Huayi Dental Laboratory, Taipei, Taiwan; School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Oral Hygiene, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, Taiwan; Research Center of Precision Biomedical Implants, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
J Dent. 2024 Jun;145:105023. doi: 10.1016/j.jdent.2024.105023. Epub 2024 Apr 24.
Multilayer monolithic zirconia (M-Zr) crowns can be engineered to achieve gradational translucency and color intensity. However, this modification may compromise the mechanical strength, raising concerns regarding the ability of M-Zr crowns to withstand occlusal stresses. The effects of M-Zr crown thickness on translucency and ability to endure occlusal forces were investigated at different tooth positions (incisors, premolars, and molars). The objective was to determine the minimal thickness of M-Zr crowns used in tooth preparation to meet aesthetic and functional demands.
M-Zr samples (Vita A1) with four thicknesses (0.5, 1.0, 1.5, and 2.0 mm) were prepared and subjected to translucency testing using a digital colorimeter by 3-third and 9-square division methods. Crown-shaped M-Zr samples with three thicknesses (1.0, 1.5, and 2.0 mm) and three tooth positions (incisor, premolar, and molar) were digitally designed, and 2.0 mm metal abutments were fabricated. The samples were bonded to the abutments; their fracture characteristics were evaluated using a universal testing machine, and their fracture surfaces examined using an optical microscope. Statistical analyses included the Shapiro-Wilk test, Pearson correlation, and one-way and two-way ANOVA with a post hoc Tukey HSD test (α = 0.05).
Color analysis results revealed a significant negative correlation between thickness and translucency (r < -0.96, P < 0.01), with the highest values in the incisal region. Cross-sectional profiles confirmed the uniform thickness and morphology of the digitally designed M-Zr crowns. The results of fracture strength analysis showed position-dependent variability, a strong positive correlation with thickness (r > 0.96, P < 0.01), and fracture strengths consistently exceeding 1200 N across all tooth positions. Fracture patterns indicated that thinner crowns at the incisors and molars were more prone to cracking, whereas those at the premolars demonstrated significantly higher strength (4872.51 N, P < 0.05), only with crack or even no fracture occurring at 2.0 mm.
Thickness significantly influenced both the translucency and fracture strength of M-Zr, with the tooth position playing an additional role, albeit to a lesser extent. Although thinner crowns exhibited lower strength at each tooth position, even at a thickness of 1.0 mm, fracture strength exceeding 1200 N was maintained, surpassing the typical occlusal forces. Thus, it can be asserted that M-Zr crowns with a minimum thickness of 1.0 mm can meet both aesthetic and functional requirements.
多层整体氧化锆(M-Zr)牙冠可以通过工程设计实现渐变的半透明度和颜色强度。然而,这种修饰可能会影响机械强度,引发对 M-Zr 牙冠承受咀嚼力能力的担忧。本研究旨在探讨不同牙位(切牙、前磨牙和磨牙)下 M-Zr 牙冠厚度对透明度和耐咀嚼力的影响,确定用于牙体预备的 M-Zr 牙冠最小厚度,以满足美观和功能需求。
制备厚度分别为 0.5、1.0、1.5 和 2.0mm 的 M-Zr 样本(Vita A1),并采用数字比色仪通过三分法和九分法进行半透明度测试。设计厚度分别为 1.0、1.5 和 2.0mm 的三种牙位(切牙、前磨牙和磨牙)的牙冠形状的 M-Zr 样本,并制作 2.0mm 的金属基台。将样本黏接到基台上,使用万能试验机评估其断裂特征,并使用光学显微镜观察其断裂表面。统计分析包括 Shapiro-Wilk 检验、Pearson 相关分析、单因素和双因素方差分析以及事后 Tukey HSD 检验(α=0.05)。
颜色分析结果显示,厚度与半透明度之间存在显著的负相关关系(r<-0.96,P<0.01),切端区域的半透明度最高。横截面轮廓证实了数字化设计的 M-Zr 牙冠具有均匀的厚度和形态。断裂强度分析结果表明,位置依赖性的变异性与厚度呈强正相关(r>0.96,P<0.01),所有牙位的断裂强度均持续超过 1200N。断裂模式表明,切牙和磨牙的较薄牙冠更容易出现裂纹,而前磨牙的牙冠则表现出显著更高的强度(4872.51N,P<0.05),即使在 2.0mm 时,也仅出现裂纹甚至无断裂。
厚度显著影响 M-Zr 的半透明度和断裂强度,牙位则起到次要作用。尽管每个牙位的较薄牙冠强度较低,但即使厚度为 1.0mm,也能维持超过 1200N 的断裂强度,超过典型的咀嚼力。因此,可以断言,最小厚度为 1.0mm 的 M-Zr 牙冠可以同时满足美观和功能需求。