Abstract
Statement of problem
The mechanical behavior of ceramic endocrowns is unclear.
Purpose
The purpose of this in vitro and 3-dimensional finite element analysis (3D-FEA) study
was to evaluate the mechanical behavior of endodontically treated teeth restored with
ceramic endocrowns made by using different computer-aided design and computer-aided
manufacturing (CAD-CAM) systems.
Material and methods
Sixty mandibular human molars were endodontically treated, prepared for endocrowns,
and divided into 4 groups (n=15) according to the following various ceramic systems:
leucite-based glass-ceramic (LC group), lithium disilicate-based glass-ceramic (LD
group), glass-ceramic based on zirconia-reinforced lithium silicate (LSZ group), and
monolithic zirconia (ZR group). After adhesive bonding, the specimens were subjected
to thermomechanical loading and then to fracture resistance testing in a universal
testing machine. The failure mode of the specimens was qualitatively evaluated. Three-dimensional
FEA was performed to evaluate the stress distribution in each group. Data were analyzed
by using a 1-way ANOVA and the Tukey HSD test (α=.05).
Results
Statistically significant differences among the groups were observed (P<.05). The outcomes of the LC, LD, and LSZ groups were similar (1178 N, 1935 N, and
1859 N) but different from those of the ZR group (6333 N). The LC and LD groups had
a higher ratio of restorable failures, while LSZ and ZR had more nonrestorable failures.
Fractographic analysis indicated a regular failure pattern in the ZR group and irregular
failure patterns in the other groups. Three-dimensional FEA revealed similar values
and stress pattern distributions among the groups.
Conclusions
The mechanical performance of monolithic zirconia was better than that of the other
ceramic endocrowns considered in this research; however, monolithic zirconia presented
a higher rate of catastrophic tooth structure failure.
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
- Fabrication of a metal-free ceramic restoration utilizing the monobloc technique.Pract Periodontics Aesthet Dent. 1995; 7: 83-94
- Clinical evaluation of adhesively placed Cerec endo-crowns after 2 years--preliminary results.J Adhes Dent. 1999; 1: 255-265
- Comparison of fracture strength of endocrowns and glass fiber post-retained conventional crowns.Oper Dent. 2012; 37: 130-136
- Endocrown in premolar using lithium disilicate-reinforce ceramic: a case report.J Oral Investig. 2017; 6: 43-49
- Survival of ceramic computer-aided design/manufacturing crowns bonded to preparations with reduced macroretention geometry.Int J Prosthodont. 2005; 18: 219-224
- Estimation of the failure risk of a maxillary premolar with different crack depths with endodontic treatment by computer-aided design/computer-aided manufacturing ceramic restorations.J Endod. 2013; 39: 375-379
- The endocrown: an alternative approach for restoring extensively damaged molars.J Esthet Restor Dent. 2013; 25: 383-390
- Restoration of endodontically treated molars using all ceramic endocrowns.Case Rep Dent. 2013; 2013: 210763
- Effect of intracoronal depth of teeth restored with endocrowns on fracture resistance: in vitro and 3-dimensional finite element analysis.J Endod. 2018; 44: 1179-1185
- 3D–Finite element analysis of molars restored with endocrowns and posts during masticatory simulation.Dent Mater. 2013; 29: e309-e317
- Fiber-reinforced resin coating for endocrown preparations: a technical report.Oper Dent. 2013; 38: 242-248
- Resin-composite blocks for dental CAD/CAM applications.J Dent Res. 2014; 93: 1232-1234
- Fracture strength, failure type and Weibull characteristics of lithium disilicate and multiphase resin composite endocrowns under axial and lateral forces.Dent Mater. 2016; 32: 607-614
- Influence of remaining tooth structure and restorative material type on stress distribution in endodontically treated maxillary premolars: a finite element analysis.J Prosthet Dent. 2017; 117: 646-655
- Mechanical failure of endocrowns manufactured with different ceramic materials: an in vitro biomechanical study.J Prosthodont. 2018; 27: 340-346
- Features of fracture of prosthetic tooth-endocrown constructions by means of acoustic emission analysis.Dent Mater. 2018; 34: e46-e55
- Load-bearing capacity of various CAD/CAM monolithic molar crowns under recommended occlusal thickness and reduced occlusal thickness conditions.J Adv Prosthodont. 2017; 9: 423-431
- Properties and clinical application of three types of dental glass-ceramics and ceramics for CAD-CAM technologies.Materials. 2010; 3: 3700-3713
- Chairside CAD/CAM materials. Part 2: Flexural strength testing.Dent Mater. 2017; 33: 99-109
- The importance of the lifelike esthetic appearance of all-ceramic restorations on anterior teeth.Case Rep Dent. 2015; 2015: 704348
- Influence of translucence/opacity and shade in the flexural strength of lithium disilicate ceramics.J Conserv Dent. 2015; 18: 394-398
- Mechanical properties of zirconia reinforced lithium silicate glass-ceramic.Dent Mater. 2016; 32: 908-914
- Wear, strength, modulus and hardness of CAD/CAM restorative materials.Dent Mater. 2016; 32: e275-e283
- State of the art of zirconia for dental applications.Dent Mater. 2008; 24: 299-307
- Current status of zirconia restoration.J Prosthodont Res. 2013; 57: 236-261
- Influence of the preparation design and artificial aging on the fracture resistance of monolithic zirconia crowns.J Adv Prosthodont. 2016; 8: 30-36
- Effect of grain size on the monoclinic transformation, hardness, roughness, and modulus of aged partially stabilized zirconia.Dent Mater. 2015; 31: 1487-1492
- Effect of different aging methods on the mechanical behavior of multi-layered ceramic structures.Dent Mater. 2016; 32: 1536-1542
- ADM guidance-ceramics: guidance to the use of fractography in failure analysis of brittle materials.Dent Mater. 2017; 33: 599-620
- Chairside CAD/CAM materials. Part 1: measurement of elastic constants and microstructural characterization.Dent Mater. 2017; 33: 84-98
- Finite element analysis of non-axial versus axial loading of oral implants in the mandible of the dog.J Oral Rehabil. 1998; 25: 847-858
- Dentin stresses in post reconstructed teeth with diminishing bone support.J Dent Res. 1983; 62: 1002-1008
- The influence of cavity design and glass fiber posts on biomechanical behavior of endodontically treated premolars.J. Endod. 2008; 34: 1015-1019
- Composition and mechanical properties of gutta-percha endodontic points.J Dent Res. 1975; 54: 921-925
- Biomechanical aspects and material properties.1st ed. Gothia Fortbildning, Stockholm2013: 116-130
- Masticatory efficiency and bite force in individuals with normal occlusion.Arch Oral Biol. 2014; 59: 1065-1074
Article info
Publication history
Published online: February 10, 2020
Footnotes
Supported by São Paulo State Research Foundation (FAPESP) (research grant numbers 2016/25311-7).
Identification
Copyright
© 2019 by the Editorial Council for The Journal of Prosthetic Dentistry.
