Effect of sintering time on the marginal and internal fit of monolithic zirconia crowns containing 3-4 mol% Y2O3.

BACKGROUND: Short-term sintering may offer advantages including saving time and energy but there is limited evidence on the effect that altering sintering time has on the accuracy of monolithic zirconia crowns. The purpose of this in vitro study was to investigate the effect of shortened sintering time on the marginal and internal fit of 3Y-TZP and 4Y-TZP monolithic crowns. METHODS: Sixty monolithic zirconia crowns were fabricated for the maxillary first molar tooth on the prefabricated implant abutment. Groups were created according to the material composition: 3Y-TZP Generation 1, 3Y-TZP Generation 2 and 4Y-TZP. Two different sintering protocols were performed: same final sintering temperature (1500 °C) and various rates of heating (10 °C/min and 40 °C/min), cooling down speed (- 10 °C/min and - 40 °C/min), holding time (45 and 120 minutes), and total sintering time (approximately 2 and 7 hours, respectively). The marginal and internal fit of the crowns were determined using the silicone replica technique. Comparisons between groups were analyzed using two-way ANOVA. Pairwise multiple comparisons were performed using t-test (p < 0.05). RESULTS: The mean marginal gap values of 4Y-TZP zirconia revealed statistically significant increase for the short-term sintering protocol (p < 0.0001), while no difference was observed between the sintering protocols for the mean marginal gap values of 3Y-TZP groups. Although all groups showed clinically acceptable gap values, altering the sintering time had an effect on marginal fit of the crowns manufactured from 4Y-TZP zirconia. CONCLUSIONS: Shortening the sintering time may lead to differences within clinically acceptable limits. The manufacturer's recommendations according to material composition should be implemented with care.

Zirconia Cantilever Fixed Dental Prostheses Supported by One or Two Implants: An In Vitro Study on Mechanical Stability and Technical Outcomes.

PURPOSE: To evaluate the mechanical stability of highly translucent zirconia (Zr) cantilevered fixed dental prostheses (cFDPs) and to investigate the influence of the number of implants (one versus two) supporting cFDPs with different restorative materials on their mechanical stability and load-bearing capacity. MATERIALS AND METHODS: Thirty-two specimens consisting of implant-supported prostheses embedded in resin blocks were fabricated. Sixteen specimens received one implant (bone-level implant, 4.1-mm diameter, 13-mm length; Straumann) to support two-unit cement-retained cFDPs with one extension unit and the other 16 received two implants (bone-level implant, 4.1-mm diameter, 13-mm length; Straumann) positioned corresponding to the missing maxillary central incisors to support three-unit cement-retained cFDPs with one extension unit. Two different prosthetic materials, chromium-cobalt (Cr-Co; Wirobond C+, Bego) and highly translucent Zr (Lava Plus, 3M ESPE) were selected to fabricate the two- and three-unit cFDPs. Standardized twoand three-unit Cr-Co frameworks (CC-I, n = 8; CC-II, n = 8) and highly translucent Zr frameworks (Zr-I, n = 8; Zr-II, n = 8) with a 6-mm cantilever extension were fabricated using CAD/CAM (EOS M 290). Following thermomechanical fatigue loading, the specimens were tested for fracture resistance under static loading. The influence of restoration material and number of supporting implants on fracture resistance were tested using two-way analysis of variance (ANOVA). The level of statistical significance was set below 5% (α < .05). RESULTS: All specimens survived aging. The mean (± standard deviation) fracture resistance values were 416.25 (± 42.71) N for Zr-I, 548.75 (± 75.41) N for Zr-II, 601.0 (± 41.51) N for CC-I, and 664.5 (± 37.59) N for CC-II. CC and Zr group specimens showed significantly different fracture resistance results (P < .001). The number of implants significantly influenced the fracture resistance of Zr groups (P = .001), whereas the influence was not significant for CC groups (P = .089). CONCLUSION: Within the limitations of this in vitro study, highly translucent zirconia cFDP frameworks demonstrated the potential to withstand reported physiologic occlusal forces applied in the anterior region. The increase in the number of implants supporting zirconia cFDPs significantly contributed to achieving higher fracture resistance values.

Effect of irrigants on the color stability, solubility, and surface characteristics of calcium-silicate based cements.

Objectives: This study aimed to investigate the color stability, solubility, and surface characteristics of 3 calcium silicate-based cements (CSCs) after immersion in different solutions. Materials and Methods: ProRoot white mineral trioxide aggregate (MTA), Biodentine, and Endosequence Root Repair Material (ERRM) were placed in cylindrical molds and stored at 37°C for 24 hours. Each specimen was immersed in distilled water, 5% sodium hypochlorite (NaOCl), 2% chlorhexidine, or 0.1% octenidine hydrochloride (OCT) for 24 hours. Color changes were measured with a spectrophotometer. Solubility was determined using an analytical balance with 10-5 g accuracy. The surface characteristics were analyzed using scanning electron microscopy and energy-dispersive spectroscopy. Data were analyzed using 2-way analysis of variance, the Tukey test, and the paired t-test. Results: MTA exhibited significant discoloration in contact with NaOCl (p < 0.05). White precipitation occurred on the surfaces of Biodentine and ERRM after contact with the solutions, and none of the materials presented dark brown discoloration. All materials showed significant solubility after immersion in the solutions (p < 0.05), irrespective of the solution type (p > 0.05). The surface topography and elemental composition of the samples showed different patterns of crystal formation and precipitation depending on the solution type. Conclusions: All materials presented some amount of solubility and showed crystal precipitation after contact with the solutions. Biodentine and ERRM are suitable alternatives to ProRoot MTA as they do not exhibit discoloration. The use of OCT can be considered safe for CSCs.

Mechanical Stability of Zirconia Implant Abutments Supporting Cantilevered Fixed Dental Prostheses After Fatigue Loading.

PURPOSE: To evaluate the mechanical stability and complication rates of titanium (Ti) or zirconia (Zr) abutments restored with cantilevered fixed dental prostheses (cFDPs) when supported by 1 or 2 implants. MATERIALS AND METHODS: A total of 32 samples were fabricated. Half of the samples received 1 implant, and the other half received 2 implants (Bone Level Implant, Ø 4.1, 13 mm, Straumann) to simulate the clinical situation of 2 or 3 missing maxillary incisors, respectively. Each group was divided into two subgroups (n = 8). Ti-I and Ti-II groups received Ti abutments (Anatomic Abutment, Straumann) supporting 2- or 3-unit metal cFDPs, respectively, while Zr-I and Zr-II groups received Zr abutments (IPS e.max Anatomic Abutment, Straumann). Following the cementation of cFDPs using resin cement (Multilink Automix, Ivoclar Vivadent), the samples were subjected to thermomechanical fatigue load and were subsequently loaded until fracture in a universal testing machine. Following the static loading test, stereomicroscopic analyses (Carl Zeiss) were done to identify the weakest component of the cFDP, abutment, and implant assembly. Mann-Whitney U test was used to evaluate the effect of the number of supporting implants and abutment material on fracture strength values, and the level of statistical significance was set at 5% (α = .05). RESULTS: All specimens survived the aging, and no screw loosening or fracture was recorded. The mean fracture strength values were 226 N (± 26.45 ), 551.12 N (± 82.19 ), 601 N (± 41.51 ), and 664.5 N (± 37.59 ) for Zr-I, Zr-II, Ti-I, and Ti-II, respectively. The difference between fracture strength values of Ti and Zr groups was significant in favor of Ti abutments (P < .001). The number of supporting implants showed a significantly positive effect on the fracture strength of Zr abutments. CONCLUSION: Zirconia abutments demonstrated lower fracture strength values than titanium abutments independent from the number of supporting implants when used under cFDPs. Two-implant supported cFDPs with zirconia abutments have the potential to withstand physiologic forces applied in the anterior region.

Effect of Anti-Rotational Abutment Features and Novel Computerized Fabrication Techniques on the Marginal Fit of Implant-Supported Metal Copings.

PURPOSE: An in vitro study to compare the marginal fit of cobalt-chromium (Co-Cr) metal copings fabricated with selective laser melting (SLM), computer-aided design and computer-aided manufacturing (CAD/CAM) milling, and lost-wax (LW) techniques, on abutments with two different antirotational features. MATERIALS AND METHODS: A total of 60 stainless steel abutments with the same length and convergence angles were fabricated using a numerical control machining. Half of the abutments had one flat plane, while the other half had three grooves as an antirotation feature. Thirty abutments of each kind were then divided into three subgroups, and metal copings were fabricated with SLM, CAD/CAM milling, or the LW technique (n = 10). The metal copings were cemented with polycarboxylate cement. Marginal gap measurements were performed using a stereomicroscope at a magnification of × 45 and data were analyzed with two-way analysis of variance (ANOVA) tests. RESULTS: The LW (p = 0.002) and CAD/CAM (p < 0.001) techniques exhibited increased marginal gaps on the abutments with a three groove antirotational feature; however, no significant difference was detected with the SLM technique (p = 0.259). The copings fabricated with the SLM technique demonstrated significantly lower gap values in both abutment types (p < 0.001). CONCLUSION: While all marginal gap values were within the clinically acceptable range (<120 µm), abutments with more antirotational grooves exhibited wider marginal gaps with the LW and CAD/CAM techniques.

Biomechanical Behavior of Implants with a Sloped Marginal Configuration.

PURPOSE: To evaluate the biomechanical behavior of implants with different neck designs. MATERIALS AND METHODS: Finite element models of implants with two different neck designs (OsseoSpeed EV and OsseoSpeed Profile EV) were generated. Implants and abutments were subjected to buccally and lingually directed 30-degree oblique loads of 200 N. RESULTS: Under buccally angulated load, the Profile implant model showed lower minimum principal stress when compared to the standard implant model (-63.4 vs -91.9 MPa), whereas the von Mises stress value of the Profile implant model was higher (342 MPa). CONCLUSION: This preliminary study showed that Profile implants placed in alveolar ridges with buccolingual bone height discrepancy showed similar stress distribution and stress value outcomes when compared to standard implants.

The Fracture Resistance of Composite Core Materials Reinforced by Varying Fiber Orientations.

This study aimed to compare the fracture resistance of composite core materials reinforced with varying fiber orientations. Composite cores of endodontically treated roots were prepared by reinforcing with woven fiber discs, fiber strips, or fiber chips, and their fracture resistance was compared to those with no reinforcement using a universal test machine (Instron, Lloyd Instruments). Reinforcement with fiber chips showed the highest fracture resistance and 50% retrievability, while no reinforcement showed the lowest fracture resistance with 62.5% retrievability. It can be concluded that the use of fiber chips may be an effective and practical method for reinforcement of the core material.

Comparison of implant versus tooth-supported zirconia-based single crowns in a split-mouth design: a 4-year clinical follow-up study.

OBJECTIVES: This study aims to evaluate the 4-year clinical performance of tooth versus implant-supported single-unit zirconia crowns (LAVA™) placed on posterior region. MATERIALS AND METHODS: Twenty-four patients (10 men and 14 women) who had received 48 single crowns (24 implant-supported and 24 tooth-supported) from January 2007 to December 2009, were included. California Dental Association (CDA) quality assessment system, plaque and gingival index scores were used to evaluate the performance of the crowns at baseline and at all follow-up examinations. RESULTS: During the follow-up period, no fracture of zirconia coping has occurred. Major complication was chipping in three patients that required a new crown fabrication. Except for the failure ones, all crowns in both groups were rated as satisfactory at the follow-up examinations based on the CDA quality assessment criteria. There were no statistically significant differences between tooth and implant-supported crowns in terms of periodontal parameters. CONCLUSIONS: The present 4-year follow-up clinical study demonstrates that single-unit tooth- and implant-supported zirconia crowns have similar prosthetic and periodontal outcomes. CLINICAL RELEVANCE: Single-unit implant or tooth-supported zirconia crowns may be considered acceptable treatment modalities for restoration of either missing or compromised posterior teeth.

Effect of timing of post space preparation on the apical seal when using different sealers and obturation techniques.

BACKGROUND/PURPOSE: To prepare the post apace, some of the root-canal filling material has to be removed, which can affect the apical seal. The aim of this study was to compare the effect of immediate post space preparation to that of delayed post space preparation on apical sealing using three different endodontic sealers and obturation techniques. MATERIALS AND METHODS: In total, 90 decrowned single-rooted human teeth were studied. After root canals were prepared with 0.06 tapered nickel-titanium rotary files to size 30, the roots were categorized randomly into three experimental groups according to the obturation material: (1) AH plus/gutta-percha; (2) Sealite Ultra/gutta-percha; and (3) Epiphany/Resilon. Furthermore in all groups, specimens were categorized randomly into three subgroups according to the obturation technique (n = 10): (1) single cone; (2) cold lateral compaction; and (3) System B + Obtura. After root-canal filling, post space preparation was immediately performed in Group 1, after 24 hours in Group 2, and after 7 days in Group 3. Apical leakage was measured using the fluid-filtration method. Statistical analysis was performed using the Kruskal-Wallis test and Wilcoxon signed ranks test at P < 0.001. RESULTS: Regardless of the obturation technique and sealers used, significantly better (P < 0.001) sealing was achieved at the apical ends using delayed post space preparation than with immediate post preparation. The obturation techniques tested did not significantly affect leakage values. The following statistical ranking of fluid filtration values was obtained for the obturation materials: Epiphany/Resilon > Sealite Ultra/gutta-percha > AH plus/gutta-percha (P < 0.001). CONCLUSION: To reduce apical leakage, clinicians should use AH plus together with any of the obturation techniques after 7 days of obturation.

The Effect of Water or Wax-based Binders on the Chemical and Morphological Characteristics of the Margin Ceramic-Framework Interface.

This study evaluated the effect of binder choice in mixing ceramic powder on the chemical and morphological features between the margin ceramic-framework interfaces. Titanium and zirconia frameworks (15 x 5 x 0.5 mm3) were veneered with margin ceramics prepared with two different binders, namely a) water/conventional or b) wax-based. For each zirconia framework material, four different margin ceramics were used: a- Creation Zi (Creation Willi Geller International); b- GC Initial Zr (GC America); Triceram (Dentaurum); and d- IPS emax (voclar Vivadent). For the titanium framework, three different margin ceramics were used: a- Creation Ti (Creation Willi Geller International); b- Triceram (Dentaurum); and c- VITA Titaniumkeramik (Vita Zahnfabrik). The chemical composition of the framework-margin ceramic interface was analyzed using Energy Dispersive X-ray Spectroscopy (EDS) and porosity level was quantified within the margin ceramic using an image program (ImageJ) from four random areas (100 x 100 pixels) on each SEM image. EDS analysis showed the presence of Carbon at the margin ceramic-framework interface in the groups where wax-based binder technique was used with the concentration being the highest for the IPS emax ZirCAD group. While IPS system (IPS ZirCAD and IPS Emax) presented higher porosity concentration using wax binder, in the other groups wax-based binder reduced the porosity of margin ceramic, except for Titanium - Triceram combination.

Zirconia-based crowns up to 5 years in function: a retrospective clinical study and evaluation of prosthetic restorations and failures.

PURPOSE: The purpose of this retrospective study was to evaluate the 5-year clinical performance and failure rate of single- or multiple-unit zirconia-based crowns. MATERIALS AND METHODS: A total of 148 patients (39 men and 109 women, mean age: 46.9 ± 10.6 years) treated in university and private practices with 618 single- or multiple-unit zirconia-based (Lava) crowns made on natural teeth from January 2007 to December 2008 were included. Two hundred fifty-nine anterior and 359 posterior crowns were examined. A core and/or veneer fracture that required replacement of the restoration was considered to be a failure. The cumulative survival rate (CSR) was described with Kaplan-Meier survival functions. The crowns replaced for other reasons were deemed lost to follow-up, and esthetic, functional, and biologic complications were rated. RESULTS: At the 5-year follow-up, no zirconia core fractures were observed. Twelve veneer fractures that required crown replacement were detected. The CSR was 98.1%. There was a statistically significant difference between survival of the anterior and posterior restorations (P < .001). In total, 116 crowns experienced biologic and technical complications. The most common complications were smooth veneer fracture (4, 0.6%), loss of retention (7, 1%), staining because of smoking (24, 4%), and gingival recession (48, 8%). CONCLUSIONS: According to the 5-year CSR (98.1%) observed in this study, zirconia-based single or multiple crowns may be considered an acceptable treatment modality for the replacement of anterior and posterior teeth. RESULTS from the current study should be supported by additional randomized clinical trials.

Effect of engraving speeds of CO2 laser irradiation on In-Ceram Alumina roughness: a pilot study.

OBJECTIVES: The aim of the study was to determine the effect of CO2 laser on surface roughness of In-Ceram-Alumina-ceramic. MATERIALS AND METHODS: Four aluminum-oxide ceramic disc specimens were prepared of In-Ceram Alumina. Discs received CO2 laser irradiation with different engraving speeds (100, 400, 600 and 800 mm/min) as a surface treatment. The roughness of the surfaces was measured on digital elevation models reconstructed from stereoscopic images acquired by scanning-electron-microscope. Surface roughness data were analyzed with One-Way-Analysis-of-Variance at a significance level of p<0.05. RESULTS: There was no significant difference between the roughness values (p=0.82). Due to higher laser durations, partial melting signs were observed on the surfaces. Tearing, smearing and swelling occurred on melted surfaces. Swelling accompanying melting increased the surface roughness, while laser power was fixed and different laser engraving speeds were applied. CONCLUSION: Although different laser irradiation speeds did not affect the roughness of ceramic surfaces, swelling was observed which led to changes on surfaces.

Correlation between clinical and magnetic resonance imaging findings in the treatment of anterior disc displacement.

PURPOSE: This study aimed to compare the agreement of clinical examination and magnetic resonance imaging (MRI) results before and after the treatment of nonreduction temporomandibular joint (TMJ) disc displacement. MATERIALS AND METHODS: The study group consisted of 22 patients, each with anterior disc displacement without reduction in at least one TMJ. Diagnosis was performed clinically and with MRI prior to treatment. All patients received the same treatment protocol, consisting of occlusal appliance therapy and exercise for a period of 24 weeks. By the end of treatment, clinical and imaging examinations were repeated and the results subjected to statistical analysis. RESULTS: Before treatment, MRI and clinical examinations matched in 35 of 44 joints (79.5%). On the basis of the kappa index, the agreement between clinical and imaging examinations was moderate (mean kappa index = 0.59, P = .0001). After treatment, these examinations matched in only 16 of 44 cases (36%) and the agreement was poor. CONCLUSION: Clinical criteria do not necessarily correlate with MRI findings in the postoperative period in patients treated for TMJ anterior disc displacement.

Effect of mixing techniques on bacterial attachment and disinfection time of polyether impression material.

OBJECTIVE: The aim of this study was 2-fold. The first aim was to evaluate the effects of mixing technique (hand-mixing or auto-mixing) on bacterial attachment to polyether impression materials. The second aim was to determine whether bacterial attachment to these materials was affected by length of exposure to disinfection solutions. MATERIALS AND METHODS: Polyether impression material samples (n = 144) were prepared by hand-mixing or auto-mixing. Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were used in testing. After incubation, the bacterial colonies were counted and then disinfectant solution was applied. The effect of disinfection solution was evaluated just after the polymerization of impression material and 30 min after polymerization. Differences in adherence of bacteria to the samples prepared by hand-mixing and to those prepared by auto-mixing were assessed by Kruskal-Wallis and Mann-Whitney U-tests. For evaluating the efficiency of the disinfectant, Kruskal-Wallis multiple comparisons test was used. RESULTS: E. coli counts were higher in hand-mixed materials (P < 0.05); no other statistically significant differences were found between hand- and auto-mixed materials. According to the Kruskal-Wallis test, significant differences were found between the disinfection procedures (Z > 2.394). CONCLUSION: The methods used for mixing polyether impression material did not affect bacterial attachment to impression surfaces. In contrast, the disinfection procedure greatly affects decontamination of the impression surface.

Effect of preparation taper and height on strength and retention of zirconia crowns.

This study aimed to determine the effect of the taper and height of tooth preparations on the fracture strength and retention of zirconia crowns. Sixty-four dies were designed to simulate a crown preparation. Dies were machined with a height of either 4 mm (n = 16) or 7 mm (n = 16) and a taper of either 6 degrees (n = 16) or 20 degrees (n = 16). Copings were created from Lava zirconia blanks. Retention tests were performed using a universal testing machine. Copings were recemented on the dies, thermocycled, and tested for fracture strength. Data were analyzed using factorial analysis of variance. Retention was greater in the taller and less-tapered preparation designs. Taller preparations showed superior fracture strength. Preparing posterior teeth with higher axial walls and less taper is recommended to achieve increased retention and strength for zirconia crowns.

Effect of repeated firings on microtensile bond strength of In-Ceram Alumina with two different veneering ceramics.

Microtensile bond strengths of In-Ceram Alumina cores veneered with two ceramics after different numbers of firing cycles were evaluated. After In-Ceram Alumina cores were fabricated, they were veneered with either Vitadur Alpha or Vita VM7. A control group of each core-veneer combination was fired twice, and a second group was fired five times to induce thermal fatigue. Obtained microbars were subjected to microtensile bond strength tests. Data were analyzed using two-way analysis of variance. Microtensile bond strength values for Vita VM7 specimens were higher than those for Vitadur Alpha (P < .001). Although the number of firing cycles revealed no change in bond strength, the veneering material proved to be an important factor.

Comparison of 3 luting agents on retention of implant-supported crowns on 2 different abutments.

BACKGROUND: For fixed prostheses, retention is one of the most important factors for clinical success. It is unknown whether grooves that increase surface area of implant abutment while retaining the diameter and wall height provide greater uniaxial retention force. The purpose of this study was to determine the retention of 3 different cements on 2 implant abutments with different surface configurations. MATERIALS AND METHODS: Thirty samples on 2 different abutments (a total of 60 crowns) with different margin and axial walls configuration and surface area were used. Metal crowns were fabricated on the abutment and cemented with 3 different (zinc-phosphate [ZP], glass ionomer [GI], or eugenol-free zinc oxide [ZO]) cements. After cementation, implant-abutment-casting assemblies were thermal cycled 1000 times with 1-minute dwell-time between 5°C and 55°C then subjected to tensile test with universal testing machine until decementation occurred. The mean force required to dislodge castings from abutment was determined. RESULTS: The luting agents influenced retention of castings on implant abutments, whereas different surface configurations and total surface area of the abutments did not influence the uniaxial retention forces. Among the cements tested, ZP exhibited higher values of retention, followed by GI and eugenol-free ZO. CONCLUSIONS: The increase in surface area of abutment did not result in improved retention. The present results suggest using ZP rather than GI and eugenol-free ZO in implant-supported crowns to provide higher retention.

Does the surface treatment affect the bond strength of various fibre-post systems to resin-core materials?

OBJECTIVES: The aim of this study was to evaluate the effects of surface treatments on bond strength of resin-core materials to three different types of fibre posts. METHODS: Prefabricated glass (FRC Postec, Ivoclar), quartz (DT light, Bisco) and individually formed glass (Everstick, Stick Tech) fibre posts with a coronal diameter of 1.5 mm were randomly divided into three groups according to the surface treatment performed. In Group 1 sandblasting with aluminium oxide particles (Rocatec Pre, 3M Espe) was followed by the application of a silane coupling agent. In Group 2, posts were immersed in 9.6% hydrofluoric acid gel for 60 s and silanized for 60 s. In Group 3, no surface treatment was performed and it served as control. The resin-core material (Biscore, Bisco) or resin composites (Admira, Voco) were applied to the tube in 2-mm thick increments and light-cured for 40 s using a halogen light curing unit. 1 mm thick discs (n=10/per group) were prepared for the micropush-out test. The discs were pushed out in a universal testing machine (Lloyd Instruments). Statistical significance was determined by a multifactorial analysis of variance followed by Tukey's post hoc test or independent t tests. RESULTS: ANOVA revealed that fibre posts and core materials had a significant effect on micropush-out bond strength values (p<0.001). The surface treatment with hydrofluric acid gel and sandblasting with aluminium oxide particles significantly enhanced bond strength values of fibre posts except Everstick post (p<0.05). CONCLUSION: Different surface treatments of fibre posts might affect the bonding capacity of resin-core systems to these posts.

Bonding of resin core materials to lithium disilicate ceramics: the effect of resin cement film thickness.

The aim of this study was to investigate the effect of different resin cement film thicknesses on the shear bond strength of resin core materials to lithium disilicate ceramics. Forty IPS Empress 2 ceramic disks were bonded to the core materials (Bis-core and Smile) with resin cement film thicknesses of 50 or 100 µm. Shear bond strength was measured using a universal testing machine. Data were analyzed using two-way analysis of variance and independent t tests. The core material used and resin cement film thickness had a significant effect on shear bond strength values (P < .001). Greater resin cement film thickness resulted in decreased bond strength of the core materials to lithium disilicate ceramics.

Influence of thermomechanical fatigue loading on the fracture resistance of all-ceramic posterior crowns.

This study evaluated the fracture resistance and the survival rate of different all-ceramic crowns in-vitro after thermomechanical fatigue loading in comparison to porcelain-fused-to-metal posterior crowns. Sixteen crowns for human mandibular first molars were made of each of the following: Cercon, IPS-Empress 2 In-Ceram Zirconia, Procera AllZircon and porcelain-fused-to-metal. Half of the specimens of each group was thermocycled and dynamically loaded using a chewing simulator All samples were thereafter tested for the maximum fracture resistance. The survival rates after 1-2 million cycles in the artificial mouth were 100% in all the tested crown systems. The chewing simulation and thermocycling did not significantly decrease the fracture strength of the ceramic crowns (P>0.005). The median fracture load of Cercon, Procera AllZircon, In-Ceram Zirconia and PFM was significantly higher than IPS-Empress 2 both for loaded and non loaded groups (P<0.005) while the difference between Cercon, Procera AllZircon, In-Ceram Zirconia and PFM was not significant (P>0.005). All-ceramic systems showed fracture load values similar to those of porcelain-fused-to-metal molar crowns and therefore may be considered for use in clinical studies.