Mechanical behavior of different machinable ceramic crowns using vertical and horizontal preparations: an in-vitro study

Abstract

Objective: the aim of this study was to compare the mechanical behavior of different ceramics when used in thin
vertical preparations versus traditional horizontal preparation. Material and Methods: two stainless-steel dies
were milled to simulate a minimally invasive vertical preparation (VP) and a traditional horizontal preparation
(HP) for an all-ceramic crown of a maxillary first premolar. The stainless-steel dies were duplicated using epoxy
resin. Eighty monolithic crowns were milled and divided into 2 groups according to preparation design. Each
design group was subdivided into 4 sub-groups according to material (n=10): IPS e.max CAD (lithium disilicate),
Bruxzir shaded zirconia (full contour zirconia), CeraSmart (resin nanoceramic) and CEREC Tessera (advanced
lithium disilicate). The crowns were cemented on their relevant epoxy resin dies using self-adhesive resin cement.
All specimens were subjected to 15,000 thermocycles and then loaded to fracture in a universal testing machine.
Data were analyzed using two-way ANOVA and Tukey pair wise comparison test. Results: the fracture resistance
mean values of the VP (1344 + 118 N) was significantly lower than the HP design (1646 + 191 N). Ceramic
crowns made of full contour zirconia had higher fracture resistance mean values (2842 + 380 N) than advanced
lithium disilicate (1272 + 125 N) followed by lithium disilicate crowns (983 + 52 N) and resin nanoceramic
(882 + 61 N). Conclusion: both vertical and horizontal preparations, regardless the different ceramic materials,
showed clinically acceptable fracture resistance values.

KEYWORDS
Dental crown; Prosthodontics; Zirconia; Lithium disilicate; Hybrid ceramics.