Effects of surface finish and fatigue testing on the fracture strength of CAD-CAM and pressed-ceramic crowns.

STATEMENT OF PROBLEM All-ceramic molar crowns can be fabricated with CAD-CAM or laboratory methods with different materials, and a polished or oven-glazed surface. PURPOSE This in vitro study determined the fracture strength of various all-ceramic crowns, with and without prior cyclic loading. MATERIAL AND METHODS Standardized molar crowns were fabricated with a CAD-CAM machine (Cerec 2), software with machinable ceramic materials (Vita Mark II and ProCAD), and also conventional heat-pressed IPS Empress crowns fabricated at 2 dental laboratories. Groups of 40 crowns of each material were manufactured with either a polished or an oven-glazed surface finish. Cyclic loading that simulated oral conditions were performed on half of each group. Afterward, all crowns were loaded until catastrophic failure.Results. Fracture loads of the polished ProCAD crowns without prior cyclic loading was 2120 +/- 231 N, significantly higher than that of the polished Vita Mark II crowns (1905 +/- 235 N), but was not significantly different from the strength of 2 laboratory-fabricated Empress crowns. Oven-glazing of ProCAD crowns improved the fracture strength significantly, up to 2254 +/- 186 N. Prior cyclic loading decreased the strength of all tested crowns significantly, but the reduction was less for the Cerec crowns than the Empress crowns. CONCLUSION Cerec ProCAD crowns demonstrated significantly greater strength than the Vita Mark II crowns, better resistance to cyclic loading and lower failure probability than the laboratory-fabricated IPS Empress crowns. Prior cyclic loading significantly reduced the strength of all-ceramic crowns, but had less effect on Cerec crowns than on the IPS Empress crowns. Oven-glazing of ProCAD crowns resulted in significantly higher strength and higher resistance to cyclic loading than surface polishing.