Fracture resistance of single-tooth implant-supported zirconia-based indirect composite-layered molar restorations

Objectives: This study evaluated the fracture resistance of single-tooth implant-supported zirconia-based indirect composite-layered molar restorations. Material and methods: Forty-four titanium abutments (GingiHue Post) were placed on dental implants (Osseotite Implant). Standardized single-tooth cement-retained implant-supported mandibular molar restorations were fabricated for each of four test groups (n = 11) as follows: porcelain-fused-to-metal crowns (PFM), zirconia-based all-ceramic crowns (ZAC), zirconia-based indirect composite-layered crowns primed with Estenia Opaque Primer for zirconia frameworks (ZIC-E), and zirconia-based indirect composite-layered crowns (ZIC). The crowns were luted with a glass-ionomer cement (Ketac Cem Easymix). Fracture resistance (N) was determined by force application of a perpendicular load to the crowns with a universal testing machine. One-way analysis of variance (ANOVA) and the Tukey's HSD test were used to assess differences in fracture resistance values (α = 0.05). Results: Mean fracture resistances (SD) were 3.09 (0.22) kN, 3.11 (0.34) kN, 2.84 (0.21) kN, and 2.50 (0.36) kN for the PFM, ZAC, ZIC-E, and ZIC groups, respectively. Fracture resistance in the ZIC specimens was significantly lower (P < 0.044) than that in the other groups, which did not significantly differ. Conclusions: The fracture resistance of single-tooth implant-supported zirconia-based indirect composite-layered molar crowns primed with Estenia Opaque Primer for zirconia frameworks (ZIC-E) is comparable to that of porcelain-fused-to-metal (PFM) and zirconia-based all-ceramic (ZAC) restorations. Application of Estenia Opaque Primer to zirconia ceramic framework provides superior fracture resistance in implant-supported zirconia-based indirect composite-layered molar crowns.