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VOLUME 20 , ISSUE 5 ( May, 2019 ) > List of Articles


Evaluation of the Adaptation and Fracture Resistance of Three CAD–CAM Resin Ceramics: An In vitro Study

Nicolas Naffah, Mutlu Özcan, Hsein Bassal

Keywords : Fracture resistance, Internal fit, Lithium disilicate, Resin ceramics

Citation Information : Naffah N, Özcan M, Bassal H. Evaluation of the Adaptation and Fracture Resistance of Three CAD–CAM Resin Ceramics: An In vitro Study. J Contemp Dent Pract 2019; 20 (5):571-576.

DOI: 10.5005/jp-journals-10024-2560

License: CC BY-NC 4.0

Published Online: 00-05-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Aim: The internal fit and resistance to fracture of resin ceramics are to be evaluated compared to that of lithium disilicate as the control group. Materials and methods: Four groups of 20 crowns each (GC Cerasmart, Vita Enamic, Coltène Brilliant Crios, and e.max CAD) were cemented on identical metal dies. Marginal gaps were measured before cementation and load to fracture was applied after cementation, half of each group was thermodynamically aged (3,000 cycles of 5° to 55° immersion followed by 200,000 cycles of 100 N load), finally the crowns were loaded until fracture in a universal testing machine. Statistical package for social sciences (SPSS) package 23 was used for statistical work. Results: Marginal gaps ranged between 68.5 ± 23.8 ìm and 87 ± 29.1 ìm while occlusal gaps ranged from 220.7 ± 33.3 ìm to 275.5 ± 46.5 ìm and were not significantly different between groups. Fracture loads ranged from 633.8 ± 127.3 N to 1596.4 ± 497.7 N with lithium disilicate glass ceramics (LDGCs) and Enamic having higher values than resin nano-ceramics (RNCs). The fracture resistance was more related to material than aging and gap value. Conclusion: The margin adaptation of resin ceramics was comparable to lithium disilicate with no significant difference. Lithium disilicate showed a higher resistance than resin ceramics and there was a higher resistance to fracture for polymer-infiltrated ceramic-network (PICN) than RNCs. Clinical significance: Resin ceramics can have marginal adaptation and fracture resistance within clinical acceptance; therefore, they can be a good chair-side solution achieved in a single appointment session.

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  1. Pradies G, Zarauz C, et al. Clinical evaluation comparing the fit of all-ceramic crowns obtained from silicone and digital intraoral impressions based on wavefront sampling technology. J Dent 2015;43(2):201–208. DOI: 10.1016/j.jdent.2014.12.007.
  2. Vichi A, Louca C, et al. Color related to ceramic and zirconia restorations: a review. Dent Mater 2011;27(1):97–108. DOI: 10.1016/
  3. van den Breemer CR, Vinkenborg C, et al. The Clinical Performance of Monolithic Lithium Disilicate Posterior Restorations After 5, 10, and 15 Years: A Retrospective Case Series. Int J Prosthodont 2017;30(1):62–65. DOI: 10.11607/ijp.4997.
  4. Mainjot AK, Dupont NM, et al. From Artisanal to CAD–CAM Blocks: State of the Art of Indirect Composites. J Dent Res 2016;95(5):487–495. DOI: 10.1177/0022034516634286.
  5. Argyrou R, Thompson GA, et al. Edge chipping resistance and flexural strength of polymer infiltrated ceramic network and resin nanoceramic restorative materials. J Prosth Dent 2016;116(3):397–403. DOI: 10.1016/j.prosdent.2016.02.014.
  6. Goujat A, Abouelleil H, et al. Mechanical properties and internal fit of 4 CAD–CAM block materials. J Prosth Dent 2018;119(3):384–389. DOI: 10.1016/j.prosdent.2017.03.001.
  7. El Zhawi H, Kaizer MR, et al. Polymer infiltrated ceramic network structures for resistance to fatigue fracture and wear. Dent Mater 2016;32(11):1352–1361. DOI: 10.1016/
  8. Bottino MA, Campos F, et al. Inlays made from a hybrid material: adaptation and bond strengths. Oper Dent 2015;40(3):E83–E91. DOI: 10.2341/13-343-L.
  9. Zhao K, Wei YR, et al. Influence of veneer and cyclic loading on failure behavior of lithium disilicate glass-ceramic molar crowns. Dent Mater 2014;30(2):164–171. DOI: 10.1016/
  10. Rahme HY, Tehini GE, et al. In vitro evaluation of the “replica technique” in the measurement of the fit of Procera crowns. J Contemp Dent Pract 2008;9(2):25–32.
  11. Laurent M, Scheer P, et al. Clinical evaluation of the marginal fit of cast crowns – validation of the silicone replica method. J Oral Rehabil 2008;35(2):116–122. DOI: 10.1111/j.1365-2842.2003.01203.x.
  12. Belli R, Geinzer E, et al. Mechanical fatigue degradation of ceramics versus resin composites for dental restorations. Dent Mater 2014;30(4):424–432. DOI: 10.1016/
  13. Aboushelib MN, de Jager N, et al. Effect of loading method on the fracture mechanics of two layered all-ceramic restorative systems. Dent Mater 2007;23(8):952–959. DOI: 10.1016/j. dental.2006.06.036.
  14. Donnelly TJ, Burke FJ. In vitro failure of crowns produced by two CAD/CAM systems. Eur J Prosthodont Restor Dent 2011;19(3):111–116.
  15. Wang XD, Jian YT, et al. Effect of core ceramic grinding on fracture behaviour of bilayered lithium disilicate glass-ceramic under two loading schemes. J Dent 2014;42(11):1436–1445. DOI: 10.1016/j.jdent.2014.03.014.
  16. Johansson C, Kmet G, et al. Fracture strength of monolithic allceramic crowns made of high translucent yttrium oxide-stabilized zirconium dioxide compared to porcelain-veneered crowns and lithium disilicate crowns. Acta Odontol Scand 2014;72(2):145–153. DOI: 10.3109/00016357.2013.822098.
  17. Dietschi D, Maeder M, et al. In vitro resistance to fracture of porcelain inlays bonded to tooth. Quintessence Int 1990;21(10): 823–831.
  18. Sagsoz O, Yildiz M, et al. In vitro Fracture strength and hardness of different computer-aided design/computer-aided manufacturing inlays. Niger J Clin Pract 2018;21(3):380–387.
  19. Rekow D, Thompson VP. Engineering long term clinical success of advanced ceramic prostheses. J Mater Sci Mater Med 2007;18(1): 47–56. DOI: 10.1007/s10856-006-0661-1.
  20. Liu B, Lu C, et al. The effects of adhesive type and thickness on stress distribution in molars restored with all-ceramic crowns. J Prosthodont 2011;20(1):35–44. DOI: 10.1111/j.1532-849X.2010.00650.x.
  21. Carbajal Mejia JB, Yatani H, et al. Marginal and Internal Fit of CAD/CAM Crowns Fabricated Over Reverse Tapered Preparations. J Prosthodont 2017; (Epub ahead of print). DOI: 10.1111/jopr.12715.
  22. Scherrer SS, de Rijk WG, et al. Effect of cement film thickness on the fracture resistance of a machinable glass-ceramic. Dent Mater 1994;10(3):172–177.
  23. Awada A, Nathanson D. Mechanical properties of resin-ceramic CAD/CAM restorative materials. J Prosthet Dent 2015;114(4):587–593. DOI: 10.1016/j.prosdent.2015.04.016.
  24. Tsitrou EA, Northeast SE, et al. Brittleness index of machinable dental materials and its relation to the marginal chipping factor. J Dent 2007;35(12):897–902. DOI: 10.1016/j.jdent.2007.07.002.
  25. Ayse Gozde T, Metin S, et al. Evaluation of adaptation of ceramic inlays using optical coherence tomography and replica technique. Braz Oral Res 2018;32:e005. DOI: 10.1590/1807-3107BOR-2018.vol32.0005.
  26. Al-Akhali M, Chaar MS, et al. Fracture resistance of ceramic and polymer-based occlusal veneer restorations. J Mech Behav Biomed Mater 2017;74:245–250. DOI: 10.1016/j.jmbbm.2017.06.013.
  27. Eldafrawy M, Ebroin MG, et al. Bonding to CAD–CAM Composites: An Interfacial Fracture Toughness Approach. J Dent Res 2018;97(1):60–67. DOI: 10.1177/0022034517728714.
  28. Sagsoz NP, Yanikoglu N. Evaluation of the fracture resistance of computer-aided design/computer-aided manufacturing monolithic crowns prepared in different cement thicknesses. Niger J Clin Pract 2018;21(4):417–422. DOI: 10.4103/njcp.njcp_137_17.
  29. Sonmez N, Gultekin P, et al. Evaluation of five CAD/CAM materials by microstructural characterization and mechanical tests: a comparative in vitro study. BMC Oral Health 2018;18(1):5. DOI: 10.1186/s12903-017- 0458-2.
  30. Wendler M, Belli R, et al. Chairside CAD/CAM materials. Part 3: Cyclic fatigue parameters and lifetime predictions. Dent Mater 2018;34(6): 910–921. DOI: 10.1016/
  31. Stawarczyk B, Liebermann A, et al. Evaluation of mechanical and optical behavior of current esthetic dental restorative CAD/CAM composites. J Mech Behav Biomed Mater 2015;55:1–11. DOI: 10.1016/j.jmbbm.2015.10.004.
  32. Albero A, Pascual A, et al. Comparative characterization of a novel CAD–CAM polymer-infiltrated-ceramic-network. J Clin Exp Dent 2015;7(4):e495–e500. DOI: 10.4317/jced.52521.
  33. Ehlers V, Kampf G, et al. Effect of thermocycling with or without 1 year of water storage on retentive strengths of luting cements for zirconia crowns. J Prosthet Dent 2015;113(6):609–615. DOI: 10.1016/j.prosdent.2014.12.001.
  34. Aboushelib MN, Elsafi MH. Survival of resin infiltrated ceramics under influence of fatigue. Dent Mater 2016;32(4):529–534. DOI: 10.1016/
  35. Shim JS, Lee JS, et al. Effect of software version and parameter settings on the marginal and internal adaptation of crowns fabricated with the CAD/CAM system. J Appl Oral Sci 2015;23(5):515–522. DOI: 10.1590/1678-775720150081.
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