1
|
Munshi NM, Alsufayri M, Alzahrani A, Jurado CA, Hajjaj MS, Altassan M, Alzahrani SJ. Fracture Resistance of Zirconia Surveyed Crowns With Digitally Designed and Hand-Modified Occlusal Rest Seats. Cureus 2024; 16:e64423. [PMID: 39135816 PMCID: PMC11318952 DOI: 10.7759/cureus.64423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2024] [Indexed: 08/15/2024] Open
Abstract
Background In light of the trend of using zirconia crowns, clinicians will likely face abutment included in removable partial dentures (RPD) designs with existing zirconia. However, the decision to replace the existing crown with a surveyed crown or modify the existing crown to accept the RPD is unclear. To the best of our knowledge, there is a lack of literature on the effect of preparing a rest seat on the existing monolithic zirconia crown in the patient's mouth on the fracture resistance of the crown. Therefore, in this study, we aimed to evaluate the fracture resistance of computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia surveyed crowns with digitally designed rest seats and hand-modified rest seats. Methods Thirty CAD/CAM zirconia surveyed crowns were digitally designed and fabricated and divided into groups (n=10 per group) as follows: Group 1 comprised surveyed crowns with no occlusal rest seat; Group 2 comprised surveyed crowns with a digitally designed mesial rest seat; and Group 3 comprised surveyed crowns with a hand-modified mesial rest seat. Then, with all the crowns cemented to metal dies, the specimens were subjected to a fracture resistance test using a universal testing machine (Model 8501 Instron, Norwood, MA, USA). Results Surveyed crowns without any rest seat and those with digitally created and hand-modified rest seats displayed different fracture resistances: crowns with no rest seat offered the highest fracture resistance (5831 ± 895.15 N), followed by those with a digitally designed and milled rest seat (5280 ± 1673.33 N). Crowns with a hand-modified rest seat provided the lowest fracture resistance (4976 ± 322.5 N). Based on our results, surveyed crowns without a rest seat displayed higher fracture resistance than those with a rest seat. Conclusion The fracture resistance of crowns with a digitally designed and milled rest seat was statistically similar to that of control crowns with no rest seat, whereas hand-modified rest seats significantly reduced the fracture resistance of surveyed zirconia crowns.
Collapse
Affiliation(s)
- Nabeel M Munshi
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | | | - Adham Alzahrani
- Department of General Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Carlos A Jurado
- Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, USA
| | - Maher S Hajjaj
- Department of Restorative Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Mosa Altassan
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Saeed J Alzahrani
- Department of Restorative Dentistry, King Abdulaziz University, Jeddah, SAU
| |
Collapse
|
2
|
Jurado CA, Davila CE, Davila A, Hernandez AI, Odagiri Y, Afrashtehfar KI, Lee D. Influence of occlusal thickness on the fracture resistance of chairside milled lithium disilicate posterior full-coverage single-unit prostheses containing virgilite: A comparative in vitro study. J Prosthodont 2024. [PMID: 38790151 DOI: 10.1111/jopr.13870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open
Abstract
PURPOSE To evaluate the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate mandibular posterior crowns with virgilite of different occlusal thicknesses and compare them to traditional lithium disilicate crowns. MATERIALS AND METHODS Seventy-five chairside CAD-CAM crowns were fabricated for mandibular right first molars, 60 from novel lithium disilicate with virgilite (CEREC Tessera, Dentsply Sirona), and 15 from traditional lithium disilicate (e.max CAD, Ivoclar Vivadent). These crowns were distributed across five groups based on occlusal thickness and material: Group 1 featured CEREC Tessera crowns with 0.8 mm thickness, Group 2 had 1.0 mm thickness, Group 3 had 1.2 mm thickness, Group 4 with 1.5 mm thickness, and Group 5 included e.max CAD crowns with 1.0 mm thickness. These crowns were luted onto 3D-printed resin dies using Multilink Automix resin cement (Ivoclar Vivadent). Subsequently, they underwent cyclic loading (2,000,000 cycles at 1 Hz with a 275 N force) and loading until fracture. Scanning electron microscopy (SEM) assessed the fractured specimens. Statistical analysis involved one-way ANOVA and the Kruskal-Wallis Test (α = 0.05). RESULTS Fracture resistance varied significantly (<0.001) across mandibular molar crowns fabricated from chairside CAD-CAM lithium disilicate containing virgilite, particularly between crowns with 0.8 mm and those with 1.2 and 1.5 mm occlusal thickness. However, no significant differences were found when comparing crowns with 1, 1.2, and 1.5 mm thicknesses. CEREC Tessera crowns with 1.5 mm thickness exhibited the highest resistance (2119 N/mm2), followed by those with 1.2 mm (1982 N/mm2), 1.0 mm (1763 N/mm2), and 0.8 mm (1144 N/mm2) thickness, whereas e.max CAD crowns with 1.0 mm occlusal thickness displayed the lowest resistance (814 N/mm2). CONCLUSIONS The relationship between thickness and fracture resistance in the virgilite lithium disilicate full-coverage crowns was directly proportional, indicating that increased thickness corresponded to higher fracture resistance. No significant differences were noted among crowns with thicknesses ranging from 1 to 1.5 mm. This novel ceramic exhibited superior fracture resistance compared to traditional lithium disilicate.
Collapse
Affiliation(s)
- Carlos A Jurado
- Operative Dentistry Division, Department of General Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Christian Edgar Davila
- Division of Prosthodontics, Department of Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, Florida, USA
- Division of Prosthodontics, Department of Restorative Sciences, School of Dentistry, University of Alabama, Birmingham, Alabama, USA
| | - Alexandra Davila
- Division of Prosthodontics, Department of Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Alfredo I Hernandez
- A.T. Still University Arizona School of Dentistry and Oral Health, Mesa, Arizona, USA
| | - Yukari Odagiri
- Department of Operative Dentistry, School of Dentistry, Aichi Gakuin University, Nagoya, Japan
| | - Kelvin I Afrashtehfar
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, UAE
- Consultant Private Practice Limited to Prosthodontics and Pre-Prosthetic Surgery, Abu Dhabi, UAE
- Consultant Private Practice Limited to Prosthodontics, Esthetic and Implant Dentistry, Dubai, UAE
- Division of Periodontology, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, Aachen, Germany
| | - Damian Lee
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| |
Collapse
|
3
|
Jurado CA, Tsujimoto A, Molisani J, Fu CC, Sadid-Zadeh R. Fracture resistance of chairside CAD-CAM lithium disilicate occlusal veneer with various designs after mechanical aging. J Prosthodont 2024. [PMID: 38706398 DOI: 10.1111/jopr.13852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 03/15/2024] [Indexed: 05/07/2024] Open
Abstract
PURPOSE This study evaluated the fracture resistance of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) lithium disilicate crown, onlay, and non-anatomical occlusal veneer (A-OV) with and without margin fabricated. MATERIALS AND METHODS Sixty-four CAD-CAM lithium disilicate restorations were designed as (1) complete coverage crown (CCC); (2) A-OV with margin; (3) non-A-OV with margin (NA-OV-M); and (4) non-A-OV without margin (NA-OV-NM), 16 of each. Restorations were crystallized and adhesively luted to resin dies using resin cement. Specimens were then subjected to 400,000 cycles of chewing in a mastication simulator. A universal testing machine was used to apply a compressive load at a crosshead speed of 1 mm/min to the long axis of the tooth with a stainless-steel sphere until fracture occurred. One-way ANOVA followed by post hoc tests were used to assess the impact of preparation design on the fracture load of CAD-CAM lithium disilicate restorations. RESULTS The highest fracture load was recorded for CAD-CAM lithium disilicate indirect restorations for non-A-OVs preparation with margin (2549 ± 428 N) and onlay (2549 ± 293 N) and the lowest fracture load was recorded for CCCs (2389 ± 428 N); however, there was no significant (p = 0.640) between groups. CONCLUSIONS CAD-CAM lithium disilicate restorations fabricated for anatomical and non-A-OV preparation display a fracture resistance similar to CCCs. Conservative partial coverage restorations may be considered an acceptable approach for posterior teeth.
Collapse
Affiliation(s)
- Carlos A Jurado
- Department of General Dentistry, University of Tennessee Health Science College of Dentistry, Memphis, Tennessee, USA
| | - Akimasa Tsujimoto
- Department of Operative Dentistry, Aichi Gaukin University School of Dentistry, Nagoya, Aichi, Japan
- Department of Operative Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
- Department of General Dentistry, Creighton University School of Dentistry, Omaha, Nebraska, USA
| | - Joseph Molisani
- University of Alabama at Birmingham School of Dentistry, Birmingham, Alabama, USA
| | - Chin-Chuan Fu
- Department of Restorative Sciences, University of Alabama at Birmingham, School of Dentistry, Birmingham, Alabama, USA
| | - Ramtin Sadid-Zadeh
- Department of Restorative Sciences, University of Alabama at Birmingham, School of Dentistry, Birmingham, Alabama, USA
| |
Collapse
|
4
|
Kui A, Manziuc M, Petruțiu A, Buduru S, Labuneț A, Negucioiu M, Chisnoiu A. Translucent Zirconia in Fixed Prosthodontics-An Integrative Overview. Biomedicines 2023; 11:3116. [PMID: 38137337 PMCID: PMC10740999 DOI: 10.3390/biomedicines11123116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
Over the past two decades, dental ceramics have experienced rapid advances in science and technology, becoming the fastest-growing field of dental materials. This review emphasizes the significant impact of translucent zirconia in fixed prosthodontics, merging aesthetics with strength, and highlights its versatility from single crowns to complex bridgework facilitated by digital manufacturing advancements. The unique light-conducting properties of translucent zirconia offer a natural dental appearance, though with considerations regarding strength trade-offs compared to its traditional, opaque counterpart. The analysis extends to the mechanical attributes of the material, noting its commendable fracture resistance and durability, even under simulated physiological conditions. Various zirconia types (3Y-TZP, 4Y-TZP, 5Y-TZP) display a range of strengths influenced by factors like yttria content and manufacturing processes. The study also explores adhesive strategies, underlining the importance of surface treatments and modern adhesives in achieving long-lasting bonds. In the realm of implant-supported restorations, translucent zirconia stands out for its precision, reliability, and aesthetic adaptability, proving suitable for comprehensive dental restorations. Despite its established benefits, the review calls for ongoing research to further refine the material's properties and adhesive protocols and to solidify its applicability through long-term clinical evaluations, ensuring its sustainable future in dental restorative applications.
Collapse
Affiliation(s)
- Andreea Kui
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Manuela Manziuc
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Adrian Petruțiu
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, 13 Victor Babes Street, 400008 Cluj-Napoca, Romania
| | - Smaranda Buduru
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Anca Labuneț
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Marius Negucioiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Andrea Chisnoiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| |
Collapse
|