Fracture resistance of 3-unit monolithic ZrO2 ceramics FPDs with different preparation designs of the distal abutment - an in-vitro study

Abstract

Introduction: Masticatory pressure increases in the distal areas of the dentition. This should be considered when restoring partially edentulous patients with a metal-free fixed partial denture (FPD). An alternative abutment preparation design can be used in order to increase the materials’ volume in the most fracture-prone “connector area” of an FPD. The increased size of the connection might positively influence the constructions’ mechanical durability, thereby increasing its success and survivability. Aim: The aim of the present study was to investigate the influence of two preparation designs of the distal abutment on the fracture resistance of three-unit, monolithic, ZrO2 FPDs. Materials and methods: 3D printed replicas of a partially edentulous mandibular segment and a ZrO2, milled in full-contour, three-unit FPDs were used for this investigation. Two experimental groups (n=10 ) were defined based on the preparation design of the distal abutment tooth – classical shoulder preparation 0.8 mm deep, and endocrown preparation with a 2-mm retention cavity. The bridge – mandibular segment replica assembly was done with relyXU200(3M ESPE, USA), light-cured for 10 seconds per side with D-light Duo (GC, Europe). After cementation the test specimens were subjected to loading in a universal testing machine Zwick (Zwick-Roell Group, Germany). Statistical analysis was performed using R and includes descriptive statistics, t-test for quantitative and chi-squared test for qualitative variables. Results: The results showed no difference between the two studied groups in the maximum force required to fracture the test specimens [t=−1.8088 (17.39), p-value=0.087; P>0.05]. 95% of the fracture lines were located in the distal connector. Conclusions: Within the limitations of this study, it can be concluded that both tested preparation designs show similar results in terms of the load required to fracture the test specimens. Furthermore, it is confirmed that the distal connector is the weakest area of an all-ceramic 3-unit FPD in the posterior area.