The effect of cyclic loading on the fracture resistance of 3D-printed and CAD/CAM milled zirconia crowns-an in vitro study

Clin Oral Investig. 2023 Oct;27(10):6125-6133. doi: 10.1007/s00784-023-05229-2. Epub 2023 Aug 24.

Abstract

Objectives: The aim of this study was to evaluate the effect of cyclic mechanical loading on the fracture resistance of 3D-printed zirconia crowns in comparison to milled zirconia crowns.

Materials and methods: Monolithic zirconia crowns (n = 30) were manufactured using subtractive milling (group M) and 3D additive printing (group P). Nine samples of each group were fractured under one-time loading while the other 6 samples were subjected to cyclic loading for 1.2 million cycles before being subjected to one-time loading until fracture. Scanning electron microscope (SEM) fractographic analysis was carried out on fractured fragments of representative samples.

Results: The mean for fracture resistance of group M was 1890 N without cyclic loading and 1642 N after being subjected to cyclic loading, and they were significantly higher than that of group P (1658 N and 1224 N respectively).

Conclusions: The fabrication technique and cyclic loading affect the fracture resistance of zirconia crowns. Although the fracture resistance values for the 3D-printed crowns were lower than those of the milled, still they are higher than the masticatory forces and thus could be considered being clinically acceptable.

Clinical relevance: Concerning fracture resistance, 3D-printed crowns can withstand the masticatory forces for the long term without any cracks or failure.

Keywords: 3D printing; Cyclic loading; Fracture resistance; Zirconia.