Occlusal veneers and load-bearing capacity of a restored tooth.

Topias Yli-Urpo, Lippo Lassila, Timo Närhi, Pekka Vallittu
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Abstract

Purpose: The aim of this study was to evaluate the influence of restoration bonding and type of preparation on load bearing capacity of a tooth restored with indirect glass ceramic or hybrid ceramic occlusal veneer restoration.

Materials and methods: Occlusal surfaces of extracted human molar teeth were prepared for indirect occlusal veneers with or without circumferential chamfer. The occlusal veneers were milled either from CAD/CAM hybrid ceramic (HC) Cerasmart (GC), or lithium-disilicate glass ceramic (LDGC) IPS e.max CAD (Ivoclar Vivadent) blocks. Finalized veneers were bonded to teeth following manufacturers' instructions or according to the technique for the intended deteriorated bonding using n-hexane wax solution preconditioning on restorations (n=8/group). The ultimate fracture load was recorded, and fracture types were analyzed and classified visually. Statistical analysis was performed using one-way ANOVA.

Results: The highest fracture load was recorded in teeth with bonded LDGC veneer (p≤0.0007). The bonded HC veneers had only marginally higher fracture load compared to non-bonded veneers. In all groups with deteriorated bonding, veneers loosened without tooth fracture whereas in the bonded veneer groups tooth fractures were observed, especially in teeth restored with LDGC material.

Conclusions: Bonded LDGC occlusal veneers have high load bearing capacity which exceeds the fracture resistance of tooth structure. Circumferential chamfer preparation for an occlusal veneer has no influence on fracture load of a restored tooth.

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咬合贴面和修复后牙齿的承重能力。
目的:本研究的目的是评估修复粘接和制备类型对间接玻璃陶瓷或混合陶瓷咬合贴面修复的牙齿承载能力的影响:材料和方法: 将拔出的人类磨牙的咬合面制备成带或不带圆周倒角的间接咬合贴面。咬合贴面由 CAD/CAM 混合陶瓷(HC)Cerasmart(GC)或锂二硅酸盐玻璃陶瓷(LDGC)IPS e.max CAD(Ivoclar Vivadent)块研磨而成。按照生产商的说明,或按照使用正己烷蜡溶液对修复体进行预处理的预定劣化粘接技术,将最终完成的贴面粘接到牙齿上(8 人/组)。记录极限断裂载荷,并对断裂类型进行分析和目测分类。采用单因素方差分析进行统计分析:结果:粘结 LDGC 贴面的牙齿断裂负荷最高(p≤0.0007)。与未粘接的贴面相比,粘接了 HC 贴面的牙齿的折断负荷略高。在所有粘结性变差的组别中,贴面松动而没有牙齿断裂,而在粘结贴面组别中,特别是在使用 LDGC 材料修复的牙齿上,可以观察到牙齿断裂:结论:粘结的 LDGC 咬合贴面具有很高的承载能力,超过了牙齿结构的抗折能力。咬合贴面的环形倒角制备对修复后牙齿的折断负荷没有影响。
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