Effect of cementation techniques on fracture load of monolithic zirconia crowns.

Aim: The aim of this study was to evaluate the effect of cement on the fracture load of monolithic zirconia crowns with different yttria content (3 and 5 mol%).

Methods: A total of 62 monolithic zirconia crowns, 40 3Y-zirconia crowns (Prettau^® Zirconia, Zirkonzahn) and 22 5Y-zirconia crowns (Prettau^® 4 Anterior^®, Zirkonzahn) were produced to a shallow chamfer molar preparation. The 3Y-crowns were divided into four groups and attached to composite abutment duplicates (SDR^® flow+, Dentsply DeTrey GmbH) using the following four cementation techniques; (1) Self-adhesive resin-based cement, (2) Pre-treatment with air-abrasion and self-adhesive resin-based cement, (3) Zinc phosphate cement, (4) Glass-ionomer cement. The 5Y-crowns were divided into two groups and attached to the duplicates with; (1) Self-adhesive resin-based cement, or (2) Air-abrasion pre-treatment and self-adhesive resin-based cement. All crowns were loaded axially (0.5 mm/min) on the occlusal surface until fracture occurred.

Results: Among the 3Y-zirconia groups, the zinc phosphate cement group fractured at lower loads compared to the resin-based cement groups, with and without air-abrasion, (p < .012). Among the 5Y-groups the air-abraded crowns fractured at statistically significant lower loads compared to the untreated crowns (p < .028). Load at fracture values were significantly different between the two zirconia materials (p < .001), with fracture loads ranging from 3873 to 7500 N in the 3Y-groups, and 2100 to 4948 N in the 5Y-groups.

Conclusions: Resin-based cementation increased the fracture load compared to non-adhesive cementation. The 3Y-crowns fractured at almost twice the loads of the 5Y-crowns. Pre-treatment with air abrasion reduced the strength of the 5Y-crowns only, showing the importance of differentiating the treatment of the two materials.