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Fracture load of three-unit full-contour fixed dental prostheses fabricated with subtractive and additive CAD/CAM technology

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Abstract

Objectives

The aim of this study was to test the fracture load of ceramic and composite three-unit full-contour fixed dental prostheses (FDPs) fabricated with additive and subtractive computer-aided design (CAD)/computer-aided manufacturing (CAM) technology.

Materials and methods

A newly developed alveolar socket replica model for a three-unit FDP replacing one molar was used in this study. Five CAD/CAM materials were used for fabrication of three-unit FDPs (each n = 12). The subtractive CAD/CAM fabrication method was used for groups BC (BRILLIANT Crios), TC (Telio CAD), EX (e.max CAD), and TZ (inCoris TZI C), and the additive method was used for group 3D (els 3D resin even stronger). FDPs were adhesively seated to the abutment dies (PANAVIA V5 system). Thermomechanical loading was performed prior to fracture testing with a universal testing machine. The data for maximum fracture load values was analyzed with one-way ANOVA and post hoc Scheffé test (α = 0.05).

Results

All FDPs survived the thermomechanical loading test. Statistically significant differences were found for the fracture load of three-unit FDPs fabricated from different CAD/CAM materials (p < 0.05). The highest mean fracture load was found for group TZ (2099.5 ± 382.1 N). Group 3D showed the lowest mean fracture load (928.9 ± 193.8 N). Group BC performed statistically significantly differently from group 3D with a mean fracture load of 1494.8 ± 214.5 N (p < 0.05).

Conclusions

Particle-filled composite resin CAD/CAM materials showed fracture load values within the range of ceramic materials with a specific indication of use for three-unit FDPs.

Clinical relevance

Particle filled composite CAD/CAM materials may offer new treatment possibilities for the CAD/CAM workflow.

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References

  1. Yamashita J, Wang Q, Dechow PC (2006) Biomechanical effects of fixed partial denture therapy on strain patterns of the mandible. J Prosthet Dent 95:55–62

    PubMed  Google Scholar 

  2. Walton TR (2015) An up-to-15-year comparison of the survival and complication burden of three-unit tooth-supported fixed dental prostheses and implant-supported single crowns. Int J Oral Maxillofac Implants 30:851–861

    PubMed  Google Scholar 

  3. Poggio CE, Ercoli C, Rispoli K, Maiorana C, Esposito M (2017) Metal-free materials for fixed prosthodontic restorations. Cochrane Database Syst Rev (12):Cd009606

  4. Kerschbaum T, Haastert B, Marinello CP (1996) Risk of debonding in three-unit resin-bonded fixed partial dentures. J Prosthet Dent 75:248–253

    PubMed  Google Scholar 

  5. De Backer H, Van Maele G, De Moor N, Van den Berghe L (2006) Single-tooth replacement: is a 3-unit fixed partial denture still an option? A 20-year retrospective study. Int J Prosthodont 19:567–573

    PubMed  Google Scholar 

  6. Kern M, Sasse M, Wolfart S (2012) Ten-year outcome of three-unit fixed dental prostheses made from monolithic lithium disilicate ceramic. J Am Dent Assoc 143:234–240

    PubMed  Google Scholar 

  7. Pelaez J, Cogolludo PG, Serrano B, Lozano JF, Suarez MJ (2012) A prospective evaluation of zirconia posterior fixed dental prostheses: three-year clinical results. J Prosthet Dent 107:373–379

    PubMed  Google Scholar 

  8. Reich S, Endres L, Weber C, Wiedhahn K, Neumann P, Schneider O, Rafai N, Wolfart S (2014) Three-unit CAD/CAM-generated lithium disilicate FDPs after a mean observation time of 46 months. Clin Oral Investig 18:2171–2178

    PubMed  Google Scholar 

  9. Yang Y, Yu J, Gao J, Guo J, Li L, Zhao Y, Zhan S (2016) Clinical outcomes of different types of tooth-supported bilayer lithium disilicate all-ceramic restorations after functioning up to 5 years: a retrospective study. J Dent 51:56–61

    PubMed  Google Scholar 

  10. Wolfart S, Eschbach S, Scherrer S, Kern M (2009) Clinical outcome of three-unit lithium-disilicate glass-ceramic fixed dental prostheses: up to 8 years results. Dent Mater 25:e63–e71

    PubMed  Google Scholar 

  11. Land MF, Hopp CD (2010) Survival rates of all-ceramic systems differ by clinical indication and fabrication method. J Evid Based Dent Pract 10:37–38

    PubMed  Google Scholar 

  12. Beuer F, Steff B, Naumann M, Sorensen JA (2008) Load-bearing capacity of all-ceramic three-unit fixed partial dentures with different computer-aided design (CAD)/computer-aided manufacturing (CAM) fabricated framework materials. Eur J Oral Sci 116:381–386

    PubMed  Google Scholar 

  13. Ruse ND, Sadoun MJ (2014) Resin-composite blocks for dental CAD/CAM applications. J Dent Res 93:1232–1234

    PubMed  PubMed Central  Google Scholar 

  14. Wiegand A, Stucki L, Hoffmann R, Attin T, Stawarczyk B (2015) Repairability of CAD/CAM high-density PMMA- and composite-based polymers. Clin Oral Investig 19:2007–2013

    PubMed  Google Scholar 

  15. Pfeilschifter M, Preis V, Behr M, Rosentritt M (2018) Edge strength of CAD/CAM materials. J Dent 74:95–100

    PubMed  Google Scholar 

  16. Zimmermann M, Mehl A, Reich S (2013) New CAD/CAM materials and blocks for chairside procedures. Int J Comput Dent 16:173–181

    PubMed  Google Scholar 

  17. Giordano R (2006) Materials for chairside CAD/CAM-produced restorations. J Am Dent Assoc 137 Suppl:14s–21s

    PubMed  Google Scholar 

  18. Zimmermann M, Ender A, Egli G, Özcan M, Mehl A (2018) Fracture load of CAD/CAM-fabricated and 3D-printed composite crowns as a function of material thickness. Clin Oral Investig 23:2777–2784. https://doi.org/10.1007/s00784-018-2717-2

    Article  PubMed  Google Scholar 

  19. Rosentritt M, Behr M, Lang R, Handel G (2004) Flexural properties of prosthetic provisional polymers. Eur J Prosthodont Restor Dent 12:75–79

    PubMed  Google Scholar 

  20. Edelhoff D, Schraml D, Eichberger M, Stawarczyk B (2016) Comparison of fracture loads of CAD/CAM and conventionally fabricated temporary fixed dental prostheses after different aging regimens. Int J Comput Dent 19:101–112

    PubMed  Google Scholar 

  21. Behr M, Rosentritt M, Handel G (2003) Fiber-reinforced composite crowns and FPDs: a clinical report. Int J Prosthodont 16:239–243

    PubMed  Google Scholar 

  22. Shi L, Fok AS (2009) Structural optimization of the fibre-reinforced composite substructure in a three-unit dental bridge. Dent Mater 25:791–801

    PubMed  Google Scholar 

  23. Erkmen E, Meric G, Kurt A, Tunc Y, Eser A (2011) Biomechanical comparison of implant retained fixed partial dentures with fiber reinforced composite versus conventional metal frameworks: a 3D FEA study. J Mech Behav Biomed Mater 4:107–116

    PubMed  Google Scholar 

  24. Keilig L, Stark H, Bourauel C (2016) Does the material stiffness of novel high-performance polymers for fixed partial dentures influence their biomechanical behavior? Int J Prosthodont 30:595–597

    PubMed  Google Scholar 

  25. Krejci I, Reich T, Lutz F, Albertoni M (1990) An in vitro test procedure for evaluating dental restoration systems. 1. A computer-controlled mastication simulator. Schweiz Monatsschr Zahnmed 100:953–960

    PubMed  Google Scholar 

  26. Tortopidis D, Lyons MF, Baxendale RH, Gilmour WH (1998) The variability of bite force measurement between sessions, in different positions within the dental arch. J Oral Rehabil 25:681–686

    PubMed  Google Scholar 

  27. Lyons MF, Cadden SW, Baxendale RH, Yemm R (1996) Twitch interpolation in the assessment of the maximum force-generating capacity of the jaw-closing muscles in man. Arch Oral Biol 41:1161–1168

    PubMed  Google Scholar 

  28. Özcan M, Jonasch M (2018) Effect of cyclic fatigue tests on aging and their translational implications for survival of all-ceramic tooth-borne single crowns and fixed dental prostheses. J Prosthodont 27:364–375

    PubMed  Google Scholar 

  29. Stawarczyk B, Ender A, Trottmann A, Özcan M, Fischer J, Hämmerle CH (2012) Load-bearing capacity of CAD/CAM milled polymeric three-unit fixed dental prostheses: effect of aging regimens. Clin Oral Investig 16:1669–1677

    Google Scholar 

  30. Blackburn C, Rask H, Awada A (2018) Mechanical properties of resin-ceramic CAD-CAM materials after accelerated aging. J Prosthet Dent 119:954–958

    PubMed  Google Scholar 

  31. Plengsombut K, Brewer JD, Monaco EA Jr, Davis EL (2009) Effect of two connector designs on the fracture resistance of all-ceramic core materials for fixed dental prostheses. J Prosthet Dent 101:166–173

    PubMed  Google Scholar 

  32. Oh W, Gotzen N, Anusavice KJ (2002) Influence of connector design on fracture probability of ceramic fixed-partial dentures. J Dent Res 81:623–627

    PubMed  Google Scholar 

  33. Vult von Steyern P, Kokubo Y, Nilner K (2005) Use of abutment-teeth vs. dental implants to support all-ceramic fixed partial dentures: an in-vitro study on fracture strength. Swed Dent J 29:53–60

    PubMed  Google Scholar 

  34. Wimmer T, Ender A, Roos M, Stawarczyk B (2013) Fracture load of milled polymeric fixed dental prostheses as a function of connector cross-sectional areas. J Prosthet Dent 110:288–295

    PubMed  Google Scholar 

  35. Choi JW, Kim SY, Bae JH, Bae EB, Huh JB (2017) In vitro study of the fracture resistance of monolithic lithium disilicate, monolithic zirconia, and lithium disilicate pressed on zirconia for three-unit fixed dental prostheses. J Adv Prosthodont 9:244–251

    PubMed  PubMed Central  Google Scholar 

  36. Rosentritt M, Plein T, Kolbeck C, Behr M, Handel G (2000) In vitro fracture force and marginal adaptation of ceramic crowns fixed on natural and artificial teeth. Int J Prosthodont 13:387–391

    PubMed  Google Scholar 

  37. Guess PC, Schultheis S, Wolkewitz M, Zhang Y, Strub JR (2013) Influence of preparation design and ceramic thicknesses on fracture resistance and failure modes of premolar partial coverage restorations. J Prosthet Dent 110:264–273

    PubMed  PubMed Central  Google Scholar 

  38. Wimmer T, Erdelt KJ, Eichberger M, Roos M, Edelhoff D, Stawarzak B (2014) Influence of abutment model materials on the fracture loads of three-unit fixed dental prostheses. Dent Mater J 33:717–724

    PubMed  Google Scholar 

  39. Rosentritt M, Behr M, Gebhard R, Handel G (2006) Influence of stress simulation parameters on the fracture strength of all-ceramic fixed-partial dentures. Dent Mater 22:176–182

    PubMed  Google Scholar 

  40. Kinney JH, Marshall SJ, Marshall GW (2003) The mechanical properties of human dentin: a critical review and re-evaluation of the dental literature. Crit Rev Oral Biol Med 14:13–29

    PubMed  Google Scholar 

  41. Ho SP, Kurylo MP, Fong TK, Lee SS, Wagner HD, Ryder MI, Marshall GW (2010) The biomechanical characteristics of the bone-periodontal ligament-cementum complex. Biomaterials 31(25):6635–6646

    PubMed  PubMed Central  Google Scholar 

  42. Scherrer SS, de Rijk WG, Belser UC, Meyer JM (1994) Effect of cement film thickness on the fracture resistance of a machinable glass-ceramic. Dent Mater 10:172–177

    PubMed  Google Scholar 

  43. Wimmer T, Erdelt KJ, Raith S, Schneider JM, Stawarczyk B, Beuer F (2014) Effects of differing thickness and mechanical properties of cement on the stress levels and distributions in a three-unit zirconia fixed prosthesis by FEA. J Prosthodont 23:358–366

    PubMed  Google Scholar 

  44. Reymus M, Roos M, Eichberger M, Edelhoff D, Hickel R, Stawarczyk B (2019) Bonding to new CAD/CAM resin composites: influence of air abrasion and conditioning agents as pretreatment strategy. Clin Oral Investig 23:529–538

    PubMed  Google Scholar 

  45. Mormann WH, Stawarczyk B, Ender A, Sener B, Attin T, Mehl A (2013) Wear characteristics of current aesthetic dental restorative CAD/CAM materials: two-body wear, gloss retention, roughness and Martens hardness. J Mech Behav Biomed Mater 20:113–125

    PubMed  Google Scholar 

Download references

Funding

The work was supported by the Division of Computerized Restorative Dentistry, Center of Dental Medicine, University of Zurich, which was in part financially supported by Saremco Dental AG and Coltène AG to conduct the study.

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Authors and Affiliations

  1. Division of Computerized Restorative Dentistry, Clinic for Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland

    Moritz Zimmermann, Andreas Ender & Albert Mehl

  2. Clinic for Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland

    Thomas Attin

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  1. Moritz Zimmermann
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Correspondence to Moritz Zimmermann.

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Zimmermann, M., Ender, A., Attin, T. et al. Fracture load of three-unit full-contour fixed dental prostheses fabricated with subtractive and additive CAD/CAM technology. Clin Oral Invest 24, 1035–1042 (2020). https://doi.org/10.1007/s00784-019-03000-0

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