Fracture strength of zirconia and lithium disilicate restorations following endodontic access

Lucas, Thomas J.; Lawson, Nathaniel C.; Englert, Brandon; Goldstein, Ken; Goldstein, Ronald E.

doi:10.1111/jerd.12829

Cited by 5 publications

(1 citation statement)

References 22 publications

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“…However, it's important to note that the strength of 3 yttria zirconia crowns was compromised when accessed with a fine diamond instrument. In contrast, there was no adverse impact observed on lithium disilicate crowns subjected to endodontic access [10] . Ceramic materials such as zirconia and lithium disilicate provide good strength as prosthetic materials; however, you must choose correctly when using each material.…”

Section: Resistancementioning

confidence: 77%

Lithium disilicate and zirconia as prosthetic restorative materials

Parra,

Fierro,

Palencia

2023

Int. J. Appl. Dent. Sci.

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Introduction: Metal-free restorations such as lithium disilicate and zirconia are an alternative to metal restorations; however, lithium disilicate presents enhanced optical characteristics, it possesses inferior mechanical properties when compared to zirconia. Objective: To analyze the literature on lithium disilicate and zirconia as prosthetic restorative materials. Resistance, survival, antagonistic wear, and its use in digital flow will be analyzed. Methodology: An electronic search of articles published in the last 5 years was carried out through PubMed and Google Scholar, using the terms "lithium disilicate", "zirconia", "e. Max", "lithium disilicate vs zirconia". Results: When choosing a restorative material such as zirconia or lithium disilicate, it should be considered: Strength: zirconia does not offer the same translucency characteristics as lithium disilicate. Survival in the medium and long term is possible as long as the minimum thickness of the material is respected. Antagonist wear: in zirconia, if it is well polished, that wear is minimal. Digital flow offers greater predictability and a better marginal fit. Conclusions: Zirconia and lithium disilicate provide good strength and survival. Zirconia does not offer the same translucency characteristics as lithium disilicate and is therefore not as aesthetically pleasing, but it is much more resistant.

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Section: Resistancementioning

confidence: 77%

Lithium disilicate and zirconia as prosthetic restorative materials

Parra,

Fierro,

Palencia

2023

Int. J. Appl. Dent. Sci.

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Fracture resistance of chairside CAD‐CAM lithium disilicate occlusal veneer with various designs after mechanical aging

Jurado,

Tsujimoto,

Molisani

et al. 2024

Journal of Prosthodontics

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PurposeThis study evaluated the fracture resistance of chairside computer‐aided design and computer‐aided manufacturing (CAD‐CAM) lithium disilicate crown, onlay, and non‐anatomical occlusal veneer (A‐OV) with and without margin fabricated.Materials and MethodsSixty‐four CAD‐CAM lithium disilicate restorations were designed as (1) complete coverage crown (CCC); (2) A‐OV with margin; (3) non‐A‐OV with margin (NA‐OV‐M); and (4) non‐A‐OV without margin (NA‐OV‐NM), 16 of each. Restorations were crystallized and adhesively luted to resin dies using resin cement. Specimens were then subjected to 400,000 cycles of chewing in a mastication simulator. A universal testing machine was used to apply a compressive load at a crosshead speed of 1 mm/min to the long axis of the tooth with a stainless‐steel sphere until fracture occurred. One‐way ANOVA followed by post hoc tests were used to assess the impact of preparation design on the fracture load of CAD‐CAM lithium disilicate restorations.ResultsThe highest fracture load was recorded for CAD‐CAM lithium disilicate indirect restorations for non‐A‐OVs preparation with margin (2549 ± 428 N) and onlay (2549 ± 293 N) and the lowest fracture load was recorded for CCCs (2389 ± 428 N); however, there was no significant (p = 0.640) between groups.ConclusionsCAD‐CAM lithium disilicate restorations fabricated for anatomical and non‐A‐OV preparation display a fracture resistance similar to CCCs. Conservative partial coverage restorations may be considered an acceptable approach for posterior teeth.

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Effect of preparation design and endodontic access on fracture resistance of zirconia overlays in mandibular molars: An in vitro study

Jurado,

Afrashtehfar,

Robles

et al. 2024

Journal of Prosthodontics

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PurposeTo evaluate the fracture resistance of zirconia overlays, considering various preparation designs and the presence of endodontic access.Materials and MethodsNinety translucent zirconia (5Y‐PSZ) overlay restorations were divided into six groups (n = 15/group) based on different preparation designs, with and without endodontic access: chamfer margin 4 mm above the gingival level without (group 1) and with endodontic access (group 2); margin 2 mm above the gingival level without (group 3) and with endodontic access (group 4); overlay with no chamfer margin without (group 5) and with endodontic access (group 6). Restorations were bonded to mandibular first molar resin dies, and the groups with endodontic access were sealed with flowable resin composite. All restorations underwent 100,000 cycles of thermal cycling between 5°C and 55°C, followed by loading until fracture. Maximum load and fracture resistance were recorded. ANOVA with Tukey post‐hoc tests were used for statistical comparison (α < 0.05).ResultsFracture resistance significantly varied among overlay designs with and without endodontic access (p < 0.001), except for the no‐margin overlays (groups 5 and 6). Overlays with a 2 mm margin above the gingival margin with endodontic access (group 4) exhibited significantly higher fracture resistance compared to both the 4‐mm supragingival (group 2) and no‐margin (group 6) designs, even when compared to their respective intact groups (groups 1 and 5). There were no significant differences between the no‐margin and 4‐mm supragingival overlays.ConclusionThe more extensive zirconia overlay for mandibular molars is the first choice since the 2 mm margin above the gingival level design withstood considerable loads even after undergoing endodontic access. A no‐margin overlay is preferred over the 4‐mm supragingival design as it preserves more tooth structure and there was no outcome difference, irrespective of endodontic access. Caution is warranted in interpreting these findings due to the in vitro nature of the study.

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Fracture strength of zirconia and lithium disilicate restorations following endodontic access

Cited by 5 publications

References 22 publications

Lithium disilicate and zirconia as prosthetic restorative materials

Lithium disilicate and zirconia as prosthetic restorative materials

Fracture resistance of chairside CAD‐CAM lithium disilicate occlusal veneer with various designs after mechanical aging

Effect of preparation design and endodontic access on fracture resistance of zirconia overlays in mandibular molars: An in vitro study

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