Advertisement

Odontology

, Volume 107, Issue 4, pp 482–490 | Cite as

Fatigue resistance of monolithic lithium disilicate occlusal veneers: a pilot study

  • Paolo Baldissara
  • Carlo Monaco
  • Enrico Onofri
  • Renata Garcia Fonseca
  • Leonardo CioccaEmail author
Original Article
  • 325 Downloads

Abstract

The use of thin lithium disilicate (LD) occlusal veneers is an effective method to increase the vertical dimension of occlusion in cases of tooth wear. However, doubt remains regarding the threshold thickness to be used in this restoration class. This study aims to evaluate the effect of ceramic thickness on the survival rate and failure pattern of LD molar veneer restorations using a simplified fatigue testing machine. Sixty sound, freshly extracted human molars were used. Three groups (n = 20) were randomly created with different ceramic thicknesses (0.5, 0.8, and 1.2 mm), and 60 LD IPS e.max Press LT occlusal veneers were fabricated. The ceramic restorations were luted with a resin cement. The stainless-steel rotating drum of the ball mill contained 10 zirconia (Y-TZP) and 10 stainless steel spheres, in 500 mL of distilled water at 37 ± 1 °C. Crack growth in the LD restorations was evaluated under a stereomicroscope following each fatigue testing run (12 60-min runs). Progressive damage was observed as a function of cycling time. Survival was significantly influenced by the restoration thickness (p = 0.002, log-rank test), with thicker restorations exhibiting a higher survival rate. Thinner restorations (0.5 mm) showed significantly lower survival rate than 0.8- and 1.2-mm restorations (p < 0.016); no significant difference was observed between the 0.8- and 1.2-mm restorations. A threshold value of 0.8 mm may represent an acceptable compromise between fatigue resistance and tooth reduction.

Keywords

Lithium disilicate Fatigue cycling Dental ceramics Occlusal veneers Survival rate 

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This research did not involve Human Participants and/or animals.

References

  1. 1.
    Guess PC. Influence of preparation design and ceramic thicknesses on fracture resistance and failure modes of premolar partial coverage restorations. J Prosthet Dent. 2013;110:264–73.CrossRefGoogle Scholar
  2. 2.
    Magne P, Carvalho AO, Bruzi G, Giannini M. Fatigue resistance of ultrathin CAD/CAM complete crowns with a simplified cementation process. J Prosthet Dent. 2015;114:574–9.CrossRefGoogle Scholar
  3. 3.
    Magne P, Schlichting LH, Maia HP, Baratieri LN. In vitro fatigue resistance of CAD/CAM composite resin and ceramic posterior occlusal veneers. J Prosthet Dent. 2010;104:149–57.CrossRefGoogle Scholar
  4. 4.
    Scherrer SS, de Rijk WG, Belser UC, Meyer JM. Effect of cement film thickness on the fracture resistance of a machinable glass-ceramic. Dent Mater. 1994;10:172–7.CrossRefGoogle Scholar
  5. 5.
    Prakki A, Cilli R, Da Costa AU, Gonçalves SE, Mondelli RF, Pereira JC. Effect of resin luting film thickness on fracture resistance of a ceramic cemented to dentin. J Prosthodont. 2007;16:172–8.CrossRefGoogle Scholar
  6. 6.
    Schulte AG, Vockler A, Reinhardt R. Longevity of ceramic inlays and onlays luted with a solely light-curing composite resin. J Dent. 2005;33:433–42.CrossRefGoogle Scholar
  7. 7.
    Pol CW, Kalk W. A systematic review of ceramic inlays in posterior teeth: an update. Int J Prosthodont. 2011;24:566–75.Google Scholar
  8. 8.
    Coelho PG, Bonfante EA, Silva NRF, Rekow ED, Thompson VP. Laboratory simulation of Y-TZP all-ceramic crown clinical failures. J Dent Res. 2009;88:382–6.CrossRefGoogle Scholar
  9. 9.
    Schlichting LH, Maia HP, Baratieri LN, Magne P. Novel-design ultra-thin CAD/CAM composite resin and ceramic occlusal veneers for the treatment of severe dental erosion. J Prosthet Dent. 2011;105:217–26.CrossRefGoogle Scholar
  10. 10.
    Sasse M, Krummel A, Klosa K, Kern M. Influence of restoration thickness and dental bonding surface on the fracture resistance of full-coverage occlusal veneers made from lithium disilicate ceramic. Dent Mater. 2015;31:907–15.  https://doi.org/10.1016/j.dental.2015.04.017.CrossRefGoogle Scholar
  11. 11.
    Dhima M, Carr AB, Salinas TJ, Lohse C, Berglund L, Nan KA. Evaluation of fracture resistance in aqueous environment under dynamic loading of lithium disilicate restorative systems for posterior applications. Part 2. J Prosthodont. 2014;23:353–7.  https://doi.org/10.1111/jopr.12124.CrossRefGoogle Scholar
  12. 12.
    Carvalho AO, Bruzi G, Giannini M, Magne P. Fatigue resistance of CAD/CAM complete crowns with a simplified cementation process. J Prosthet Dent. 2014;111:310–7.CrossRefGoogle Scholar
  13. 13.
    Bakeman EM, Rego N, Chaiyabutr Y, Kois JC. Influence of ceramic thickness and ceramic materials on fracture resistance of posterior partial coverage restorations. Oper Dent. 2015;40:211–7.CrossRefGoogle Scholar
  14. 14.
    Al-Akhali M, Chaar MS, Elsayed A. Samran A, Kern M. Fracture resistance of ceramic and polymer-based occlusal veneer restorations. J Mech Behav Biomed Mater. 2017;74:245–50.CrossRefGoogle Scholar
  15. 15.
    Rocca GT, Rizcalla N, Krejci I, Dietschi D. Evidence-based concepts and procedures for bonded inlays and onlays. Part II. Guidelines for cavity preparation and restoration fabrication. Int J Esthet Dent. 2015;10:392–413.Google Scholar
  16. 16.
    Seydler B, Rues S, Müller D, Schmitter M. In vitro fracture load of monolithic lithium disilicate ceramic molar crowns with different wall thickness. Clin Oral Investig. 2014;18:1165–71.CrossRefGoogle Scholar
  17. 17.
    Kelly JR, Benetti P, Rungruanganunt P, Bona AD. The slippery slope: critical perspectives on in vitro research methodologies. Dent Mater. 2012;28:41–51.CrossRefGoogle Scholar
  18. 18.
    Zhang Y, Kim JW, Bhowmick S, Thompson VP, Rekow ED. Competition of fracture mechanisms in monolithic dental ceramics: flat model systems. J Biomed Mater Res B App Biomater. 2009;88:402–11.CrossRefGoogle Scholar
  19. 19.
    Oilo M, Kvam K, Tibballs JE, Gjerdet NR. Clinically relevant fracture testing of all-ceramic crowns. Dent Mater. 2013;29:815–23.  https://doi.org/10.1016/j.dental.2013.04.026.CrossRefGoogle Scholar
  20. 20.
    Li Ma PC, Guess Yu, Zhang. Load-bearing properties of minimal-invasive monolithic lithium disilicate and zirconia occlusal onlays: finite element and theoretical analyses. Dent Mater. 2013;29:742–51.CrossRefGoogle Scholar
  21. 21.
    Schmitter M, Mueller D, Rues S. Chipping behaviour of all-ceramic crowns with zirconia framework and CAD/CAM manufactured veneer. J Dent. 2012;40:154–62.CrossRefGoogle Scholar
  22. 22.
    Lorenzoni FC, Martins LM, Silva NR, Coelho PG, Guess PC, Bonfante EA, Thompson VP, Bonfante G. Fatigue life and failure modes of crowns systems with a modified framework design. J Dent. 2010;38:626–34.  https://doi.org/10.1016/j.jdent.2010.04.011.CrossRefGoogle Scholar
  23. 23.
    Skouridou N, Pollington S, Rosentritt M, Tsitrou E. Fracture strength of minimally prepared all-ceramic CEREC crowns after simulating 5 years of service. Dent Mater. 2013;29:70–7.CrossRefGoogle Scholar
  24. 24.
    Silva NR, Bonfante EA, Martins LM, Valverde GB, Thompson VP, Ferencz JL, Coelho PG. Reliability of reduced-thickness and thinly veneered lithium disilicate crowns. J Dent Res. 2012;91:305–10.CrossRefGoogle Scholar
  25. 25.
    Rekow D, Thompson VP. Engineering long term clinical success of advanced ceramic prostheses. J Mater Sci Mater Med. 2007;18:47–56.CrossRefGoogle Scholar
  26. 26.
    Borges GA, Caldas D, Taskonak B, et al. Fracture loads of all-ceramic crowns under wet and dry fatigue conditions. J Prosthodont. 2009;18:649–55.CrossRefGoogle Scholar
  27. 27.
    Lawn BR. Indentation of ceramics with spheres: a century after hertz. J Am Ceram Soc. 1998;81:1977–94.CrossRefGoogle Scholar
  28. 28.
    Thompson VP, Rekow DE. Dental ceramics and the molar crown testing ground. J Appl Oral Sci. 2004;12:26–36.CrossRefGoogle Scholar
  29. 29.
    Ozcan M, Jonasch M. Effect of cyclic fatigue tests on aging and their translational implications for survival of all-ceramic tooth-borne single crowns and fixed dental prostheses. J Prosthodont. 2016;27:364–75.CrossRefGoogle Scholar
  30. 30.
    Nawafleh N, Hatamleh M, Elshiyab S, Mack F. Lithium disilicate restorations fatigue testing parameters: a systematic review. J Prosthodont. 2016;25:116–26.CrossRefGoogle Scholar
  31. 31.
    Abu Kasim NH, Millett DT, McCabe JF. The ball mill as a means of investigating the mechanical failure of dental materials. J Dent. 1996;24:117–24.CrossRefGoogle Scholar
  32. 32.
    Spink K. Comminution methods of machinery. Min Miner Erg. 1972;8:5–21.Google Scholar
  33. 33.
    Conrad HJ, Seong WJ, Pesun IJ. Current ceramic materials and systems with clinical recommendations: a systematic review. J Prosthet Dent. 2007;98:389–404.CrossRefGoogle Scholar
  34. 34.
    Stappert CF, Guess PC, Chitmongkolsuk S, Gerds T, Strub JR. All-ceramic partial coverage restorations on natural molars. Masticatory fatigue loading and fracture resistance. Am J Dent. 2007;20:21–6.Google Scholar
  35. 35.
    Quinn GD. A NIST recommended practice guide: fractography of ceramics and glasses. Special publication 960-16e2. Washington, DC: National Institute of Standards and Technology; 2016. http://nvlpubs.nist.gov/nistpubs/ specialpublications/NIST.SP.960-16e2.pdf.
  36. 36.
    Suresh S. Fatigue and materials. 2nd ed. Cambridge solid state science series. Cambridge, UK: Cambridge University Press; 1991. p. 383Google Scholar
  37. 37.
    Chaudhri MM. Dynamic fracture of inorganic glasses by hard spherical and conical projectiles. Philos Trans A Math Phys Eng Sci. 2015.  https://doi.org/10.1098/rsta.2014.0135.Google Scholar
  38. 38.
    Kelly JR. Clinically relevant approach to failure testing of all-ceramic restorations. J Prosthet Dent. 1999;81:652–61.CrossRefGoogle Scholar
  39. 39.
    Yin M, Luo XP, Yao H, Liu X. Comparison of shear bond strength of different resin cements to ceramic and dentin. Chin J Stomatol. 2009;44(02):113–6.  https://doi.org/10.3760/cma.j.issn.1002-0098.2009.02.015.Google Scholar
  40. 40.
    Prado M, Prochnow C, Marchionatti AME, Baldissara P, Valandro LF, Wandscher VF. Ceramic surface treatment with a single-component primer: resin adhesion to glass ceramics. J Adhes Dent. 2018;20(2):99–105.  https://doi.org/10.3290/j.jad.a40303.Google Scholar
  41. 41.
    Lawn BR, Deng Y, Miranda P, Pajares A, Chai H, Kim DK. Overview: damage in brittle layer structures from concentrated loads. J Mater Res. 2002;17:3019–36.CrossRefGoogle Scholar
  42. 42.
    Wang R-R, Lu C-L, Wang G, Zhang DS. Influence of cyclic loading on the fracture toughness and load bearing capacities of all-ceramic crowns. Int J Oral Sci. 2014;6:99–104.CrossRefGoogle Scholar
  43. 43.
    Egbert JS, Johnson AC, Tantbirojnc D, Versluis A. Fracture strength of ultrathin occlusal veneer restorations made from CAD/CAM composite or hybrid ceramic materials. Oral Sci Int. 2015;12:53–8.CrossRefGoogle Scholar
  44. 44.
    Bhowmick S, Zhang Y, Lawn BR. Competing fracture modes in brittle materials subject to concentrated cyclic loading in liquid environments: bilayer structures. J Mater Res. 2005;20:2792–800.CrossRefGoogle Scholar
  45. 45.
    Ozcan M, Jonasch M. Effect of cyclic fatigue tests on aging and their translational implications for survival of all-ceramic tooth-borne single crowns and fixed dental prostheses. J Prosthodont. 2018;27:364–75.CrossRefGoogle Scholar
  46. 46.
    Kaidonis JA, Ranjitkar S, Lekkas D, Brook AH, Townsend GC. Functional dental occlusion: an anthropological perspective and implications for practice. Aust Dent J. 2014;59(Suppl 1):162–73.CrossRefGoogle Scholar
  47. 47.
    Kaifu Y, Kasai K, Townsend GC, Richards LC. Tooth wear and the “design” of the human dentition: a perspective from evolutionary medicine. Am J Phys Anthropol. 2003;Suppl 37:47–61.CrossRefGoogle Scholar

Copyright information

© The Society of The Nippon Dental University 2019

Authors and Affiliations

  1. 1.Department of Biomedical and Neuromotor Science, Division of ProsthodonticsAlma Mater Studiorum, University of BolognaBolognaItaly
  2. 2.Department of Biomedical and Neuromotor Sciences, Division of ProsthodonticsAlma Mater Studiorum, University of BolognaBolognaItaly
  3. 3.Dental SchoolAlma Mater Studiorum, University of BolognaBolognaItaly
  4. 4.Department of Dental Materials and ProsthodonticsAraraquara Dental School, Unesp-Univ Estadual Paulista, AraraquaraSão PauloBrazil
  5. 5.Department of Biomedical and Neuromotor Science, Division of ProsthodonticsAlma Mater Studiorum, University of BolognaBolognaItaly
  6. 6.BolognaItaly

Personalised recommendations