Fracture Resistance, Marginal Gap and Internal Gap of Lithium Disilicate Occlusal Veneers with Two Preparation Designs
Abstract
Objectives: Lithium disilicate is commonly used for restoring worn teeth. Various preparation designs have been introduced for occlusal overlay restorations, potentially impacting the properties of the restoration. This study evaluated the fracture resistance, marginal gap, and internal gap of lithium disilicate occlusal veneers prepared with two different preparation designs.
Materials and Methods: In this study, 22 extracted mandibular molars were randomly assigned to two groups (n=11). In the non-retentive (NR) preparation group, the occlusal surface was reduced by 0.8mm in the fissures and 1mm at the cusp tips. In the retentive (R) group, in addition to occlusal reduction, the axial surfaces were reduced with a round-end shoulder finish line created around the axial wall, with both height and depth measuring 1mm. Occlusal veneers were fabricated using lithium disilicate (IPS e.max Press). The marginal and internal gaps were measured using the silicone replica technique before cementation. After cementation, the restorations underwent thermocycling and load cycling, followed by fracture resistance testing in a universal testing machine. Data were analyzed by independent t-test.
Results: The fracture resistance of the R group was insignificantly higher than that of the NR group (P=0.310). The marginal gap (P=0.001) and internal gap (P=0.021) of the R veneers were significantly larger than those of the NR veneers.
Conclusion: Both R and NR occlusal veneers exhibited sufficient strength for posterior tooth restorations. The marginal and internal gaps of R and NR occlusal veneers fabricated from lithium disilicate (IPS e.max Press) were found to be within the acceptable range.
1. Magne P, Cheung R. Numeric simulation of occlusal interferences in molars restored with ultrathin occlusal veneers. J Prosthet Dent. 2017 Jan;117(1):132-137.
2. Yazigi C, Kern M, Chaar MS. Influence of various bonding techniques on the fracture strength of thin CAD/CAM-fabricated occlusal glass-ceramic veneers. J Mech Behav Biomed Mater. 2017 Nov;75:504-511.
3. Elsayed S, Elbasty R. Influence of Conventional Versus Digital Workflow on Marginal Fit and Fracture Resistance of Different Pressable Occlusal Veneers After Thermomechanical Fatigue Loading. Egyptian Dental Journal. 2021;67(Issue 1 - January (Fixed Prosthodontics, Removable Prosthodontics and Dental Materials)):597–613.
4. Abbas R, Mandour M, Hasan S. Effect of Material Type and Thickness on Fatigue Resistance of Posterior Bonded Occlusal Veneers. Al-Azhar Dental Journal for Girls. 2020;7(2):171–8.
5. Bustamante-Hernández N, Montiel-Company JM, Bellot-Arcís C, Mañes-Ferrer JF, Solá-Ruíz MF, Agustín-Panadero R, Fernández-Estevan L. Clinical Behavior of Ceramic, Hybrid and Composite Onlays. A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020 Oct 19;17(20):7582.
6. Al-Akhali M, Chaar MS, Elsayed A, Samran A, Kern M. Fracture resistance of ceramic and polymer-based occlusal veneer restorations. J Mech Behav Biomed Mater. 2017 Oct;74:245-250.
7. Angerame D, De Biasi M, Agostinetto M, Franzò A, Marchesi G. Influence of preparation designs on marginal adaptation and failure load of full-coverage occlusal veneers after thermomechanical aging simulation. J Esthet Restor Dent. 2019 May;31(3):280-289.
8. Grippo JO. Abfractions: a new classification of hard tissue lesions of teeth. J Esthet Dent. 1991 Jan-Feb;3(1):14-9.
9. Hoda Mohamed Abdel Sadek MKA-Q, Marwa Mohamed Wahsh. The Effect of Ceramic Material and PREPARATION Design on the Fracture Resistance of Onlay Restorations. Egyptian Dent J. 2021;67:9.
10. Xhonga FA. Bruxism and its effect on the teeth. J Oral Rehabil. 1977 Jan;4(1):65-76.
11. Giordano RA 2nd, Campbell S, Pober R. Flexural strength of feldspathic porcelain treated with ion exchange, overglaze, and polishing. J Prosthet Dent. 1994 May;71(5):468-72.
12. Abduo J, Lyons K, Swain M. Fit of zirconia fixed partial denture: a systematic review. J Oral Rehabil. 2010 Nov;37(11):866-76.
13. Zamzam H, Olivares A, Fok A. Load capacity of occlusal veneers of different restorative CAD/CAM materials under lateral static loading. J Mech Behav Biomed Mater. 2021 Mar;115:104290.
14. Elsayed M, Sherif R, El-khodary N. Fracture resistance of Vita suprinity versus IPS e.max CAD vonlays restoring premolars (An in vitro study). International Journal of Applied Dental Sciences. 2020;6(3):734–41.
15. Ahmed E. Abd Elmonam TAH, Mohammed Hosny Abd-El Aziz. a Comparative study on the effect of different preparation design and type of materials on the marginal fit of occlusal veneer. Al-Azhar Journal of Dental Science. 2017;20(1):6.
16. Son K, Lee S, Kang SH, Park J, Lee KB, et al. A Comparison Study of Marginal and Internal Fit Assessment Methods for Fixed Dental Prostheses. J Clin Med. 2019 Jun 1;8(6):785.
17. Alkadi L, Ruse ND. eMax CAD vs eMax Press: a fracture mechanics characterization2013.
18. Huang X, Zou L, Yao R, Wu S, Li Y. Effect of preparation design on the fracture behavior of ceramic occlusal veneers in maxillary premolars. J Dent. 2020 Jun;97:103346.
19. Sachs C, Groesser J, Stadelmann M, Schweiger J, Erdelt K, Beuer F. Full-arch prostheses from translucent zirconia: accuracy of fit. Dent Mater. 2014 Aug;30(8):817-23.
20. Alhilou A, Beddis HP, Mizban L, Seymour DW. Basic Erosive Wear Examination: assessment and prevention. Dental Nursing. 2015;11(5):262–7.
21. Magne P, Schlichting LH, Maia HP, Baratieri LN. In vitro fatigue resistance of CAD/CAM composite resin and ceramic posterior occlusal veneers. J Prosthet Dent. 2010 Sep;104(3):149-57.
22. Emam Z, A. Aleem N. Influence of Different Materials and Preparation Designs on Marginal Adaptation and Fracture Resistance of CAD/CAM Fabricated Occlusal Veneers. Egyptian Dent J. 2020;66(1):439–52.
23. Emam ZN, A. Aleem NA. Influence of Different Materials and Preparation Designs on Marginal Adaptation and Fracture Resistance of CAD/CAM Fabricated Occlusal Veneers. Egyptian Dental Journal. 2020;66(Issue 1 - January (Fixed Prosthodontics, Dental Materials, Conservative Dentistry & Endodontics)):439–52.
24. Huang X, Zou L, Yao R, Wu S, Li Y. Effect of preparation design on the fracture behavior of ceramic occlusal veneers in maxillary premolars. J Dent. 2020 Jun;97:103346.
25. Clausen JO, Abou Tara M, Kern M. Dynamic fatigue and fracture resistance of non-retentive all-ceramic full-coverage molar restorations. Influence of ceramic material and preparation design. Dent Mater. 2010 Jun;26(6):533-8.
26. Sasse M, Krummel A, Klosa K, Kern M. Influence of restoration thickness and dental bonding surface on the fracture resistance of full-coverage occlusal veneers made from lithium disilicate ceramic. Dent Mater. 2015 Aug;31(8):907-15.
27. Tribst JPM, Tach Q, de Kok P, Dal Piva AMO, Kuijs RH, Kleverlaan CJ. Thickness and Substrate Effect on the Mechanical Behaviour of Direct Occlusal Veneers. Int Dent J. 2023 Oct;73(5):612-619.
28. Guess PC, Schultheis S, Wolkewitz M, Zhang Y, Strub JR. Influence of preparation design and ceramic thicknesses on fracture resistance and failure modes of premolar partial coverage restorations. J Prosthet Dent. 2013 Oct;110(4):264-73.
29. McLean JW, von Fraunhofer JA. The estimation of cement film thickness by an in vivo technique. Br Dent J. 1971 Aug 3;131(3):107-11.
30. Bindl A, Mörmann WH. Marginal and internal fit of all-ceramic CAD/CAM crown-copings on chamfer preparations. J Oral Rehabil. 2005 Jun;32(6):441-7.
31. Anadioti E, Aquilino SA, Gratton DG, Holloway JA, Denry I, Thomas GW, Qian F. 3D and 2D marginal fit of pressed and CAD/CAM lithium disilicate crowns made from digital and conventional impressions. J Prosthodont. 2014 Dec;23(8):610-7.
32. Ahlers MO, Mörig G, Blunck U, Hajtó J, Pröbster L, Frankenberger R. Guidelines for the preparation of CAD/CAM ceramic inlays and partial crowns. Int J Comput Dent. 2009;12(4):309-25. English, German.
33. Schlenz MA, Vogler J, Schmidt A, Rehmann P, Wöstmann B. New Intraoral Scanner-Based Chairside Measurement Method to Investigate the Internal Fit of Crowns: A Clinical Trial. Int J Environ Res Public Health. 2020 Mar 25;17(7):2182.
34. Vianna ALSV, Prado CJD, Bicalho AA, Pereira RADS, Neves FDD, Soares CJ. Effect of cavity preparation design and ceramic type on the stress distribution, strain and fracture resistance of CAD/CAM onlays in molars. J Appl Oral Sci. 2018;26:e20180004.
35. Ozturk N, Aykent F. Dentin bond strengths of two ceramic inlay systems after cementation with three different techniques and one bonding system. J Prosthet Dent. 2003 Mar;89(3):275-81.
36. Al-Akhali M, Kern M, Elsayed A, Samran A, Chaar MS. Influence of thermomechanical fatigue on the fracture strength of CAD-CAM-fabricated occlusal veneers. J Prosthet Dent. 2019 Apr;121(4):644-650.
37. Krummel A, Garling A, Sasse M, Kern M. Influence of bonding surface and bonding methods on the fracture resistance and survival rate of full-coverage occlusal veneers made from lithium disilicate ceramic after cyclic loading. Dent Mater. 2019 Oct;35(10):1351-1359.
38. Zar B, Eckert S, Kunkela J, Ingr T, Mounajjed R. The marginal fit of lithium disilicate crowns: Press vs. CAD/CAM. Braz Oral Res. 2018;32:e001.
39. Naumova EA, Ernst S, Schaper K, Arnold WH, Piwowarczyk A. Adhesion of different resin cements to enamel and dentin. Dent Mater J. 2016;35(3):345-52.
40. Tozo-Burgos JG, Juárez-Vizcarra CF, Calla-Poma R, Sánchez-Tito M. Fracture Resistance of CAD/CAM Nanohybrid Resin Occlusal Veneers Based on Bonding Surface: Enamel vs. Enamel-Dentin vs. Enamel-Resin Coating. J Clin Exp Dent. 2025 Jun 1;17(6):e675-e682.
2. Yazigi C, Kern M, Chaar MS. Influence of various bonding techniques on the fracture strength of thin CAD/CAM-fabricated occlusal glass-ceramic veneers. J Mech Behav Biomed Mater. 2017 Nov;75:504-511.
3. Elsayed S, Elbasty R. Influence of Conventional Versus Digital Workflow on Marginal Fit and Fracture Resistance of Different Pressable Occlusal Veneers After Thermomechanical Fatigue Loading. Egyptian Dental Journal. 2021;67(Issue 1 - January (Fixed Prosthodontics, Removable Prosthodontics and Dental Materials)):597–613.
4. Abbas R, Mandour M, Hasan S. Effect of Material Type and Thickness on Fatigue Resistance of Posterior Bonded Occlusal Veneers. Al-Azhar Dental Journal for Girls. 2020;7(2):171–8.
5. Bustamante-Hernández N, Montiel-Company JM, Bellot-Arcís C, Mañes-Ferrer JF, Solá-Ruíz MF, Agustín-Panadero R, Fernández-Estevan L. Clinical Behavior of Ceramic, Hybrid and Composite Onlays. A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020 Oct 19;17(20):7582.
6. Al-Akhali M, Chaar MS, Elsayed A, Samran A, Kern M. Fracture resistance of ceramic and polymer-based occlusal veneer restorations. J Mech Behav Biomed Mater. 2017 Oct;74:245-250.
7. Angerame D, De Biasi M, Agostinetto M, Franzò A, Marchesi G. Influence of preparation designs on marginal adaptation and failure load of full-coverage occlusal veneers after thermomechanical aging simulation. J Esthet Restor Dent. 2019 May;31(3):280-289.
8. Grippo JO. Abfractions: a new classification of hard tissue lesions of teeth. J Esthet Dent. 1991 Jan-Feb;3(1):14-9.
9. Hoda Mohamed Abdel Sadek MKA-Q, Marwa Mohamed Wahsh. The Effect of Ceramic Material and PREPARATION Design on the Fracture Resistance of Onlay Restorations. Egyptian Dent J. 2021;67:9.
10. Xhonga FA. Bruxism and its effect on the teeth. J Oral Rehabil. 1977 Jan;4(1):65-76.
11. Giordano RA 2nd, Campbell S, Pober R. Flexural strength of feldspathic porcelain treated with ion exchange, overglaze, and polishing. J Prosthet Dent. 1994 May;71(5):468-72.
12. Abduo J, Lyons K, Swain M. Fit of zirconia fixed partial denture: a systematic review. J Oral Rehabil. 2010 Nov;37(11):866-76.
13. Zamzam H, Olivares A, Fok A. Load capacity of occlusal veneers of different restorative CAD/CAM materials under lateral static loading. J Mech Behav Biomed Mater. 2021 Mar;115:104290.
14. Elsayed M, Sherif R, El-khodary N. Fracture resistance of Vita suprinity versus IPS e.max CAD vonlays restoring premolars (An in vitro study). International Journal of Applied Dental Sciences. 2020;6(3):734–41.
15. Ahmed E. Abd Elmonam TAH, Mohammed Hosny Abd-El Aziz. a Comparative study on the effect of different preparation design and type of materials on the marginal fit of occlusal veneer. Al-Azhar Journal of Dental Science. 2017;20(1):6.
16. Son K, Lee S, Kang SH, Park J, Lee KB, et al. A Comparison Study of Marginal and Internal Fit Assessment Methods for Fixed Dental Prostheses. J Clin Med. 2019 Jun 1;8(6):785.
17. Alkadi L, Ruse ND. eMax CAD vs eMax Press: a fracture mechanics characterization2013.
18. Huang X, Zou L, Yao R, Wu S, Li Y. Effect of preparation design on the fracture behavior of ceramic occlusal veneers in maxillary premolars. J Dent. 2020 Jun;97:103346.
19. Sachs C, Groesser J, Stadelmann M, Schweiger J, Erdelt K, Beuer F. Full-arch prostheses from translucent zirconia: accuracy of fit. Dent Mater. 2014 Aug;30(8):817-23.
20. Alhilou A, Beddis HP, Mizban L, Seymour DW. Basic Erosive Wear Examination: assessment and prevention. Dental Nursing. 2015;11(5):262–7.
21. Magne P, Schlichting LH, Maia HP, Baratieri LN. In vitro fatigue resistance of CAD/CAM composite resin and ceramic posterior occlusal veneers. J Prosthet Dent. 2010 Sep;104(3):149-57.
22. Emam Z, A. Aleem N. Influence of Different Materials and Preparation Designs on Marginal Adaptation and Fracture Resistance of CAD/CAM Fabricated Occlusal Veneers. Egyptian Dent J. 2020;66(1):439–52.
23. Emam ZN, A. Aleem NA. Influence of Different Materials and Preparation Designs on Marginal Adaptation and Fracture Resistance of CAD/CAM Fabricated Occlusal Veneers. Egyptian Dental Journal. 2020;66(Issue 1 - January (Fixed Prosthodontics, Dental Materials, Conservative Dentistry & Endodontics)):439–52.
24. Huang X, Zou L, Yao R, Wu S, Li Y. Effect of preparation design on the fracture behavior of ceramic occlusal veneers in maxillary premolars. J Dent. 2020 Jun;97:103346.
25. Clausen JO, Abou Tara M, Kern M. Dynamic fatigue and fracture resistance of non-retentive all-ceramic full-coverage molar restorations. Influence of ceramic material and preparation design. Dent Mater. 2010 Jun;26(6):533-8.
26. Sasse M, Krummel A, Klosa K, Kern M. Influence of restoration thickness and dental bonding surface on the fracture resistance of full-coverage occlusal veneers made from lithium disilicate ceramic. Dent Mater. 2015 Aug;31(8):907-15.
27. Tribst JPM, Tach Q, de Kok P, Dal Piva AMO, Kuijs RH, Kleverlaan CJ. Thickness and Substrate Effect on the Mechanical Behaviour of Direct Occlusal Veneers. Int Dent J. 2023 Oct;73(5):612-619.
28. Guess PC, Schultheis S, Wolkewitz M, Zhang Y, Strub JR. Influence of preparation design and ceramic thicknesses on fracture resistance and failure modes of premolar partial coverage restorations. J Prosthet Dent. 2013 Oct;110(4):264-73.
29. McLean JW, von Fraunhofer JA. The estimation of cement film thickness by an in vivo technique. Br Dent J. 1971 Aug 3;131(3):107-11.
30. Bindl A, Mörmann WH. Marginal and internal fit of all-ceramic CAD/CAM crown-copings on chamfer preparations. J Oral Rehabil. 2005 Jun;32(6):441-7.
31. Anadioti E, Aquilino SA, Gratton DG, Holloway JA, Denry I, Thomas GW, Qian F. 3D and 2D marginal fit of pressed and CAD/CAM lithium disilicate crowns made from digital and conventional impressions. J Prosthodont. 2014 Dec;23(8):610-7.
32. Ahlers MO, Mörig G, Blunck U, Hajtó J, Pröbster L, Frankenberger R. Guidelines for the preparation of CAD/CAM ceramic inlays and partial crowns. Int J Comput Dent. 2009;12(4):309-25. English, German.
33. Schlenz MA, Vogler J, Schmidt A, Rehmann P, Wöstmann B. New Intraoral Scanner-Based Chairside Measurement Method to Investigate the Internal Fit of Crowns: A Clinical Trial. Int J Environ Res Public Health. 2020 Mar 25;17(7):2182.
34. Vianna ALSV, Prado CJD, Bicalho AA, Pereira RADS, Neves FDD, Soares CJ. Effect of cavity preparation design and ceramic type on the stress distribution, strain and fracture resistance of CAD/CAM onlays in molars. J Appl Oral Sci. 2018;26:e20180004.
35. Ozturk N, Aykent F. Dentin bond strengths of two ceramic inlay systems after cementation with three different techniques and one bonding system. J Prosthet Dent. 2003 Mar;89(3):275-81.
36. Al-Akhali M, Kern M, Elsayed A, Samran A, Chaar MS. Influence of thermomechanical fatigue on the fracture strength of CAD-CAM-fabricated occlusal veneers. J Prosthet Dent. 2019 Apr;121(4):644-650.
37. Krummel A, Garling A, Sasse M, Kern M. Influence of bonding surface and bonding methods on the fracture resistance and survival rate of full-coverage occlusal veneers made from lithium disilicate ceramic after cyclic loading. Dent Mater. 2019 Oct;35(10):1351-1359.
38. Zar B, Eckert S, Kunkela J, Ingr T, Mounajjed R. The marginal fit of lithium disilicate crowns: Press vs. CAD/CAM. Braz Oral Res. 2018;32:e001.
39. Naumova EA, Ernst S, Schaper K, Arnold WH, Piwowarczyk A. Adhesion of different resin cements to enamel and dentin. Dent Mater J. 2016;35(3):345-52.
40. Tozo-Burgos JG, Juárez-Vizcarra CF, Calla-Poma R, Sánchez-Tito M. Fracture Resistance of CAD/CAM Nanohybrid Resin Occlusal Veneers Based on Bonding Surface: Enamel vs. Enamel-Dentin vs. Enamel-Resin Coating. J Clin Exp Dent. 2025 Jun 1;17(6):e675-e682.
| Issue | Vol 22 (Continuously Published Article-Based) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/fid.v22i51.20633 | |
| Keywords | ||
| Dental Marginal Adaptation Dental Veneers Flexural Strength Lithia Disilicate | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Barakati T, Geramipanah F, Memarian M, Lari Z. Fracture Resistance, Marginal Gap and Internal Gap of Lithium Disilicate Occlusal Veneers with Two Preparation Designs. Front Dent. 2026;22.
