Comparison of load-fatigue performance of posterior ceramic onlay restorations under different preparation designs

The objective of this study was to evaluate the load-fatigue performance of posterior ceramic onlay restorations relative to two variables: preparation design (with or without buccal veneers); and the existing amount of tooth structure (non-worn tooth, worn tooth).

Sixty extracted third molars were divided into five groups. One group received a mesial-occlusal-distal (MOD) gold onlay restoration (control). The other four experimental groups were prepared for ceramic onlay restorations. Two of the groups additionally received 2-mm occlusal reduction to simulate occlusal wear. All restored teeth were subjected to thermocycling prior to fatigue testing. A fatigue load of 150 N was applied on the occlusal surface at a frequency of 1.2 hz, at an angle of 135 degrees to the long axis of the tooth. Specimen failure was defined as the occurrence of crack propagation in the luting cement layer. This was monitored by the strain gauge on the specimen.

All specimens restored on worn tooth had significantly lower fatigue failure cycle counts than those of non-worn tooth. The fracture mode analysis revealed that ceramic fracture tended to be demonstrated only in the group of worn tooth groups.

The addition of a buccal veneer component had no significant effect on the load-fatigue performance of posterior ceramic onlay restorations, but the existing amount of tooth structure did have a significant effect on the load-fatigue performance of posterior ceramic onlay restorations. Catastrophic failures (ceramic fracture) occurred only in the group of worn tooth.