Objectives
The aim of this study is to investigate the influence of the material and corresponding sintering protocol, layer thickness, and aging on the two-body wear (2BW) and fracture load (FL) of 4Y-TZP crowns.
Materials and methods
Multi-layer 4Y-TZP crowns in three thicknesses (0.5 mm/1.0 mm/1.5 mm) were sintered by high-speed (Zolid RS) or conventional (Zolid Gen-X) sintering. 2BW of ceramic and enamel antagonist after aging (1,200,000 mechanical-, 6000 thermal-cycles) was determined by 3D-scanning before and after aging and subsequent matching to determine volume and height loss (6 subgroups, n = 16/subgroup). FL was examined initially and after aging (12 subgroups, n = 16/subgroup). Fractographic analyses were performed using light-microscope imaging. Global univariate analysis of variance, one-way ANOVA, linear regression, Spearman’s correlation, Kolgomorov–Smirnov, Mann–Whitney U, and t test were computed (alpha = 0.05). Weibull moduli were determined. Fracture types were analyzed using Ciba Geigy table.
Results
Material/sintering protocol did not influence 2BW (crowns: p = 0.908, antagonists: p = 0.059). High-speed sintered Zolid RS presented similar (p = 0.325–0.633) or reduced (p < 0.001–0.047) FL as Zolid Gen-X. Both 4Y-TZPs showed an increased FL with an increasing thickness (0.5(797.3–1429 N) < 1.0(2087–2634 N) < 1.5(2683–3715 N)mm; p < 0.001). For most groups, aging negatively impacted FL (p < 0.001–0.002). Five 0.5 mm specimens fractured, four showed cracks during and after aging.
Conclusions
High-speed sintered crowns with a minimum thickness of 1.0 mm showed sufficient mechanical properties to withstand masticatory forces, even after a simulated aging period of 5 years.
Clinical relevance
Despite the manufacturer indicating a thickness of 0.5 mm to be suitable for single crowns, a minimum thickness of 1.0 mm should be used to ensure long-term satisfactory results.
The present investigation tested the effect of the cleaning method on the tensile bond strength (TBS) between one resin composite cement (RCC) and three different computer aided design/computer aided manufacturing (CAD/CAM) materials, namely zirconia, lithium disilicate ceramic and resin composite. Ninety specimens were prepared from each CAD/CAM material (N = 270). The specimens were pre-treated respectively, divided into five subgroups and subjected to five different cleaning protocols, namely i. 37% phosphoric acid, ii. ethanol, iii. phosphoric acid + ethanol, iv. cleaning paste, v. distilled water. After cleaning, the specimens were either conditioned using a universal primer or a universal adhesive and bonded using a dual-curing RCC. After thermo-cycling (20,000x at 5 °C/55 °C), TBS and fracture patterns were evaluated. The data was analyzed using 1- and 2-way Analysis of Variance (ANOVA) with post-hoc Scheffé and partial eta-squared (ƞP²), Kruskal–Wallis, Mann–Whitney U and Chi2 tests (p < 0.05). The CAD/CAM material showed an impact on the BS while the cleaning protocol did not affect the results. Zirconia obtained the highest BS, followed by lithium-disilicate-ceramic. Resin composite resulted in the overall lowest BS. For most fracture patterns, the cohesive type occurred. All tested cleaning protocols resulted in same BS values within one CAD/CAM material indicating that the impact of the cleaning method for the restorative material seems to play a subordinate role in obtaining durable bond strength to resin composite cement. Further, it indicates that the recommended bonding protocols are well adjusted to the respective materials and might be able to compensate the impact of not accurately performed cleaning protocols.
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