Fatigue and Fracture Resistance of Zirconia Crowns Prepared with Different Finish Line Designs

Comparison of subcritical growth parameters of a Y-TZP obtained via cyclic or dynamic fatigue tests

OBJECTIVE

The objective of this study was to 1) compare the stress corrosion coefficient (n) of a Y-TZP obtained by two fatigue tests: cyclic and dynamic and 2) evaluate the effect of frequency in the characteristic lifetime and the existence of interaction between the cyclic fatigue and slow crack growth.

METHODS

A total of 145 Y-TZP specimens were produced in accordance with the manufacturer's instructions. These specimens, measuring 4.0 × 3.0 × 25.0 mm, were used for dynamic (n = 70) and cyclic fatigue tests (n = 75). The specimens were obtained from CAD/CAM blocks, sectioned, and sintered in a furnace at 1530 °C with a heating rate of 25 °C/min. They were tested in their "as-sintered" form without any additional surface treatment. The fatigue tests were conducted using a four-point bending to obtain the slow crack growth parameters (n). The cyclic fatigue test was also conducted in two frequencies (2 and 10 Hz), using stress levels between 350 and 600 MPa. Data from these tests were analyzed using ASTM C 1368-00 formulas and Weibull statistics. Scanning electron microscope (SEM) was used for fracture surface analysis to identify the origin of the fracture. Critical defect size was measured and used, along with flexural strength values, to estimate fracture toughness. Dynamic fatigue test data were used to obtain subcritical crack growth (SCG) parameters and perform Weibull statistical analysis. The cyclic fatigue data were used in the General Log-linear Model equation using the ALTA PRO software. Data were analyzed using one-way ANOVA followed by Tukey post-hoc tests and Student's t-test at a significance level of p ≤ 0.05.

RESULTS

In the dynamic fatigue test, the values obtained for σfo and n were 667 and 54, respectively. This parameter indicates how the strength of the material diminishes over time due to internal cracks. The Weibull parameters obtained from the same test results were m = 7.9, σ0 = 968, 9 and σ5% = 767, which indicates the reliability of the material. The Weibull parameters obtained by cyclic fatigue were statistically similar for the two frequencies used, the m* was 0.17 (2 Hz) and 0.21 (10 Hz); characteristic lifetimes (η) were 1.93 × 106 and 40,768, respectively. The n values obtained by cyclic fatigue were 48 and 40 at frequencies of 2 and 10 Hz, respectively. There was no effect of the frequency, the stress level or the interaction of the two in the Y-TZP lifetime, when analysed by General Log Linear Model.

SIGNIFICANCE

the n values obtained by cyclic and dynamic fatigue tests showed no statistically significant difference and the effect of frequency in the characteristic lifetime and the existence of interaction between the cyclic fatigue and subcritical growth were not observed in the tested specimens.

Fractographic and Microhardness Evaluation of All-Ceramic Hot-Pressed and CAD/CAM Restorations after Hydrothermal Aging

All-ceramic dental restorations have great advantages, such as highly esthetical properties, a less complex fabrication, and a similar abrasion resistance to enamel. Despite these advantages, ceramic materials are more prone to fracture due to their brittle microstructure. The main aim of this in vitro study was to determine the difference in hot-pressed and milled glass-ceramic mechanical properties such as fracture resistance and microhardness (VHN). Four types of ceramics, two hot-pressed and two milled, feldspathic glass-ceramics and zirconia-reinforced glass-ceramics were selected in this study and tested using the static loading test and Vicker’s testing. Hydrothermal aging, consisting of different baths with temperatures between 5 degrees Celsius and 55 degrees Celsius, was chosen as the in vitro aging method. Statistical analyses are performed using SPSS Statistics software at a significance level of p < 0.05. Micro-hardness values decrease after hydrothermal aging. The static loading test reveals a significant difference between the feldspathic hot-pressed glass-ceramic, which fractures at lower forces, and milled zirconia-reinforced lithium silicate glass-ceramic, which fractures at greater forces (N). Fractographic analysis of the fractured fragments resulted in the static loading test revealing different surface features about the crack origins and propagations under a stereomicroscope.

Fracture Strength of Monolithic Zirconia Crowns with Modified Vertical Preparation: A Comparative In Vitro Study

Objective  The aim of this study was to evaluate the influence of different marginal designs (deep chamfer, vertical, and modified vertical with reverse shoulder) on the fracture strength and failure modes of monolithic zirconia crowns.

Materials and Methods  Thirty sound human maxillary first premolar teeth with comparable size were used in this study. The teeth were divided randomly into three groups according to the preparation design ( n = 10): (1) group A: teeth prepared with a deep chamfer finish line; (2) group B: teeth prepared with vertical preparation; and (3) group C: teeth prepared with modified vertical preparation, where a reverse shoulder of 1 mm was placed on the buccal surface at the junction of middle and occlusal thirds. All samples were scanned by using an intraoral scanner (CEREC Omnicam, Sirona, Germany), and then the crowns were designed by using Sirona InLab 20.0 software and milled with a 5-axis machine. Each crown was then cemented on its respective tooth with self-adhesive resin cement by using a custom-made cementation device. A single load to failure test was used to assess the fracture load of each crown by using a computerized universal testing machine that automatically recorded the fracture load of each sample in Newton (N).

Statistical Analysis  The data were analyzed statistically by using one-way analysis of variance test and Bonferroni test at a level of significance of 0.05.

Results  The highest mean of fracture load was recorded by chamfer (2,969.8 N), which followed by modified vertical (2,899.3 N) and the lowest mean of fracture load was recorded by vertical (2,717.9 N). One-way ANOVA test revealed a significant difference among the three groups. Bonferroni test showed a significant difference between group A and group B, while a nonsignificant difference was revealed between group C with group A and group B.

Conclusion  Within the limitations of this in vitro study, the mean values of fracture strength of monolithic zirconia crowns of all groups were higher than the maximum occlusal forces in the premolar region. The modification of the vertical preparation with a reverse shoulder placed at the buccal surface improved the fracture strength up to the point that it was statistically nonsignificant with the chamfer group.

On the behaviour of zirconia-based dental materials: A review

Zirconia-based dental materials are extensively used in clinical practice due to their tooth-like appearance, biofunctionality, biocompatibility, and affordability. However, premature clinical failures of veneering porcelains raise a concern about their integrity. Extensive studies have been performed over a decade to resolve this issue, but it is challenging to reference all information effectively. A single source identifying the significance of potential parameters on material performance has not previously been available. An evidence-based meta-narrative review technique was used to review the characteristic parameters that can affect the overall behaviour of zirconia-based materials. Keywords were chosen to assess manuscripts based on scientific coherence with this paper's research objective. Online keyword searches were carried out on ScienceDirect, PubMed, and SAGE databases for relevant published manuscripts from year 1985-2020.261 out of 3170 identified manuscripts were included. A total of 10 parameters were identified and classified into the material, manufacturing, and geometric aspects. The effect of every parameter was reviewed on the performance of the material. A discrepancy in findings was observed and is attributed to the fact that there is no standard methodology. This review acts as a single source that summarizes various parameters' contribution to zirconia-based dental materials' performance. This review facilitates manufacturing improvements by accounting for every parameter's effect on overall performance.

Comparison of Fracture Resistance for Chairside CAD/CAM Lithium Disilicate Crowns and Overlays with Different Designs

PURPOSE

To determine the fracture resistance of chairside computer-aided design and computer-assisted manufacturing (CAD/CAM) lithium disilicate full coverage crowns and two different designs of overlay restorations for premolars.

MATERIALS AND METHODS

CAD/CAM lithium disilicate (IPS e.max CAD for CEREC/HT A1 C14, Ivoclar Vivadent) restorations (15 specimens/group) with 1.5 mm occlusal thickness and 1.0 mm chamfer were designed and fabricated with a chairside CAD/CAM system (CEREC, Dentsply Sirona). The restorations were prepared in three different designs: (1) full coverage crowns, (2) overlays with the margin located 2 mm above the gingiva, and (3) overlays with the margin located 4 mm above the gingiva. Restorations were cemented using conventional resin luting cement (Multilink, Ivoclar Vivadent) with primer system (Monobond Plus, Ivoclar Vivadent) to resin printed dies, load cycled (2,000,000 load cycles at 1 Hz with 275 N force), and then finally loaded with a steel indenter until failure. Scanning electron microscopy observations of fractured surfaces were also conducted. Group results were analyzed with one-way analysis of variance, and the medians were evaluated independently with Kruskal-Wallis.

RESULTS

The fracture force of CAD/CAM lithium disilicate restorations was significantly different (p < 0.001) depending on the design of the restoration. Full coverage crowns showed significantly higher force to fracture (1018.8 N) than both types of overlays (p = 0.002 for overlay 2.0 mm and p < 0.001 for overlay 4.0 mm above gingiva). Among the two overlays, the restoration with the margin located 2 mm above the gingiva showed significantly higher fracture force (813.8 N) than the overlay with margin at 4 mm above the gingiva (436.1 N; p < 0.001). The fracture appearance of the crowns was much more complex than that of the overlay restorations.

CONCLUSIONS

Full coverage chairside CAD/CAM lithium disilicate premolar crown showed higher fracture resistance than overlay restorations. Overlays with the margin located 2 mm above the margin demonstrated higher resistance than those with the margin located 4 mm above the gingiva.

Novel CAD-CAM zirconia coping design to enhance the aesthetics and strength for anterior PLZ crowns

BACKGROUND

The aesthetics and strength of anterior porcelain layered zirconia (PLZ) crowns are mainly affected by the zirconia (Zr) coping design. There is a need for a modified design to enhance aesthetics with strength.

OBJECTIVES

The purpose of this study was to compare the fracture resistance of anterior PLZ crowns having modified CAD-CAM Zr coping designs (in terms of thickness and marginal collar designs) with standard Zr copings.

METHODS

Fifty PLZ crowns were fabricated and divided into two groups: Gr 1: Standard Zr Coping (SZC) (control gr) with 0.5 mm thickness (Facial-F, Mesial-M, Distal-D, incisal-I, and Palatal-P) without a collar; Gr 2: Collar Zr Coping (CZC) (test gr) with 2.5 mm collar height on M, D, P and 0.2 mm F and variable facial wall thickness. Subgroups: Gr 2a: (CZC-0.5 mm) facial wall thickness 0.5 mm; Gr 2b: (CZC-0.4 mm) facial wall thickness 0.4 mm; Gr 2c: (CZC-0.3 mm) facial wall thickness 0.3 mm; Gr 2d: (CZC-0.2 mm) facial wall thickness 0.2 mm. The fracture load was determined and analysed using One-way ANOVA and Dunnet test.

RESULTS

The minimum fracture load was 927.36 ± 127.80 N observed for Gr 2c (CZC at 0.3 mm) while the maximum fracture load was 1373.61 ± 146.54 N observed for Gr 2a (CZC at 0.5 mm). A highly significant difference in mean fracture load among various Zr coping groups (p< 0.001) was determined.

CONCLUSIONS

Novel Zr coping design for anterior PLZ crowns can provide better aesthetics with strength. Reducing the thickness of Zr coping in the aesthetic zone to 0.2 mm and providing a modified collar design (2.5 mm collar height on M, D, P, and 0.2 mm F) would provide strength without jeopardizing aesthetics.

Influence of fatigue loading on fracture resistance of endodontically treated teeth restored with endocrowns

PURPOSE

This in vitro study aimed to evaluate the influence of fatigue loading on fracture resistance of endodontically treated molars restored with endocrowns using different machinable blocks.

METHODS

Endodontically treated mandibular first molars were prepared using a standardized method. Specimens were divided into 4 groups (n = 10).Anatomically shaped endocrowns groups were manufactured using VITA ENAMIC (VE) and KATANA Zirconia (KZ). Layered endocrowns groups were manufactured using IPS e.max CAD (EM) and BioHPP (BH). Half of the specimens of each group were subjected to fracture resistance test, while the other half were subjected to thermocycling and chewing simulation. After fatigue loading, specimens were loaded until failure. Specimens were examined using stereomicroscopy. Data were analyzed using ANOVA analysis of variance and Bonferroni post hoc test (α=0.05).

RESULTS

KZ group had the highest initial fracture resistance value (1810.20± 119.56 N) and BH had the lowest value (579.50± 76.15 N). The reduction of fracture resistance after fatigue loading was significant for KZ group (1588.30±216.25 N) and BH group (502.60±11.53 N) and non-significant to VE group (1101.70±77.05 N) and EM group (1112.10±74.12 N). Failure modes of KZ and EM groups showed high percentage of non-restorable fractures, while VE and BH groups showed high percentage of restorable fractures.

CONCLUSIONS

Within the limitations of this study, the following can be concluded: Poly infiltrated ceramics should be considered as a proper material to be used as an endocrown material because of its ability to be restorable if failure occurred.

A comparative evaluation of fracture load of monolithic and bilayered zirconia crowns with and without a cervical collar: an in vitro study

Introduction

The use of zirconia based all-ceramic restorations are preferred nowadays owing to superior biologic and esthetic properties. However, these restorations have also reported higher incidences of fracture and chipping. The clinical success may be enhanced by optimizing the core design, through the introduction of monolithic zirconia, or the layered crowns can be strengthened by adding the cervical collar to them.

Objective

This study was performed with the objective to compare and evaluate the fracture load of monolithic and bilayered zirconia crowns with and without a cervical collar.

Methods

A prospective observational study was carried out to compare 45 fabricated zirconia crowns of three different designs on a customized metal mould. The samples were oriented on the metal mould and subjected to confocal microscope for the evaluation of marginal integrity followed by cementing the crown on the metal mould and subjecting it to the universal testing machine for the analysis for the flexural strength. Data were analyzed using one way Anova and t- test for inter and intra groups. The significance level was set at P ≤ 0.05.

Results

The monolith zirconia crowns and layered zirconia crowns with cervical collar reported more flexural strength.

Conclusion

The amount of force required to fracture the zirconia crowns was higher in the case of monolith zirconia crown and layered zirconia crown with cervical collar as compared to the layered zirconia crown without cervical collar.

Effects of Finish Line Design and Fatigue Cyclic Loading on Phase Transformation of Zirconia Dental Ceramics: A Qualitative Micro-Raman Spectroscopic Analysis

Objectives: Stresses produced during the fabrication of copings and by chewing activity can induce a tetragonal-to-monoclinic (t–m) transformation of zirconia. As a consequence, in the m-phase, the material is not able to hinder possible cracks by the favorable mechanism known as “transformation toughening”. This study aimed at evaluating if different marginal preparations of zirconia copings can cause a premature phase transformation immediately after manufacturing milling and after chewing simulation. Methods: Ninety copings using three commercial zirconia ceramics (Nobel Procera Zirconia, Nobel Biocare Management AG; Lava Classic, 3M ESPE; Lava Plus, 3M ESPE) were prepared with deep-chamfer, slight-chamfer, or feather-edge finish lines (n = 10). Specimens were tested in a chewing simulator (CS-4.4, SD Mechatronik) under cyclic occlusal loads simulating one year of clinical service. Raman spectra were acquired and analyzed for each specimen along the finish lines and at the top of each coping before and after chewing simulation, respectively. Results: Raman analysis did not show any t–m transformation both before and after chewing simulation, as the typical monoclinic bands at 181 cm⁻¹ and 192 cm⁻¹ were not detected in any of the tested specimens. Conclusions: After a one-year simulation of chewing activity, irrespective of preparation geometry, zirconia copings did not show any sign of t–m transformation, either in the load application areas or at the margins. Consequently, manufacturing milling even in thin thickness did not cause any structural modification of zirconia ceramics “as received by manufacturers” both before and after chewing simulation.

Effect of margin design on fracture load of zirconia crowns

Zirconia‐based restorations are showing an increase as the clinicians’ preferred choice at posterior sites because of the strength and esthetic properties of such restorations. However, all‐ceramic restorations fracture at higher rates than do metal‐based restorations. Margin design is one of several factors that can affect the fracture strength of all‐ceramic restorations. The aim of this study was to assess the effect of preparation and crown margin design on fracture resistance. Four groups of bilayer zirconia crowns (with 10 crowns in each group) were produced by hard‐ or soft‐machining technique, with the following four different margin designs: chamfer preparation (control); slice preparation; slice preparation with an additional cervical collar of 0.7 mm thickness; and reduced occlusal thickness (to 0.4 mm) on slice preparation with an additional cervical collar of 0.7 mm thickness. Additionally, 10 hard‐machined crowns with slice preparation were veneered and glazed with feldspathic porcelain. In total, 90 crowns were loaded centrally in the occlusal fossa until fracture. The load at fracture was higher than clinically relevant mastication loads for all preparation and margin designs. The crowns on a chamfer preparation fractured at higher loads compared with crowns on a slice preparation. An additional cervical collar increased load at fracture for hard‐machined crowns.

Adaptation of zirconia crowns created by conventional versus optical impression: in vitro study

PURPOSE

The aim of this study was to compare the precision of optical impression (Trios, 3Shape) versus that of conventional impression (Imprint IV, 3M-ESPE) with three different margins (shoulder, chamfer, and knife-edge) on Frasaco teeth.

MATERIALS AND METHODS

The sample comprised of 60 zirconia half-crowns, divided into six groups according to the type of impression and margin. Scanning electron microscopy enabled us to analyze the gap between the zirconia crowns and the Frasaco teeth, using ImageJ software, based on eight reproducible and standardized measuring points.

RESULTS

No statistically significant difference was found between conventional impressions and optical impressions, except for two of the eight points. A statistically significant difference was observed between the three margin types; the chamfer and knife-edge finishing lines appeared to offer better adaptation results than the shoulder margin.

CONCLUSION

Zirconia crowns created from optical impression and those created from conventional impression present similar adaptation. While offering identical results, the former have many advantages. In view of our findings, we believe the chamfer margin should be favored.

Osteogenesis ability of CAD/CAM porous zirconia scaffolds enriched with nano-hydroxyapatite particles

Background

The aim of this study was to evaluate osteogenesis ability of CAD/CAM porous zirconia scaffolds enriched with hydroxy apatite used to augment large boney defects in a dog model.

Methods

Surgical defects were made bilaterally on the lower jaw of 12 Beagle dogs. Cone beam CT images were used to create three dimensional images of the healed defects. Porous zirconia scaffolds were fabricated by milling custom made CAD/CAM blocks into the desired shape. After sintering, the pores of half of the scaffolds were filled with a nano-hydroxy apatite (HA) powder while the other half served as control. The scaffolds were inserted bilaterally in the healed mandibular jaw defects and were secured in position by resorbable fixation screws. After a healing time of 6 weeks, bone-scaffold interface was subjected to histomorphometric analysis to detect the amount of new bone formation. Stained histological sections were analyzed using a computer software (n=12, α=0.05). Mercury porosimetery was used to measure pore sizes, chemical composition was analyzed using energy dispersive x-ray analysis (EDX), and the crystal structure was identified using x-ray diffraction micro-analysis (XRD).

Results

HA enriched zirconia scaffolds revealed significantly higher volume of new bone formation (33% ± 14) compared to the controls (21% ± 11). New bone deposition started by coating the pore cavity walls and proceeded by filling the entire pore volume. Bone in-growth started from the surface of the scaffold and propagated towards the scaffold core. Islands of entrapped hydroxy apatite particles were observed in mineralized bone matrix.

Conclusions

Within the limitations of this study, hydroxy apatite enhanced osteogenesis ability of porous zirconia scaffolds.

Effect of screw access hole preparation on fracture load of implant-supported zirconia-based crowns: an in vitro study

Background. Fracture load of implant-supported restorations is an important factor in clinical success. This study evaluated the effect of two techniques for screw access hole preparation on the fracture load of cement-screw-retained implant-supported zirconia-based crowns.

Methods. Thirty similar cement-screw-retained implant-supported zirconia-based maxillary central incisor crowns were evaluated in three groups of 10. Group NH: with no screw access holes for the control; Group HBS: with screw access holes prepared with a machine before zirconia sintering; Group HAS: with screw access holes prepared manually after zirconia sintering. In group HBS, the access holes were virtually designed and prepared by a computer-assisted design/computer-assisted manufacturing system. In group HAS, the access holes were manually prepared after zirconia sintering using a diamond bur. The dimensions of the screw access holes were equal in both groups. The crowns were cemented onto same-size abutments and were then subjected to thermocycling. The fracture load values of the crowns were measured using a universal testing machine. Data were analyzed with ANOVA and Tukey test (P < 0.05).

Results. The mean fracture load value for the group NH was 888.37 ± 228.92 N, which was the highest among the groups, with a significant difference (P < 0.0001). The fracture load values were 610.48 ± 125.02 N and 496.74 ± 104.10 Nin the HBS and HAS groups, respectively, with no significant differences (P = 0.44).

Conclusion. Both techniques used for preparation of screw access holes in implant-supported zirconia-based crowns decreased the fracture load.

Fracture resistance of three-unit zirconia fixed partial denture with modified framework

Obtaining ideal prosthetic framework design is at times hindered by anatomical limitations in the posterior region that might increase the risk for zirconia restoration fracture. Modification such as increasing the bulk thickness especially in the connector region could result in strengthening the zirconia framework. Three-unit zirconia fixed partial dentures replacing mandibular molars were fabricated using the following two techniques: CAD/CAM technology and manual copy milling. Modified framework with unveneered full thickness connectors were designed and fabricated with the aforementioned methods. Conventional frameworks (0.5 mm thick with rounded 3 mm connectors) served as control (N = 20). After cementation on epoxy dies, the frameworks were loaded to fracture in a universal testing machine. Fractured surfaces were prepared for examination using scanning electron microscopy. Statistical analysis revealed significant differences in fracture resistance between conventional and modified framework design for both fabrication techniques tested. SEM examination indicated that critical crack originated at the tensile surface of the connectors for conventional frameworks. The critical crack for modified frameworks occurred on the axial wall of the abutments. The modification of the zirconia framework design presented significant improvement of the fracture resistance compared to the conventional design.

Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function

Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all-ceramic single-tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass-ceramic, and alumina single-tooth restorations. Design features seem to be of great importance for fracture initiation.

Simulation of clinical fractures for three different all-ceramic crowns

Comparison of fracture strength and fracture modes of different all-ceramic crown systems is not straightforward. Established methods for reliable testing of all-ceramic crowns are not currently available. Published in-vitro tests rarely simulate clinical failure modes and are therefore unsuited to distinguish between the materials. The in-vivo trials usually lack assessment of failure modes. Fractographic analyses show that clinical crowns usually fail from cracks initiating in the cervical margins, whereas in-vitro specimens fail from contact damage at the occlusal loading point. The aim of this study was to compare three all-ceramic systems using a clinically relevant test method that is able to simulate clinical failure modes. Ten incisor crowns of three types of all-ceramic systems were exposed to soft loading until fracture. The initiation and propagation of cracks in these crowns were compared with those of a reference group of crowns that failed during clinical use. All crowns fractured in a manner similar to fracture of the clinical reference crowns. The zirconia crowns fractured at statistically significantly higher loads than alumina and glass-ceramic crowns. Fracture initiation was in the core material, cervically in the approximal areas.

Clinically relevant fracture testing of all-ceramic crowns

OBJECTIVES

Fracture strength measured in vitro indicates that most all-ceramic crowns should be able to withstand mastication forces. Nevertheless, fractures are one of the major clinical problems with all-ceramic restorations. Furthermore, the fracture mode of all-ceramic crowns observed in clinical use differs from that found in conventional fracture strength tests. The aim of the present study was to develop and investigate a method that simulates clinical fracture behavior in vitro.

METHODS

30 crowns with alumina cores were made to fit a cylindrical model with a molar-like preparation design. These crowns were randomly allocated to 3 tests groups (n=10). The crowns in group 1 were cemented to abutment models of epoxy and subsequently fractured by occlusal loading without contact damage. The crowns in group 2 were fractured by cementation with expanding cement. The crowns in group 3 were cemented on an abutment model of epoxy split almost in two and fractured by increasing the diameter of the model in the bucco-lingual direction. The fractured crowns were analyzed by fractographic methods and compared to a reference group of 10 crowns fractured in clinical use.

RESULTS

The fracture modes of all the in vitro crowns were similar to clinical fracture modes. The fracture modes in group 1 were most closely matched to the clinical fractures. These crowns also fractured at clinically relevant loads.

CONCLUSION

Laboratory tests that induce a distortion of the abutment model during occlusal loading without occlusal contact damage can simulate clinical fractures of all-ceramic crowns.

Effect of core thickness differences on post-fatigue indentation fracture resistance of veneered zirconia crowns

PURPOSE

Despite the excellent esthetics of veneered zirconia crowns, the incidence of chipping and fracture of veneer porcelain on zirconia crowns has been recognized to be higher than in metal ceramic crowns. The objective of this investigation was to study the effect of selected variations in core thickness on the post-fatigue fracture resistance of veneer porcelain on zirconia crowns.

MATERIALS AND METHODS

Zirconia crowns for veneering were prepared with three thickness designs of (a) uniform 0.6-mm thick core (group A), (b) extra-thick 1.7 mm occlusal core support (group B), and (c) uniform 1.2-mm thick core (group C). The copings were virtually designed and milled by the CAD/CAM technique. Metal ceramic copings (group D) with the same design as in group C were used as controls. A sample size of N = 20 was used for each group. The copings were veneered with compatible porcelain and fatigue tested under a sinusoidal loading regimen. Loading was done with a 200 N maximum force amplitude under Hertzian axial loading conditions at the center of the crowns using a spherical tungsten carbide indenter. After 100,000 fatigue cycles, the crowns were axially loaded to fracture and maximum load levels before fracture was recorded. One-way ANOVA (P < 0.05) and post hoc Tukey tests (α = 0.05) were used to determine significant differences between means.

RESULTS

The mean fracture failure load of group B was not significantly different from that of control group D. In contrast, the mean failure loads of groups A and C were significantly lower than that of control group D. Failure patterns also indicated distinct differences in failure mode distributions. The results suggest that proper occlusal core support improves veneer chipping fracture resistance in zirconia crowns.

CONCLUSIONS

Extra-thick occlusal core support for porcelain veneer may significantly reduce the veneer chipping and fracture of zirconia crowns. This is suggested as an important consideration in the design of copings for zirconia crowns.