Purpose: To investigate the influence of cement film thickness, cement type, and substrate (enamel or dentin) on ceramic fracture resistance.
Materials And Methods: One hundred extracted human third molars were polished to obtain 50 enamel and 50 dentin specimens. The specimens were cemented to 1-mm-thick lithium disilicate ceramic plates with different cement film thicknesses (100 and 300 μm) using metal strips as spacers. The cements used were etch-and-rinse (RelyX Ultimate) and self-adhesive (RelyX U200) resin cements. Compressive load was applied on the ceramic plates using a universal testing machine, and fracture loads were recorded in Newtons (N). Statistical analysis was performed by multiple regression (p < 0.05). Representative specimens were evaluated by scanning electron microscopy to control the cement film thickness.
Results: The RelyX Ultimate group with a cement thickness of 100 μm cemented to enamel showed the highest mean fracture load (MFL; 1591 ± 172.59 N). The RelyX Ultimate groups MFLs were significantly higher than the corresponding RelyX U200 groups (p < 0.05), and thinner film cement demonstrated a higher MFL than thicker films (p < 0.05). Bonding to dentin resulted in lower MFL than with enamel (p < 0.001).
Conclusions: Higher fracture loads were related to thinner cement film thickness and RelyX Ultimate resin cement. Bonding to dentin resulted in lower fracture loads than bonding to enamel.
Clinical Significance: Reduced resin film thickness could reduce lithium disilicate restoration fracture. Etch-and-rinse resin cements are recommended for cementing on either enamel or dentin, compared with self-adhesive resin cement, for improved fracture resistance.
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