Load-bearing capacity of all-ceramic posterior four-unit fixed partial dentures with different zirconia frameworks

The aim of this in vitro study was to compare the load-bearing capacity of posterior four-unit fixed partial dentures (FPDs) produced with two different yttria-stabilized polycrystalline tetragonal zirconia (Y-TZP) ceramics, one being a presintered material, the other a fully sintered, hot isostatically pressed material. Additionally, as a novel approach, the influence of preliminary mechanical damage upon the fracture force of an FPD has been investigated. A total of 20 frameworks each were milled from presintered zirconia and from fully sintered zirconia. Prior to veneering, 10 frameworks of each material were 'damaged' by a defined saw cut similar to an accidental flaw generated during shape cutting. Before fracture testing, all FPDs were subjected to thermal and mechanical cycling. Additionally, scanning electron microscopy was used to investigate fracture surfaces. Statistical analysis showed that FPDs milled from fully sintered zirconia had a significantly higher fracture resistance compared with specimens made from presintered material, whereas preliminary damage did not have a significant effect. After aging, FPDs made from both materials were capable of withstanding occlusal forces reported in the literature. Therefore, both types of Y-TZP may be suitable for posterior four-unit all-ceramic FPDs, although further prolonged aging experiments and prospective clinical trials are required to prove their fitness for clinical use.