Fracture resistance of additively or subtractively manufactured resin-based definitive crowns: Effect of restorative material, resin cement, and cyclic loading.

Çakmak, Gülce; Dönmez, Mustafa Borga; Molinero-Mourelle, Pedro; Kahveci, Çiğdem; Abou-Ayash, Samir; Peutzfeldt, Anne; Yilmaz, Burak (2024). Fracture resistance of additively or subtractively manufactured resin-based definitive crowns: Effect of restorative material, resin cement, and cyclic loading. Dental materials, 40(7), pp. 1072-1077. Elsevier 10.1016/j.dental.2024.05.020

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OBJECTIVE

To evaluate how restorative material, resin cement, and cyclic loading affect the fracture resistance of resin-based crowns fabricated by using additive or subtractive manufacturing.

METHODS

A right first molar crown standard tessellation language (STL) file was used to fabricate 120 crowns from one subtractively manufactured polymer-infiltrated ceramic network (SM) and two additively manufactured resin composites (AM-B and AM-S) (N = 40). These crowns were randomly divided into 4 groups within each material according to the dual-polymerizing resin cement to be used (RX and PN) and the aging condition (n = 10). After cementation, the crowns without cyclic loading were subjected to fracture testing, while the others were first cyclically loaded (1.7 Hz, 1.2 million cycles, and 49-N load) and then subjected to fracture testing. Data were analyzed with generalized linear model analysis (α = .05).

RESULTS

Fracture resistance of the crowns was affected by material, resin cement, and cyclic loading (P ≤ .030). However, none of the interactions significantly affected fracture resistance of tested crowns (P ≥ .140). Among tested materials, SM had the highest fracture resistance, whereas AM-B had the lowest (P ≤ .025). RX led to higher fracture resistance, and cyclic loading decreased the fracture resistance (P ≤ .026).

SIGNIFICANCE

Tested materials can be considered reliable in terms of fracture resistance in short- or mid-term (5 years of intraoral simulation) when used for single molar crowns with 2 mm occlusal thickness. In the long term, polymer-infiltrated ceramic network crowns cemented with RelyX Universal may provide promising results and be less prone to complications considering higher fracture resistance values obtained.

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