Compressive strength of connectors with different areas in three-unit polychromatic monolithic zirconia fixed partial dentures
DOI:
https://doi.org/10.20453/reh.v36i1.5805Keywords:
fixed partial dental prosthesis, monolithic zirconia, compressive strength, CAD/CAM technologyAbstract
Objective: To compare the compressive strength of connectors with different areas in three-unit fixed partial dentures (FPDs) fabricated from three types of polychromatic monolithic zirconia using CAD/CAM technology. Materials and methods: An in vitro experimental study was conducted with 30 FPD samples fabricated from three brands of polychromatic monolithic zirconia: IPS e.max® ZirCAD MT Multi (Ivoclar Vivadent; Schaan, Liechtenstein), KatanaTM Zirconia Super Translucent Multi Layered (STML) (Noritake Dental Supply; Okayama, Japan), and Ceramill® Zolid fx Multilayer (Amann Girrbach; Koblach, Austria). For each brand, 10 specimens were fabricated and subdivided into two subgroups according to connector area: 9 mm² (n = 5) and 12 mm² (n = 5). The specimens were subjected to compressive strength testing in a universal testing machine (CMT-5L, LG; Anyang, South Korea), applying a vertical load at the center of the pontic until fracture occurred. The obtained data were analyzed using the Kruskal -Wallis and Mann -Whitney U tests. Results: The 12 mm² connectors showed significantly greater compressive strength than the 9 mm² connectors, regardless of the brand used (medians of 1557.76 N [IQR: 425.54 N] vs. 1180.40 N [IQR: 708.32 N]; p = 0.024). KatanaTM Zirconia STML and IPS e.max® ZirCAD MT Multi zirconia achieved higher strength values than Ceramill® Zolid fx Multilayer for both connector sizes (p < 0.05). Conclusions: Connector area significantly influenced the compressive strength of polychromatic monolithic zirconia FPDs. The 12 mm² connectors exhibited greater strength, and KatanaTM Zirconia STML and IPS e.max® ZirCAD MT Multi showed better performance compared with Ceramill® Zolid fx Multilayer. These findings suggest that increasing connector area may favor the clinical longevity of restorations.
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Ambré M, Aschan F, Steyern P. Fracture Strength of Yttria-Stabilized Zirconium-Dioxide (Y-TZP) Fixed Dental Prostheses (FDPs) with different abutment core thicknesses and connector dimensions. J Prosthodont. 2013;22(5):377-82. doi:10.1111/jopr.12003
Anusavice KJ. Standardizing failure, success, and survival decisions in clinical studies of ceramic and metal-ceramic fixed dental prostheses. Dent Mater. 2012;28(1):102-11. doi:10.1016/j.dental.2011.09.012
Pjetursson BE, Sailer I, Makarov NA, et al. All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs) a systematic review of the survival and complication rates. Part II: Multiple-unit FDPs. Dent Mater. 2015;31(6):624-39. doi:10.1016/j.dental.2015.02.013
Heintze S, Monreal D, Reinhardt M, et al. Fatigue resistance of all-ceramic fixed partial dentures - Fatigue test and finite elemente analysis. Dent Mater. 2018;34(3):494-507. doi:10.1016/j.dental.2017.12.005
Choi JW, Kim SY, Bae EB, et al. In vitro study of the fracture resistance of monolithic lithium disilicate, monolithic zirconia, and lithium disilicate pressed on zirconia for three-unit fixed dental prostheses. J Adv Prosthodont. 2017;9(4):244-51. doi:10.4047/jap.2017.9.4.244
Zhang F, Inokoshi M, Batuk M, et al. Strength, toughness and aging stability of highly-translucent Y-TZP ceramics for dental restorations. Dent Mater. 2016;32(12):e327-37. doi:10.1016/j.dental.2016.09.025
Güth JF, Stawarczyk B, Edelhoff D, et al. Zirconia and its novel compositions: What do clinicians need to know? Quintessence Int. 2019;50(7):512-20. doi:10.3290/j.qi.a42653
Hamza TA, Attia MA, Khalil El-Hossary MM. Flexural strength of small connector designs of zirconia-based partial fixe dental prostheses. J Prosthet Dent. 2016;115(2):224-9. doi:10.1016/j.prosdent.2015.06.022
Plengsombut K, Brewer JD, Monaco EA, et al. Effect of two connector designs on the fracture resistance of all-ceramic core materials for fixed dental prostheses. J Prosthet Dent. 2009;101(3):166-73. doi:10.1016/S0022-3913(09)60022-6
Bachhav VC, Aras MA. Zirconia-based fixed partial dentures: a clinical review. Quintessence Int [Internet]. 2011;42(2):173-82. Disponible en: https://www.quintessence-publishing.com/deu/en/article/840363
Stawarczyk B, Keul C, Eichberger M, et al. Three generations of zirconia: from veneered to monolithic. Part I. Quintessence Int. 2017;48(5):369-80. doi:10.3290/j.qi.a38057
Mallat-Callis E, Cadafalch-Cabani J, De Miguel-Figuero J. Las claves de la prótesis fija en cerámica. Valencia: Lisermed Editorial; 2018.
Öztürk C, Çelik E. Influence of heating rate on the flexural strength of monolithic zirconia. J Adv Prosthodont. 2019;11(4):202-8. doi:10.4047/jap.2019.11.4.202
Shahmiri R, Standard OC, Hart JN, et al. Optical properties of zirconia ceramics for esthetic dental restorations: a systematic review. J Prosthet Dent. 2018;119(1):36-46. doi:10.1016/j.prosdent.2017.07.009
Nassary Zadeh P, Lümkemann N, Sener B, et al. Flexural strength, fracture toughness, and translucency of cubic/tetragonal zirconia materials. J Prosthet Dent. 2018;120(6):948-54. doi:10.1016/j.prosdent.2017.12.021
Kongkiatkamon S, Rokaya D, Kengtanyakich S, et al. Current classification of zirconia in dentistry: an updated review. PeerJ. 2023;11:e15669. doi:10.7717/peerj.15669
Bakitian F, Seweryniak P, Papia E, et al. Load-bearing capacity of monolithic zirconia fixed dental prostheses fabricated with different connector designs and embrasure shaping methods. J Prosthodont. 2019;28(1):64-70. doi:10.1111/jopr.13002
Lüthy H, Filser F, Loeffel O, et al. Strength and reliability of four-unit all-ceramic posterior bridges. Dent Mater. 2005;21(10):930-7. doi:10.1016/j.dental.2004.11.012
Larsson C, Holm L, Lovgren N, et al. Fracture strength of four-unit Y-TZP FPD cores designed with varying connector diameter. An in-vitro study. J Oral Rehabil. 2007;34(9):702-9. doi:10.1111/j.1365-2842.2007.01770.x
Oh WS, Anusavice KJ. Effect of connector design on the fracture resistance of all-ceramic fixed partial dentures. J Prosthet Dent. 2002;87(5):536-42. doi:10.1067/mpr.2002.123850
SaranBabu KA, Perisetty DK, Thota G, et al. Influence of radius of curvature at gingival embrasure in connector area on stress distribution of three-unit posterior full-contour monolithic zirconia fixed partial denture on various amounts of load application: a finite element study. J Int Soc Prev Community Dent. 2019;9(4):338-48. doi:10.4103/jispcd.jispcd_20_19
Erdelt K, Engler ML, Beuer F, et al. Computable translucency as a function of thickness in a multi-layered zirconia. J Prosthet Dent. 2019;121(4):683-9. doi:10.1016/j.prosdent.2018.08.013
Ueda K, Güth JF, Erdelt K, et al. Light transmittance by a multi-coloured zirconia material. Dent Mater J. 2015;34(3):310-4. doi:10.4012/dmj.2014-238
Arellano AM, Peñate L, Arregui M, et al. State of the art of different zirconia materials and their indications according to evidence-based clinical performance: a narrative review. Dent J. 2023;11(1):18. doi:10.3390/dj11010018
Subsomboon C, Urapepon S. Effect of connector configuration on the fracture load in conventional and translucent zirconia three-unit fixed dental prostheses. J Adv Prosthodont. 2023;15(4):171-8. doi:10.4047/jap.2023.15.4.171
Kim YJ, Ko KH, Park CJ, et al. Connector design effects on the in vitro fracture resistance of 3-unit monolithic prostheses produced from 4 CAD-CAM materials. J Prosthet Dent. 2022;128(6):1319.e1-10. doi:10.1016/j.prosdent.2022.09.018
Hafezeqoran A, Koodaryan R, Hemmati Y, et al. Effect of connector size and design on the fracture resistance of monolithic zirconia fixed dental prosthesis. J Dent Res Dent Clin Dent Prospects. 2020;14(4):218-22. doi:10.34172/joddd.2020.039
Salimi H, Mosharraf R, Savabi O. Effect of framework design on fracture resistance of zirconium oxide posterior fixed partial dentures. Dent Res J [Internet]. 2012;9(6):764-9. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC3612228/
Studart AR, Filser F, Kocher P, et al. Fatigue of zirconia under cyclic loading in water and its implications for the design of dental bridges. Dent Mater. 2007;23(1):106-14. doi:10.1016/j.dental.2005.12.008
Heidari N, Amawi R, Seweryniak P, et al. Fracture resistance and fracture behaviour of monolithic multi-layered translucent zirconia fixed dental prostheses with different placing strategies of connector: an in vitro study. Clin Cosmet Investig Dent. 2022;14:61-9. doi:10.2147/CCIDE.S344941
Coldea A, Meinen J, Hoffmann M, et al. Shrinkage behavior of strength-gradient multilayered zirconia materials. Materials. 2025;18(14):3217. doi:10.3390/ma18143217
Koc D, Dogan A, Bek B. Bite force and influential factors on bite force measurements: a literature review. Eur J Dent. 2010;4(2):223-32. doi:10.1055/s-0039-1697833
Ferrario VF, Sforza C, Zanotti G, et al. Maximal bite forces in healthy young adults as predicted by surface electromyography. J Dent. 2004;32(6):451-7. doi:10.1016/j.jdent.2004.02.009
Pontevedra P, Lopez-Suarez C, Rodriguez V, et al. Randomized clinical trial comparing monolithic and veneered zirconia three-unit posterior fixed partial dentures in a complete digital flow: three-year follow-up. Clin Oral Investig. 2022;26:4327-35. doi:10.1007/s00784-022-04396-y
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Copyright (c) 2026 Williams Gregory Gomez Pacheco, Adriana Echevarría-Goche, Arturo Kobayashi Shinya, Gustavo Huertas Mogollón
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