Fracture Strength of Lithium Disilicate Cantilever Resin Bonded Fixed Dental Prosthesis

Objectives: Metal and Zirconia cantilever resin bonded fixed dental prosthesis (RBFDPs) are extensively used when missing anterior teeth. Lithium disilicate is not used a lot as it is not indicated by the manufacturers. The aim of this in vitro study was to investigate the fracture strength of lithium disilicate cantilever RBFDPs with different configurations and compare them to metal and zirconium RBFDPs.

Methods: Sound extracted human canines (N = 60) were divided into six groups, to be restored with a cantilever RBFDP. Specimen were randomly divided over 6 groups (n = 10): Full crown of lithium disilicate (FCL); Veneer wing of lithium disilicate (VL); Connector of lithium disilicate (CL); Palatal wing of lithium disilicate (PL); Palatal wing of zirconia (PZ) and Palatal wing of metal ceramic (PM). All bridges were bonded with an adhesive system. After thermalcyclic ageing (20 × 10x, 5-55 °C) all samples were loaded until fracture occurred. Failure types were classified and representative SEM done.

Results: The mean fracture strength results per group were: 588N (FCL) 588N (PM), 550N (CL), 534N (PL), 465N (VL), 38N (PZ). A significant (p = 0.001) difference was found between the groups, all groups had a higher fracture strength than the zirconia RBFDPs. Failure type analysis showed some trends among the groups. Irrepairable fractures of the root were only seen in samples restored with lithium disilicate. Metal and zirconia RBFDPs predominantly failed on the adhesive interface, where 60% of the zirconia samples had pretest debondings.

Significance: No differences in fracture strength were found between cantilever RBFDPs made from metal or lithium disilicate. Metal (0% pre-test failures) and zirconium (60% pretest failures) RBFDPs failed predominantly on the adhesive interface whereas the lithium disilicate (0% pre-test failures) samples showed fractures in the contact area. The least invasive connector (CL) and Metal (PM) RBFDP obtained a high fracture strength and optimal fracture pattern.