Influence of the Connector Area on the Chipping Rate of the VM9 Veneering Ceramic in a Posterior Four-Unit Yttria-Stabilized Tetragonal Zirconia Polycrystal Fixed Dental Prostheses: A Pilot Study

Objective The purpose of this study was to evaluate the influence of the connector area on the chipping rate of the VM9 veneering ceramic in a 4-unit yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) framework, using a novel sonographic technique. Materials and Methods The framework was designed as a 4-unit fixed dental prostheses (FDP) with two abutment teeth at the first mandibular premolar and second mandibular molar. The cross-sectional area of the connector was 7.5, 8, or 9 mm2. The prepared teeth were scanned using CAD/CAM technology, and five frameworks were prepared for each design, making a total of 15. The frameworks were divided according to the veneering ceramics: Y-TZP FDPs using Vita VM9 (12 frameworks), and porcelain fused to metal (PFM) FDPs using Vita VM13 (3 frameworks). The specimens were statically loaded until failure. To capture the initiation of the failure within the specimens, a novel sonographic technique, designed for this research, combining acoustic emission and visual monitoring during live load bearing tests, was used to determine the failure load value. Failed frameworks were inspected using a microscope, and failure patterns were identified. One-way ANOVA and Tukey HSD tests were applied for statistical analysis of the results (p-value ≤ 0.05). Results Despite the fact that the chipping strength is proportional to the cross-sectional area of the connector, the effect of the cross-sectional area on chipping load revealed no statistically significant differences, while PFMs showed superior chipping strength relative to the zirconia frameworks regardless of the connector's size. A high rate of catastrophic fracture occurred while loading the specimens. Conclusion The effect of the cross-sectional area on chipping load revealed no statistically significant differences in Y-TZP frameworks. The novel sonographic technique may be a potential method to study the behavior of dental ceramics, including chipping and fracture.

[1]  R. Basting,et al.  Influence of Core‐Veneer Thickness Ratio on the Fracture Load and Failure Mode of Zirconia Crowns , 2019, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[2]  Per Svanborg,et al.  A Three-Year Retrospective Study on Survival of Ceramic-Veneered Zirconia (Y-TZP) Fixed Dental Prostheses Performed in Private Practices , 2017, International journal of dentistry.

[3]  S. Ha,et al.  Effects of coping designs on fracture modes in zirconia crowns: Progressive load test , 2016 .

[4]  S. Ha,et al.  Effects of coping designs on stress distributions in zirconia crowns: Finite element analysis , 2016 .

[5]  M. Özcan,et al.  Chipping of Veneering Ceramics in Zirconium Dioxide Fixed Dental Prosthesis , 2015, Current Oral Health Reports.

[6]  C. Sforza,et al.  Seven-year prospective clinical study on zirconia-based single crowns and fixed dental prostheses , 2015, Clinical Oral Investigations.

[7]  S. Scherrer,et al.  Three- to nine-year survival estimates and fracture mechanisms of zirconia- and alumina-based restorations using standardized criteria to distinguish the severity of ceramic fractures , 2015, Clinical Oral Investigations.

[8]  Elie E. Daou.  The Zirconia Ceramic: Strengths and Weaknesses , 2014, The open dentistry journal.

[9]  A. Mainjot,et al.  Clinical risk factors related to failures with zirconia-based restorations: an up to 9-year retrospective study. , 2013, Journal of dentistry.

[10]  Marcus J Ambré,et al.  Fracture strength of yttria-stabilized zirconium-dioxide (Y-TZP) fixed dental prostheses (FDPs) with different abutment core thicknesses and connector dimensions. , 2013, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[11]  S. Rinke,et al.  Prospective evaluation of zirconia posterior fixed partial dentures: four-year clinical results. , 2013, The International journal of prosthodontics.

[12]  Deog-Gyu Seo,et al.  Wear evaluation of the human enamel opposing different Y-TZP dental ceramics and other porcelains. , 2012, Journal of dentistry.

[13]  Matthias Goellner,et al.  Zirconia posterior fixed partial dentures: 5-year clinical results of a prospective clinical trial. , 2012, The International journal of prosthodontics.

[14]  M. Hatamleh,et al.  Fracture resistance of fixed partial dentures supported by different abutment combinations: an ex vivo study. , 2012, General dentistry.

[15]  M. Schmitter,et al.  Clinical performance of long-span zirconia frameworks for fixed dental prostheses: 5-year results. , 2012, Journal of oral rehabilitation.

[16]  M. P. Salido,et al.  Prospective clinical study of zirconia-based posterior four-unit fixed dental prostheses: four-year follow-up. , 2012, The International journal of prosthodontics.

[17]  K. Chung,et al.  Survival and complications of zirconia-based fixed dental prostheses: a systematic review. , 2012, The Journal of prosthetic dentistry.

[18]  G. Schajer,et al.  Influence of veneer thickness on residual stress profile in veneering ceramic: measurement by hole-drilling. , 2012, Dental materials : official publication of the Academy of Dental Materials.

[19]  G. Schajer,et al.  Influence of cooling rate on residual stress profile in veneering ceramic: measurement by hole-drilling. , 2011, Dental materials : official publication of the Academy of Dental Materials.

[20]  Yoshihiko Hamamoto,et al.  A robust automatic crack detection method from noisy concrete surfaces , 2011, Machine Vision and Applications.

[21]  Irena Sailer,et al.  Randomized controlled clinical trial of zirconia-ceramic and metal-ceramic posterior fixed dental prostheses: a 3-year follow-up. , 2009, The International journal of prosthodontics.

[22]  M. Schmitter,et al.  Clinical performance of extended zirconia frameworks for fixed dental prostheses: two-year results. , 2009, Journal of oral rehabilitation.

[23]  N. Heussen,et al.  Clinical behavior of zirconia-based fixed partial dentures made of DC-Zirkon: 3-year results. , 2008, The International journal of prosthodontics.

[24]  P. Vult von Steyern,et al.  Fracture strength of four-unit Y-TZP FPD cores designed with varying connector diameter. An in-vitro study. , 2007, Journal of oral rehabilitation.

[25]  Irena Sailer,et al.  Five-year clinical results of zirconia frameworks for posterior fixed partial dentures. , 2007, The International journal of prosthodontics.

[26]  N. Ferree,et al.  Which mechanical and physical testing methods are relevant for predicting the clinical performance of ceramic-based dental prostheses? , 2007, Clinical oral implants research.

[27]  Ariel J Raigrodski,et al.  The efficacy of posterior three-unit zirconium-oxide-based ceramic fixed partial dental prostheses: a prospective clinical pilot study. , 2006, The Journal of prosthetic dentistry.

[28]  G. Sjögren,et al.  Surface roughness of five different dental ceramic core materials after grinding and polishing. , 2006, Journal of oral rehabilitation.

[29]  Frank Filser,et al.  Strength and reliability of four-unit all-ceramic posterior bridges. , 2005, Dental materials : official publication of the Academy of Dental Materials.

[30]  S. Campbell,et al.  Evaluation of the fit and strength of an all-ceramic fixed partial denture. , 1988, The Journal of prosthetic dentistry.

[31]  S. Rinke,et al.  Prospective evaluation of zirconia posterior fixed partial dentures: 7-year clinical results. , 2013, The International journal of prosthodontics.

[32]  Toru Sato,et al.  Effect of framework design on fracture resistance in zirconia 4-unit all-ceramic fixed partial dentures. , 2013, The Bulletin of Tokyo Dental College.

[33]  C. Hämmerle,et al.  10-year clinical outcomes of fixed dental prostheses with zirconia frameworks. , 2011, International journal of computerized dentistry.