Fracture load of CAD/CAM-fabricated and 3D-printed composite crowns as a function of material thickness

OBJECTIVES: Indirect CAD/CAM restorations can be fabricated using both subtractive and additive CAD/CAM technology. This study investigated the fracture load of crowns fabricated from three particle-filled composite CAD/CAM materials and one 3D-printed composite material. MATERIALS AND METHODS: Lava Ultimate, Cerasmart and Brilliant Crios were used as particle-filled composite CAD/CAM material and els-3D Harz as 3D-printed composite material. For each group, crowns with three different material thicknesses (0.5/1.0/1.5 mm) were fabricated. Control group was composed of ceramic-based CAD/CAM materials e.max CAD and Enamic. Totally, n = 180 crowns were fabricated and adhesively seated on SLA fabricated dies. Thermomechanical loading and fracture testing were performed. The data for fracture loading force were statistically analyzed by two-way ANOVA followed with multiple comparisons by post hoc Tukey's test (α = 0.05). RESULTS: In contrast to ceramics, all particle-filled composite crowns with 0.5-mm thickness survived fatigue testing. Forces varied statistically significantly. Brilliant Crios showed highest maximum loading force with 1580.4 ± 521.0 N (1.5 mm). Two-way ANOVA indicated that both the material and the thickness affected the fracture load (p < 0.05). CONCLUSIONS: Particle-filled composite resin CAD/CAM materials may have advantageous material characteristics compared to ceramic CAD/CAM materials for minimal restoration thicknesses. CLINICAL RELEVANCE: Composite-based CAD/CAM materials may offer new possibilities in minimally invasive restorative treatment concepts