Research on the mechanical differences of machinable lithium disilicate all-ceramic crowns_Journal of Biomedical Engineering

Authors：

LIN Xiaomin ¹ , XU Yuanzhi ² , YANG Qixiang ² ,  ZHANG Dongsheng ³

1. Shanghai Institute of Applied Mathematics and Mechanics, Shanghai 200072, P.R.China;
2. Department of Stomatology, The Tenth People's Hospital of Tongji University, Shanghai 200072, P.R.China;
3. Department of Mechanics, Shanghai University, Shanghai 200444, P.R.China;

Corresponding author：

ZHANG Dongsheng, Email: donzhang@staff.shu.edu.cn

Keywords：

machinable lithium disilicate; monolithic crown; adhesive; finite element analysis; stress

DOI：

10.7507/1001-5515.201604055

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Due to the superior pigment and high flexural strength, machinable lithium disilicate ceramics can be used as a monolithic crown or veneering porcelains on the zirconia core to form the all-ceramic crowns by sintering or bonding procedures. This paper reports the research on the differences in stress distributions amongst these three types of all-ceramic crowns under typical loading conditions. Three-dimensional numerical models of the restored crown based on the first mandibular molar were developed. The vertical concentrated load and 8-point uniformly distributed load were applied, respectively. The maximum stress and stress distribution were resulted from finite element evaluation. It was found that the maximum tensile stress in 3 types of restored crowns subjected to the concentrate load was less than the flexural strength of IPS e.max. The stress distributions in the sintered and bonded double layered crowns were basically identical, and different from the monolithic crown. The stress magnitude in veneer porcelain of the bonded crown was greater than that in the sintered crown. The use of IPS e.max computer aided design monolithic crown as molar restorations should be careful to avoid high stress as the cyclic stress is a concern of fatigue which may influence the longevity of the restored crown. The bonded double layer crowns bear greater risks of veneer chipping compared with the sintered crowns. The conclusions of this study provide helpful guidelines in clinical applications for preparation of computer aided design/computer aided manufacture lithium disilicate all-ceramic restorations.

Citation： LINXiaomin, XUYuanzhi, YANGQixiang, ZHANGDongsheng. Research on the mechanical differences of machinable lithium disilicate all-ceramic crowns. Journal of Biomedical Engineering, 2017, 34(1): 48-52. doi: 10.7507/1001-5515.201604055 Copy

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2.	Roediger M, Gersdorff N, Huels A, et al. Prospective evaluation of zirconia posterior fixed partial dentures: Four-Year clinical results. International Journal of Prosthodontics, 2010, 23(2): 141-148.
3.	Schiey J S, Heussen N, Reich S, et al. Survival probability of zirconia-based fixed dental prostheses up to 5 yr: a systematic review of the literature. Eur J Oral Sci, 2010, 118(5): 443-450.
4.	Fasbinder D J, Dennison J B, Heys D, et al. A clinical evaluation of chairside Lithium disilicate CAD/CAM crowns A two-year report. Journal of the American Dental Association, 2010, 141(S): 10S-14S.
5.	Guess P C, Zavanelli R A, Silva N R, et al. Monolithic CAD/CAM Lithium disilicate versus veneered Y-TZP crowns: comparison of failure modes and reliability after fatigue. International Journal of Prosthodontics, 2010, 23(5): 434-442.
6.	Schmitter M, Mueller D, Rues S. Chipping behaviour of all-ceramic crowns with zirconia framework and CAD/CAM manufactured veneer. J Dent, 2012, 40(2): 154-162.
7.	Lee J, Wang Y, Lloyd I K, et al. Joining veneers to ceramic cores and dentition with adhesive interlayers. J Dent Res, 2007, 86(8): 745-748.
8.	Pozzi A, Tallarico M, Barlattani A. Monolithic Lithium disilicate Full-Contour crowns bonded on CAD/CAM zirconia Complete-Arch implant bridges with 3 to 5 years of Follow-Up. Journal of Oral Implantology, 2015, 41(4): 450-458.
9.	Cooper L F, Stanford C, Feine J, et al. Prospective assessment of CAD/CAM zirconia abutment and Lithium disilicatecrown restorations: 2. 4 year results. J Prosthet Dent, 2016, 116(1): 33-39.
10.	Schultheis S, Strub J R, Gerds T A, et al. Monolithic and bi-layer CAD/CAM Lithium-disilicate versus metal-ceramic fixed dental prostheses: Comparison of fracture loads and failure modes after fatigue. Clin Oral Investig, 2013, 17(5): 1407-1413.
11.	Bindl A, Luthy H, Mormann W H. Strength and fracture pattern of monolithic CAD/CAM-generated posterior crowns. Dental Materials, 2006, 22(1): 29-36.
12.	吴艳玲, 鲁成林, 张东升, 等. 下颌第一磨牙全瓷冠三维有限元建模及力学分析. 口腔颌面修复学杂志, 2009, 10(2): 98-100, 94.
13.	Liu Bin, Lu Chenglin, Wu Yanling, et al. The effects of adhesive type and thickness on stress distribution in molars restored with All-Ceramic crowns. Journal of prosthodontics-implant esthetic and reconstructive dentistry, 2011, 20(1): 35-44.
14.	刘斌, 鲁成林, 张修银. 黏接剂厚度对 IPS Empress Ⅱ全瓷冠应力的影响分析. 医用生物力学, 2010, 25(1): 56-62.
15.	Agustin-panadero R, Fons-font A, Luis Roman-rodriguez J, et al. Zirconia versus metal: a preliminary comparative analysis of ceramic veneer behavior. International Journal of Prosthodontics, 2012, 25(3): 294-300.
16.	Aboushelib M N, Wang Hang, Kleverlaan C J. Fatigue behavior of zirconia under different loading conditions. Dental Materials, 2016, 32(7): 915-920.
17.	Shembish F A, Tong Hui, Kaizer M, et al. Fatigue resistance of CAD/CAM resin composite molar crowns. Dental Materials, 2016, 32(4): 499-509.
18.	Dibner A C, Kelly J R. Fatigue strength of bilayered ceramics under cyclic loading as a function of core veneer thickness ratios. J Prosthet Dent, 2016, 115(3): 335-340.
19.	von Steyern P V, Ebbesson S, Holmgren J, et al. Fracture strength of two oxide ceramic crown systems after cyclic pre-loading and thermocycling. J Oral Rehabil, 2006, 33(9): 682-689.
20.	Rekow D, Thompson V P. Near-surface damage-a persistent problem in crowns obtained by computer-aided design and manufacturing. Proceedings of the Institution of Mechanical EngineersJournal of Engineering in Medicine, 2005, 219(4): 233-243.
21.	Jung Y G, Peterson I M, Kim D K, et al. Lifetime-limiting strength degradation from contact fatigue in dental ceramics. J Dent Res, 2000, 79(2): 722-731.

1. Miyazaki T, Hotta Y. CAD/CAM systems available for the fabrication of crown and bridge restorations. Aust Dent J, 2011, 56(1): 97-106.
2. Roediger M, Gersdorff N, Huels A, et al. Prospective evaluation of zirconia posterior fixed partial dentures: Four-Year clinical results. International Journal of Prosthodontics, 2010, 23(2): 141-148.
3. Schiey J S, Heussen N, Reich S, et al. Survival probability of zirconia-based fixed dental prostheses up to 5 yr: a systematic review of the literature. Eur J Oral Sci, 2010, 118(5): 443-450.
4. Fasbinder D J, Dennison J B, Heys D, et al. A clinical evaluation of chairside Lithium disilicate CAD/CAM crowns A two-year report. Journal of the American Dental Association, 2010, 141(S): 10S-14S.
5. Guess P C, Zavanelli R A, Silva N R, et al. Monolithic CAD/CAM Lithium disilicate versus veneered Y-TZP crowns: comparison of failure modes and reliability after fatigue. International Journal of Prosthodontics, 2010, 23(5): 434-442.
6. Schmitter M, Mueller D, Rues S. Chipping behaviour of all-ceramic crowns with zirconia framework and CAD/CAM manufactured veneer. J Dent, 2012, 40(2): 154-162.
7. Lee J, Wang Y, Lloyd I K, et al. Joining veneers to ceramic cores and dentition with adhesive interlayers. J Dent Res, 2007, 86(8): 745-748.
8. Pozzi A, Tallarico M, Barlattani A. Monolithic Lithium disilicate Full-Contour crowns bonded on CAD/CAM zirconia Complete-Arch implant bridges with 3 to 5 years of Follow-Up. Journal of Oral Implantology, 2015, 41(4): 450-458.
9. Cooper L F, Stanford C, Feine J, et al. Prospective assessment of CAD/CAM zirconia abutment and Lithium disilicatecrown restorations: 2. 4 year results. J Prosthet Dent, 2016, 116(1): 33-39.
10. Schultheis S, Strub J R, Gerds T A, et al. Monolithic and bi-layer CAD/CAM Lithium-disilicate versus metal-ceramic fixed dental prostheses: Comparison of fracture loads and failure modes after fatigue. Clin Oral Investig, 2013, 17(5): 1407-1413.
11. Bindl A, Luthy H, Mormann W H. Strength and fracture pattern of monolithic CAD/CAM-generated posterior crowns. Dental Materials, 2006, 22(1): 29-36.
12. 吴艳玲, 鲁成林, 张东升, 等. 下颌第一磨牙全瓷冠三维有限元建模及力学分析. 口腔颌面修复学杂志, 2009, 10(2): 98-100, 94.
13. Liu Bin, Lu Chenglin, Wu Yanling, et al. The effects of adhesive type and thickness on stress distribution in molars restored with All-Ceramic crowns. Journal of prosthodontics-implant esthetic and reconstructive dentistry, 2011, 20(1): 35-44.
14. 刘斌, 鲁成林, 张修银. 黏接剂厚度对 IPS Empress Ⅱ全瓷冠应力的影响分析. 医用生物力学, 2010, 25(1): 56-62.
15. Agustin-panadero R, Fons-font A, Luis Roman-rodriguez J, et al. Zirconia versus metal: a preliminary comparative analysis of ceramic veneer behavior. International Journal of Prosthodontics, 2012, 25(3): 294-300.
16. Aboushelib M N, Wang Hang, Kleverlaan C J. Fatigue behavior of zirconia under different loading conditions. Dental Materials, 2016, 32(7): 915-920.
17. Shembish F A, Tong Hui, Kaizer M, et al. Fatigue resistance of CAD/CAM resin composite molar crowns. Dental Materials, 2016, 32(4): 499-509.
18. Dibner A C, Kelly J R. Fatigue strength of bilayered ceramics under cyclic loading as a function of core veneer thickness ratios. J Prosthet Dent, 2016, 115(3): 335-340.
19. von Steyern P V, Ebbesson S, Holmgren J, et al. Fracture strength of two oxide ceramic crown systems after cyclic pre-loading and thermocycling. J Oral Rehabil, 2006, 33(9): 682-689.
20. Rekow D, Thompson V P. Near-surface damage-a persistent problem in crowns obtained by computer-aided design and manufacturing. Proceedings of the Institution of Mechanical EngineersJournal of Engineering in Medicine, 2005, 219(4): 233-243.
21. Jung Y G, Peterson I M, Kim D K, et al. Lifetime-limiting strength degradation from contact fatigue in dental ceramics. J Dent Res, 2000, 79(2): 722-731.

Journal of Biomedical Engineering

Research on the mechanical differences of machinable lithium disilicate all-ceramic crowns

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