The influence of support properties and complexity on fracture strength and fracture mode of all-ceramic fixed dental prostheses.

Abstract Objective. When a new material is released, clinical studies are indicated. For the clinical studies to be defensible, in-vitro studies, which are as clinically relevant as possible, must be performed. The aim of this study was to investigate how the choice of material used for supporting tooth analogues and support complexity influences test results concerning the fracture strength of fixed dental prostheses (FDPs) made from a brittle material: Y-TZP. Material and methods. Twenty-four FDPs were produced in Y-TZP. The FDP cores were subjected to heat treatment to simulate veneering and then thermocycled for 5000 cycles to simulate ageing. The FDPs were divided into three groups and were cemented on tooth-supporting analogues made from aluminium, polymer and DuraLay( ). The FDPs were preloaded for 10,000 cycles and finally loaded to fracture. Results. There were no significant differences in load to fracture or fracture mode between the groups cemented on polymer and DuraLay tooth analogues. The FDPs cemented on aluminium tooth analogues showed a significantly higher load at fracture and a different fracture mode. Conclusions. Within the limitations of this in-vitro study, the following could be concluded. To achieve mutually comparable results there is a need for a standardized, simple test set-up for in-vitro testing of all-ceramic FDPs intended for cementation upon natural teeth. Resilient, non-complex and resilient, complex tooth analogues give comparable test results when the test set-up is unchanged in all other aspects. Non-resilient (with an elastic modulus equivalent to or higher than that of aluminium) tooth analogues give high and unrealistic load-at-fracture values together with adverse fracture modes compared to FDPs failing in clinical situations.