Statement of problem
Ultra-thin bonded posterior occlusal veneers represent a conservative alternative
to traditional inlays and complete coverage crowns for the treatment of severe erosive
lesions. There is a lack of data regarding selection of the most appropriate material
and its influence on fatigue resistance, which may affect restoration longevity.
Purpose
The purpose of this study was to assess the influence of CAD/CAM restorative material
(ceramic vs. composite resin) on fatigue resistance of ultra-thin occlusal veneers.
Material and methods
A standardized nonretentive tooth preparation (simulating advanced occlusal erosion)
was applied to 40 extracted molars including removal of occlusal enamel, and immediate
dentin sealing (Optibond FL). All teeth were restored with a 0.6 mm-thick occlusal
veneer (Cerec3 chairside CAD/CAM system). Reinforced ceramics (Empress CAD and e.max
CAD) and composite resins (Paradigm MZ100 and XR (experimental blocks)) were used
to mill the restorations (n=10). The intaglio surfaces were HF-etched and silanated
(reinforced ceramics) or airborne-particle abraded and silanated (composite resins).
Preparations were airborne-particle abraded and etched before restoration insertion.
All restorations were adhesively luted with preheated Filtek Z100. Cyclic isometric
loading was applied at 5 Hz, beginning with a load of 200N (x5,000), followed by stages
of 400, 600, 800, 1000, 1200 and 1,400N at a maximum of 30,000 cycles each. The number
of cycles at initial failure (first cracks) was recorded. Specimens were loaded until
catastrophic failure (lost restoration fragment) or to a maximum of 185,000 cycles.
Groups were compared using the life table survival analysis (α=.008, Bonferroni-method).
Results
Empress CAD and e.max CAD initially failed at an average load of 500N and 800N, respectively
with no specimen withstanding all 185,000 load cycles (survival 0%); with MZ100 and
XR the survival rate was 60% and 100%, respectively.
Conclusions
Both composite resins (MZ100 and XR) increased the fatigue resistance of ultra-thin
occlusal veneers (P<.001) when compared to the ceramics evaluated (Empress CAD and
e.max CAD).
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Prosthetic DentistryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Understanding the intact tooth and the biomimetic principle.in: Magne Belser Bonded Porcelain Restorations in the Anterior Dentition: A Biomimetic Approach. Quintessence Publishing Co, Chicago2002: 23-55
- Dental erosion in gastroesophageal reflux disease.J Can Dent Assoc. 2003; 69: 84-89
- Buonocore Memorial Lecture. Dental Erosion.Oper Dent. 2009; 34: 251-262
- The role of erosion in tooth wear: aetiology, prevention and management.Int Dent J. 2005; 55: 277-284
- Full-mouth adhesive rehabilitation of a severely eroded dentition: the three-step technique. Part 1.Eur J Esthet Dent. 2008; 3: 30-44
- Full-mouth adhesive rehabilitation of a severely eroded dentition: the three-step technique. Part 2.Eur J Esthet Dent. 2008; 3: 128-146
- Full-mouth adhesive rehabilitation of a severely eroded dentition: the three-step technique. Part 3.Eur J Esthet Dent. 2008; 3: 236-257
- Patient evaluation and problem-oriented treatment planning.in: Summitt JB Robbins JW Hilton TJ Fundamentals of Operative Dentistry: a contemporary approach. Quintessence Publishing Co, Chicago2006: 37-67
- Minimal preparation designs for single posterior indirect prostheses with the use of the Cerec system.Int J Comput Dent. 2008; 11: 227-240
- Partial ceramic crowns. Influence of preparation design and luting material on margin integrity–a scanning electron microscopic study.Clin Oral Invest. 2005; 9: 8-17
- Composite resins and bonded porcelain: The postamalgam era?.J Calif Dent Assoc. 2006; 34: 135-147
- In vitro fatigue resistance of CAD/CAM composite resin and ceramic posterior occlusal veneers.J Prosthet Dent. 2010; 104: 149-157
- Tooth structure removal associated with various preparation designs for posterior teeth.Int J Periodontics Restorative Dent. 2002; 22: 241-249
- Tooth structure removal associated with various preparation designs for anterior teeth.J Prosthet Dent. 2002; 87: 503-509
- Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition.Oper Dent. 2004; 29: 481-508
- Longevity of glass ceramic inlays and amalgam – results up to 6 years.Clin Oral Investig. 1997; 1: 40-46
- Maximising the fracture resistance of dentine-bonded all-ceramic crowns.J Dent. 1999; 27: 169-173
- Survival rate of mono-ceramic and ceramic-core CAD/CAM-generated anterior crowns over 2-5 years.Eur J Oral Sci. 2004; 112: 197-204
- Fracture resistance of lithium disilicate-, alumina-, and zirconia-based three-unit fixed partial dentures: a laboratory study.Int J Prosthodont. 2001; 14: 231-238
- Digital dentistry: an overview of recent developments for CAD/CAM generated restorations.Br Dent J. 2008; 204: 505-511
- Ask the expert. Will ceramic restorations be challenged in the future?.J Am Dent Assoc. 2001; 132: 46-47
- Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition.Oper Dent. 2004; 29: 481-508
- Indirect posterior composite resins.Compend Contin Educ Dent. 2005; 26: 495-503
- Clinical performance and marginal adaptationof class II direct and semidirect composite restorations over 3.5 years in vivo.J Dent. 2005; 33: 499-507
- Composites.in: Callister Jr, Materials science and engineering: an introduction. 4th ed. John Wiley & Sons, New York1998: 510-548
- Effect of composite basing on the resistance to bulk fracture of industrial porcelain inlays.J Dent. 1998; 26: 183-189
- The effect of postcuring on quantity of remaining double bonds, mechanical properties, and in vitro wear of two resin composites.J Dent. 2000; 28: 447-452
- Wear evaluation of MZ100 compared to ceramic CAD/CAM materials.Int J Comput Dent. 2001; 4: 171-184
- Stress distribution of inlay-anchored adhesive fixed partial dentures: a finite element analysis of the influence of restorative materials and abutment preparation design.J Prosthet Dent. 2002; 87: 516-527
- Simulated fatigue resistance of composite resin versus porcelain CAD/CAM overlay restorations on endodontically treated molars.Quintessence Int. 2009; 40: 125-133
- Influence of overlay restorative materials and load cusps on the fatigue resistance of endodontically treated molars.Quintessence Int. 2009; 40: 125-133
- Low force cementation.J Dent. 1996; 24: 269-273
- Fatigue resistance of teeth restored with cuspal-coverage composite restorations.Int J Prosthodont. 2004; 17: 313-317
- Thickness of CAD-CAM composite resin overlays influences fatigue resistance of endodontically treated premolars.Dent Mater. 2009; 25: 1264-1268
- Masticatory function - a review of the literature. III. Masticatory performance and efficiency.J Oral Rehabil. 1976; 3: 57-67
- Cracked tooth syndrome.J Prosthet Dent. 1982; 47: 36-43
- Clinically relevant approach to failure testing of all-ceramic restorations.J Prosthet Dent. 1999; 81: 652-661
- Immediate dentin sealing: a fundamental procedure for indirect bonded restorations.J Esthet Restor Dent. 2005; 17: 144-154
- Porcelain veneers: dentin bonding optimization and biomimetic recovery of the crown.Int J Prosthodont. 1999; 12: 111-121
- Marginal and internal adaptation of class II restorations after immediate or delayed composite placement.J Dent. 2002; 30: 259-269
- Immediate dentin sealing supports delayed restoration placement.J Prosthet Dent. 2007; 98: 166-174
- Minimally invasive restorative treatment.J Adhes Dent. 1999; 1: 267-284
- Porcelain versus composite inlays/onlays: effects of mechanical loads on stress distribution, adhesion, and crown flexure.Int J Periodontics Restorative Dent. 2003; 23: 543-555
- Perspectives on strength.Dent Mater. 1995; 11: 103-110
- Selected properties of dental composites.J Dent Res. 1979; 58: 1544-1550
- Composite resin reinforced with pre-tensioned glass fibers. Influence of prestressing on flexural properties.Dent Mater. 2010; 26: 118-125
- Rationalization of esthetic restorative dentistry based on biomimetics.J Esthet Dent. 1999; 11: 5-15
Article info
Footnotes
This study was supported by the Brazilian Federal Agency for Support and Evaluation of Graduate Education (CAPES) (Grant no. BEX 1689/08-8).
Identification
Copyright
© 2011 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.
