Fracture Resistance of Zirconia Surveyed Crowns With Digitally Designed and Hand-Modified Occlusal Rest Seats

Background In light of the trend of using zirconia crowns, clinicians will likely face abutment included in removable partial dentures (RPD) designs with existing zirconia. However, the decision to replace the existing crown with a surveyed crown or modify the existing crown to accept the RPD is unclear. To the best of our knowledge, there is a lack of literature on the effect of preparing a rest seat on the existing monolithic zirconia crown in the patient's mouth on the fracture resistance of the crown. Therefore, in this study, we aimed to evaluate the fracture resistance of computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia surveyed crowns with digitally designed rest seats and hand-modified rest seats. Methods Thirty CAD/CAM zirconia surveyed crowns were digitally designed and fabricated and divided into groups (n=10 per group) as follows: Group 1 comprised surveyed crowns with no occlusal rest seat; Group 2 comprised surveyed crowns with a digitally designed mesial rest seat; and Group 3 comprised surveyed crowns with a hand-modified mesial rest seat. Then, with all the crowns cemented to metal dies, the specimens were subjected to a fracture resistance test using a universal testing machine (Model 8501 Instron, Norwood, MA, USA). Results Surveyed crowns without any rest seat and those with digitally created and hand-modified rest seats displayed different fracture resistances: crowns with no rest seat offered the highest fracture resistance (5831 ± 895.15 N), followed by those with a digitally designed and milled rest seat (5280 ± 1673.33 N). Crowns with a hand-modified rest seat provided the lowest fracture resistance (4976 ± 322.5 N). Based on our results, surveyed crowns without a rest seat displayed higher fracture resistance than those with a rest seat. Conclusion The fracture resistance of crowns with a digitally designed and milled rest seat was statistically similar to that of control crowns with no rest seat, whereas hand-modified rest seats significantly reduced the fracture resistance of surveyed zirconia crowns.