Influence of veneer application on fracture behavior of lithium-disilicate-based ceramic crowns

SUMMARY Objective: To evaluate the significance of reduced axial wall height on retention of adhesively luted, all-ceramic, lithium disilicate premolar computer-aided design/computer-aided manufacturing (CAD/CAM) crowns based on preparations with a near ideal total occlusal convergence of 10°. Methods: Forty-eight recently extracted premolars were randomly divided into four groups (n=12). Each group received all-ceramic CAD/CAM crown preparations featuring axial wall heights of 0, 1, 2, and 3 mm, respectively, all with a 10° total occlusal convergence. Scanned preparations were fitted with lithium disilicate all-ceramic crowns that were luted with a self-etching resin cement. Specimens were tested to failure at a 45° angle to the tooth long axis with failure load converted to megapascals (MPa) based on the measured bonding surface area. Mean data were analyzed using analysis of variance/Tukey's post hoc test (α=0.05). Results: Lithium disilicate crowns adhesively luted on preparations with 0 axial wall height demonstrated significantly less failure resistance compared with the crowns luted on preparations with axial wall heights of 1 to 3 mm. There was no failure stress difference between preparations with 1 to 3 mm axial wall height. Conclusions: Under conditions of this study, adhesively luted lithium disilicate bicuspid crowns with a total occlusal convergence of 10° demonstrated similar failure resistance independent of axial wall height of 1 to 3 mm. This study provides some evidence that adhesion combined with an ideal total occlusal convergence may compensate for reduced axial wall height.

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Clinical Evaluation of Reduced-Thickness Monolithic Lithium-Disilicate Crowns: One-Year Follow-Up Results

Processes ◽

10.3390/pr9122119 ◽

2021 ◽

Vol 9 (12) ◽

pp. 2119

Author(s):

Davor Špehar ◽

Marko Jakovac

Keyword(s):

Survival Rate ◽

United States Public Health ◽

Lithium Disilicate ◽

Good Alternative ◽

Double Blind ◽

Invasive Approach ◽

Less Invasive Approach ◽

Ceramic Crowns ◽

One Year

Purpose: The purpose of this in vivo study was to investigate whether the less invasive approach (reduced thickness of the restoration) will result in a comparable risk of failure and similar aesthetic results, compared to conventional layered full porcelain crowns, and can, therefore, be used as a good alternative. Material and Methods: The tested ceramic was lithium-disilicate ceramic (IPS e.max). Forty-four patients with endodontically treated premolars or molars were randomized into two groups and provided with single crowns. One group received conventional all-ceramic crowns made from a lithium-disilicate core and hand-veneered aesthetic ceramic, while another group received full-contoured lithium-disilicate ceramic crowns with reduced wall thickness than manufactures recommendations. The teeth for conventional crowns were prepared with 1 mm rounded shoulder and 2 mm occlusal reduction, while teeth for monolithic crowns were prepared with 0.6 mm wide rounded shoulder and 1 mm occlusal reduction. All crowns were prepared by the same clinician and manufactured in the same laboratory by the same technician. The survival and aesthetics of the crowns were assessed by the independent clinician. Apart from this, patients’ aesthetic satisfaction was evaluated. The assessment was double blind as both the examiner and the patients did not know which type of crown was provided. The observation period was 36 months. Survival of the crowns was assessed using the modified United States Public Health Service (USPHS) criteria and aesthetics and participants’ aesthetic satisfaction with the crowns was evaluated using a visual analogue scale. Results: The one-year survival rate for layered crowns was 100% and for monolithic crowns 95.5%. The median patients’ aesthetic satisfaction with both crowns was 100%. Conclusions: The results indicate similar one-year survival rate of reduced-thickness monolithic lithium-disilicate crowns and conventional veneered crowns. Differences with patients’ satisfaction with the aesthetics of both crowns were not statistically significant and it can be said that the patients’ aesthetic satisfaction was the same for both crowns.

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