Influence of ceramic thickness and ceramic materials on fracture resistance of posterior partial coverage restorations.

This study evaluated the influence of ceramic thickness and ceramic materials on fracture resistance of posterior partial coverage ceramic restorations. Forty extracted molars were allocated into four groups (n=10) to test for two variables: 1) the thickness of ceramic (1 mm or 2 mm) and 2) the ceramic materials (a lithium disilicate glass-ceramic [IPS e.max] or leucite-reinforced glass ceramic [IPS Empress]). All ceramic restorations were luted with resin cement (Variolink II) on the prepared teeth. These luted specimens were loaded to failure in a universal testing machine, in the compression mode, with a crosshead speed of 1.0 mm/min. The data were analyzed using two-way analysis of variance and the Tukey Honestly Significantly Different multiple comparison test (alpha =0.05). The fracture resistance revealed a significant effect for materials (p<0.001); however, the thickness of ceramic was not significant (p=0.074), and the interaction between the thickness of ceramic and the materials was not significant (p=0.406). Mean (standard deviation) fracture resistance values were as follows: a 2-mm thickness of a lithium disilicate bonded to tooth structure (2505 [401] N) revealed a significantly higher fracture resistance than did a 1-mm thickness of leucite-reinforced (1569 [452] N) and a 2-mm thickness of leucite-reinforced ceramic bonded to tooth structure (1716 [436] N) (p<0.05). There was no significant difference in fracture resistance values between a lithium disilicate ceramic at 1-mm thickness (2105 [567] N) and at 2-mm thickness. Using a lithium disilicate glass ceramic for partial coverage restoration significantly improved fracture resistance compared to using a leucite-reinforced glass ceramic. The thickness of ceramic had no significant effect on fracture resistance when the ceramics were bonded to the underlying tooth structure.