Dental and Medical Problems
2018, vol. 55, nr 1, January-March, p. 35–42
Publication type: original article
Influence of crown design and material on chipping-resistance of all-ceramic molar crowns: An in vitro study
Wpływ kształtu i materiału pełnoceramicznych koron trzonowców na odporność na odpryskiwanie – badanie in vitro
1 Faculty of Dentistry, University of Toronto, Canada
2 Faculty of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
3 Department of Restorative Dentistry, Faculty of Dentistry, University of Toronto, Canada
4 Faculty of Dentistry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
Background. All-ceramic restorations have become popular and the trend is ongoing. However, the incidence of chipping within the veneering layer has been a commonly reported failure in clinical practice.
Objectives. The aim of this in vitro study was to evaluate the effect of ceramic crown design (monolithic vs bi-layered) and material on the chipping resistance of molar crowns submitted to compressive cyclic loading.
Material and Methods. Fifty identical epoxy resin replicas of a mandibular first molar with crown preparation were divided into 5 groups (n = 10) as follows: the MLD group – monolithic CAD/CAM lithium-disilicate glass-ceramic (LDGC) crowns; 30 zirconia cores were veneered with either feldspathic porcelain by hand-layering technique (ZHL) or by heat-pressing technique (ZVP), or with milled LDGC veneers and subsequently fused to the cores (ZLD); 10 porcelain-fused-to-metal (PFM) crowns acted as a control group. All crowns were cemented using Panavia® F2.0 resin cement (Kuraray Dental, Tokyo, Japan). After storage in water at 37°C for 1 week, the specimens were subjected to compressive cyclic loading at the mesiobuccal cusp which was tilted at 30°. A load cycle of 50–450 N was used and specimens were maintained in an aqueous environment throughout 500,000 cycles in a universal testing machine (Instron, Norwood, USA). The data was statistically analyzed at 5% significant level with Fisher’s exact test and Kaplan-Meier survival analysis.
Results. Significant differences in survival rates of the specimens used in the groups (p < 0.001) were found. Specimens of the PFM, ZHL and ZVP groups underwent failures at different stages of the 500,000 fatigue cycles, while specimens of the MLD and ZLD groups survived the entire fatigue test. ZHL and ZVP crowns had the worst chipping-resistance, while PFM crowns performed slightly better. The Kaplan-Meier test revealed significantly higher survival rates for the MLD and ZLD specimens compared to the other 3 groups.
Conclusion. The use of LDGC as a monolithic molar crown and as a veneer over a zirconia core resulted in superior resistance to cuspal chipping.
fatigue, crown, chipping, monolithic, posterior
badanie zmęczeniowe, korona, odpryski, monolityczny, tylny
- Miyazaki T, Hotta Y, Kunii J, Kuriyama S, Tamaki Y. A review of dental CAD/CAM: Current status and future perspectives from 20 years of experience. Dent Mater J. 2009;28:44-56.
- Beuer F, Schweiger J, Eichberger M, Kappert HF, Gernet W, Edelhoff D. High-strength CAD/CAM-fabricated veneering material sintered to zirconia copings: A new fabrication mode for all-ceramic restorations. Dent Mater. 2009;25:121-128.
- Piconi C, Maccauro G. Zirconia as a ceramic biomaterial. Biomater. 1999;20:1-25.
- Guess PC, Schultheis S, Bonfante EA, Coelho PG, Ferencz JL, Silva NRFA. All-ceramic systems: Laboratory and clinical performance. Dent Clin North Am. 2011;55:333-352.
- Manicone PF, Rossi Iommetti P, Raffaelli L. An overview of zirconia ceramics: Basic properties and clinical applications. J Dent. 2007;35:819-826.
- Benetti P, Pelogia F, Valandro LF, Bottino MA, Bona AD. The effect of porcelain thickness and surface liner application on the fracture behavior of a ceramic system. Dent Mater. 2011;27:948-953.
- Stawarczyk B, Özcan M, Roos M, Trottmann A, Sailer I, Hämmerle CHF. Load-bearing capacity and failure types of anterior zirconia crowns veneered with overpressing and layering techniques. Dent Mater. 2011;27:1045-1053.
- Heintze SD, Rousson V. Survival of zirconia- and metal-supported fixed dental prostheses: A systematic review. Int J Prosthodont. 2010;23:493-502.
- Özkurt Z, Kazazoĝlu E. Clinical success of zirconia in dental applications. J Prosthodont. 2010;19:64-68.
- Schwarz S, Schröder C, Hassel A, Bömicke W, Rammelsberg P. Survival and chipping of zirconia-based and metal-ceramic implant-supported single crowns. Clin Implant Dent Relat Res. 2012;14(Suppl 1):e119-e125.
- Christensen RP, Ploeger BJ. A clinical comparison of zirconia, metal and alumina fixed-prosthesis frameworks veneered with layered or pressed ceramic: A three-year report. J Am Dent Assoc. 2010;141:1317-1329.
- Ishibe M, Raigrodski AJ, Flinn BD, Chung KH, Spiekerman C, Winter RR. Shear bond strengths of pressed and layered veneering ceramics to high-noble alloy and zirconia cores. J Prosthet Dent. 2011;106:29-37.
- Rekow ED, Silva NRFA, Coelho PG, Zhang Y, Guess P, Thompson VP. Performance of dental ceramics: Challenges for improvements. J Dent Res. 2011;90:937-952.
- Aboushelib MN, Feilzer AJ, De Jager N, Kleverlaan CJ. Prestresses in bilayered all-ceramic restorations. J Biomed Mater Res B Appl Biomater. 2008;87:139-145.
- Tinschert J, Schulze KA, Natt G, Latzke P, Heussen N, Spiekermann H. Clinical behavior of zirconia-based fixed partial dentures made of DC-Zirkon: 3-year results. Int J Prosthodont. 2008;21:217-222.
- Thompson JY, Stoner BR, Piascik JR, Smith R. Adhesion/cementation to zirconia and other non-silicate ceramics: Where are we now? Dent Mater. 2011;27:71-82.
- Aboushelib MN, Feilzer AJ, Kleverlaan CJ. Bridging the gap between clinical failure and laboratory fracture strength tests using a fractographic approach. Dent Mater. 2009;25:383-391.
- Schmitter M, Mueller D, Rues S. Chipping behaviour of all-ceramic crowns with zirconia framework and CAD/CAM manufactured veneer. J Dent. 2012;40:154-162.
- Reich S, Fischer S, Sobotta B, Klapper HU, Gozdowski S. A preliminary study on the short-term efficacy of chairside computer-aided design/computer-assisted manufacturing generated posterior lithium disilicate crowns. Int J Prosthodont. 2010;23:214-216.
- Fasbinder DJ, Dennison JB, Heys D, Neiva G. A clinical evaluation of chairside lithium disilicate CAD/CAM crowns: A two-year report. J Am Dent Assoc. 2010;141:10S-14S.
- Guess PC, Zavanelli RA, Silva NR, Bonfante EA, Coelho PG, Thompson VP. Monolithic CAD/CAM lithium disilicate versus veneered Y-TZP crowns: Comparison of failure modes and reliability after fatigue. Int J Prosthodont. 2010;23:434-442.
- Haddad MF, Rocha EP, Assunção WG. Cementation of prosthetic restorations: From conventional cementation to dental bonding concept. J Craniofac Surg. 2011;22:952-958.
- Teixeira EC, Piascik JR, Stoner BR, Thompson JY. Dynamic fatigue and strength characterization of three ceramic materials. J Mater Sci Mater Med. 2007;18:1219-1224.
- Helkimo E, Carlsson GE, Helkimo M. Bite force and state of dentition. Acta Odontol Scand. 1977;35:297-303.
- Kelly JR. Clinically relevant approach to failure testing of all-ceramic restorations. J Prosthet Dent. 1999;81:652-661.
- Wiskott HW, Nicholls JI, Belser UC. Stress fatigue: Basic principles and prosthodontic implications. Int J Prosthodont. 1995;8:105-116.
- Rinke S, Schäfer S, Lange K, Gersdorff N, Roediger M. Practice-based clinical evaluation of metal-ceramic and zirconia molar crowns: 3-year results. J Oral Rehabil. 2013;40:228-237.
- Swain MV. Unstable cracking (chipping) of veneering porcelain on all-ceramic dental crowns and fixed partial dentures. Acta Biomater. 2009;5:1668-1677.
- Tsalouchou E, Cattell MJ, Knowles JC, Pittayachawan P, McDonald A. Fatigue and fracture properties of yttria partially stabilized zirconia crown systems. Dent Mater. 2008;24:308-318.
- Preis V, Letsch C, Handel G, Behr M, Schneider-Feyrer S, Rosentritt M. Influence of substructure design, veneer application technique, and firing regime on the in vitro performance of molar zirconia crowns. Dent Mater. 2013;29:e113-e121.
- Fischer J, Grohmann P, Stawarczyk B. Effect of zirconia surface treatments on the shear strength of zirconia/veneering ceramic composites. Dent Mater J. 2008;27:448-454.
- Zhang Y, Lee JJW, Srikanth R, Lawn BR. Edge chipping and flexural resistance of monolithic ceramics. Dent Mater. 2013;29:1201-1208.
- Zahran M, El-Mowafy O, Tam L, Watson PA, Finer Y. Fracture strength and fatigue resistance of all-ceramic molar crowns manufactured with CAD/CAM technology. J Prosthodont. 2008;17:370-377.