Effect of Reduced Occlusal Thickness with Two Margin Designs on Fracture Resistance of Monolithic Zirconia Crowns

Abstract

Objectives The aim of this study was to compare the effects of two margin designs (shoulderless and slight chamfer) with two occlusal thicknesses on fracture resistance and failure mode of the monolithic zirconia crowns. Materials and Methods Forty nickel–chromium dies were duplicated from the previous two prepared teeth using a three-dimensional optical scanner. Nickel–chromium supporting dies were divided into two main groups (n = 20) according to the type of margin design: group A, slight chamfer margin design and group B, shoulderless margin design. These groups were further divided into two subgroups according to the occlusal thicknesses (0.5 and 1 mm). The digital imaging of each die was done using a three-dimensional optical scanner, then zirconia blocks were milled by 5-axis machine. The crowns were cleaned by alcohol, air dried, and cemented by resin cement. Next, the crowns were subjected to 500 hot and cold cycles (30 seconds for each cycle). The samples were subjected to a static load until failure using an electronic universal testing machine and fracture resistance was recorded in Newton (N). Statistical Analysis Data were analyzed using the test of normality (Shapiro–Wilk test) and two-way analysis of variance (ANOVA) test. Results The highest mean fracture load was recorded by the shoulderless (1 mm occlusal thickness) subgroup (3,992.5 N), followed by shoulderless (0.5 mm occlusal thickness) subgroup (3,244.4 N), and the slight chamfer (1 mm occlusal thickness) subgroup (2,811 N). The lowest mean of fracture load was recorded by slight chamfer (0.5 mm occlusal thickness) subgroup (1,632.9 N). The two-way ANOVA test revealed a significant difference between the four subgroups. Regarding the fracture mode, the slight chamfer subgroups showed a severe fracture of the restoration while the shoulderless subgroups showed a fracture through the midline of the restoration. Conclusion Within the limitation of the comparative study, shoulderless margin design has a more favorable outcome than a slight chamfer design in all thicknesses. Although the restoration with reduced occlusal thickness has lower fracture resistance than 1 mm occlusal thickness, the 0.5 mm restorations still can tolerate occlusal forces.

Fracture Strength of Monolithic Zirconia Crowns with Modified Vertical Preparation: A Comparative In Vitro Study

“…Similar findings by Mitov et al 2 and Jasim et al 5 who attained higher fracture strength with shoulderless preparation compared with the chamfer, they tested monolithic zirconia crowns cemented on metal dies that have higher elastic modulus than dentin, and this might increase the fracture strength values. 27 However, the fracture resistance of the restorations could give more precise results if natural teeth were used as abutments.…”

“…This is consistent with other in vitro studies. 5 17 18 While other studies found no such effects. 16 19 20 However, these conflicting results could be due to the different experimental settings for fracture load assessment as well as the tested materials.…”

“…This showed agreement with the result by other in vitro studies, suggesting that monolithic zirconia crowns can be advocated with a reduced thickness in the posterior region. 3 5 24 Moreover, a clinical study revealed that the performance of full-contour zirconia crowns with feather edge and chamfer finish lines showed no differences in survival and success rates after 4 years of clinical service. 25 …”

“… 2 Currently, monolithic zirconia can be milled even with a reduced thickness due to its high flexural strength, which affords adequate strength even for the posterior fixed dental prosthesis. 3 4 5 …”

Influence of the Type and Thickness of Cervical Margins on the Strength of Posterior Monolithic Zirconia Crowns: A Review

“…On the marginal thickness, the 0.5 mm margin was considered as the ideal conservative thickness as the values of the fracture resistance of the crown were superior to the maximum mastication force of humans (850 N). 16 17 22…”