[Comparison of fracture strength of two chairside CAD/CAM ceramic blocs with different thickness].

Purpose: To provide theoretical basis for clinical CAD/CAM restorations with a comparison of the fracture strength between two chairside CAD/CAM immediate restorative materials (IPS e.max CAD and Vita Enamic) with different occlusal thickness in vitro.
Methods: IPS e.max CAD and Vita Enamic full-crowns with occlusal thicknesses 1.5/2.0/2.5 mm were fabricated with CEREC and adhesively seated to dies customized by manufacturer (n=42). All specimens were stored in distilled water at 37 ℃ for 24 h. Later, static fractural loading was performed. The fracture surface was observed through scanning electron microscope (SEM) and energy dispersive spectrum (EDS). The composites of two materials were detected by X-Ray diffraction (XRD) techniques. The results of fracture strength were analyzed by one-way ANOVA and t-test via SPSS 20.0 software package.
Results: With the increase of occlusal thickness, the fracture strength of IPS e.max CAD increased remarkably. However, the Vita Enamic's fracture strength remained the same with no significant difference. With the occlusal thickness increased from 1.5 to 2.0 mm, there was no significant difference in the fracture strength between IPS e.max CAD group and Vita Enamic group. As the thickness increased from 1.5 to 2.0 mm, the fracture strength of IPS e.max CAD group was significantly higher than that of Vita Enamic group. The results of SEM showed that the filler particles of IPS e.max CAD were smaller compared to that of Vita Enamic. Cone cracks were mainly found in the fracture surface of IPS e.max CAD, while radical cracks appeared in Vita Enamic. EDS showed the metal oxide and SiO2 in Vita Enmic was significantly higher than that in IPS e.max CAD. XRD showed that the primary crystal phase of IPS e.max CAD was lithium silicate, while Vita Enamic was amorphous.
Conclusions: Both IPS e.max CAD and Vita Enamic can meet the standard of clinical application as the occlusal thickness reaches 1.5 mm. IPS e.max CAD showed better fracture resistance when the thickness was greater than 2.0 mm.