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PubMedDate not supplied

A 10-year longitudinal study of fixed prosthodontics: clinical characteristics and outcome of single-unit metal-ceramic crowns.

PURPOSE: The purpose of this study was to report on the clinical characteristics and outcome of 688 single-unit metal-ceramic crowns placed in a specialist prosthodontic practice between January 1984 and December 1992. MATERIALS AND METHODS: Clinical and laboratory techniques were standardized and patients were recalled by the author between June and December of 1993. The outcome of all crowns was allocated to one of 6 fields in this assessment period. RESULTS: Clinical review examination by the author covered 87% of the crowns. Of these, 52% had been in service for 5 to 10 years and 48% for less than 5 years but more than 1 year; 67% of the crowns were placed on vital teeth and 94% were given a "good prognosis" rating at examination. The repair and failure rates of crowns in the 5 to 10 years in clinical service group were both 3%. Crowns on nonvital teeth in the same grouping had a significantly greater failure rate (5%) than crowns on vital teeth (1%), and anterior teeth had a significantly greater retreatment rate than posterior teeth. Retreatment for all 25 crowns occurred within 66 months after cementation. Tooth fracture accounted for 56% of retreatments, while caries and loss of retention accounted for only 24% of retreatments; 2% of initially vital teeth were endodontically treated during the survey period. CONCLUSION: Single-unit metal-ceramic crowns have a high expectancy of exceeding 10 years of clinical service when the described clinical and laboratory protocol is applied.

Adult↗
PubMed1998

Adhesive-fixed partial dentures in anterior and posterior areas. Results of an on-going prospective study begun in 1985.

Within the framework of an on-going prospective clinical study begun in 1985, 120 adhesive-fixed partial dentures (AFPD) continued to be examined. The manufacture and the fitting of the AFPDs were carried out following a standard procedure. The preparation technique and the metal framework conditioning (silica-coating, sand-blasting and electrochemical etching) has varied throughout the duration of the study. Using Kaplan-Meier analysis, the survival rate was determined and an analysis of risk with regard to location factors (anterior, posterior; maxilla, mandible), conditioning and preparation techniques (retentive/non-retentive) was determined using the Cox regression model. The location of the AFPD had no influence on the survival rate. The survival time was determined mainly by the preparation technique. Strict preparation of seating grooves and pin holes made a 95% survival rate possible after 10 years (Kaplan-Meier estimation). Without retention, the risk of failure increased by a factor of 3.7.

Adolescent↗
PubMed2004

The milled surface as a precision attachment.

The creation of paralleled, milled surfaces in natural or restored abutment teeth, coupled with removable partial denture castings that have optimal contact with these preparations, results in a path of insertion and removal that is controlled in a manner similar to one using conventional precision attachments. Because the milled surfaces are primarily extracoronal, little if any, additional tooth reduction is required for adequate mouth preparation. Avoiding additional tooth reduction minimizes later abutment fracture. The great increase in stability and resistance to rotational movements, when combined with conventional posterior clasping, provides a reasonable alternative to the precision attachment in providing maximal esthetics for the partially edentulous patients.

Dental Abutments↗
PubMed2005

Influence of specimen size and regional variation on long-term resin-dentin bond strength.

OBJECTIVES: Verify whether the dimension of a bonded specimen stored prior microtensile testing and its regional variation may affect the resin-dentin bond strength (BS) over time. METHODS: Thirty human third molars had a flat dentin surface exposed and all peripheral enamel removed. Two adhesive systems (Single-Bond and One-Step) were applied and composite resin crowns (Z250) were constructed. Teeth were divided into three groups (n = 5). Group A specimens were sectioned to obtain sticks to be tested in tension (0.5 mm/min) immediately. Group B specimens were stored in water for 6 months, before sectioning and testing. Group C specimens were sectioned; the sticks were stored for 6 months and tested. In groups A and B, the origin of the sticks, periphery and inner regions was controlled. Bond strength (BS) was expressed as an index that considers cohesive failures and estimated values of premature debonded specimens. One-way ANOVA and Tukey's test (alpha = 0.05) were used to compare groups A, B and C, and a second analytical approach (A and B) employed a two-way ANOVA (time versus regional differences) for each adhesive system. RESULTS: For Single-Bond (SB), the BS for specimens in group A was higher than for groups B and C. For One-Step (OS), the BS in group A was higher than for B, which was in turn higher than for C. In the second group approach, no difference was found when the test was performed immediately; however, after 6 months, the inner sticks from group B showed significantly higher BS. SIGNIFICANCE: (1) The amount of decrease in BS is dependent on the specimen size; (2) the decrease in BS was greater for peripheral specimens than more centrally located specimens.

Analysis of Variance↗
PubMed2005

The influence of design parameters on the FEA-determined stress distribution in CAD-CAM produced all-ceramic dental crowns.

INTRODUCTION: Knowledge of factors, which influence stress and its distribution is of key importance to the successful production of durable all-ceramic restorations. The objective of this study was to evaluate, by finite element analysis (FEA), the influence of the shape of the preparation and the cement layer on the stress distribution in CAD-CAM produced all-ceramic crowns and in their cement layer. MATERIAL AND METHODS: The CAD models of multi-layer all-ceramic crowns for posterior tooth 46 of three patients produced with CAD-CAM-technology were translated into a three-dimensional FEA program. The stress distribution due to the combined influences of bite forces, residual stresses caused by the difference in expansion coefficient of the two ceramic layers, and the influence of shrinkage of the cement was investigated. RESULTS: The tensile stresses in the crown for the chamfer knife-edge preparation might put the integrity of the currently available ceramic materials at risk, while a non-uniform cement layer might result in stresses exceeding the bond strength. It was concluded that for long lasting restorations in the posterior region it is advisable to make a chamfer with collar preparation, the cement layer as uniform, and the difference in thermal expansion for the two ceramics as small as possible. SIGNIFICANCE: This study indicates that for full ceramic crowns in the posterior region, specific design rules should be followed, and that FEA utilizing CAD-CAM data can be a successful tool to develop design guidelines for all-ceramic restorations.

Bite Force↗
PubMed2005

Microleakage of various cementing agents for full cast crowns.

OBJECTIVES: To evaluate microleakage and marginal gaps in full cast crown restorations bonded with six different types of cementing agents. METHODS: Sixty non-carious human premolars and molars were prepared in a standardized manner for full cast crown restorations. The mesial and distal margins were located in dentin, while the vestibular and palatal/lingual margins were located in enamel. Crowns were made from a high-gold alloy using a standardized technique. The specimens were randomized to six groups of cementing agents: one zinc-phosphate cement (Harvard cement), one conventional glass-ionomer cement (Fuji I), one resin-modified glass-ionomer cement (Fuji Plus), two standard resin cements (RelyX ARC, Panavia F), and one self-adhesive universal resin cement (RelyX Unicem). After 4 weeks of storage in distilled water at 37 degrees C, the specimens were subjected to 5000 thermocycles ranging from 5 to 55 degrees C. Then, they were placed in a silver nitrate solution, embedded in resin blocks, and vertically cut in buccolingual and mesiodistal direction. Subsequently, the objects were evaluated for microleakage and marginal gap using a high-resolution digital microscope camera. RESULTS: A number of inter-group differences were statistically significant. RelyX Unicem showed the smallest degree of microleakage both in enamel and in dentin. Panavia F und RelyX Unicem were associated with significantly larger marginal gaps than all other cementing agents. No association was observed between microleakage and marginal gap other than a weak direct correlation when using Harvard cement on enamel. SIGNIFICANCE: The cementing agents investigated revealed different sealing abilities. These differences were not associated with specific types of materials.

Bisphenol A-Glycidyl Methacrylate↗
PubMed2005

Qualitative computer aided evaluation of dental impressions in vivo.

OBJECTIVES: Clinical investigations dealing with the precision of different impression techniques are rare. Objective of the present study was to develop and evaluate a procedure for the qualitative analysis of the three-dimensional impression precision based on an established in-vitro procedure. The zero hypothesis to be tested was that the precision of impressions does not differ depending on the impression technique used (single-step, monophase and two-step-techniques) and on clinical variables. METHODS: Digital surface data of patient's teeth prepared for crowns were gathered from standardized manufactured master casts after impressions with three different techniques were taken in a randomized order. Data-sets were analyzed for each patient in comparison with the one-step impression chosen as the reference. The qualitative analysis was limited to data-points within the 99.5%-range. Based on the color-coded representation areas with maximum deviations were determined (preparation margin and the mantle and occlusal surface). To qualitatively analyze the precision of the impression techniques, the hypothesis was tested in linear models for repeated measures factors (p < 0.05). RESULTS: For the positive 99.5% deviations no variables with significant influence were determined in the statistical analysis. In contrast, the impression technique and the position of the preparation margin significantly influenced the negative 99.5% deviations. SIGNIFICANCE: The influence of clinical parameter on the deviations between impression techniques can be determined reliably using the 99.5 percentile of the deviations. An analysis regarding the areas with maximum deviations showed high clinical relevance. The preparation margin was pointed out as the weak spot of impression taking.

Computer-Aided Design↗
PubMed2005

Factorial analysis of variables influencing stress in all-ceramic crowns.

OBJECTIVE: The objective of this investigation was to evaluate the relative contribution of variables in the crown-cement-tooth system that can influence magnitude of maximum principal stress in all-ceramic crowns. METHODS.: Factorial analysis was performed to calculate the coefficients of main and interactive effects of seven variables on maximum stress distribution in a series of finite element models of an axisymmetric stylized ceramic crown-cement-tooth system. Variables investigated at two levels were selected for their clinical relevance and included those relating to crown material and geometry (thickness and cuspal incline), cement modulus and thickness, supporting tooth core, and position at which the occlusal load was applied. RESULTS: The average principal stress for all combinations of all variables was 135.1 MPa but stress magnitude ranged from 73.7 to 214.0 MPa. Crown material and thickness are of primary importance in stress magnitude but other variables (cement modulus, load position, and supporting tooth core) also contribute to the stress magnitude. Interactions between these variables can have an important influence, particularly since the stress in the crown is not necessarily sensitive to the same factors for all crown material systems. SIGNIFICANCE: Comprehensive evaluation of stress in a crown of a crown-cement-tooth system must integrate the influence of single variables and their interactions.

Aluminum Silicates↗
PubMed2006

Mechanical properties and bond strength of dual-cure resin composites to root canal dentin.

OBJECTIVES: To evaluate the regional mechanical properties of dual-cure resin composites and their regional bond strengths to root canal dentin. METHODS: One of the following dual-cure resin composites was placed in artificial post spaces: Unifil Core (UC), Clearfil DC Core (DC), Build-It FR (BI), Clearfil DC Core-automix (DCA), and photo-cured for 60s. After 24h storage, each specimen was serially sliced to harvest eight hour-glass shaped specimens for measurement of regional ultimate tensile strength (UTS), and the remaining eight semi-circular slabs were polished for the measurement of Knoop Hardness Number (KHN). For the microtensile bond strength (muTBS) test, post cavities were prepared in human premolar roots, and the cavity surfaces treated with Clearfil SE Bond and photo-cured for 10s. The post spaces were then filled with one of the above resin composites and photo-cured for 60s. After 24h storage, each specimen was serially sliced into 8, 0.6x0.6 mm-thick beams for the muTBS test. The data were divided into coronal and apical regions and analyzed using ANOVA and post hoc test (alpha=0.05). RESULTS: UTS and KHN were affected by the type of dual-cure resin composite and region (p<0.0001). There was no relationship between UTS and KHN for each material. The auto-mix type of resin composite possessed superior UTS to that of the hand-mix type. muTBS among the four composite materials were not significantly different at both apical and coronal regions (p>0.05). Regional differences in bond strengths were found for all materials (p<0.05). SIGNIFICANCE: The UTS and KHN of the dual-cure resin composites varied among each material, however, differences in the mechanical properties of the resin core materials did not affect their adhesion to root canal dentin.

Composite Resins↗
PubMed2006

Assessment of the amount of remaining coronal dentine in root-treated teeth.

OBJECTIVES: There is currently no standardised technique to measure the amount of coronal dentine remaining in a root-treated tooth after crown preparation. The aim of this study was to develop a method of measuring remaining coronal dentine in root-treated teeth and to propose an index for grading tooth restorability. METHODS: The study recruited 20 patients who had completed molar endodontic treatment at the Eastman Dental Hospital and had been prescribed an amalgam coronal-radicular core with a full coverage cast restoration. Using a series of interlocking special trays and impressions, a method was devised to produce a cast of the amount of remaining dentine coronal to the finish line after crown preparation. This cast was scanned using a laser profilometer and the volume of remaining dentine was calculated. A tooth restorability index (TRI) was developed to assess the strategic value of the remaining dentine. The TRI allowed scores of 0-3 in each sextant with a maximum score of 18 per tooth. RESULTS: Twenty teeth were scored by three examiners and the TRI scores varied from 2 to 13. The volume of coronal dentine varied from 61.73 to 232.22 mm(3). CONCLUSIONS: A tooth restorability index has been devised to assess the strategic value of remaining dentine. A Kappa statistic was calculated to produce values of 0.584, 0.688 and 0.720, giving moderate-good agreement between the examiners.

Crowns↗
PubMed2006

Axial-wall inclination angle and vertical height interactions in molar full crown preparations.

OBJECTIVE: This study has been designed to evaluate the interaction of axial wall heights with inclination angles in full crown tooth preparations. The interaction of these parameters was related to the resulting preparation surface area. MATERIALS AND METHODS: A right regular pyramid was used to simulate a single mandibular molar preparation with known convergence angles and vertical heights. Various combinations of these two variables allowed the calculation of surface areas with a formula for the area of a pyramid and right triangles through trigonometric manipulations. The pyramidal model system had a 9-mm square base with vertical heights from 3- to 5-mm and single-side inclination angles from 2 to 25 degrees. The occlusal surface was a flat, square or rectangular surface and was included in the total area. RESULTS: A percentage of surface area lost or gained served as the dependent variables. The significance levels were set at 10.0% or greater magnitude of loss/gain in a surface area compared to the ideal 2 degree-level. Significant area loss was demonstrated in all alpha-level comparisons. The largest change was found in the 5-mm height grouping compared to the 3-mm height grouping, -36.6% difference between groups at the 2 degree-level. CONCLUSIONS: Axial single-side inclination angles greater than 10 degrees in 3- and 4-mm height-molars are detrimental to maximum surface area in full crown restorations. The 5-mm axial wall height with < or = 10 degree single wall has been shown to maximize the luting agent surface area between restoration and tooth structure.

Crowns↗
PubMed2003

In vitro marginal fit of three all-ceramic crown systems.

STATEMENT OF PROBLEM: Studies on marginal discrepancies of single restorations using various systems and materials have resulted in statistical inferences that are ambiguous because of small sample sizes and limited numbers of measurements per specimen. PURPOSE: The purpose of this study was to compare the marginal adaptation of single anterior restorations made using different systems. MATERIAL AND METHODS: The in vitro marginal discrepancies of 3 different all-ceramic crown systems (Celay In-Ceram, conventional In-Ceram, and IPS Empress 2 layering technique), and a control group of metal ceramic restorations were evaluated and compared by measuring the gap dimension between the crowns and the prepared tooth at the marginal opening. The crowns were made for 1 extracted maxillary central incisor prepared with a 1-mm shoulder margin and 6-degree tapered walls by milling. Thirty crowns per system were fabricated. Crown measurements were recorded with an optical microscope, with an accuracy of +/-0.1 microm, at 50 points spaced approximately 400 microm along the circumferential margin. The criterion of 120 microm was used as the maximum clinically acceptable marginal gap. Mean gap dimensions and standard deviations were calculated for marginal opening. The data were analyzed with a 1-way analysis of variance (alpha=.05). RESULTS: Mean gap dimensions and standard deviations at the marginal opening for the incisor crowns were 87 +/- 34 microm for control, 83 +/- 33 microm for Celay In-Ceram, 112 +/- 55 microm for conventional In-Ceram, and 46 +/- 16 microm for the IPS Empress 2 layering technique. Significant differences were found among the crown groups (P<.05). Compared with the control group, the IPS Empress 2 group had significantly smaller marginal discrepancies (P<.05), and the conventional In-Ceram group exhibited significantly greater marginal discrepancies (P<.05). There was no significant difference between the Celay In-Ceram and the control group. CONCLUSION: Within the limitations of this study, the marginal discrepancies were all within the clinically acceptable standard set at 120 microm. However, the IPS Empress 2 system showed the smallest and most homogeneous gap dimension, whereas the conventional In-Ceram system presented the largest and more variable gap dimension compared with the metal ceramic (control) restoration.

Aluminum Oxide↗
PubMed2004

In vitro fracture strength of teeth restored with different all-ceramic crown systems.

STATEMENT OF PROBLEM: There is insufficient knowledge of the strength of all-ceramic crowns bonded to natural teeth to warrant the use of all-ceramic crowns in place of metal-ceramic crowns. PURPOSE: The purpose of this study was to evaluate and compare fracture resistance of crowns made of 3 different types of 2 all-ceramic crown systems-0.4-mm and 0.6-mm aluminum oxide coping crowns and zirconia ceramic coping crowns-and metal-ceramic crowns. MATERIAL AND METHODS: Forty intact, noncarious human maxillary central incisors were divided into 4 groups (n=10): Group MCC (control), metal-ceramic crown (JRVT High Noble Alloy); Group AC4, crown with 0.4-mm aluminum oxide coping (Procera AllCeram); Group AC6, crown with 0.6-mm aluminum oxide coping (Procera AllCeram); and Group ZC6, crown with 0.6-mm zirconia ceramic coping (Procera AllZirkon). Teeth were prepared for complete-coverage all-ceramic crowns so that a final dimension of 5.5 +/- 0.5 mm was achieved incisocervically, mesiodistally, and faciolingually. A 1.0-mm deep shoulder finish line was used with a rounded internal line angle. All restorations were treated with bonding agent (Clearfil SE Bond) and luted with phosphate-monomer-modified adhesive cement (Panavia 21). Fracture strength was tested with a universal testing machine at a crosshead speed of 2 mm per minute with an angle of 30 degrees to the long axis of the tooth after restorations were stored in 100% relative humidity of a normal saline solution for 7 days. The mode of fracture was examined visually. Means were calculated and analyzed with 1-way ANOVA and Tukey's HSD (alpha=.05). RESULTS: The means of fracture strength were: Group MCC, 405 +/- 130 N; Group AC4, 447 +/- 123 N; Group AC6, 476 +/- 174 N; and Group ZC6, 381 +/- 166 N. There was no significant difference between groups ( P =.501). The mode of failure for all specimens was fracture of the natural tooth. CONCLUSIONS: There was no significant difference in the fracture strength of the teeth restored with all-ceramic crowns with 0.4- and 0.6-mm aluminum oxide copings, 0.6-mm zirconia ceramic copings, and metal ceramic crowns.

Aluminum Oxide↗
PubMed2005

Assessment of sensitivity and specificity of clinical evaluation of cast restoration marginal accuracy compared to stereomicroscopy.

STATEMENT OF PROBLEM: One of the most important criteria for the clinical acceptability and longevity of cast restorations is marginal adaptation. However, there is limited information on the accuracy of commonly practiced evaluation techniques. PURPOSE: This study assessed the effect of preparation design on marginal adaptation. In addition, sensitivity and specificity of clinical evaluations of marginal adaptations of cast restorations were assessed and compared to stereomicroscopy. MATERIAL AND METHODS: Three Ivorine molar teeth of differing designs were prepared: (1) a complete crown preparation with a chamfer finish line, (2) a complete crown preparation with a buccal shoulder and beveled finish line, and (3) a three-quarter crown preparation with proximal boxes and beveled finish line. Twenty-four castings (n = 8) were prepared (Ney technique casting metal). Twelve circumferential sites were identified for examination on each casting using a stereomicroscope, which was interpreted using software (Bioquant 98). The clinical examinations included explorer examination to detect marginal gap by tactile feel, followed by examination with a disclosing media (GC FitChecker). Chi-square tests of independence were used to evaluate the effect of preparation design and compare agreement between examination methods for detection of marginal gap size of greater than or equal to 30 microm (alpha=.05). RESULTS: The overall marginal adaptation of preparation designs was not significantly different. Results of explorer examination at 30-microm sensitivity and specificity were 46% and 97%, respectively. Similar values for disclosing media at 30 microm were 12% sensitivity and 97% specificity. The overall percent agreement with the stereomicroscope using the explorer was 58.3%, with 23.6% correct acceptance rate and 34.7% correct rejection rate. With respect to detection of marginal fit, the combination of disclosing material with explorer data did not yield significantly improved results (59.4%), as compared to explorer alone. A receiver operator characteristic curve yielded satisfactory sensitivity (0.8) and specificity (0.9) at a gap size value of 124 microm. CONCLUSION: Within the limitations of this study, the preparation design did not significantly affect the marginal adaptation. Clinical detection, with similar sensitivity and specificity as the stereomicroscope, occurred at marginal openings greater than or equal to 124 microm. Therefore, commonly used clinical evaluation techniques using an explorer and disclosing media may be inadequate for assessments of marginal accuracy.

Chi-Square Distribution↗
PubMed2005

The effect of box preparation on the strength of glass fiber-reinforced composite inlay-retained fixed partial dentures.

STATEMENT OF PROBLEM: Nonstandardized box dimensions for inlay-retained fixed partial dentures (FPDs) may result in uneven distribution of the forces on the connector region of such restorations. PURPOSE: The objective of this in vitro study was to evaluate the effect of box dimensions on the initial and final failure strength of inlay-retained fiber-reinforced composite (FRC) FPDs. MATERIAL AND METHODS: Twenty-one inlay-retained FPDs were prepared using FRC (everStick) frameworks with unidirectional fiber reinforcement between mandibular first premolars and first molars. Boxes were prepared using conventional inlay burs (Cerinlay), and small and large ultrasonic tips (SONICSYS approx). Box dimensions were measured after preparation with a digital micrometer. All restorations were subjected to thermal cycling (6000 cycles, 5 degrees C-55 degrees C). Fracture testing was performed in a universal testing machine (1 mm/min). Acoustic emission signals were monitored during loading of the specimens. Initial and final fracture strength values (2-way ANOVA, Bonferroni post hoc tests, alpha =.05) and failure types (Fisher exact test) were statistically compared for each group. RESULTS: Significant differences (P =.0146 and P =.0086) were observed between the groups in the dimensions of the boxes prepared using conventional burs buccolingually (2.8-3.0 mm in molars, 3.1-4.3 mm in premolars) and the small size (2.5-2.9, 2.9-3.8 mm) or large size (2.6-3.8, 3.2-4.9 mm) ultrasonic tips for the premolars and the molars, respectively. No significant differences were found at the initial and final failures between the conventionally prepared group (842 +/- 267 N, 1161 +/- 428 N) and those prepared with either small (1088 +/- 381 N, 1320 +/- 380 N) or large ultrasonic tips (1070 +/- 280 N, 1557 +/- 321 N), respectively. The failure analysis demonstrated no significant difference in failure types but predominant delamination of the veneering resin (85%) in all experimental groups. According to acoustic emission tests, a higher energy level was required for final failure of the FRC FPDs with boxes finished using small ultrasonic tips. CONCLUSION: Standardized box dimensions showed no significant effect on fracture strength at either initial or final failure of the fiber-reinforced FPDs. The FRC FPDs with boxes refined with small ultrasonic burs required a greater energy level before failure. The type of failure observed after the fracture tests was primarily delamination of the veneering resin.

Acoustics↗
PubMed2005

Longevity and failure load of ceramic veneers with different preparation designs after exposure to masticatory simulation.

STATEMENT OF PROBLEM: Laminate veneers are widely used in the management of unesthetic anterior teeth. However, limited information is available regarding the influence of preparation design on longevity of ceramic veneers. PURPOSE: This study evaluated the influence of preparation design on longevity and failure load of ceramic veneers bonded to human maxillary central incisors after cyclic loading and thermal cycling in a dual-axis masticatory simulator. MATERIAL AND METHODS: Sixty-four caries-free maxillary central incisors were divided into 4 groups (n = 16). The control group remained unprepared (NP). For Group WP, a window preparation was made. Specimens in Group IOP were prepared with an incisal overlap of 2 mm without palatal chamfer. For Group CVP, specimens were prepared with a complete-veneer design of 3-mm incisal reduction and 2-mm palatal extension. Forty-eight IPS Empress 1 ceramic veneers were bonded adhesively with dual-polymerizing composite (Variolink II). All specimens were subjected to cyclic mechanical loading (1.2 million cycles, cycle frequency 1.3 Hz, invariable palatal load 49 N) and thermal cycling (5 degrees C-55 degrees C, dwell time 60 seconds, 5500 cycles) in a masticatory simulator. Failure was defined by bulk fracture of a specimen. Subcritical crack patterns were observed. Surviving specimens were loaded in a universal testing machine until fracture. The failure-load values (N) (1.5 mm/min crosshead speed) were automatically recorded by controlling software. Statistical analysis of data was performed by Kruskal-Wallis analysis of variance (alpha = .05) and pairwise Wilcoxon rank sum tests (alpha = .05). RESULTS: Three specimens from group NP, 1 specimen each from the WP and CVP groups, and 2 specimens from group IOP fractured during fatigue. After 1.2 million cycles, the highest crack rates were observed for complete veneers and originated in the palatal concavity extending to the facial surface. The median (interquartile range = x .25 - x .75 ) failure loads (N) were as follows: NP 713.3 (404.4-777.1), WP 549.5 (477.5-597.7), IOP 695.3 (400.0-804.6), and CVP 519.2 (406.1-732.9). No significant differences in longevity and failure load were demonstrated between natural teeth and teeth restored with ceramic veneers ( P = .555). CONCLUSION: Maxillary teeth restored with the 3 types of IPS Empress 1 veneers showed fracture resistance similar to that of unprepared incisors ( P = .555).

Aluminum Silicates↗