Impact of the material and sintering protocol, layer thickness, and thermomechanical aging on the two-body wear and fracture load of 4Y-TZP crowns.

Mayinger, Felicitas; Buser, Ramona; Laier, Maximilian; Schönhoff, Lisa Marie; Kelch, Matthias; Hampe, Rüdiger; Stawarczyk, Bogna (2022). Impact of the material and sintering protocol, layer thickness, and thermomechanical aging on the two-body wear and fracture load of 4Y-TZP crowns. Clinical oral investigations, 26(11), pp. 6617-6628. Springer-Verlag 10.1007/s00784-022-04616-5

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OBJECTIVES

The aim of this study is to investigate the influence of the material and corresponding sintering protocol, layer thickness, and aging on the two-body wear (2BW) and fracture load (FL) of 4Y-TZP crowns.

MATERIALS AND METHODS

Multi-layer 4Y-TZP crowns in three thicknesses (0.5 mm/1.0 mm/1.5 mm) were sintered by high-speed (Zolid RS) or conventional (Zolid Gen-X) sintering. 2BW of ceramic and enamel antagonist after aging (1,200,000 mechanical-, 6000 thermal-cycles) was determined by 3D-scanning before and after aging and subsequent matching to determine volume and height loss (6 subgroups, n = 16/subgroup). FL was examined initially and after aging (12 subgroups, n = 16/subgroup). Fractographic analyses were performed using light-microscope imaging. Global univariate analysis of variance, one-way ANOVA, linear regression, Spearman's correlation, Kolgomorov-Smirnov, Mann-Whitney U, and t test were computed (alpha = 0.05). Weibull moduli were determined. Fracture types were analyzed using Ciba Geigy table.

RESULTS

Material/sintering protocol did not influence 2BW (crowns: p = 0.908, antagonists: p = 0.059). High-speed sintered Zolid RS presented similar (p = 0.325-0.633) or reduced (p < 0.001-0.047) FL as Zolid Gen-X. Both 4Y-TZPs showed an increased FL with an increasing thickness (0.5(797.3-1429 N) < 1.0(2087-2634 N) < 1.5(2683-3715 N)mm; p < 0.001). For most groups, aging negatively impacted FL (p < 0.001-0.002). Five 0.5 mm specimens fractured, four showed cracks during and after aging.

CONCLUSIONS

High-speed sintered crowns with a minimum thickness of 1.0 mm showed sufficient mechanical properties to withstand masticatory forces, even after a simulated aging period of 5 years.

CLINICAL RELEVANCE

Despite the manufacturer indicating a thickness of 0.5 mm to be suitable for single crowns, a minimum thickness of 1.0 mm should be used to ensure long-term satisfactory results.

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