Repair of monolithic zirconia restorations with different direct resin composites: effect on the fatigue bonding and mechanical performance

Clinical Oral Investigations(2024)

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Abstract
Objective The study aims to evaluate the shear bond and flexural strength fatigue behavior of yttrium-stabilized zirconia (4YSZ) repaired using different resin composites. Materials and methods Cylindric specimens of 4YSZ were obtained for the bond strength (Ø = 6 mm, 1.5 mm of thickness) and biaxial flexural strength (Ø = 15 mm, 1 mm of thickness) fatigue tests and divided into 3 groups according to the repair resin composite: EVO (nanohybrid), BULK (bulk-fill), and FLOW (flowable). The zirconia surface was air-abraded with alumina particles, a 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) primer was applied, and the resin composite was build-up over the zirconia. Fatigue shear bond strength and flexural fatigue strength tests were performed ( n = 15). One-way ANOVA and Tukey post hoc tests were carried out for both outcomes, besides scanning electron microscopy and finite element analysis. Results The repair material affected the fatigue shear bond strength of zirconia ceramic. The BULK group (18.9 MPa) depicted higher bond strength values than FLOW (14.8 MPa) ( p = 0.04), while EVO (18.0 MPa) showed similar results to both groups. No effect was observed for the mechanical behavior ( p = 0.53). The stress distribution was similar for all groups. Conclusion The repair of yttrium-stabilized zirconia (4YSZ) ceramics with bulk-fill resin composites was the best option for high fatigue bond strength. However, the fatigue mechanical performance was similar regardless of the applied repair material. Clinical relevance The repair of yttrium-stabilized zirconia (4YSZ) monolithic restorations may be performed with nanohybrid and bulk-fill resin composites in order to promote longevity in the treatment.
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Key words
Bond strength,Bulk-fill,Cyclic fatigue,Finite element analysis,Flowable resin,Resin composite
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