Fracture Resistance and Failure Mode of Monolithic Zirconia, Veneered Zirconia, and Metal-Ceramic Full-Coverage Restorations: A Comparative In Vitro Study.

Abstract

To evaluate and compare the fracture mode and strength of monolithic zirconia to veneered zirconia and metal-ceramic full-coverage restorations following artificial aging and to test the performance of translucent zirconia in terms of load-bearing capacity. Two mandibular first molars were prepared and scanned for their respective groups of full-coverage restorations. A total of 75 full-coverage restorations were fabricated and divided into five groups: two groups for monolithic zirconia, two groups for veneered zirconia, and one group for metal-ceramic. Then, 75 light-cured hybrid composite resin dies were fabricated to serve as abutments. Before cementation, all full-coverage restorations were subjected to accelerated aging. After cementation, all full-coverage restorations were subjected to compressive loading until fracture in an electromechanical universal testing machine. A two-way nested ANOVA and Tukey test were used to analyze the results with 95% confidence levels. Monolithic zirconia full-coverage restorations showed the highest mean fracture resistance of 4,201.0 N, followed by metalceramic full-coverage restorations of 3,609.3 N, and veneered zirconia full-coverage restorations showed the lowest mean fracture resistance of 2,524.6 N. The main mode of failure was cohesive bulk fracture for the monolithic zirconia group, cohesive/adhesive failure with infrastructure damage for the veneered zirconia group, and cohesive/adhesive failure without infrastructure damage for the metal-ceramic group. Monolithic zirconia full-coverage restorations showed superior resistance to fracture compared to metal-ceramic full-coverage restorations and are highly reliable in terms of load-bearing capacity within the posterior regions of the mouth.