comprehensive Evaluation of Antibacterial, Mechanical, and Optical Properties","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eAll-ceramic dental ceramics are among the most successful materials in dentistry due to their exceptional aesthetic properties, biocompatibility, and chemical inertness [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Recent advancements in material science and production techniques have significantly enhanced dental ceramics. Notably, glass ceramics like the IPS\u0026trade; e.max series offer an ideal combination of aesthetic and mechanical properties, making them a preferred choice for dental restorations [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. The longevity of a restoration is closely linked to its surface topology and roughness. Higher surface roughness can promote the formation of superficial cracks, compromising the restoration's strength over time [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Glazing is a routine finishing technique applied to dental ceramic restorations to create smooth, glass-coated surfaces that enhance both aesthetics and hygiene [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. This process not only strengthens brittle ceramics by reducing surface defects but also helps seal cracks, thereby reinforcing the material's structural integrity [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Glazed surfaces also show reduced plaque accumulation, limiting the ceramic\u0026rsquo;s exposure to the oral cavity while maintaining the necessary smoothness [\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003ePlaque and biofilms on dental materials form complex micro-ecosystems of oral microorganisms surrounded by an extracellular matrix of proteins and polysaccharides [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. These biofilms contribute to dental caries, periodontal diseases, peri-implantitis, and plaque formation, ultimately leading to enamel demineralization. Biofilms adhere readily to both biotic and abiotic surfaces, including prostheses, implants, and tooth-restoration interfaces [\u003cspan additionalcitationids=\"CR10\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Reducing microbial colonization on dental materials is essential for improving treatment outcomes [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eZeolite, a crystalline aluminosilicate with a tetrahedral structure, has diverse applications, including potential use in dentistry as an antimicrobial agent. Ion-embedded zeolites can inactivate key microbial enzymes, disrupt DNA replication, and impair respiration, thereby inhibiting the growth of pathogenic microorganisms [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, the addition of zeolite to dental materials necessitates careful evaluation of its mechanical impact. Properties like flexural strength, bond strength, compressive strength, setting time, and surface microhardness are critical to the long-term performance of dental restorations [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Studies indicate that adding ion-loaded zeolite in concentrations of 0.2% to 2% by weight is generally optimal, as higher concentrations may compromise the mechanical properties of materials like MTA and acrylic resin [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eHypothesis (H₀): The addition of Ag/Zn/Zeolite to the glaze layer of IPS\u0026trade; e.max Press is hypothesized to enhance the antibacterial properties of restorations while maintaining or improving their mechanical and optical properties.\u003c/p\u003e"},{"header":"2. MATERIALS \u0026 METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1. Preparation of Samples\u003c/h2\u003e\u003cp\u003eLithium disilicate (IPS\u0026trade; e.Max Press, Ivoclar Vivadent) samples were fabricated using the lost wax technique. The material was pressed in a Programat EP 5010 porcelain furnace (Ivoclar Vivadent, Schaan, Liechtenstein) at 920˚C under a pressure of 5 bar, following the manufacturer's guidelines. To ensure clean surfaces, the samples were immersed in a 1% solution of hydrofluoric and phosphoric acid (IPS\u0026trade; e.max Press Invex Liquid, Schaan, Liechtenstein) for 10 minutes. They were then rinsed with distilled water, dried, and sandblasted using aluminum oxide (type 100) at a pressure of 1 bar. Surface smoothing was achieved with a diamond bur (grain size: 15\u0026ndash;20 \u0026micro;m) followed by polishing with silicon carbide discs (White Dove Abrasives Co., Ltd., China) in successive grids (600, 800, and 1200) using a Metkon FORCIPOL 1V polisher (Metkon, Turkey).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2. Preparation of Zeolite and Glaze Porcelain Content\u003c/h2\u003e\u003cp\u003eZeolite A crystals with a gel formulation of 11.25SiO₂:1.8Al₂O₃:13.4(TMA)₂O:0.6Na₂O:700H₂O were synthesized via an 18-hour aging process followed by an 8-hour hydrothermal reaction. After synthesis, the zeolite crystals were washed three times with distilled water, centrifuged, and dried in an oven at 60\u0026deg;C. The resulting crystals were characterized using Scanning Electron Microscopy (SEM) and X-Ray Diffraction (XRD). An aqueous solution containing 0.247 g of silver nitrate (AgNO₃) and 3.83 g of zinc sulfate heptahydrate (ZnSO₄\u0026middot;6H₂O) in 300 mL of distilled water was prepared to introduce antibacterial properties to the zeolite structure. Three grams of zeolite A were added to the solution for ion exchange. The mixture was stirred magnetically in the dark for 24 hours at room temperature, then centrifuged and washed three times with deionized water. The samples were dried at 45\u0026deg;C for 24 hours. To convert the ions in the zeolite into nanoparticles, a chemical reduction reaction was performed using an aqueous solution of sodium borohydride (NaBH₄). Three grams of ion-exchanged zeolite A were added to 375 mL of distilled water containing three grams of dissolved NaBH₄. After centrifuging and washing the zeolite crystals three times with distilled water, the samples were dried at 45\u0026deg;C for 24 hours. The chemical composition of Ag/Zn/Zeolite was analyzed using inductively coupled plasma optical emission spectrometry (ICP-OES). Reagents used included tetramethylammonium hydroxide solution (TMAOH, 25 wt.% in H₂O), aluminum isopropoxide (\u0026ge;\u0026thinsp;98%), sodium hydroxide (NaOH) from Sigma-Aldrich, and tetraethyl orthosilicate (TEOS) from Merck. A Milli-Q water purification system was employed to distill deionized water from tap water. For the glaze porcelain preparation, Ips\u0026trade; Ivocolor glaze porcelain powder was mixed homogeneously with 1% or 2% (by weight) zeolite powder containing Ag and Zn. Clean brushes were used for each sample to apply equal volumes of the glaze mixture. The samples were baked at 770\u0026deg;C in a Programat P300 porcelain furnace (Ivoclar Vivadent, Schaan, Liechtenstein) according to the manufacturer\u0026rsquo;s instructions.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3. Characterization of Zeolite and Ag/Zn/Zeolite\u003c/h2\u003e\u003cp\u003eThe morphology of the synthesized zeolite A crystals was analyzed using a field-emission scanning electron microscope (FE-SEM, FEI Quanta 400). Phase identification of the zeolite A crystals was performed through X-ray powder diffraction (XRD) with a Rigaku-Ultima IV. The chemical composition and ion exchange properties of the zeolite A crystals were evaluated using inductively coupled plasma optical emission spectrometry (ICP-OES, Perkin Elmer Optima 4300DV).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4. Measurement of Surface Roughness of Samples\u003c/h2\u003e\u003cp\u003eFive samples (2 mm thick and 10 mm in diameter) were prepared for each of the three groups containing different ratios of zeolite (0%, 1%, and 2%). Surface roughness measurements were performed using a profilometer (Surftest SJ-210 Mitutoyo, Tokyo, Japan) with a tip diameter of 5 \u0026micro;m. The device was calibrated as per the manufacturer\u0026rsquo;s instructions using a calibration plate. Each sample was placed sequentially on the device\u0026rsquo;s standard measuring table, maintaining a 90\u0026deg; contact angle between the profilometer\u0026rsquo;s reader tip and the sample disc. Measurements were conducted at 4 mm intervals with a measurement speed of 2 mm/sec and a cut-off value of 0.8 mm. Each sample was measured in three different regions (center and sides), and the mean of these values represented the surface roughness (Ra) for that sample. The instrument was recalibrated after every five measurements. To stabilize the samples during measurement, Patafix (UHU GmbH \u0026amp; Co. KG), an elastic and reusable adhesive, was used.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5. Measurement of Surface Hardness Degrees of Samples\u003c/h2\u003e\u003cp\u003eTen samples (2 mm thick and 10 mm in diameter) were prepared for each of the three groups containing varying zeolite ratios (0%, 1%, and 2%). Surface hardness was measured using a Vickers microhardness tester in accordance with the ASTM E384-11 standard. A diamond pyramid-shaped indenter was applied with a load of 200 gf for a dwell time of 10 seconds.\u003c/p\u003e\u003cp\u003eThe Vickers Hardness (HV) value was calculated using the formula:\u003c/p\u003e\u003cp\u003eHV\u0026thinsp;=\u0026thinsp;1.8544 \u0026times; (P/d\u0026sup2;)\u003c/p\u003e\u003cp\u003ewhere HV is the hardness value, P represents the applied load, and d is the diagonal length of the indentation.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e2.6. Measurement of Flexural Strength of Samples\u003c/h2\u003e\u003cp\u003eFlexural strength was measured using a three-point bending test in accordance with ISO 6872:2008 standards. Thirty rectangular prism specimens were prepared for each of the three groups, with dimensions specified as 1.6 \u0026times; 4 \u0026times; 20 mm, as required for the three-point bending test of Type 1 ceramics. The test was performed using a computer-assisted universal testing machine (Shimadzu AGS-X, Japan) with a power capacity of 10 kN. The specimens were positioned parallel to each other on abutments spaced 16 mm apart. The testing device applied force at a speed of 1 mm/min until the specimens fractured. The maximum load (in Newtons, N) exerted on each specimen at the point of fracture was recorded. Flexural strength values were calculated in Megapascals (MPa) using Trapezium X data processing software connected to the testing machine.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e2.7. Color Measurement Test to Investigate the Effect of Zeolite on the Colors of the Samples\u003c/h2\u003e\u003cp\u003eFifteen samples (2 mm thick and 10 mm in diameter) were prepared for the color measurement test. Measurements were conducted using a VITA Easyshade Compact V device (VITA Zahnfabrik, Bad S\u0026auml;ckingen, Germany). The device was calibrated prior to each measurement using D65 light on a white background.\u003c/p\u003e\u003cp\u003eSamples were immersed in distilled water at 37 \u0026ordm;C for 24 hours and dried before measurement. During each measurement, the device\u0026rsquo;s fiber optic tip was placed perpendicular to the sample surface and parallel to the ground. For each sample in the control and experimental groups, color measurements were repeated three times, and the average was recorded. The color difference (ΔE₀₀) was calculated using the CIEDE2000 formula:\u003c/p\u003e\u003cp\u003e\u003cem\u003eΔE₀₀ = \u0026radic;[(ΔL*/(kL*SL))\u0026sup2; + (ΔC*/(kC*SC))\u0026sup2; + (ΔH*/(kH*SH))\u0026sup2; + RT(ΔC*/(kC*SC))(ΔH*/(kH*SH))].\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e2.8. Application of Coloration Tests\u003c/h2\u003e\u003cp\u003eFive samples(2 mm thick and 10 mm in diameter) from each group (control, 1% Ag/Zn/Zeolite, and 2% Ag/Zn/Zeolite) were immersed in 15 mL of test solutions for 7 days at a controlled temperature of 37\u0026thinsp;\u0026plusmn;\u0026thinsp;1\u0026deg;C in a dark environment. The test solutions included Coca-Cola, tea (Lipton Yellow Label Tea), and coffee (Nescafe Gold). Tea and coffee were prepared according to the manufacturer\u0026rsquo;s instructions, refreshed daily, and stirred every 12 hours to ensure solution homogeneity.\u003c/p\u003e\u003cp\u003eAfter 7 days, the samples were removed, rinsed with distilled water, and dried using tissue paper. The color of each sample was measured three times both before and after immersion, with the averages recorded. The color difference (ΔE₀₀) was calculated using the CIEDE2000 color difference formula: \u003cem\u003eΔE₀₀ = \u0026radic;[(ΔL*/(kL*SL))\u0026sup2; + (ΔC*/(kC*SC))\u0026sup2; + (ΔH*/(kH*SH))\u0026sup2; + RT(ΔC*/(kC*SC))(ΔH*/(kH*SH))].\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e2.9. Preparation of the Bacterial Suspension\u003c/h2\u003e\u003cp\u003eThe standard strain of \u003cem\u003eStreptococcus mutans\u003c/em\u003e (ATCC 25175), registered in the American Type Culture Collection (ATCC), was used in this study. The strain was thawed from \u0026minus;\u0026thinsp;80\u0026deg;C to room temperature and rehydrated with approximately 0.5 mL of brain heart infusion (BHI broth). It was streaked onto a BHI agar plate and incubated at 35\u0026thinsp;\u0026plusmn;\u0026thinsp;2\u0026deg;C in a CO₂ incubator (N\u0026uuml;ve, Turkey) for 48\u0026ndash;72 hours.\u003c/p\u003e\u003cp\u003eThe resulting bacterial colonies were re-streaked on fresh BHI agar plates and incubated under the same conditions for another 48\u0026ndash;72 hours. Following the second passage, 2\u0026ndash;4 bacterial colonies were selected using a sterile loop and suspended in 4 mL of saline solution. The absorbance of the suspension was measured spectrophotometrically using a McFarland device (PhoenixSpec, BD, NJ, USA). The bacterial suspension was adjusted to a 0.5 McFarland standard, equivalent to 1 \u0026times; 10⁸ CFU/mL.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e2.10. Application of the Direct Contact Test Method\u003c/h2\u003e\u003cp\u003eThree discs from each group (0%, 1%, and 2% Ag/Zn/Zeolite) were sterilized with ethylene oxide and placed into individual wells of a microplate. To each well, 10 \u0026micro;L of bacterial suspension (0.5 McFarland \u003cem\u003eS. mutans\u003c/em\u003e) was added. The plate was incubated at 35\u0026thinsp;\u0026plusmn;\u0026thinsp;2\u0026deg;C in a CO₂ incubator, and colony counts (CFU/mL) were determined at 12, 24, and 48 hours. Three discs were used per group for each time point. At 6, 12, 24, and 48 hours, one control disc, one 1% Ag/Zn/Zeolite disc, and one 2% Ag/Zn/Zeolite disc were vortexed in 300 \u0026micro;L of BHI broth to produce the initial bacterial suspension for each group. Simultaneously, 90 \u0026micro;L of BHI broth was dispensed into 18 wells (six wells per group). For ten-fold serial dilutions, 10 \u0026micro;L of the bacterial suspensions were transferred to the wells containing 90 \u0026micro;L of BHI broth and mixed thoroughly. The plates were incubated for 6, 12, 24, and 48 hours. At each time point, 10 \u0026micro;L was taken from each well and inoculated onto BHI agar plates divided into four quadrants. Colony counts from six serial dilutions were used for analysis. The bacterial count was multiplied by the dilution factor to calculate CFU/mL.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003e2.11. Evaluation of Biofilm Formation by Scanning Electron Microscopy (SEM)\u003c/h2\u003e\u003cp\u003eBiofilm formation was evaluated for control samples and those containing 1% and 2% Ag/Zn/Zeolite following prolonged exposure to \u003cem\u003eS. mutans\u003c/em\u003e. Each test disc was placed in a microcentrifuge tube and immersed in 300 \u0026micro;L of a \u003cem\u003eS. mutans\u003c/em\u003e suspension prepared at a concentration equivalent to a 0.5 McFarland standard (approximately 1.5 \u0026times; 10⁸ CFU/mL) in BHI medium supplemented with 1% sucrose.\u003c/p\u003e\u003cp\u003eThe samples were incubated at 37\u0026deg;C in a 5% CO₂ incubator for 24 hours, 7 days, and 30 days. After incubation, the samples were washed with sterile saline for 1 minute to remove planktonic bacteria. To assess biofilm formation, the samples were fixed in 10% formalin for one week, then dehydrated sequentially using ethanol solutions of increasing concentration (75%, 90%, and 100%). The processed samples were subsequently analyzed by Scanning Electron Microscopy (SEM).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003e2.12. Statistical Analyses\u003c/h2\u003e\u003cp\u003eThe data were analyzed using SPSS 20.0 (Statistical Package for Social Sciences). Descriptive statistics, including the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation, were calculated at a 95% confidence interval. For variables with parametric distribution, the median, minimum, and maximum values were determined, while categorical variables were summarized using numbers and percentages. To compare the means of groups containing more than two groups, a One-Way Analysis of Variance (ANOVA) test was performed. Groups showing statistically significant differences were further analyzed using the post hoc Least Significant Difference (LSD) test. Statistical significance was defined as P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. RESULTS","content":"\u003cp\u003eThe FE-SEM images and X-ray diffraction (XRD) patterns of the synthesized zeolite crystals are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. As seen in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA, the synthesized zeolite A crystals were uniform and nano-sized with a ball-like morphology. The XRD pattern (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eB) matched well with reference patterns from the literature, with no additional peaks observed, confirming the successful synthesis of zeolite A crystals [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Inductively Coupled Plasma Optical Emission Spectrometry (ICP-OES) analysis determined the concentration of Ag and Zn in the zeolite framework. The ion-exchange process resulted in metal concentrations of 2.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.01 for silver and 11.8\u0026thinsp;\u0026plusmn;\u0026thinsp;0.09 for zinc.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe roughness values for the samples were significantly affected by the addition of Ag/Zn/Zeolite. The control group (0% Ag/Zn/Zeolite) displayed significantly higher surface roughness compared to the samples with 1% and 2% Ag/Zn/Zeolite (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eC). However, no statistically significant difference in surface roughness was observed between the 1% and 2% Ag/Zn/Zeolite groups (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The highest flexural strength was measured in the samples containing 2% Ag/Zn/Zeolite, while the lowest was observed in the control group (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB). Despite these variations, the differences in flexural strength between the groups were not statistically significant (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003eSignificant differences in surface hardness were observed across all groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05, Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA). The control group (0% Ag/Zn/Zeolite) exhibited the highest surface hardness, while the samples with 2% Ag/Zn/Zeolite demonstrated the lowest hardness.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eWhen comparing color differences (ΔE₀₀) between groups, all pairs showed statistically significant differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The smallest color difference was noted between the 1% and 2% Ag/Zn/Zeolite groups, while the largest difference occurred between the control and the 2% Ag/Zn/Zeolite group (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eB).\u003c/p\u003e\u003cp\u003eThe color stability of the samples after immersion in Coca-Cola revealed significant group differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The 2% Ag/Zn/Zeolite samples exhibited the highest color change, while the control samples showed the lowest (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003eA). For samples immersed in coffee or tea, no significant difference in color change was observed between the 1% and 2% Ag/Zn/Zeolite groups, though the control samples displayed significantly lower color change compared to both experimental groups.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe results of the direct contact test demonstrated that colony counts were similar across all samples after 6 hours of contact (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). However, after 12 hours, bacterial colony counts were reduced by a factor of 5 in the samples containing 1% Ag/Zn/Zeolite and by a factor of 33 in those containing 2% Ag/Zn/Zeolite compared to the control group.\u003c/p\u003e\u003cp\u003eAt the 24-hour mark, colony counts were 100 times lower in the 1% Ag/Zn/Zeolite samples and 1250 times lower in the 2% Ag/Zn/Zeolite samples relative to the control. After 48 hours of contact, no bacterial colonies were observed in either of the experimental groups, indicating complete bacterial inhibition (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eLong-term biofilm formation was evaluated via SEM imaging on days 1, 7, and 30 (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). These images revealed notable differences in biofilm coverage between the control group and the experimental groups. Samples containing 1% and 2% Ag/Zn/Zeolite exhibited significantly less biofilm formation than the control group, with the 2% Ag/Zn/Zeolite samples showing the greatest antibacterial effect over the 30-day period.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"4. DISCUSSIONS","content":"\u003cp\u003eThe findings from this study indicate that surface roughness decreased with increasing concentrations of Ag/Zn/Zeolite in the glaze layer. This suggests that the addition of ion-loaded zeolite improves the smoothness of the material, which can positively influence its mechanical properties. Although no direct comparisons could be made with studies examining the effect of ion-loaded zeolite in the glaze layer of dental ceramics, our results align with similar findings reported for ion-loaded zeolite in PMMA resin [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn contrast, surface hardness decreased as the ratio of Ag/Zn/Zeolite in the glaze layer increased. The control sample (0% Ag/Zn/Zeolite) had an average surface hardness of 6.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.09 GPa, while samples containing 1% and 2% Ag/Zn/Zeolite exhibited surface hardness values of 5.9\u0026thinsp;\u0026plusmn;\u0026thinsp;0.07 GPa and 5.6\u0026thinsp;\u0026plusmn;\u0026thinsp;0.17 GPa, respectively. Despite this reduction, the surface hardness values for all samples remained within acceptable limits, as outlined by the scientific documentation for IPS\u0026trade; e.max ceramics [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The flexural strength of the samples increased with higher Ag/Zn/Zeolite concentrations, although the differences were not statistically significant. Control samples had an average flexural strength of 296\u0026thinsp;\u0026plusmn;\u0026thinsp;49 MPa, while samples with 1% and 2% Ag/Zn/Zeolite exhibited values of 315\u0026thinsp;\u0026plusmn;\u0026thinsp;46 MPa and 324\u0026thinsp;\u0026plusmn;\u0026thinsp;25 MPa, respectively. These values surpass those reported in earlier studies (239\u0026ndash;281 MPa) [\u003cspan additionalcitationids=\"CR22 CR23 CR24\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] and are consistent with the flexural strength range of 300\u0026ndash;400 MPa reported in other investigations [\u003cspan additionalcitationids=\"CR27 CR28\" citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Variations in test design may account for discrepancies in reported values across studies [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Paravina et al. and de Oliveira et al. emphasized the importance of visual thresholds in interpreting numerical color differences. A ΔE\u003csub\u003e00\u003c/sub\u003e value of \u0026le;\u0026thinsp;0.8, referred to as the detection threshold, means 50% of observers perceive a color difference between two objects, while the other 50% do not. Similarly, a ΔE\u003csub\u003e00\u003c/sub\u003e value between 0.8 and 1.8(the acceptability threshold) indicates that 50% of observers find the color difference acceptable, while the other 50% may consider it to require correction [\u003cspan additionalcitationids=\"CR31\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eSilver-containing materials are often associated with poor color stability [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. However, no prior research has investigated how the incorporation of Ag/Zn/Zeolite into the glaze layer of dental ceramics affects color stability. In this study, we observed that adding Ag/Zn/Zeolite at 1% and 2% by weight caused concentration-dependent color changes. Despite these changes, the ΔE\u003csub\u003e00\u003c/sub\u003e values for all samples remained below the acceptable threshold of \u0026le;\u0026thinsp;1.8. Specifically, the ΔE\u003csub\u003e00\u003c/sub\u003e value was 1.126 between the control and 1% Ag/Zn/Zeolite samples, and 1.318 between the control and 2% Ag/Zn/Zeolite samples. The literature on dental materials highlights coffee as the most frequently used staining solution for evaluating color stability, followed by tea and Coca-Cola. In vitro, a one-week immersion period is considered to simulate the consumption of one cup of coffee or Coca-Cola daily for approximately seven months [\u003cspan additionalcitationids=\"CR35 CR36 CR37 CR38 CR39\" citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. In this study, samples immersed in Coca-Cola for 7 days exhibited significant differences in color change depending on the concentration of zeolite added (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The highest color change was observed in the 2% Ag/Zn/Zeolite samples (ΔE\u003csub\u003e00\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.559), while the control samples displayed the lowest color change (ΔE\u003csub\u003e00\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.435). For samples immersed in coffee or tea, no significant difference in color change was detected between the 1% and 2% Ag/Zn/Zeolite groups after 7 days. However, the control group exhibited significantly lower color changes than both experimental groups. The 2% Ag/Zn/Zeolite samples had the highest color change (ΔE\u003csub\u003e00\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.769 and 0.643 for coffee and tea, respectively), while the control group showed the lowest values (ΔE\u003csub\u003e00\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.727 and 0.598 for coffee and tea, respectively). Although the addition of Ag/Zn/Zeolite increased discoloration, the highest recorded ΔE\u003csub\u003e00\u003c/sub\u003e value of 0.769 (2% Ag/Zn/Zeolite samples immersed in coffee) remained below the perceptibility threshold of ΔE\u003csub\u003e00\u003c/sub\u003e\u0026thinsp;\u0026le;\u0026thinsp;0.8. \u003cem\u003eS. mutans\u003c/em\u003e is a dominant microorganism in dental plaques and oral biofilm, making it a relevant choice for this study. This species is known to follow a bi-species biofilm pattern, colonizing supragingival biofilms early often within the first 8 hours. Additionally, \u003cem\u003eS. mutans\u003c/em\u003e is a major acid producer implicated in dental caries formation [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e, \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. However, true oral biofilms are highly heterogeneous, involving a range of attachment modes and interspecies interactions that were beyond the scope of this study [\u003cspan additionalcitationids=\"CR44\" citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e]. The Direct Contact Test results demonstrated significant antimicrobial activity against \u003cem\u003eS. mutans\u003c/em\u003e in samples containing 1% and 2% Ag/Zn/Zeolite. The activity was both time- and concentration-dependent. These findings are consistent with previous studies that highlighted the antibacterial properties of ion-loaded zeolite in various materials [\u003cspan additionalcitationids=\"CR47 CR48 CR49\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. The antibacterial mechanism likely stems from the controlled, sustained release of silver and zinc ions with antimicrobial properties into the surrounding environment, as supported by earlier research [\u003cspan additionalcitationids=\"CR47 CR48 CR49\" citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e]. Long-term exposure to \u003cem\u003eS. mutans\u003c/em\u003e inoculum resulted in biofilm formation in all sample groups. However, SEM analysis showed that biofilm formation was significantly reduced in samples containing 1% and 2% Ag/Zn/Zeolite compared to the control group. Furthermore, the antimicrobial activity of these samples persisted over 30 days, with the 2% Ag/Zn/Zeolite samples demonstrating the highest level of inhibition against biofilm formation.\u003c/p\u003e\u003cp\u003eFuture studies, including clinical trials, are recommended to further validate these findings to assess the effects of incorporating Ag/Zn/Zeolite into the glaze layer of lithium disilicate restorations. Such studies would help clarify the long-term clinical implications of the antimicrobial and mechanical properties observed in this in vitro investigation.\u003c/p\u003e"},{"header":"5. CONCLUSIONS","content":"\u003cp\u003eThis study investigated the effects of incorporating zeolite containing 0%, 1%, and 2% silver and zinc into the glaze layer of a widely used dental ceramic material (IPS\u0026trade; e.max Press). The mechanical, optical, and antimicrobial properties of the resulting glaze porcelain were evaluated following the firing process.\u003c/p\u003e\u003cp\u003e\u003cem\u003eThe key findings of the study are as follows\u003c/em\u003e:\u003c/p\u003e\u003cp\u003e\u003col style=\"list-style-type:lower-alpha;\"\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eSurface roughness decreased in samples containing 1% and 2% Ag/Zn/Zeolite compared to the control group, indicating improved smoothness.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eFlexural strength increased in the experimental groups (1% and 2% Ag/Zn/Zeolite) compared to the control group, although this increase was not statistically significant.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eSurface hardness decreased in the 1% and 2% Ag/Zn/Zeolite groups but remained above the minimum acceptable value specified by the manufacturer, consistent with previous studies.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eColor differences (ΔE₀₀) increased with higher concentrations of Ag/Zn/Zeolite, but all values were within the acceptable range for dental restorations.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eDiscoloration caused by cola, coffee, and tea immersion was higher in the 1% and 2% Ag/Zn/Zeolite samples compared to the control group. However, the observed changes remained below the perceptibility threshold.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eAntibacterial activity was significantly higher in the 1% and 2% Ag/Zn/Zeolite samples, with the greatest effect observed in the 2% group.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eConflict of Interest\u003c/h2\u003e\u003cp\u003eThe authors have no conflicts of interest to declare.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eHAS conceptualized the study, performed data curation, formal analysis, investigation, and visualization, developed the methodology and software, acquired funding, and drafted the original manuscript.ZBD contributed to conceptualization, data curation, methodology, and supervision; acquired funding and resources; and participated in project administration, validation, and writing, review, and editing.UAS contributed to conceptualization, investigation, methodology, resources, and supervision, and was involved in project administration, validation, and writing, review, and editing.MIB and BA provided resources and supervision.ESC and TA contributed to the investigation and methodology.All authors reviewed and approved the final version of the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgments\u003c/h2\u003e\u003cp\u003eThis research is supported by the Suleyman Demirel University Scientific Research Projects Coordination Unit with the project number TDH-2021-8298.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eAll data generated or analyzed during this study, including antibacterial, mechanical, and optical test results, are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePilathadka S, Vahalova D. Contemporary all-ceramic materials, part-1. Acta Medica (Hradec Kralove). 2007;50(2):101\u0026ndash;4. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.14712/18059694.2017.63\u003c/span\u003e\u003cspan address=\"10.14712/18059694.2017.63\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWillard A, Gabriel Chu TM. The science and application of IPS e.Max dental ceramic. Kaohsiung J Med Sci. 2018;34(4):238\u0026ndash;42. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.kjms.2018.01.012\u003c/span\u003e\u003cspan address=\"10.1016/j.kjms.2018.01.012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFlury S, Peutzfeldt A, Lussi A. Influence of surface roughness on mechanical properties of two computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic materials. Oper Dent. 2012;37(6):617\u0026ndash;24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2341/11-391-L\u003c/span\u003e\u003cspan address=\"10.2341/11-391-L\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlbakry M, Guazzato M, Swain MV. Effect of sandblasting, grinding, polishing and glazing on the flexural strength of two pressable all-ceramic dental materials. J Dent. 2004;32(2):91\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jdent.2003.08.006\u003c/span\u003e\u003cspan address=\"10.1016/j.jdent.2003.08.006\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAksoy G, Polat H, Polat M, Coskun G. Effect of various treatment and glazing (coating) techniques on the roughness and wettability of ceramic dental restorative surfaces. Colloids Surf B Biointerfaces. 2006;53(2):254\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.colsurfb.2006.09.016\u003c/span\u003e\u003cspan address=\"10.1016/j.colsurfb.2006.09.016\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFairhurst CW, Lockwood PE, Ringle RD, Thompson WO. The effect of glaze on porcelain strength. Dent Mater. 1992;8(3):203\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/0109-5641(92)90084-p\u003c/span\u003e\u003cspan address=\"10.1016/0109-5641(92)90084-p\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eal-Wahadni A, Martin DM. Glazing and finishing dental porcelain: a literature review. J Can Dent Assoc. 1998;64(8):580\u0026ndash;3. PMID: 9785688.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKolenbrander PE, Palmer RJ Jr, Periasamy S, Jakubovics NS. Oral multispecies biofilm development and the key role of cell-cell distance. Nat Rev Microbiol. 2010;8(7):471\u0026ndash;80. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/nrmicro2381\u003c/span\u003e\u003cspan address=\"10.1038/nrmicro2381\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAmmons MC, Tripet BP, Carlson RP, et al. Quantitative NMR metabolite profiling of methicillin-resistant and methicillin-susceptible Staphylococcus aureus discriminates between biofilm and planktonic phenotypes. J Proteome Res. 2014;13(6):2973\u0026ndash;85. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1021/pr500120c\u003c/span\u003e\u003cspan address=\"10.1021/pr500120c\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eVo DT, Arola D, Romberg E, Driscoll CF, Jabra-Rizk MA, Masri R. Adherence of Streptococcus mutans on lithium disilicate porcelain specimens. J Prosthet Dent. 2015;114(5):696\u0026ndash;701. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.prosdent.2015.06.017\u003c/span\u003e\u003cspan address=\"10.1016/j.prosdent.2015.06.017\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDal Piva A, Contreras L, Ribeiro FC, et al. Monolithic Ceramics: Effect of Finishing Techniques on Surface Properties, Bacterial Adhesion and Cell Viability. Oper Dent. 2018;43(3):315\u0026ndash;25. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2341/17-011-L\u003c/span\u003e\u003cspan address=\"10.2341/17-011-L\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBowen WH, Burne RA, Wu H, Koo H. Oral Biofilms: Pathogens, Matrix, and Polymicrobial Interactions in Microenvironments. Trends Microbiol. 2018;26(3):229\u0026ndash;42. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.tim.2017.09.008\u003c/span\u003e\u003cspan address=\"10.1016/j.tim.2017.09.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKraljević Pavelić S, Simović Medica J, Gumbarević D, Filošević A, Pržulj N, Pavelić K. Critical Review on Zeolite Clinoptilolite Safety and Medical Applications \u003cem\u003ein vivo\u003c/em\u003e. Front Pharmacol. 2018;9:1350. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fphar.2018.01350\u003c/span\u003e\u003cspan address=\"10.3389/fphar.2018.01350\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2018 Nov 27.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDerakhshankhah H, Jafari S, Sarvari S, et al. Biomedical Applications of Zeolitic Nanoparticles, with an Emphasis on Medical Interventions. Int J Nanomed. 2020;15:363\u0026ndash;86. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2147/IJN.S234573\u003c/span\u003e\u003cspan address=\"10.2147/IJN.S234573\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2020 Jan 21.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSivakumar I, Arunachalam KS, Sajjan S, Ramaraju AV, Rao B, Kamaraj B. Incorporation of antimicrobial macromolecules in acrylic denture base resins: a research composition and update. J Prosthodont. 2014;23(4):284\u0026ndash;90. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jopr.12105\u003c/span\u003e\u003cspan address=\"10.1111/jopr.12105\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWang L, D'Alpino PH, Lopes LG, Pereira JC. Mechanical properties of dental restorative materials: relative contribution of laboratory tests. J Appl Oral Sci. 2003;11(3):162\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1590/s1678-77572003000300002\u003c/span\u003e\u003cspan address=\"10.1590/s1678-77572003000300002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHao J, Lang S, Mante F, Pavelić K, Ozer F. Antimicrobial and Mechanical Effects of Zeolite Use in Dental Materials: A Systematic Review. Acta Stomatol Croat. 2021;55(1):76\u0026ndash;89. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.15644/asc55/1/9\u003c/span\u003e\u003cspan address=\"10.15644/asc55/1/9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFan W, Meneau F, Bras W, Ogura M, Sankar G, Okubo T. Effects of silicon sources on the formation of nanosized LTA: An in situ small angle X-ray scattering and wide angle X-ray scattering study. Microporous Mesoporous Mater. 2007;101:134\u0026ndash;41. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.micromeso.2006.10.007\u003c/span\u003e\u003cspan address=\"10.1016/j.micromeso.2006.10.007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eEsmaeilzadeh M, Divband B, Ranjkesh B, et al. Antimicrobial and Mechanical Properties of Orthodontic Acrylic Resin Containing Zinc Oxide and Titanium Dioxide Nanoparticles Supported on 4A Zeolite. Int J Dent. 2022;2022:8155971. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1155/2022/8155971\u003c/span\u003e\u003cspan address=\"10.1155/2022/8155971\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2022 Jul 14.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eB\u0026uuml;hler-Zemp P, V\u0026ouml;lkel T, Fischer K. Scientific Documentation IPS e.Max Press. Schaan, Liechtenstein: Ivoclar Vivadent; 2011.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChung KH, Liao JH, Duh JG, Chan DC. The effects of repeated heat-pressing on properties of pressable glass-ceramics. J Oral Rehabil. 2009;36(2):132\u0026ndash;41. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1365-2842.2008.01909.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1365-2842.2008.01909.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGorman CM, Horgan K, Dollard RP, Stanton KT. Effects of repeated processing on the strength and microstructure of a heat-pressed dental ceramic. J Prosthet Dent. 2014;112(6):1370\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.prosdent.2014.06.015\u003c/span\u003e\u003cspan address=\"10.1016/j.prosdent.2014.06.015\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDella Bona A, Mecholsky JJ Jr, Anusavice KJ. Fracture behavior of lithia disilicate- and leucite-based ceramics. Dent Mater. 2004;20(10):956\u0026ndash;62. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.dental.2004.02.004\u003c/span\u003e\u003cspan address=\"10.1016/j.dental.2004.02.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGuazzato M, Albakry M, Ringer SP, Swain MV. Strength, fracture toughness and microstructure of a selection of all-ceramic materials. Part I. Pressable and alumina glass-infiltrated ceramics. Dent Mater. 2004;20(5):441\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.dental.2003.05.003\u003c/span\u003e\u003cspan address=\"10.1016/j.dental.2003.05.003\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAl-Thobity AM, Alsalman A. Flexural properties of three lithium disilicate materials: An in vitro evaluation. Saudi Dent J. 2021;33(7):620\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.sdentj.2020.07.004\u003c/span\u003e\u003cspan address=\"10.1016/j.sdentj.2020.07.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlbakry M, Guazzato M, Swain MV. Biaxial flexural strength and microstructure changes of two recycled pressable glass ceramics. J Prosthodont. 2004;13(3):141\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1532-849X.2004.04025.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1532-849X.2004.04025.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTang X, Tang C, Su H, Luo H, Nakamura T, Yatani H. The effects of repeated heat-pressing on the mechanical properties and microstructure of IPS e.max Press. J Mech Behav Biomed Mater. 2014;40:390\u0026ndash;6. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jmbbm.2014.09.016\u003c/span\u003e\u003cspan address=\"10.1016/j.jmbbm.2014.09.016\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eFabian Fonzar R, Carrabba M, Sedda M, Ferrari M, Goracci C, Vichi A. Flexural resistance of heat-pressed and CAD-CAM lithium disilicate with different translucencies. Dent Mater. 2017;33(1):63\u0026ndash;70. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.dental.2016.10.005\u003c/span\u003e\u003cspan address=\"10.1016/j.dental.2016.10.005\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAlbakry M, Guazzato M, Swain MV. Biaxial flexural strength, elastic moduli, and x-ray diffraction characterization of three pressable all-ceramic materials. J Prosthet Dent. 2003;89(4):374\u0026ndash;80. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1067/mpr.2003.42\u003c/span\u003e\u003cspan address=\"10.1067/mpr.2003.42\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ede Oliveira DC, Ayres AP, Rocha MG, et al. Effect of Different In Vitro Aging Methods on Color Stability of a Dental Resin-Based Composite Using CIELAB and CIEDE2000 Color-Difference Formulas. J Esthet Restor Dent. 2015;27(5):322\u0026ndash;30. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jerd.12155\u003c/span\u003e\u003cspan address=\"10.1111/jerd.12155\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eParavina RD, P\u0026eacute;rez MM, Ghinea R. Acceptability and perceptibility thresholds in dentistry: A comprehensive review of clinical and research applications. J Esthet Restor Dent. 2019;31(2):103\u0026ndash;12. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jerd.12465\u003c/span\u003e\u003cspan address=\"10.1111/jerd.12465\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eParavina RD. Critical appraisal. Color in dentistry: match me, match me not [published correction appears in J Esthet Restor Dent. 2009;21(3):142]. \u003cem\u003eJ Esthet Restor Dent\u003c/em\u003e. 2009;21(2):133\u0026ndash;139. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1708-8240.2009.00246.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1708-8240.2009.00246.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eImazato S. Antibacterial properties of resin composites and dentin bonding systems. Dent Mater. 2003;19(6):449\u0026ndash;57. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/s0109-5641(02)00102-1\u003c/span\u003e\u003cspan address=\"10.1016/s0109-5641(02)00102-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAl Ben Ali A, Kang K, Finkelman MD, Zandparsa R, Hirayama H. The effect of variations in translucency and background on color differences in CAD/CAM lithium disilicate glass ceramics. J Prosthodont. 2014;23(3):213\u0026ndash;20. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jopr.12080\u003c/span\u003e\u003cspan address=\"10.1111/jopr.12080\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGuler AU, Kurt S, Kulunk T. Effects of various finishing procedures on the staining of provisional restorative materials. J Prosthet Dent. 2005;93(5):453\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.prosdent.2005.02.001\u003c/span\u003e\u003cspan address=\"10.1016/j.prosdent.2005.02.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRagain JC Jr, Johnston WM. Minimum color differences for discriminating mismatch between composite and tooth color. J Esthet Restor Dent. 2001;13(1):41\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1708-8240.2001.tb00250.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1708-8240.2001.tb00250.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRaimondo RL Jr, Richardson JT, Wiedner B. Polished versus autoglazed dental porcelain. J Prosthet Dent. 1990;64(5):553\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/0022-3913(90)90126-w\u003c/span\u003e\u003cspan address=\"10.1016/0022-3913(90)90126-w\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGoldstein GR, Barnhard BR, Penugonda B. Profilometer, SEM, and visual assessment of porcelain polishing methods. J Prosthet Dent. 1991;65(5):627\u0026ndash;34. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/0022-3913(91)90196-4\u003c/span\u003e\u003cspan address=\"10.1016/0022-3913(91)90196-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAtay A, Karayazgan B, Ozkan Y, Akyil MS. Effect of colored beverages on the color stability of feldspathic porcelain subjected to various surface treatments. \u003cem\u003eQuintessence Int\u003c/em\u003e. 2009;40(7):e41-e48. PMID: 19626223.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKursoglu P, Karagoz Motro PF, Kazazoglu E. Correlation of surface texture with the stainability of ceramics. J Prosthet Dent. 2014;112(2):306\u0026ndash;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.prosdent.2013.09.028\u003c/span\u003e\u003cspan address=\"10.1016/j.prosdent.2013.09.028\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhu B, Macleod LC, Kitten T, Xu P. Streptococcus sanguinis biofilm formation \u0026amp; interaction with oral pathogens. Future Microbiol. 2018;13(8):915\u0026ndash;32. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2217/fmb-2018-0043\u003c/span\u003e\u003cspan address=\"10.2217/fmb-2018-0043\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAfonso Camargo SE, Mohiuddeen AS, Fares C, et al. Anti-Bacterial Properties and Biocompatibility of Novel SiC Coating for Dental Ceramic. J Funct Biomater. 2020;11(2):33. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/jfb11020033\u003c/span\u003e\u003cspan address=\"10.3390/jfb11020033\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Published 2020 May 20.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHojo K, Nagaoka S, Ohshima T, Maeda N. Bacterial interactions in dental biofilm development. J Dent Res. 2009;88(11):982\u0026ndash;90. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/0022034509346811\u003c/span\u003e\u003cspan address=\"10.1177/0022034509346811\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eJenkinson HF. Beyond the oral microbiome. Environ Microbiol. 2011;13(12):3077\u0026ndash;87. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1462-2920.2011.02573.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1462-2920.2011.02573.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKuramitsu HK, He X, Lux R, Anderson MH, Shi W. Interspecies interactions within oral microbial communities. Microbiol Mol Biol Rev. 2007;71(4):653\u0026ndash;70. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1128/MMBR.00024-07\u003c/span\u003e\u003cspan address=\"10.1128/MMBR.00024-07\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCasemiro LA, Gomes Martins CH, Pires-de-Souza Fde C, Panzeri H. Antimicrobial and mechanical properties of acrylic resins with incorporated silver-zinc zeolite - part I. Gerodontology. 2008;25(3):187\u0026ndash;94. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1741-2358.2007.00198.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1741-2358.2007.00198.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLi W, Qi M, Sun X, Chi M, Wan Y, Zheng X, et al. Novel dental adhesive containing silver exchanged EMT zeolites against cariogenic biofilms to combat dental caries. Microporous Mesoporous Mater. 2020;299:110113. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.micromeso.2020.110113\u003c/span\u003e\u003cspan address=\"10.1016/j.micromeso.2020.110113\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSaengmee-Anupharb S, Srikhirin T, Thaweboon B, et al. Antimicrobial effects of silver zeolite, silver zirconium phosphate silicate and silver zirconium phosphate against oral microorganisms. Asian Pac J Trop Biomed. 2013;3(1):47\u0026ndash;52. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/S2221-1691(13)60022-2\u003c/span\u003e\u003cspan address=\"10.1016/S2221-1691(13)60022-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKawahara K, Tsuruda K, Morishita M, Uchida M. Antibacterial effect of silver-zeolite on oral bacteria under anaerobic conditions. Dent Mater. 2000;16(6):452\u0026ndash;5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/s0109-5641(00)00050-6\u003c/span\u003e\u003cspan address=\"10.1016/s0109-5641(00)00050-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHotta M, Nakajima H, Yamamoto K, Aono M. Antibacterial temporary filling materials: the effect of adding various ratios of Ag-Zn-Zeolite. J Oral Rehabil. 1998;25(7):485\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1046/j.1365-2842.1998.00265.x\u003c/span\u003e\u003cspan address=\"10.1046/j.1365-2842.1998.00265.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Dental Ceramics, Glaze, Lithium Disilicate, Streptococcus mutans","lastPublishedDoi":"10.21203/rs.3.rs-8064545/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8064545/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjectives\u003c/h2\u003e\u003cp\u003eThis study aimed to evaluate the antibacterial, mechanical, and optical properties of lithium disilicate ceramics after the addition of Ag/Zn/Zeolite at 0%, 1%, and 2% concentrations to the glaze layer.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eIPS\u0026trade; e.max Press samples were glazed with 0%, 1%, or 2% Ag/Zn/Zeolite. Surface roughness (n\u0026thinsp;=\u0026thinsp;5), Vickers hardness (n\u0026thinsp;=\u0026thinsp;10), and flexural strength (n\u0026thinsp;=\u0026thinsp;10) were tested. Optical analysis included color change due to additive content and color stability after 7-day immersion in (Coca-Cola, Lipton Yellow Label Tea, Nescafe Gold) both assessed by ΔE₀₀ values (n\u0026thinsp;=\u0026thinsp;5). Antibacterial activity against \u003cem\u003eStreptococcus mutans\u003c/em\u003e was evaluated using the Direct Contact Test (n\u0026thinsp;=\u0026thinsp;3 per time point), and biofilm formation was observed via SEM. Data were analyzed using ANOVA and Tukey\u0026rsquo;s post hoc test.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eSurface roughness significantly decreased in experimental groups (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Flexural strength increased and surface hardness decreased slightly, with no significant differences (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). All groups showed significant color differences (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with the greatest between control and 2%. Discoloration after beverage immersion was higher in experimental groups but remained below perceptibility thresholds. Antibacterial activity increased with Ag/Zn/Zeolite concentration. SEM images confirmed reduced biofilm formation over 30 days in zeolite-containing samples.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThe addition of Ag/Zn/Zeolite improved the antibacterial properties while maintaining acceptable mechanical and optical performance in lithium disilicate ceramics.\u003c/p\u003e","manuscriptTitle":"Ag/Zn/Zeolite-Modified Glaze for Lithium Disilicate Ceramics: Comprehensive Evaluation of Antibacterial, Mechanical, and Optical Properties","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-08 15:37:57","doi":"10.21203/rs.3.rs-8064545/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-12-17T14:01:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"172361368912357053342730428967192313673","date":"2025-12-17T10:07:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-05T11:38:53+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-11T08:57:03+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-11T05:57:21+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-11T05:55:02+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2025-11-08T14:19:34+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"903ed14c-8412-4183-9a44-f8e2e0d5fd46","owner":[],"postedDate":"December 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-12-08T15:37:57+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-08 15:37:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8064545","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8064545","identity":"rs-8064545","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}