Fracture resistance, failure mode and restorability of CAD CAM Zirconia endocrowns with different pulpal extension depths bonded to maxillary molars: an in-vitro study

Abstract Background Pulpal extension depth (PED) is critical for endocrowns restored teeth stability and longevity. There is a conflicting result regarding the minimum PED needed for the success of endocrowns. The aim of the current study was to compare Fracture resistance, failure mode, and restora...

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Main Authors: Sarah Salah Gaafar, Dana El Ballouli, Mohammad Rayyan, Mohamed Sayed, Doaa Gamal Basta, Maha Fouad
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-05466-9
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author Sarah Salah Gaafar
Dana El Ballouli
Mohammad Rayyan
Mohamed Sayed
Doaa Gamal Basta
Maha Fouad
author_facet Sarah Salah Gaafar
Dana El Ballouli
Mohammad Rayyan
Mohamed Sayed
Doaa Gamal Basta
Maha Fouad
author_sort Sarah Salah Gaafar
collection DOAJ
description Abstract Background Pulpal extension depth (PED) is critical for endocrowns restored teeth stability and longevity. There is a conflicting result regarding the minimum PED needed for the success of endocrowns. The aim of the current study was to compare Fracture resistance, failure mode, and restorability of CAD-CAM zirconia endocrowns with different pulpal extension depths bonded to maxillary molars. Materials and methods Forty maxillary 1st molars were selected, decoronated, and randomly divided into 4 main groups (n = 10) according to the PED measured from the pulpal floor to the occlusal end of the wall height into; group D2, PED was 2 mm, group D3, PED was 3 mm, group D4, PED was 4 mm, group D5 PED was 5 mm. Teeth were prepared and secured in resin dies with pseudo periodontal ligament. Specimens from all groups were individually scanned using an intra oral digital scanner. Monolithic zirconia endocrowns were constructed and bonded to their corresponding. Following thermal cycling, each specimen was axially loaded in a universal testing machine at a 0.5 mm/min crosshead speed. Failure modes were inspected, and restorability of specimens was recorded. Data was collected, tabulated, and statistically analyzed. Results Descriptive statistics displayed higher mean value of the D2 group (3657 1673.8 N) followed by the D3 group (3009.3 853.5 N), then the D4 group (2087.3 413.9 N) and finally the D5 group (1972.7 ±330.4 N). At a 95% confidence level, one-way analysis of variance (ANOVA) revealed significant differences between tested groups. (P = 0.014). Regarding failure mode, D2 recorded 100% restorable failures, followed by D3 (90%) and D4 (60%), while the least was D5 (50%). Conclusions Endocrowns with 2 mm PED recorded the highest fracture resistance and the highest restorable failure modes. Endocrowns with 5 mm PED recorded the lowest fracture resistance and the lowest restorable failure modes. Tall walls should be shortened during the preparation of endocrowns in maxillary molars.
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spelling doaj-art-e97cd7b2f2d54bc9968fdafd38fa0de82025-02-02T12:45:15ZengBMCBMC Oral Health1472-68312025-02-0125111110.1186/s12903-025-05466-9Fracture resistance, failure mode and restorability of CAD CAM Zirconia endocrowns with different pulpal extension depths bonded to maxillary molars: an in-vitro studySarah Salah Gaafar0Dana El Ballouli1Mohammad Rayyan2Mohamed Sayed3Doaa Gamal Basta4Maha Fouad5Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloum UniversityDepartment of Prosthodontics, Dr. Sulaiman Al-Habib Medical GroupDepartment of Fixed Prosthodontics, Faculty of Oral and Dental Medicine, Nahda UniversityDepartment of Fixed Prosthodontics, Faculty of Dentistry, Ahram Canadian UniversityDepartment of Endodontics, Faculty of Dentistry, Sinai UniversityDepartment of Fixed Prosthodontics, Faculty of Dentistry, Galala UniversityAbstract Background Pulpal extension depth (PED) is critical for endocrowns restored teeth stability and longevity. There is a conflicting result regarding the minimum PED needed for the success of endocrowns. The aim of the current study was to compare Fracture resistance, failure mode, and restorability of CAD-CAM zirconia endocrowns with different pulpal extension depths bonded to maxillary molars. Materials and methods Forty maxillary 1st molars were selected, decoronated, and randomly divided into 4 main groups (n = 10) according to the PED measured from the pulpal floor to the occlusal end of the wall height into; group D2, PED was 2 mm, group D3, PED was 3 mm, group D4, PED was 4 mm, group D5 PED was 5 mm. Teeth were prepared and secured in resin dies with pseudo periodontal ligament. Specimens from all groups were individually scanned using an intra oral digital scanner. Monolithic zirconia endocrowns were constructed and bonded to their corresponding. Following thermal cycling, each specimen was axially loaded in a universal testing machine at a 0.5 mm/min crosshead speed. Failure modes were inspected, and restorability of specimens was recorded. Data was collected, tabulated, and statistically analyzed. Results Descriptive statistics displayed higher mean value of the D2 group (3657 1673.8 N) followed by the D3 group (3009.3 853.5 N), then the D4 group (2087.3 413.9 N) and finally the D5 group (1972.7 ±330.4 N). At a 95% confidence level, one-way analysis of variance (ANOVA) revealed significant differences between tested groups. (P = 0.014). Regarding failure mode, D2 recorded 100% restorable failures, followed by D3 (90%) and D4 (60%), while the least was D5 (50%). Conclusions Endocrowns with 2 mm PED recorded the highest fracture resistance and the highest restorable failure modes. Endocrowns with 5 mm PED recorded the lowest fracture resistance and the lowest restorable failure modes. Tall walls should be shortened during the preparation of endocrowns in maxillary molars.https://doi.org/10.1186/s12903-025-05466-9CAD CAMEndocrownsFailure modeFracture resistanceMonolith ZirconiaPulpal extension depth
spellingShingle Sarah Salah Gaafar
Dana El Ballouli
Mohammad Rayyan
Mohamed Sayed
Doaa Gamal Basta
Maha Fouad
Fracture resistance, failure mode and restorability of CAD CAM Zirconia endocrowns with different pulpal extension depths bonded to maxillary molars: an in-vitro study
BMC Oral Health
CAD CAM
Endocrowns
Failure mode
Fracture resistance
Monolith Zirconia
Pulpal extension depth
title Fracture resistance, failure mode and restorability of CAD CAM Zirconia endocrowns with different pulpal extension depths bonded to maxillary molars: an in-vitro study
title_full Fracture resistance, failure mode and restorability of CAD CAM Zirconia endocrowns with different pulpal extension depths bonded to maxillary molars: an in-vitro study
title_fullStr Fracture resistance, failure mode and restorability of CAD CAM Zirconia endocrowns with different pulpal extension depths bonded to maxillary molars: an in-vitro study
title_full_unstemmed Fracture resistance, failure mode and restorability of CAD CAM Zirconia endocrowns with different pulpal extension depths bonded to maxillary molars: an in-vitro study
title_short Fracture resistance, failure mode and restorability of CAD CAM Zirconia endocrowns with different pulpal extension depths bonded to maxillary molars: an in-vitro study
title_sort fracture resistance failure mode and restorability of cad cam zirconia endocrowns with different pulpal extension depths bonded to maxillary molars an in vitro study
topic CAD CAM
Endocrowns
Failure mode
Fracture resistance
Monolith Zirconia
Pulpal extension depth
url https://doi.org/10.1186/s12903-025-05466-9
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