Objective The aim of this study was to evaluate the influence of different marginal designs (deep chamfer, vertical, and modified vertical with reverse shoulder) on the fracture strength and failure modes of monolithic zirconia crowns. Materials and Methods Thirty sound human maxillary first premolar teeth with comparable size were used in this study. The teeth were divided randomly into three groups according to the preparation design (n = 10): (1) group A: teeth prepared with a deep chamfer finish line; (2) group B: teeth prepared with vertical preparation; and (3) group C: teeth prepared with modified vertical preparation, where a reverse shoulder of 1 mm was placed on the buccal surface at the junction of middle and occlusal thirds. All samples were scanned by using an intraoral scanner (CEREC Omnicam, Sirona, Germany), and then the crowns were designed by using Sirona InLab 20.0 software and milled with a 5-axis machine. Each crown was then cemented on its respective tooth with self-adhesive resin cement by using a custom-made cementation device. A single load to failure test was used to assess the fracture load of each crown by using a computerized universal testing machine that automatically recorded the fracture load of each sample in Newton (N). Statistical Analysis The data were analyzed statistically by using one-way analysis of variance test and Bonferroni test at a level of significance of 0.05. Results The highest mean of fracture load was recorded by chamfer (2,969.8 N), which followed by modified vertical (2,899.3 N) and the lowest mean of fracture load was recorded by vertical (2,717.9 N). One-way ANOVA test revealed a significant difference among the three groups. Bonferroni test showed a significant difference between group A and group B, while a nonsignificant difference was revealed between group C with group A and group B. Conclusion Within the limitations of this in vitro study, the mean values of fracture strength of monolithic zirconia crowns of all groups were higher than the maximum occlusal forces in the premolar region. The modification of the vertical preparation with a reverse shoulder placed at the buccal surface improved the fracture strength up to the point that it was statistically nonsignificant with the chamfer group.
The objective of this in vitro study was to evaluate and compare the fracture strength of monolithic crowns fabricated from five different all-ceramic CAD/CAM materials (lithium disilicate, zirconia, reinforced composite, hybrid dental ceramic, and zirconia-reinforced lithium silicate) using single load to failure test. Forty sound human maxillary first premolar teeth extracted for orthodontic purposes were selected for use in this study. Teeth were prepared according to a standard protocol with 1 mm deep chamfer finishing line, 4 mm axial height with planer occlusal reduction and 6º total convergence angle. Teeth were then divided into five groups of eight teeth each according to the material used for the fabrication of the monolithic crowns as follow: Group A: Crowns fabricated from lithium disilicate (IPS e.max CAD, Ivoclar Vivadent), Group B: Crowns fabricated from zirconia (CEREC Zirconia, Dentsply Sirona), Group C: Crowns fabricated from reinforced composite (BRILLIANT Crios, COLTENE), Group D: Crowns fabricated from hybrid dental ceramic (VITA ENAMIC, VITA Zahnfabric), Group E: Crowns fabricated from zirconia-reinforced lithium silicate (CELTRA DUO, Dentsply Sirona). Teeth of all groups were then scanned with CEREC Omnicam digital intraoral scanner and the crowns were then designed using CEREC Premium software (version 4.4.4) and milled using CEREC MC XL milling unit. Post-milling, crowns of each group were subjected to either a firing procedure or to a polishing only according to the manufacturer's instructions of each material. The internal surfaces of the crowns of each group were then subjected to surface treatment according to the manufacturer's instructions of each material and the crowns were then cemented on their respective teeth using a universal dual-cured adhesive resin cement (Duo-Link Universal, Bisco Inc.). All teeth with the cemented crowns were then stored in deionized distilled water at room temperature for 24 hours before testing. All samples were then subjected to compressive axial loading until fracture in computer-controlled universal testing machine (Zwick Z010, Ulm, Germany) at a crosshead speed of 0.5 mm/min. The data were statistically analyzed using one-way ANOVA test and LSD test at a level of significance of 0.05. The results of this study showed that the highest mean value of fracture strength was recorded by Group B (2337.37), followed by Group C (1880.59), Group E (1404.49), Group A (1085.39) and Group D (767.06), respectively with statistically highly significant differences among the different groups (p<0.01). From the results of this study, it seems that the differences in the chemical composition and microstructure of the tested all-ceramic CAD/CAM materials may be responsible for the differences in the fracture strength of the fabricated crowns.
Objective This study aimed to evaluate the accuracy in terms of trueness and precision of eight intraoral scanners (IOS) and the effect of different finishing line designs on the IOS's accuracy. Materials and Methods Three printed models of the maxillary arch with maxillary right first molar virtually prepared with chamfer, shoulder, and vertical preparation designs were used as master models in this study. Each model was scanned 30 times with each IOS: Medit i700, Planscan Emerald S, CEREC Primescan, TRIOS 3, CS3600, MEDIT i500, Heron 3Disc, and Cerec Omnicam. The trueness was measured by superimposition of the scanned dataset made with IOS and the scanned dataset made with a lab scanner (In Lab Medit T710) that was used as a reference and the deviation was measured and expressed as a color-coded map by the metrology program (Medit compare, version 2.3.5.892), while precision was measured by the superimposition of the scans of each IOS on each other.The data were analyzed statistically using repeated measure analysis of variance (ANOVA) test, one-way ANOVA test, and Bonferroni test at significance level of 0.05. Results The tested IOS showed significant differences in trueness and precision. Medit i700 and CEREC Primescan recorded the highest precision with no significant difference between them, while Medit i700 recorded the highest trueness as compared to other IOS. Each IOS showed significant differences in trueness and precision with the three finishing line designs except CEREC Primescan and Heron 3 disc that showed no significant difference in trueness with the three finishing line designs and CS3600 that showed no significant difference in precision with the three finishing line designs. Conclusion A significant difference in accuracy was found among the tested IOS and the type of finishing line design had a significant effect on IOS's accuracy.
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