Effect of different semimonolithic designs on fracture resistance and fracture mode of translucent and high-translucent zirconia crowns

Fahad Bakitian,1,2 Przemek Seweryniak,3 Evaggelia Papia,1 Christel Larsson,1 Per Vult von Steyern1 1Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden; 2Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia; 3Commercial Dental Laboratory, Malmö, Sweden Purpose: The aim of this study was to describe different designs of semimonolithic crowns made of translucent and high-translucent zirconia materials and to evaluate the effect on fracture resistance and fracture mode.Methods: One hundred crowns with different designs were produced and divided into five groups (n=20): monolithic (M), partially veneered monolithic (semimonolithic) with 0.3 mm buccal veneer (SM0.3), semimonolithic with 0.5 mm buccal veneer (SM0.5), semimonolithic with 0.5 mm buccal veneer supported by wave design (SMW), and semimonolithic with 0.5 mm buccal veneer supported by occlusal cap design (SMC). Each group was divided into two subgroups (n=10) according to the materials used, translucent and high-translucent zirconia. All crowns underwent artificial aging before loading until fracture. Fracture mode analysis was performed. Fracture loads and fracture modes were analyzed using two-way ANOVA and Fisher’s exact probability tests (P≤0.05).Results: SM0.3 design showed highest fracture loads with no significant difference compared to M and SMW designs (P>0.05). SM0.5 design showed lower fracture loads compared to SMW and SWC designs. Crowns made of translucent zirconia showed higher fracture loads compared to those made of high-translucent zirconia. M, SM0.3, and all but one of the SMC crowns showed complete fractures with significant differences in fracture mode compared to SMW and SM0.5 crowns with cohesive veneer fractures (P≤0.05).Conclusion: Translucent and high-translucent zirconia crowns might be used in combination with 0.3 mm microcoating porcelain layer with semimonolithic design to enhance the esthetic properties of restorations without significantly decreasing fracture resistance of the crowns. If 0.5 mm porcelain layer is needed for a semimonolithic crown, wave design or cap design might be used to increase fracture resistance. In both cases, fracture resistance gained is likely to be clinically sufficient as the registered fracture loads were high in relation to expected loads under clinical use. Keywords: monolithic zirconia, porcelain veneer, Y-TZ