Fracture Resistance in Non-Vital Teeth: Absence of Interproximal Ferrule and Influence of Preparation Depth in CAD/CAM Endocrown Overlays—An In Vitro Study

There is ample evidence to support the use of endocrowns to restore endodontic teeth. However, the influence of the position of the interproximal margins on fracture strength has not yet been studied. The aim was to determine the relationship between the apicocoronal position of the interproximal restorative margins and fracture resistance in nonvital teeth restored with CAD/CAM endocrown overlays. Forty extracted human maxillary premolars were prepared for endocrown overlay restorations without ferrule on the interproximal aspects and classified according to the position of the interproximal restoration margins in relation to the alveolar crest: 2 mm (group A), 1 mm (group B), 0.5 mm (group C), and 0 mm (group D). Fracture strength was measured using a universal testing machine applying a compressive force to the longitudinal tooth axis. Group A had a mean fracture resistance of 859.61 (±267.951) N, group B 1053.9 (±333.985) N, group C 1124.6 (±291.172) N, and group D 780.67 (±183.269) N, with statistical differences between groups. Group C had the highest values for fracture strength compared to the other groups (p < 0.05). The location of the interproximal margins appears to influence the fracture resistance of CAD/CAM endocrown overlays. A distance of 0.5 mm between the interproximal margin and the alveolar crest was associated with increased fracture resistance.

Fracture Resistance of Primary Zirconia Crowns: An In Vitro Study

In this study, we evaluated the fracture resistance of three commercially available prefabricated primary zirconia crowns and their correlation with dimensional variance. Methods: a total of 42 zirconia crowns were selected from three companies, (1) NuSmile primary zirconia crowns, (2) Cheng Crowns zirconia, and (3) Sprig EZ crowns. The crowns were divided into two groups based on their location in the oral cavity and further divided into subgroups based on the brand. All of the samples were subjected to fracture tests using a universal testing machine. Results: the mean load observed was highest with Cheng Crowns zirconia anterior crowns (1355 ± 484) and the least load was seen with Sprig EZ anterior crowns with a mean load of 339 ± 94. The mean load observed was highest with Cheng Crowns zirconia posterior crowns (1990 ± 485) followed by NuSmile posterior crowns and the least load was seen with Sprig EZ posterior crowns with a mean load of 661 ± 184. Conclusion: the Cheng crowns showed the highest fracture resistance amongst all three groups. Overall, the zirconia crowns (anterior and posterior) tested showed optimum mechanical properties to withstand the masticatory forces.

Fracture Resistance of Zirconia Abutments with or without a Titanium Base: An In Vitro Study for Tapered Conical Connection Implants

Dental implants with tapered conical connections are often combined with zirconia abutments for esthetics; however, the effect of the titanium base on the implant components remains unclear. This study evaluated the effects of a titanium base on the fracture resistance of zirconia abutments and damage to the tapered conical connection implants. Zirconia (Z) and titanium base zirconia (ZT) abutments were fastened to Nobel Biocare (NB) implants and Straumann (ST) implants and subjected to static load testing according to ISO 14801:2016. The experiments were performed with 3 mm of the platform exposed (P3) and no platform exposed (P0). The fracture loads were statistically greater in the titanium base abutments than the zirconia abutments for the NB and ST specimens in the P0 condition. In the P3 condition of the ST specimens, the deformation volume of the ZT group was significantly greater than the Z group. The titanium base increased the fracture resistance of the zirconia abutments. Additionally, the titanium base caused more deformation in the P3 condition. The implant joint design may also affect the amount of damage to the implants when under a load. The mechanical properties of the abutment should be considered when selecting a clinical design.

Influence of the endodontic access cavity design and restorative technique on hard tissue removal and fracture resistance of mandibular premolars

This study assessed the influence of traditional (TradAC) and conservative access (ConsAC) with different restorative techniques on the percentage of hard tissue removed (%HTR) and on the fracture resistance of mandibular premolars. 45 premolars were scanned in a micro-computed tomography and assigned into four groups according to access (TradAC or ConsAC) and restorative technique: composite resin (CR) or fiber post (FP) + CR. After post preparation, the teeth were rescanned to determine the volume enlargement and %HTR from the crown and root canal. After restoration, the load at fracture was recorded. Data were analyzed statistically by one-way ANOVA and Tukey’s post-hoc test, ANOVA repeated measure, and chi-square tests (P<0.05). TradAC (RC or FP) resulted in the increase (Δ%) of root canal volume and hard tissue removed up to 14 mm (%) in comparison with ConsAC (RC or FP). TradAC + FP removed a greater percentage of hard tissue from the crown when compared to TradAC + CR. The percentage of hard tissue removed in the crown in the ConsAC groups was statistically lower than in the TradAC groups. The control group showed higher fracture resistance than all experimental groups, with no differences among the latter. Restorable fracture patterns were more prevalent. Traditional endodontic access cavities removed a higher percentage of dentine than conservative endodontic access cavities. However, no differences in fracture resistance were observed. Restorations using composite resin or fiber post associated with composite resin showed similar results of fracture resistance.