Chipping of Veneering Ceramics in Zirconium Dioxide Fixed Dental Prosthesis

Effect of Cement Type on Fracture Resistance and Mode of Failure of Monolith vs Bilayered Zirconia Single Crowns

AIM

To compare the fracture resistance and the mode of failure between monolith second-generation zirconia and bilayered first-generation zirconia single crowns cemented by resin cement and glass ionomer cement (GIC).

MATERIALS AND METHODS

A total of 36 maxillary first premolar crowns (5 mm in length × 4 mm in cervical diameter, with a base of 6 mm) were computer-aided design-computer-aided manufacturing (CAD-CAM) milled. They were divided into the following two groups (n = 18) according to the fabrication techniques: Group M - monolith zirconia crown (1-mm axial thickness and 2-mm occlusal thickness) and group B - bilayer zirconia crown (0.5-mm axial thickness and 1-mm occlusal thickness). Each group was further subdivided into the following two subgroups (n = 9) according to the cement used: Subgroup G - cemented using GIC; subgroup R - cemented using resin cement. All crowns were cemented to their corresponding resin dies and stored in distilled water for 72 hours. Each specimen was mounted to the lower member of the universal testing machine with a load cell of 5 kN and a crosshead speed of 0.5 mm/minute. Failure modes were analyzed for fractured parts using scanning electron microscopy (SEM).

RESULTS

Subgroup MR recorded the highest fracture resistance mean value (3616 ± 347.2 N) while the BG subgroup recorded the statistically significant lowest fracture resistance mean value (1728.7 ± 115.3 N). One-way analysis of variance (ANOVA) followed by pairwise Tukey's post hoc tests revealed a statistically significant difference (p = 0.0001) between groups M and B. One-way ANOVA followed by pairwise Tukey's post hoc tests also showed a statistically significant difference (p = 0.0297) between the types of cement used (subgroups G and R).

CONCLUSION

Monolith zirconia crowns had better mean fracture resistance than bilayered zirconia crowns. Resin cement improved the fracture resistance compared to GIC. Monolith zirconia crowns showed bulk fracture while bilayered zirconia crowns showed chipping fracture.

CLINICAL SIGNIFICANCE

Monolith zirconia crowns present a good prosthetic alternative overcoming the veneer chipping drawback of bilayered zirconia crowns. In addition, resin cement could increase the fracture resistance of zirconia crowns.

Construction of Nanostructured Glass-Zirconia to Improve the Interface Stability of Dental Bilayer Zirconia

Bilayer zirconia restoration is one of the most commonly used restorations in dental practice, but the high frequency of the cohesive/adhesive fracture of veneered porcelain is still a problem. This paper focuses on the development of nanostructured glass-zirconia to improve the interface stability of dental zirconia substrate and veneered porcelain. A novel SiO₂-Li₂O-Al₂O₃ (SLA) glass was prepared and infiltrated into the surface of fully sintered dental zirconia to obtain nanostructured glass-zirconia structure. The prepared glass-zirconia was analyzed with scanning electron microscopes (SEM), energy dispersive spectroscopy (EDS) and X-ray diffraction spectroscopy (XRD). The wettability, roughness and 3D morphology of zirconia were altered, and shear bonding strength (SBS) test demonstrated almost double increase in SBS values of the nanostructured glass-zirconia structure. The failure modes and microstructure characteristics also verified the improved interfacial stability. This investigation provides a promising method for enhancing the structural stability of bilayer zirconia restorations.

Debonding/crack initiation and flexural strengths of bilayered zirconia core and veneering ceramic composites

The aim of this study was to evaluate the effects of the kinds of veneering ceramics and veneering methods on the debonding/crack initiation and 3-point flexural strengths in bilayered zirconia core and veneering ceramic composites. Zirconia block was used as core material, and Cerabien ZR and Lava Ceram for the layering technique and IPS e.max ZirPress and Amber LiSi-POZ for the heat pressing technique were used as veneering materials. Both debonding/crack initiation and 3-point flexural strengths of bilayered zirconia core and veneering ceramic composites as well as the bi-axial flexural strengths of veneering materials, were higher when using heat pressing technique than layering technique. It was identified that not only bonding strength between zirconia core and veneering materials but also the intrinsic strength of veneering ceramic should be high to prevent chipping of veneering material.

Influence of preparation design on fracture resistance of different monolithic zirconia crowns: A comparative study

PURPOSE

The aim of the study was to evaluate and compare the fracture resistance and modes of fracture of monolithic zirconia crowns with two preparation designs.

MATERIALS AND METHODS

Forty human maxillary first premolar teeth were extracted for orthodontic purposes and divided into two main groups (n=20): Group A: monolithic traditional zirconia; Group B: monolithic translucent zirconia. The groups were further subdivided into two subgroups (n=10): (A1, B1) shoulder margin design; (A2, B2) feather-edge margin design. Teeth were prepared with either a 1 mm shoulder margin design or a feather-edge margin design. The prepared teeth were scanned using a digital intraoral scanner. The crowns were cemented using self-adhesive resin cement. All cemented teeth were stored in water for 7 days and thermocycling was done before testing. All samples were subjected to compressive axial loading until fracture. The fractographic analysis was done to assess the modes of fracture of the tested samples.

RESULTS

The highest mean values of fracture resistance were recorded in kilo-newton and were in the order of subgroup A1 (2.903); subgroup A2 (2.3); subgroup B1 (1.854) and subgroup B2 (1.523). One-way ANOVA showed a statistically significant difference among the 4 subgroups. Concerning modes of fracture, the majority of samples in subgroups A1 and B1 were fracture of restoration and/or tooth, while in subgroups A2 and B2, the majority of samples fractured through the central fossa.

CONCLUSION

Even though all the tested crowns fractured at a higher level than the maximum occlusal forces, the shoulder margin design was better than the feather-edge margin design and the monolithic traditional zirconia was better than the monolithic translucent zirconia in terms of fracture strength.

Effects of different surface treatments on the shear bond strength of veneering ceramic materials to zirconia

PURPOSE

To evaluate and compare the effect of different materials and techniques on the shear bond strength of veneering ceramic materials to zirconia.

MATERIALS AND METHODS

136 sintered zirconia cubes were prepared and randomly divided into four study groups according to corresponding methods of surface treatment and materials: GLN (grinding followed by laser scanning using Noritake Cerabien ZR), SLN (sandblasting followed by laser scanning using Noritake Cerabien ZR), GLV (grinding followed by laser scanning using VITA VM 9), and SLV (sandblasting followed by laser scanning using VITA VM 9). Spraying technique was performed to coat the core. Profilometer, SEM, XRD, EDS, universal testing machine, and stereomicroscope were used to record surface roughness Ra, surface morphology, phase transformation, elemental compositions, shear bond strength SBS values, and failure types, respectively. Specimens were investigated in unaged (not immersed in artificial saliva) and aged (stored in artificial saliva for a month) conditions to evaluate SBS values.

RESULTS

Grinding and GLN as first and second surface treatments provided satisfactory Ra values in both conditions (1.05 ± 0.24 µm, 1.30 ± 0.21 µm) compared to sandblasting and other groups (P<.05). The group GLN showed the highest SBS values in both conditions (30.97 ± 3.12 MPa, 29.09 ± 4.17 MPa), while group SLV recorded the lowest (23.96 ± 3.60 MPa, 22.95 ± 3.68 Mpa) (P<.05). Sandblasting showed phase transformation from t-m. Mixed failure type was the commonest among all groups.

CONCLUSION

GLN showed to be a reliable method which provided satisfactory bond strength between the veneer ceramic and zirconia. This method might preserve the integrity of fixed dental crowns.