Effect of core design and veneering technique on damage and reliability of Y-TZP-supported crowns

To evaluate the effect of framework design modification and veneering techniques in fatigue reliability and failure modes of veneered Yttria-Stabilized Tetragonal Zirconia Polycrystals (Y-TZP) crowns.

A CAD-based mandibular molar crown preparation served as a master die. Y-TZP crown cores (VITA-In-Ceram-YZ, Vita-Zahnfabrik, Bad Säckingen, Germany) in conventional (0.5mm uniform thickness) or anatomically designed fashion (cusp support) were porcelain veneered with either hand-layer (VM9) or pressed (PM9) techniques. Crowns (n=84) were cemented on 30 days aged dentin-like composite dies with resin cement. Crowns were subjected to single load to fracture (n=3 each group) and mouth-motion step-stress fatigue (n=18) by sliding a WC indenter (r=3.18 mm) 0.7 mm buccally on the inner incline surface of the mesio-lingual cusp. Stress-level curves (use level probability lognormal) and reliability (with 2-sided 90% confidence bounds, CB) for completion of a mission of 50.000 cycles at 200 N load were calculated. Fractographic analyses were performed under light-polarized and scanning electron microscopes.

Higher reliability for hand-layer veneered conventional core (0.99, CB 0.98-1) was found compared to its counterpart press-veneered (0.50 CB 0.33-65). Framework design modification significantly increased reliability for both veneering techniques (PM9 [0.98 CB 0.87-0.99], VM9 [1.00 CB 0.99-1]) and resulted in reduced veneer porcelain fracture sizes. Main fracture mode observed was veneer porcelain chipping, regardless of framework design and veneering technique.

Hand-layer porcelain veneered on conventional core designs presented higher reliability than press-veneered with similar core designs. Anatomic core design modification significantly increased the reliability and resulted in reduced chip size of either veneering techniques.