Internal adjustments decrease the fatigue failure load of bonded simplified lithium disilicate restorations.

Objective: To investigate the effect of intaglio surface adjustment of simplified lithium disilicate ceramic restorations adhesively cemented to a dentin-like material on its fatigue behavior.

Methods: Ceramic discs (IPS e.max CAD) were prepared and an in-Lab simulation of machining roughness was performed by grinding with SiC paper (#60). Ceramic discs were divided into 4 groups according to the internal adjustment of the cementation surface: no adjustments (CTRL); adjustment with a medium (M), fine (F), or extra fine (FF) diamond bur. Dentin-like material discs were also produced. Ceramic disc intaglio surfaces were etched (5% hydrofluoric acid; 20s) and received a silane coating. Dentin-like material discs were etched (10% hydrofluoric acid; 1min) and received a primer coating. Pairs of ceramic/dentin-like material were adhesively cemented (Multilink Automix), and fatigue failure load tests were performed using the Staircase approach (250,000 cycles; 20Hz). Roughness, topographic and fractographic analyses were performed. Statistical analyses were carried out through ANOVA tests.

Results: All ground groups (M=521.3 N; F=536.9 N; FF=676.2 N) presented lower fatigue failure load values than the control (1241.6 N). M diamond bur created a rougher surface than F (Ra and Rz parameters). However, FF was similar to F and M for Ra, and similar to F for Rz.

Significance: Bur adjustments on the intaglio surface of simplified lithium disilicate ceramic restorations greatly decreased the fatigue failure load even using an extra-fine diamond bur. Care should be taken when internal adjustments are needed.