The fracture resistance of a CAD/CAM Resin Nano Ceramic (RNC) and a CAD ceramic at different thicknesses.

OBJECTIVES This study aimed to investigate the influence of restoration thickness to the fracture resistance of adhesively bonded Lava™ Ultimate CAD/CAM, a Resin Nano Ceramic (RNC), and IPS e.max CAD ceramic. METHODS Polished Lava™ Ultimate CAD/CAM (Group L), sandblasted Lava™ Ultimate CAD/CAM (Group LS), and sandblasted IPS e.max CAD (Group ES) discs (n=8, Ø=10 mm) with a thickness of respectively 0.5 mm, 1.0 mm, 1.5 mm, 2.0 mm, and 3.0 mm were cemented to corresponding epoxy supporting discs, achieving a final thickness of 3.5 mm. All the 120 specimens were loaded with a universal testing machine at a crosshead speed of 1 mm/min. The load (N) at failure was recorded as fracture resistance. The stress distribution for 0.5 mm restorative discs of each group was analyzed by Finite Element Analysis (FEA). The results of facture resistances were analyzed by one-way ANOVA and regression. RESULTS For the same thickness of testing discs, the fracture resistance of Group L was always significantly lower than the other two groups. The 0.5 mm discs in Group L resulted in the lowest value of 1028 (112) N. There was no significant difference between Group LS and Group ES when the restoration thickness ranged between 1.0 mm and 2.0 mm. There was a linear relation between fracture resistance and restoration thickness in Group L (R=0.621, P<0.001) and in Group ES (R=0.854, P<0.001). FEA showed a compressive permanent damage in all groups. SIGNIFICANCE The materials tested in this in vitro study with the thickness above 0.5 mm could afford the normal bite force. When Lava Ultimate CAD/CAM is used, sandblasting is suggested to get a better bonding.

[1]  M. Valera,et al.  Penetration of 38% hydrogen peroxide into the pulp chamber in bovine and human teeth submitted to office bleach technique. , 2007, Journal of endodontics.

[2]  M. Könönen,et al.  A novel bite force recorder and maximal isometric bite force values for healthy young adults. , 1993, Scandinavian journal of dental research.

[3]  C. Feng,et al.  The effect of core material, veneering porcelain, and fabrication technique on the biaxial flexural strength and weibull analysis of selected dental ceramics. , 2012, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[4]  P. Magne,et al.  Thickness of CAD-CAM composite resin overlays influences fatigue resistance of endodontically treated premolars. , 2009, Dental Materials.

[5]  Y. Momoi,et al.  Finite element stress analysis of indirect restorations prepared in cavity bases. , 2007, Dental materials journal.

[6]  W. Mörmann,et al.  Fracture load of CAD/CAM-generated slot-inlay FPDs. , 2003, The International journal of prosthodontics.

[7]  E. F. Harris,et al.  A radiographic assessment of enamel thickness in human maxillary incisors. , 1998, Archives of oral biology.

[8]  D. Arola,et al.  A comparison of fatigue crack growth in resin composite, dentin and the interface. , 2007, Dental materials : official publication of the Academy of Dental Materials.

[9]  C H Gibbs,et al.  Limits of human bite strength. , 1986, The Journal of prosthetic dentistry.

[10]  T. van Eijden Three-dimensional analyses of human bite-force magnitude and moment. , 1991, Archives of oral biology.

[11]  A Wennström,et al.  Isometric bite force and its relation to general muscle forge and body build. , 1970, Acta odontologica Scandinavica.

[12]  T. Okiji,et al.  Effect of overglazed and polished surface finishes on the compressive fracture strength of machinable ceramic materials. , 2010, Dental materials journal.

[13]  Sharifa Abdullah Alshehri,et al.  An investigation into the role of core porcelain thickness and lamination in determining the flexural strength of In-Ceram dental materials. , 2011, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[14]  C. Kurtoglu,et al.  Influence of layer thickness on stress distribution in ceramic-cement-dentin multilayer systems. , 2008, Dental materials journal.

[15]  Peter Rammelsberg,et al.  Optimizing preparation design for metal-free composite resin crowns. , 2008, The Journal of prosthetic dentistry.

[16]  O. El-Mowafy,et al.  Fatigue resistance and microleakage of CAD/CAM ceramic and composite molar crowns. , 2012, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[17]  F. Beuer,et al.  Digital dentistry: an overview of recent developments for CAD/CAM generated restorations , 2008, BDJ.

[18]  Pascal Magne,et al.  In vitro fatigue resistance of CAD/CAM composite resin and ceramic posterior occlusal veneers. , 2010, The Journal of prosthetic dentistry.

[19]  P. Rammelsberg,et al.  Fracture resistance of metal-free composite crowns-effects of fiber reinforcement, thermal cycling, and cementation technique. , 2004, The Journal of prosthetic dentistry.

[20]  J. Kruzic,et al.  Mechanistic aspects of fatigue crack growth behavior in resin based dental restorative composites. , 2009, Dental materials : official publication of the Academy of Dental Materials.

[21]  T. V. Eijden Three-dimensional analyses of human bite-force magnitude and moment. , 1991 .

[22]  E. D. Rekow,et al.  Failure Modes in Ceramic‐Based Layer Structures: A Basis for Materials Design of Dental Crowns , 2007 .

[23]  S. Rokhlin,et al.  Statistical failure analysis of brittle coatings by spherical indentation: theory and experiment , 2006 .

[24]  H. J. de Jongh,et al.  Forces acting on the mandible during bilateral static bite at different bite force levels. , 1980, Journal of biomechanics.

[25]  U. Lohbauer,et al.  Subcritical crack growth and in vitro lifetime prediction of resin composites with different filler distributions. , 2012, Dental materials : official publication of the Academy of Dental Materials.

[26]  P. Vallittu,et al.  Fiber-reinforced composite substructure: Load-bearing capacity of an onlay restoration , 2006, Acta odontologica Scandinavica.

[27]  J. Fiorellini,et al.  A phase I/II clinical trial to evaluate a combination of recombinant human platelet-derived growth factor-BB and recombinant human insulin-like growth factor-I in patients with periodontal disease. , 1997, Journal of periodontology.

[28]  J. Drummond,et al.  Fatigue behaviour of dental composite materials. , 2009, Journal of dentistry.

[29]  S. Ebisu,et al.  Fatigue behavior of resin composites in aqueous environments. , 2007, Dental materials : official publication of the Academy of Dental Materials.

[30]  J. Roulet Longevity of glass ceramic inlays and amalgam – results up to 6 years , 1997, Clinical Oral Investigations.

[31]  H. Maia,et al.  Novel-design ultra-thin CAD/CAM composite resin and ceramic occlusal veneers for the treatment of severe dental erosion. , 2011, The Journal of prosthetic dentistry.

[32]  C. Soares,et al.  Fracture resistance of teeth restored with indirect-composite and ceramic inlay systems. , 2004, Quintessence international.

[33]  L. Buso,et al.  Biaxial flexural strength of CAD/CAM ceramics. , 2011, Minerva stomatologica.

[34]  J. R. Kelly,et al.  Contact damage as a failure mode during in vitro testing. , 1996, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[35]  J. Pereira,et al.  Effect of resin luting film thickness on fracture resistance of a ceramic cemented to dentin. , 2007, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[36]  K. Hiller,et al.  Ceramic inlays and partial ceramic crowns: influence of remaining cusp wall thickness on the marginal integrity and enamel crack formation in vitro. , 2009, Operative dentistry.

[37]  N. R. Silva,et al.  Effect of mouth-motion fatigue and thermal cycling on the marginal accuracy of partial coverage restorations made of various dental materials. , 2008, Dental materials : official publication of the Academy of Dental Materials.

[38]  G. Throckmorton,et al.  Mandibular excursions and maximum bite forces in patients with temporomandibular joint disorders. , 1996, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[39]  G E Carlsson,et al.  Bite force and state of dentition. , 1977, Acta odontologica Scandinavica.

[40]  K. Ludwig,et al.  Load-bearing capacity of all-ceramic posterior inlay-retained fixed dental prostheses. , 2009, European journal of oral sciences.

[41]  R. Drew,et al.  Wettability and spreading kinetics of molten aluminum on copper-coated ceramics , 2006 .

[42]  J. Kruzic,et al.  R-curve behavior and micromechanisms of fracture in resin based dental restorative composites. , 2009, Journal of the mechanical behavior of biomedical materials.

[43]  J. Robert Kelly,et al.  Development of a clinically validated bulk failure test for ceramic crowns. , 2010, The Journal of prosthetic dentistry.

[44]  B. Lawn,et al.  Characterization of damage modes in dental ceramic bilayer structures. , 2002, Journal of biomedical materials research.

[45]  A. Razak,et al.  Evaluation of load at fracture of Procera AllCeram copings using different luting cements. , 2008, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[46]  M. Addy,et al.  Surface and intra-pulpal temperature rises during tooth bleaching: an in vitro study , 2005, BDJ.

[47]  S. Rosenstiel,et al.  The effect of a layer of resin luting agent on the biaxial flexure strength of two all-ceramic systems. , 2005, The Journal of prosthetic dentistry.

[48]  K J Anusavice,et al.  Structural reliability of alumina-, feldspar-, leucite-, mica- and zirconia-based ceramics. , 2000, Journal of dentistry.

[49]  N Verdonschot,et al.  Can internal stresses explain the fracture resistance of cusp-replacing composite restorations? , 2005, European journal of oral sciences.

[50]  N. Inai,et al.  The effects of luting resin bond to dentin on the strength of dentin supported by indirect resin composite. , 2002, Dental materials : official publication of the Academy of Dental Materials.

[51]  S. Rokhlin,et al.  Statistical failure analysis of adhesive resin cement bonded dental ceramics. , 2007, Engineering fracture mechanics.

[52]  V. Thompson,et al.  Dental ceramics and the molar crown testing ground. , 2004, Journal of applied oral science : revista FOB.

[53]  J R Kelly,et al.  Clinically relevant approach to failure testing of all-ceramic restorations. , 1999, The Journal of prosthetic dentistry.

[54]  G. Sjögren,et al.  A comparison of fracture strength of yttrium-oxide- partially-stabilized zirconia ceramic crowns with varying core thickness, shapes and veneer ceramics. , 2004, Journal of oral rehabilitation.

[55]  K. Hiller,et al.  Partial ceramic crowns: influence of ceramic thickness, preparation design and luting material on fracture resistance and marginal integrity in vitro. , 2007, Operative dentistry.

[56]  H. C. Lundeen,et al.  Occlusal forces during chewing--influences of biting strength and food consistency. , 1981, The Journal of prosthetic dentistry.

[57]  S Ishigaki,et al.  Stress analysis of metal-free polymer crowns using the three-dimensional finite element method. , 2001, The International journal of prosthodontics.