Abstract
Purpose Under thin, partial coverage restoration the proper cement thickness to be clinically employed still remains an issue. The aim of this study was to determine the failure and success rates of simplified lithium disilicate occlusal veneers as a function of cement thickness. The null hypothesis was that cement thickness has no effect on the fatigue resistance.Methods Sound human molars were severed in a plane parallel to the occlusal surface to create a flat dentin surface surrounded by enamel edges. Forty-five occlusal veneers 1.0 mm thick (IPS e.max CAD LT) were luted to the teeth with Multilink Automix resin cement, creating 3 experimental groups (n=15) with cement thicknesses of 50, 100, and 200 µm. The restorations were fatigue-cycled using a ball mill machine containing zirconia and stainless steel spheres. Twelve 60 min cycles were performed. Survival statistics were applied to "failure" and "success" events, comparing the three groups using a log-rank Mantel-Cox test and a log-rank test for trends (alpha = 0.05).Results The failure and success rates were not significantly influenced by cement thickness (P = 0.137 and P = 0.872, respectively); thus, the null hypothesis was accepted. However, when log-rank test for trends was applied to failure events, the tendency to have less failures with increasing thicknesses was found statistically significant (P = 0.047).Conclusions The cement thickness within the range adopted here did not have a significant effect on the failure or success rate of lithium disilicate occlusal veneers when exposed to randomized impact stresses generating fatigue phenomena.
Highlights
Posterior teeth wear is often associated with a reduction in the vertical dimension of occlusion, which is responsible for occlusal instability, temporo-mandibular joint diseases, increased dental sensitivity, altered intermaxillary relationship, and aesthetic impairments.[1,2,3,4,5,6,7] Improved adhesive techniques have pushed clinical practice towards more conservative restoration designs for the treatment of occlusally abraded and worn-out teeth
The cement thickness within the range adopted here did not have a significant effect on the failure or success rate of lithium disilicate occlusal veneers when exposed to randomized impact stresses generating fatigue phenomena
We investigated the fatigue resistance of lithium disilicate flat-model occlusal veneers as a function of luting cement thickness by means of impact testing with the novel ball mill machine
Summary
Posterior teeth wear is often associated with a reduction in the vertical dimension of occlusion, which is responsible for occlusal instability, temporo-mandibular joint diseases, increased dental sensitivity, altered intermaxillary relationship, and aesthetic impairments.[1,2,3,4,5,6,7] Improved adhesive techniques have pushed clinical practice towards more conservative restoration designs for the treatment of occlusally abraded and worn-out teeth. Several studies have reported encouraging clinical outcomes for thin, adhesively luted glass-ceramic partial crowns, with a survival rate on the order of 92–97% for different ceramic inlay and onlay restorations. Kaytan et al.[13] reported that only the marginal adaptation criteria of ceramic onlay restorations significantly differed over a 24-month
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