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Abstract：
OBJECTIVE: To investigate the fracture resistance and failure modalities of anterior endocrown restorations fabricated employing diverse ceramic materials, and bonded using various cementation methodologies.
METHODS: Forty maxillary central incisors were divided into two main groups based on the ceramic materials used; GroupI (Zir): zirconia endocrwons (Zolid HT+, Ceramill, Amanngirrbach) and GroupII (E-Max): e-max endocrowns (IPS e.max CAD, Ivoclar Vivadent). Both groups were further split into two subgroups depending on the cementation protocols; subgroup IA \"ZirMDP\": endocowns cemented with MDP primer + MDP resin cement, subgroup IB (ZirNon-MDP): cemented with MDP primer + non-MDP resin cement, subgroup IIA (E-maxMDP): cemented with MDP primer + MDP resin cement, subgroup IIB (E-maxNon-MDP): cemented with MDP primer + non-MDP resin cement. (n = 10/subgroup). Endocrowns were manufactured using CAD/ CAM. Teeth were subjected to 10,000 thermal cycles. The fracture test was performed at 45o with a palatal force direction until the fracture occurred. Test results were recorded in Newton. The failure mode was examined using a stereomicroscope. A One-way ANOVA test was utilized to compare different groups regarding fracture strength values. Tukey`s Post Hoc was utilized for multiple comparisons.
RESULTS: The comparative analysis of fracture strength across the diverse groups yielded non-significant differences, as indicated by a p-value exceeding 0.05. Nonetheless, an observable trend emerged regarding the mode of failure. Specifically, a statistically significant prevalence was noted in fractures localized within the endocrown/tooth complex below the cementoenamel junction (CEJ) across all groups, except for Group IIB, \"E-max Non-MDP,\" where fractures within the endocrown/tooth complex occurred above the CEJ.
CONCLUSIONS: Combining an MDP-based primer with an MDP-based resin cement did not result in a significant effect on the anterior endocrown fracture strength.
CONCLUSIONS: Regardless of the presence of the MDP monomer in its composition, adhesive resin cement achieved highly successful fracture strength when used with MDP-based ceramic primers. Additionally, ceramic materials exhibiting elastic moduli surpassing those of dentin are discouraged due to their propensity to induce catastrophic fractures within the tooth structure.
METHODS: Forty maxillary central incisors were divided into two main groups based on the ceramic materials used; GroupI (Zir): zirconia endocrwons (Zolid HT+, Ceramill, Amanngirrbach) and GroupII (E-Max): e-max endocrowns (IPS e.max CAD, Ivoclar Vivadent). Both groups were further split into two subgroups depending on the cementation protocols; subgroup IA \"ZirMDP\": endocowns cemented with MDP primer + MDP resin cement, subgroup IB (ZirNon-MDP): cemented with MDP primer + non-MDP resin cement, subgroup IIA (E-maxMDP): cemented with MDP primer + MDP resin cement, subgroup IIB (E-maxNon-MDP): cemented with MDP primer + non-MDP resin cement. (n = 10/subgroup). Endocrowns were manufactured using CAD/ CAM. Teeth were subjected to 10,000 thermal cycles. The fracture test was performed at 45o with a palatal force direction until the fracture occurred. Test results were recorded in Newton. The failure mode was examined using a stereomicroscope. A One-way ANOVA test was utilized to compare different groups regarding fracture strength values. Tukey`s Post Hoc was utilized for multiple comparisons.
RESULTS: The comparative analysis of fracture strength across the diverse groups yielded non-significant differences, as indicated by a p-value exceeding 0.05. Nonetheless, an observable trend emerged regarding the mode of failure. Specifically, a statistically significant prevalence was noted in fractures localized within the endocrown/tooth complex below the cementoenamel junction (CEJ) across all groups, except for Group IIB, \"E-max Non-MDP,\" where fractures within the endocrown/tooth complex occurred above the CEJ.
CONCLUSIONS: Combining an MDP-based primer with an MDP-based resin cement did not result in a significant effect on the anterior endocrown fracture strength.
CONCLUSIONS: Regardless of the presence of the MDP monomer in its composition, adhesive resin cement achieved highly successful fracture strength when used with MDP-based ceramic primers. Additionally, ceramic materials exhibiting elastic moduli surpassing those of dentin are discouraged due to their propensity to induce catastrophic fractures within the tooth structure.
摘要：
目的：为了研究使用不同陶瓷材料制造的前腔内修复体的抗断裂性和失效模式，并使用各种胶结方法粘结。
方法：根据所使用的陶瓷材料，将40颗上颌中切牙分为两个主要组；组I（Zir）：氧化锆内分泌（ZolidHT，Ceramill,Amanngirrbach)和GroupII(E-Max)：e-max内冠(IPSe.maxCAD，IvoclarVivadent)。根据胶结方案，将两组进一步分为两个亚组；IA亚组“ZirMDP”：用MDP底漆+MDP树脂水泥胶结的内胎，IB亚组(ZirNon-MDP):用MDP底漆+非MDP树脂水泥胶结,IIA亚组(E-maxMDP):用MDP底漆+MDP树脂水泥胶结,IIB亚组(E-maxNon-MDP):用MDP底漆+非MDP树脂水泥胶结。(n=10/亚组)。使用CAD/CAM制造内皮。牙齿经受10,000个热循环。在45o处以腭力方向进行骨折测试，直到发生骨折。测试结果以牛顿记录。使用立体显微镜检查故障模式。利用单向ANOVA测试来比较关于断裂强度值的不同组。Tukey的PostHoc被用于多重比较。
结果：不同组的断裂强度比较分析得出的差异不显著，如p值超过0.05所示。尽管如此，关于故障模式出现了一个可观察到的趋势。具体来说,在所有组的牙釉质交界处（CEJ）下方的内冠状/牙齿复合体内的骨折均具有统计学意义，除了IIB组，\"E-max非MDP,“内冠状/牙齿复合体内的骨折发生在CEJ上方。
结论：将基于MDP的底漆与基于MDP的树脂粘固剂结合使用不会对前腔内骨折强度产生显著影响。
结论：无论组合物中是否存在MDP单体，当与MDP基陶瓷底漆一起使用时，粘合剂树脂水泥获得了非常成功的断裂强度。此外,表现出超过牙本质的弹性模量的陶瓷材料是不鼓励的，因为它们倾向于在牙齿结构内引起灾难性的骨折。
方法：根据所使用的陶瓷材料，将40颗上颌中切牙分为两个主要组；组I（Zir）：氧化锆内分泌（ZolidHT，Ceramill,Amanngirrbach)和GroupII(E-Max)：e-max内冠(IPSe.maxCAD，IvoclarVivadent)。根据胶结方案，将两组进一步分为两个亚组；IA亚组“ZirMDP”：用MDP底漆+MDP树脂水泥胶结的内胎，IB亚组(ZirNon-MDP):用MDP底漆+非MDP树脂水泥胶结,IIA亚组(E-maxMDP):用MDP底漆+MDP树脂水泥胶结,IIB亚组(E-maxNon-MDP):用MDP底漆+非MDP树脂水泥胶结。(n=10/亚组)。使用CAD/CAM制造内皮。牙齿经受10,000个热循环。在45o处以腭力方向进行骨折测试，直到发生骨折。测试结果以牛顿记录。使用立体显微镜检查故障模式。利用单向ANOVA测试来比较关于断裂强度值的不同组。Tukey的PostHoc被用于多重比较。
结果：不同组的断裂强度比较分析得出的差异不显著，如p值超过0.05所示。尽管如此，关于故障模式出现了一个可观察到的趋势。具体来说,在所有组的牙釉质交界处（CEJ）下方的内冠状/牙齿复合体内的骨折均具有统计学意义，除了IIB组，\"E-max非MDP,“内冠状/牙齿复合体内的骨折发生在CEJ上方。
结论：将基于MDP的底漆与基于MDP的树脂粘固剂结合使用不会对前腔内骨折强度产生显著影响。
结论：无论组合物中是否存在MDP单体，当与MDP基陶瓷底漆一起使用时，粘合剂树脂水泥获得了非常成功的断裂强度。此外,表现出超过牙本质的弹性模量的陶瓷材料是不鼓励的，因为它们倾向于在牙齿结构内引起灾难性的骨折。
