Maxillary Left Incisor Research Articles

Finite element analysis of Neanderthal and early Homo sapiens maxillary central incisor

Neanderthal anterior teeth are very large and have a distinctive morphology characterized by robust ‘shovel-shaped’ crowns. These features are frequently seen as adaptive responses in dissipating heavy mechanical loads resulting from masticatory and non-masticatory activities. Although the long-standing debate surrounding this hypothesis has played a central role in paleoanthropology, is still unclear if Neanderthal anterior teeth can resist high mechanical loads or not. A novel way to answer this question is to use a multidisciplinary approach that considers together tooth architecture, dental wear and jaw movements. The aim of this study is to functionally reposition the teeth of Le Moustier 1 (a Neanderthal adolescent) and Qafzeh 9 (an early Homo sapiens adolescent) derived from wear facet mapping, occlusal fingerprint analysis and physical dental restoration methods. The restored dental arches are then used to perform finite element analysis on the left central maxillary incisor during edge-to-edge occlusion. The results show stress distribution differences between Le Moustier 1 and Qafzeh 9, with the former displaying higher tensile stress in enamel around the lingual fossa but lower concentration of stress in the lingual aspect of the root surface. These results seem to suggest that the presence of labial convexity, lingual tubercle and of a large root surface in Le Moustier 1 incisor helps in dissipating mechanical stress. The absence of these dental features in Qafzeh 9 is compensated by the presence of a thicker enamel, which helps in reducing the stress in the tooth crown.

Dental prosthetic rehabilitation of a patient with parafunctional habit: A case study

Introduction: Parafunctional habits such as clenching, grinding, gnashing of the teeth leave multiple consequences on the natural dentition if left untreated. Purpose: The purpose of this study is to represent a patient treated prosthetically with parafunctional habit of clenching his teeth. Material and methods: For the purpose of this study a 42 year old patient was analyzed, treated and rehabilitated with metal ceramic anterior dental bridge. He was treated with a dental splint before beginning of the treatment. His left central maxillary incisor, left maxillary lateral incisor, and left canine were treated endodontically, and then restaurated with posts and cores. After that a dental frontal aesthetic bridge was manufactured. Because the patient has a habit to clench his teeth, he needs to be monitored so that he does not damage the anterior bridge, which is the reason why a dental splint was designed for protecting the patient. Results and Discussion: Patients with parafunctional habits represent a highly challenging group for treatment. Authors worldwide have tried to find optimal solutions on how to help patients with different parafunctional habits and how to prevent them in the future. In this case study the patient was successfully treated and rehabilitated. Conclusion: The consequences that parafunctional habits can leave on the dentition can be observed, and dental prosthetic treatment can create functional – aesthetic solution that needs to be preserved.

A case report on “ODONTOMA” a riddle from time to time

Odontomas are relatively asymptomatic odontogenic hamartomatous malformations, commonly in association with impacted or retained primary teeth. They appear as small, solitary or multi-layered radio-opaque lesions which often interfere with tooth eruption. These are diagnosed during routine dental examinations. This case report describes the case of a compound odontoma in a 10-year-old girl associated with an impacted permanent left maxillary incisor. A surgical excision was performed and a histopathological examination revealed a compound odontoma.

Influence of individual education and training on quality of color matching in dentistry.

To evaluate the influence of the group and individual education of students on shade matching quality. Secondary study objective included a survey-assessment of quality and difficulty level of color matching. Forty dental student participants in Integrated Academic Studies of Dentistry at the Faculty of Medicine, University of Niš (26 female, 14 male) 21-25 years old, signed consent to voluntarily participate in the research. The Ethics Committee of the Clinic of Dentistry, Faculty of Medicine, University of Niš, approved the study under number 14/11-2019-2EO. They were randomly divided into two groups (n = 20), experimental (IE, individual education) and control (GE, group education). Each group was divided into four subgroups (n = 5). The study was performed in three phases. In Phase I (I) and III (III), students matched the shade of the maxillary central left incisor (#9) using three different shade guides. Each of the students served as a "patient" for shade matching, while the other members of the subgroup, individually (VMI ) and as a team (VMT ), visually matched the tooth shade. In Phase II (between phases I and III), group IE received standard group and individual education and training, while group GE had only group education. Shade matching results in before and after education were compared with results obtained by an intraoral spectrophotometer. CIELAB (∆E*), and CIDE2000 color differences (∆E00 ) were calculated. The color differences between VMI or VMT and ES readings were graded. In addition, the students rated the level of difficulty and quality of shade matching from 1 to 5, signifying the most to least difficult, and the worst to best match, respectively. Means and standard deviations were calculated. Differences were compared using the Student t-test. Means (s.d.) of CIEDE2000 color differences for VMI before and after IE were 4.5 (1.5) and 3.3 (0.9), respectively. Corresponding values for group GE were 4.4 (1.4) and 4.0 (1.0), respectively. As compared with GE, group IE achieved 15% better results for the best matches and 27.5% for one of the three best matches in by-point comparison. Mean (s.d.) results for VMT in the experimental group before and after IE were 3.6 (2.4) and 2.8 (1.6), respectively. Corresponding results for the control group were 4.4 (2.1) and 3.5 (1.7), respectively. Group IE had statistically higher VMI and VMT scores than GE, while, for GE, only VMT scores were statistically higher. Group IE achieved better results in by-point comparison. After education and training, the students rated the shade matching as more precise and less difficult. Results were significantly better for Quality (IE) (sig = 0.010) and Difficulty (GE) (sig = 0.021). Within the limitations of the study, the experimental group achieved significantly better results in individual color matching after education and training than the control group, while both groups made progress in team color matching. Both groups rated shade matching more accurate and easier after education. Improving the quality of shade matching is expected to enhance the esthetics of dental restorations, increase patient satisfaction, and reduce color corrections.

Clinical Approach of Extensive Periapical Lesion with Periradicular Regenerative Surgery: A Case Report with 7 Year Follow Up

The aim of this study is to report a case of two maxillary incisors with chronic apical abscess and through-and-through lesion submitted to periradicular regenerative surgery, with clinical follow-ups and evaluation through cone-beam computerized tomography for 7 years. In the presentation, there was a persistent sinus tract in the palate and sensibility to touch at the apical region of the central and left lateral maxillary incisors. The initial tomography revealed the presence of an extensive radiolucent area in the apical third of the referred teeth, with loss of the buccal and palatal cortic es. For the treatment, a periradicular regenerative surgery was performed, an association of endodontic surgery with Guided Tissue Regeneration technique, using bovine bone xenograft and bioabsorbable membrane. The clinical and radiographic evaluations, including cone-beam computerized tomography, at seven years postoperatively, showed absence of symptomatology and sinus tract, probing depth within normal standards and apical bone neoformation.

A MAXILLARY LESION WITH A RARE DIAGNOSIS; A CASE REPORT OF EWING SARCOMA

Objectives Primary Ewing sarcoma of the head and neck is rare, representing only 3% of all Ewing sarcoma cases. The aim is to present a rare case of maxillary location of a Ewing sarcoma. Case report A 23-year-old male patient presented with a chief complaint of upper lip swelling attributed to a cystic lesion in the apical area left lateral maxillary incisor. Imaging showed an apical lesion of this tooth, indicating a broad osteolytic location. The lesion was removed, and a sample was taken for biopsy. The immunohistochemical findings agreed with a malignant bone tumor that exhibits features more compatible with the diagnosis of Ewing’s Sarcoma. The patient underwent chemotherapy and radiotherapy. No signs of recurrence can be seen five years after treatment. Conclusions Most of the few published cases of primary Ewing sarcoma of the maxillary have been diagnosed as cystic lesions. Early diagnosis of head and neck Ewing sarcoma is essential for operating R0 surgeries that may not require radiotherapy. Each case's severity and needs should be evaluated to select the appropriate treatment regimen.

Does α-lipoic acid therapeutically effective against experimentally induced-acute pulpitis in rats?

The purpose of the study was to investigate the therapeutic effects of α-lipoic acid (ALA) on an induced-acute pulpitis model in rats. Twenty-four Wistar albino rats were randomly divided into three groups: control, induced-acute pulpitis (PULP) and PULP+ALA groups. In the PULP and PULP+ALA groups, the crowns of the maxillary left incisors were removed horizontally. All exposed pulp tissues were treated with 5µL LPS solution. In the PULP+ALA group, the rats were treated intraperitoneally with a single dose of ALA (100mg/kg). The rats were sacrificed 24h after pulp injury, and the trunk blood and pulp samples were collected and then determined using ELISA assay kits. TNF-α, IL-1β, MMP-1 and MMP-2levels in the serum and pulp tissues were considerably higher in the PULP group than the control group (p<0.01-0.001). In the PULP+ALA group, TNF-α, IL-1β, MMP-1 and MMP-2levels in the serum and pulp tissues decreased significantly compared to the PULP group (p<0.05-0.001). ALA decreases pro-inflammatory mediators and proteolytic enzymes, which might relieve acute inflammation.

Endodontic management of thin and double-curved root of maxillary lateral incisor

The present case report discusses the endodontic management of maxillary lateral incisor with very thin and double-curved root, also known as bayonet-shaped root. A young healthy male patient presented with acute pain in the left maxillary incisor. Clinical examination and radiographic analysis confirmed the diagnosis of previously treated pulp and symptomatic apical periodontitis. Endodontic treatment was carried out with hand and rotary instruments, and the canal was filled using lateral compaction technique. Six-month radiographic follow-up showed good signs of periapical healing. Technique to prepare and obturate such thin and double-curved root requires preoperative measurement of canal curvature angles with creation of glide path to the apex to maintain the taper of the canal and to avoid mishaps.

RADT-43. TREATMENT OF RETROPERITONEAL LEIOMYOSARCOMA BRAIN METASTASES WITH STEREOTACTIC RADIOSURGERY

Abstract INTRODUCTION Retroperitoneal leiomyosarcoma is a relatively rare disease, with infrequent metastatic spread to the CNS. We present the first report of radiosurgical treatment of this disease. METHODS A 49-year-old woman developed leiomyosarcoma of the inferior vena cava and retroperitoneum with lung metastases on diagnosis. Following multiple courses of systemic and operative treatment, she developed a tender ulcerating mass in the left upper maxillary incisor associated with numbness along the upper gum, lip, and premaxillary area. CT revealed a 3.0 cm left posterior alveolar ridge gum lesion with bone invasion, for which she elected to undergo palliative radiation therapy (30 Gy in 10 fractions). Due to potential maxillary nerve involvement altering the intended radiation therapy treatment fields, an orbit/face MRI was performed to better delineate the lesion. On this MRI, two frontal lobe lesions were visualized; subsequent dedicated brain MRI revealed a total of five metastases (0.9 cm right superior frontal gyrus, 0.9 cm left middle frontal gyrus, 0.9 cm right postcentral gyrus, 0.7 cm right occipital, and 1.6 cm left occipital). Consequently, the decision was made to treat the brain metastases with linear accelerator (LINAC) stereotactic radiosurgery (SRS) to allow simultaneous treatment of the maxillary lesion and brain metastases. RESULTS A single CT simulation was performed for her intracranial and extracranial disease, using the Encompass face mask to allow for simultaneous head immobilization and optimal SRS targeting accuracy. LINAC SRS was delivered simultaneously during maxillary lesion radiation therapy to all five lesions (22 Gy to the 80% isodose line) in a single fraction with a 0.2 cm planning target volume (PTV) margin for each lesion. CONCLUSIONS The first reported case of metastatic retroperitoneal leiomyosarcoma brain metastases treated with SRS demonstrates the flexibility of LINAC (rather than Gamma Knife) SRS in allowing for simultaneous treatment of intracranial and extracranial metastatic disease.

Unique Presentation of “U Shaped” Impacted maxillary Central Incisor with Surgical and Pedodontic perspectives: A Case report

Background Dilaceration, a developmental disturbance, is thought to be due to trauma leading to change in the position of the calcified portion of the tooth and the tooth is formed at an angle. Such an injury to a permanent tooth, resulting in dilacerations, often follows traumatic injury to the primary predecessor. A study by Patiletal, on Indian population reported the prevalence of very rare developmental dental anomalies and dilaceration was found to be only about 0.5% in prevalence. Case details A 9 year old male reported to the department of paediatric dentistry with complaint of missing central incisor in maxillary left arch. Radiographic examination revealed impacted maxillary left incisor with very unique and unusual extreme curve in root of same tooth giving it a characteristic U morphology. As the patient reported in mixed dentition stage, both the surgical, prosthodontic and pedodontic perspectives were kept in mind before planning for the treatment. Surgical removal was planned as it was not possible to save and place the tooth in the arch. Although surgical removal was challenging due to extreme curve and highly placed position of tooth, surgical removal was done successfully with roots and crown broken in two sections in spite of proper care during extraction procedure. Edentulous space was replaced with groper’s appliance considering mixed dentition stage of the patient after successful healing as per the pedodontic perspectives. Conclusion U shaped presentation of single rooted tooth is a one of the rarest findings. In children with age of interception, treatment should be planned wisely taking into consideration surgical, prosthodontic and pedodontic perspectives together. Key Words U shaped root, dilaceration, impacted tooth, surgical and pedodontic perspectives

Influence of printing angulation on the surface roughness of additive manufactured clear silicone indices: An in vitro study

Statement of problemVat-polymerization additive manufacturing (AM) technologies can be used to fabricate clear silicone indices for diagnostic trial restorations, interim restorations, and direct composite resin restorations. Different support parameters, including print orientation of the virtual design of the silicone index, need to be determined when a dental device is fabricated with AM. However, the optimal printing angulation for minimal surface texture remains unclear. PurposeThe purpose of this in vitro study was to measure the surface roughness of the AM clear silicone indices manufactured by using a vat-polymerization 3D printer with different print orientations. Material and methodsA virtual design of a facial silicone index was obtained, and the standard tessellation language file was exported and used to manufacture all the specimens using a vat-polymerization 3D printer. All the specimens were placed on the build platform with the same parameters, except for the print orientation which was selected as the only manufacturing variable. Therefore, the 5 different groups were 0, 25, 45, 75, and 90 degrees. To minimize variation in the procedure, all the specimens (N=50) were manufactured at the same time in the selected printer at a constant room temperature of 23°C. The printer had been previously calibrated following the manufacturer′s recommendations. Surface roughness was measured in the intaglio of the left central maxillary incisor using an optical profilometer with a magnification of ×20 and an array size of 640×480. Three measurements per specimen were recorded. The Shapiro-Wilk test revealed that the data were normally distributed, and the data were analyzed by using 1-way ANOVA, followed by the post hoc Sidak test (α=.05). ResultsThe 0-degree angulation printing group reported the least mean ±standard deviation surface roughness (0.9 ±0.3 μm), followed by the 90-degree group (3.0 ±0.6 μm), the 75-degree group (12.4 ±1.0 μm), the 25-degree group (13.1 ±0.9 μm), and the 45-degree group (13.5 ±1.0 μm). However, no statistically significant difference was found in the surface roughness between the 25-degree and 45-degree print orientation groups (P=.296). ConclusionsPrint orientation significantly influenced the surface roughness measured on the intaglio of the facial AM silicone indices tested.

ROOT SURFACE TREATMENT USING DIODE LASER IN TOOTH REPLANTATION (EXPERIMENTAL STUDY IN RATS)

INTRODUCTION: Avulsion of teeth radically affects the integrity of the tooth and the supporting tissue, and impairs the natural dentition as a whole; thus, all efforts must be directed to the replantation of traumatically avulsed teeth. However, its success is limited due to the occurrence of external root resorption. The challenge is to follow an effective protocol that reduces the occurrence of root resorption and allow for reestablishment of the natural architecture of the periodontal tissue. Biomodulation provided by low level laser therapy provides a promising tool in managing the inflammatory process and augmentation of the reparative process. OBJECTIVES: Was to evaluate the effect of low-level laser therapy (LLLT) on the healing process of rat teeth replanted after delayed replantation. MATERIALS AND METHODS: Thirty healthy Albino male rats had their maxillary left incisors extracted; According to the root surface treatment before the replantation, the teeth were assigned randomly to two groups (n = 15): G1 (control) – no root surface treatment; G2 (study group)-laser diode treatment on the root surface. The teeth were replanted into their respective sockets after 30 minutes, mimicking the natural timing it would take to replant an avulsed tooth. G2 were treated with LLLT performed on the buccal and palatal mucosa every 48 hours for 15 days. The rats were sacrificed after 15, 30 and 45 days of replantation. The specimens were processed for histological and histomorphometric analysis to determine the average root resorption areas and to evaluate the histological events. RESULTS: Histomorphometric analysis showed that the study group (Laser irradiated group) showed lower areas of root resorption and ankylosis, than in control group (non-irradiated group); with a significant statistical difference (p > 0.05). Histological assessment showed restoration of periodontal ligament attachment and increased vascularity in the study group. CONCLUSIONS: Laser irradiation reduces external root resorption and ankylosis in delayed tooth replantation.

The effect of risedronate on orthodontic tooth movement in ovariectomized rats

ObjectiveThis study aimed to investigate the effect of risedronate on orthodontic tooth movement in ovariectomized rats. MethodsForty-five female Sprague-Dawley rats were divided into three groups. Bilateral ovariectomies were performed on the rats in the ovariectomy and ovariectomy + risedronate groups. Two weeks after ovariectomy, risedronate was administered intraperitoneally every three days in the ovariectomy + risedronate group, while rats in the ovariectomy and sham groups were administered saline until they were sacrificed. One month after ovariectomy, nickel-titanium alloy closed-coil springs were placed between the maxillary left first molar and the maxillary left incisor. On days 3, 7 and 14, five rats from each group were sacrificed. The distance of orthodontic tooth movement was measured by a digital caliper, and slides were obtained for histological analysis. ResultsThe distance of orthodontic tooth movement and the number of tartar-resistant acid phosphatase (TRAP)-positive cells were the highest in the ovariectomy group, followed by those in the ovariectomy + risedronate group, on days 3, 7 and 14. The positive expression levels of receptor activator of nuclear factor-kappa β (RANK) ligand and cathepsin K were the strongest while the positive expression of osteoprotegerin in the ovariectomy group was the weakest, followed by the corresponding expression levels in the ovariectomy + risedronate group, on days 3, 7 and 14. ConclusionsRisedronate can inhibit orthodontic tooth movement in ovariectomized rats and may function by regulating the RANK/RANK ligand/osteoprotegerin pathway.

Remote Corticotomy Accelerates Orthodontic Tooth Movement in a Rat Model.

Introduction With an increasing demand for orthodontic treatment for adult patients, orthodontic professionals are constantly seeking novel strategies and technologies that can accelerate tooth movement in order to shorten the treatment period. For instance, in recent years, the influences of different surgical techniques on orthodontic tooth movement in the ipsilateral side of surgery were intensively investigated. Here, we attempt to examine if corticotomy could also affect the rate of tooth movement in the contralateral side of the surgery by using a rodent model. Materials and Methods 72 eight-week-old Sprague-Dawley rats were randomly divided into three groups as follows: the Control group (orthodontic treatment devices delivered only, no tooth movement), the orthodontic tooth movement (OTM) group (orthodontic treatment devices delivered and orthodontic treatment performed), and the Corticotomy + OTM group (remote corticotomy performed, orthodontic treatment devices delivered, followed by orthodontic treatment). The surgical procedure was conducted on the right side of the maxilla at the time of appliance placement and a force of 60 g was applied between the maxillary left first molar and maxillary incisors using nickel-titanium springs to stimulate OTM. The OTM distance and speed were tracked at 3, 7, 14, and 28 days post-surgery, followed by histological and immunohistochemical assessments. Results In comparison with orthodontic treatment only, the contralateral corticotomy significantly accelerated OTM. Furthermore, animals undergoing corticotomy + OTM presented with a greater number of osteoclasts on the compression side, stronger staining of the osteogenic marker on the tension side, and higher expression of an inflammatory marker than the OTM group animals. Conclusion Our current study demonstrates that remote corticotomy effectively accelerates alveolar bone remodeling and OTM. The study enriches our understanding of the regional acceleratory phenomenon (RAP) and offers an alternative strategy for accelerating OTM to shorten the orthodontic treatment period.

Root canal treatments and crown lengthening in an adult jaguar (Panthera onca)

Pathological dental conditions in zoo animals are frequently encountered, although under-reported in the veterinary literature. Teeth fractures are commonly encountered in carnivores and often require specialised endodontic intervention. This paper...

The Two Brothers: an enlightening study of ancient Egyptian teeth.

The 'Two Brothers', two 4,000-year-old Egyptian mummies, were discovered buried alongside each other in an ancient Egyptian tomb in 1907, and were later relocated to the Manchester Museum. The hieroglyphic inscriptions on the coffins indicate that the mummies, Nakht-Ankh and Khnum-Nakht, were brothers but when the mummies were unwrapped and investigated in 1908, the skeletal morphologies were found to be quite different, suggesting an absence of family relationship. In 2017, their teeth were re-examined and, similar to most ancient Egyptian teeth, they display evidence of excessive tooth wear but there is little indication of carious lesions. Khnum-Nakht presents the rare developmental disorder of fusion of the left maxillary incisor and gemination of the right incisor, probably the earliest recorded instance of this irregularity. Analysis of the DNA from their molar teeth has been able to shed some light on the longstanding question of the kinship of the Two Brothers.

PECULIARITIES OF TEETH SIZE IN ADOLESCENTS WHO ARE DIAGNOSED TO HAVE ANGLE’S CLASS I MALOCCLUSION AND DISPLAY DIFFERENT SOMATOTYPES

Introduction: The issues on identifying criteria for teeth aesthetic and teeth size evaluation regarding body constitutional characteristics are still remaining undeveloped. The aim of this study was to specify the peculiarities of teeth size in adolescents who were diagnosed with Angle's Class I malocclusion and display different somatotypes. Materials and methods: The study included 63 male and 66 female subjects diagnosed with Class I malocclusion by E. Angle classification (1906). Results: It has been determined that the 33rd tooth in hypersthenic female individuals is of a greater mesiodistal size than in normosthenic and asthenic body types (p <0.05). Left maxillary incisor in hypersthenic individuals is of a larger size than in asthenic and normosthenic (p <0,05). The normosthenic male individuals have been found out to have significantly larger size of all canines than that in the females (p <0,05). The asthenic male adolescents compared with females of the same somatotype there has been revealed the difference in the size of the left mandibular canine (p <0.05). The hypersthenic male adolescents demonstrate an increase in the size of the lateral maxillary incisors and the first right premolar (p <0,05) compared with those in female individuals of the same somatotype. Conclusions: Some peculiarities of mesiodistal size typical for adolescents with Angle's Class I malocclusion and their somatotypes should be taken into account in treatment planning and maintaining the stability of orthodontic treatment results.

Multidisciplinary approach to the treatment of a complicated crown-root fracture

Complicated crown-root fractures are uncommon type of dental trauma but usually result in significant esthetic and functional problems to those affected. This case report demonstrates sequential endodontic, restorative, orthodontic, periodontal, and prosthodontic modalities for the conservative management of a complicated crown-root fracture of the maxillary left central incisor in a young patient. After root canal treatment and core buildup, the tooth was extruded using forced orthodontic eruption for 8 weeks and retention for 7 weeks. Zinc phosphate cement acrylic crown was used to preserve esthetics and function during the forced eruption and retention period.

A combined management of a rare case of a maxillary lateral incisor with accessory root and deep mesio-radicular groove

This case report describes the combined nonsurgical endodontic retreatment and surgical intervention of a failed root canal treatment associated with a maxillary lateral incisor with an accessory root and deep mesio-radicular groove. A 42-year-old female Malay patient presented with persistent infection associated with deep mesial pocket from her maxillary left lateral incisor (#22). The medical history was noncontributory and the tooth was previously root treated. Following comprehensive clinical and radiographic examination, a combined nonsurgical endodontic retreatment and surgical management of tooth #22 were carried out. The inability to debride the periodontal defect necessitates the amputation of the accessory root, and surgical debridement of the deep radicular groove was carried out. The clinical and radiographic examination 1 year after completion of treatment revealed evidence of healing. The early recognition of root and canal variation, correct diagnosis, and appropriate management of tooth with accessory root and deep radicular groove is essential to ensure favorable treatment outcome.

Fatigue Failure Load of Lithium Disilicate Restorations Cemented on a Chairside Titanium-Base.

To evaluate the fatigue failure load of distinct lithium disilicate restoration designs cemented on a chairside titanium base for maxillary anterior implant-supported restorations. A left-maxillary incisor restoration was virtually designed and sorted into 3 groups: (n = 10/group; CTD: lithium disilicate crowns cemented on custom-milled titanium abutments; VMLD: monolithic full-contour lithium disilicate crowns cemented on a chairside titanium-base; VCLD: lithium disilicate crowns bonded to lithium disilicate customized anatomic structures and then cemented onto a chairside titanium base). The chairside titanium base was air-abraded with aluminum oxide particles. Subsequently, the titanium base was steam-cleaned and air-dried. Then a thin coat of a silane agent was applied. The intaglio surface of the ceramic components was treated with 5% hydrofluoric acid (HF) etching gel, followed by silanization, and bonded with a resin cement. The specimens were fatigued at 20 Hz, starting with a 100 N load (5000× load pulses), followed by stepwise loading from 400 N up to 1400 N (200 N increments) at a maximum of 30,000 cycles each. The failure loads, number of cycles, and fracture analysis were recorded. The data were statistically analyzed using one-way ANOVA, followed by pairwise comparisons (p < 0.05). Kaplan-Meier survival plots and Weibull survival analyses were reported. For catastrophic fatigue failure load and the total number of cycles for failure, VMLD (1260 N, 175,231 cycles) was significantly higher than VCLD (1080 N, 139,965 cycles) and CDT (1000 N, 133,185 cycles). VMLD had a higher Weibull modulus demonstrating greater structural reliability. VMLD had the best fatigue failure resistance when compared with the other two groups.