title: Influence of preliminary damage on the load-bearing capacity of zirconia fixed dental prostheses.
abstract: OBJECTIVE
  The objective of this investigation was to evaluate the influence of differently shaped preliminary cuts in combination with artificial aging on the load-bearing capacity of four-unit zirconia fixed dental prostheses (FDPs).
  
  
  METHODS
  Forty frameworks were fabricated from white-stage zirconia blanks (InCeram YZ, Vita) by means of a computer-aided design/computer-aided manufacturing system (Cerec inLab, Sirona). Frameworks were divided into four homogeneous groups with ten specimens each. Prior to veneering, frameworks of two groups were "damaged" by defined saw cuts of different dimensions, to simulate accidental flaws generated during shape cutting. After the veneering process, FDPs, with the exception of a control group without preliminary damage, were subjected to thermal and mechanical cycling (TMC) during 200 days storage in distilled water at 36°C. Following the aging procedure, all specimens were loaded until fracture, and forces at fracture were recorded. The statistical analysis of force at fracture data was performed using two-way ANOVA, with the level of significance chosen at 0.05.
  
  
  RESULTS
  Neither type of preliminary mechanical damage significantly affected the load-bearing capacity of FDPs. In contrast, artificial aging by TMC proved to have a significant influence on the load-bearing capacity of both the undamaged and the predamaged zirconia restorations (p < 0.001); however, even though load-bearing capacity decreased by about 20% due to simulated aging, the FDPs still showed mean load-bearing capacities of about 1600 N.
  
  
  CONCLUSIONS
  The results of this study reveal that zirconia restorations have a high tolerance regarding mechanical damages. Irrespective of these findings, damage to zirconia ceramics during production or finishing should be avoided, as this may nevertheless lead to subcritical crack growth and, eventually, catastrophic failure. Furthermore, to ensure long-term clinical success, the design of zirconia restorations has to accommodate the decrease in load-bearing capacity due to TMC in the oral environment.
authors: Department of Prosthetic Dentistry and Biomedical Materials Science, Hannover Medical School, Germany. Kohorst.Philipp@mh-hannover.de
authors: Philipp
authors: P
authors: Kohorst
authors: Lutz Oliver
authors: LO
authors: Butzheinen
authors: Marc Philipp
authors: MP
authors: Dittmer
authors: Wieland
authors: W
authors: Heuer
authors: Lothar
authors: L
authors: Borchers
authors: Meike
authors: M
authors: Stiesch
mesh_terms: D002484:Cementation; D017076:Computer-Aided Design; D000044:Dental Abutments; D003764:Dental Materials / Q000737:chemistry*; D003776:Dental Porcelain / Q000737:chemistry; D019232:Dental Restoration Failure; D003801:Dental Veneers; D003779:Denture Design; D003830:Denture, Partial, Fixed; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D008277:Magnesium Oxide / Q000737:chemistry; D008422:Materials Testing; D008855:Microscopy, Electron, Scanning; D011076:Polycarboxylate Cement / Q000737:chemistry; D013314:Stress, Mechanical; D013499:Surface Properties; D013696:Temperature; D014867:Water / Q000737:chemistry; D015034:Zinc Oxide / Q000737:chemistry; D015040:Zirconium / Q000737:chemistry*
chemical_list: D003764:Dental Materials; D005899:Glass Ionomer Cements; C485633:In-Ceram Zirconia; D011076:Polycarboxylate Cement; D014867:Water; D003776:Dental Porcelain; D008277:Magnesium Oxide; C040235:Ketac-cem; D015040:Zirconium; C028541:zirconium oxide; D015034:Zinc Oxide