Efficacy of Incisal Preparation Designs on the Fracture Resistance of Two Cad/Cam Laminate Veneers

Abstract

Statement of problem: Mechanical properties are cardinal for the long-term clinical success of laminate veneer restorations. The most common failure is fracture and debonding, in which unfavorable occlusion and articulation play an important role. Nonetheless, the effect of different incisal preparations on the behavior of veneers remains controversial. Objective: The purpose of this study was to evaluate the fracture load of two different CAD/ CAM laminate veneer materials: resin nano-ceramic [lava ultimate] and lithium disilicate glass ceramic [IPS e-max CAD], with two different incisal preparation designs [butt-Joint and incisal overlap]; using both in-vitro and finite element analysis studies. Materials and Methods: A total of 20 maxillary central incisors were used in this study. The samples were divided into two main groups (n=10), according to the CAD/CAM material used. Ten laminate restorations were constructed for each group following the manufacturer's directions with the two preparation designs (5 samples each), then cemented on their corresponding teeth. Fracture load was recorded for each specimen using the universal testing machine. Meanwhile, Finite element analysis study was performed to assess the in-vitro observations. Results: The results revealed that incisal overlap design with Lava ultimate laminate veneers recorded the highest mean fracture strength value (395 ±37.18 N). This was supported by the finite element results that showed that the incisal overlap design with lava ultimate laminate veneers had the lowest Von Mises stress (30.75 MPa). Conclusions: Within the limitations of the present study, it was concluded that the butt-joint and incisal overlap designs demonstrated different mechanical behaviors with regard to the two different restorative materials. The incisal overlap design tolerated stresses better than the buttjoint design with both materials. Also, the incisal overlap design with resin nano-ceramic laminate veneers had the best stress distribution. Nevertheless, both types of CAD/CAM materials and different incisal preparation designs used could be considered strong enough to withstand the average anterior masticatory biting forces.