LOAD FATIGUE OF TEETH WITH DIFFERENT FERRULE LENGTHS, RESTORED WITH FIBER POSTS, COMPOSITE RESIN CORES, AND ALL-CERAMIC CROWNS

Statement of problem. There is no evidence to suggest that the ferrule length needed for an all-ceramic crown is different from that needed for a cast metal or metal ceramic crown. Purpose. The purpose of this study was to relate different ferrule lengths with the number of fatigue cycles needed for failure of the crown cement for an all-ceramic crown cemented with a resin cement. Material and methods. Fifteen maxillary central incisors were divided into 3 groups (n=5), with ferrules of 0.0 mm (no-ferrule group), 0.5 mm (0.5-mm ferrule group), and 1.0 mm (1.0-mm ferrule group), respectively. Each tooth was restored with a 0.050-inch glass-filled composite post (ParaPost FiberWhite) and a composite resin core (ParaCore). The posts were cemented with resin cement (ParaPost Cement), and the composite resin cores were bonded to dentin using a dentin bonding agent (ParaPost Cement, Conditioner A & 13). Each specimen was prepared with a 7-mm total preparation height, a 1.5-mm lingual axial wall, and a 1.0-mm shoulder around the tooth. The crowns for all specimens were pressed with a pressable ceramic material (IPS Empress 2) and cemented with resin cement (Variolink 11). A 6-kg cyclic test load was applied to each specimen at 135 degrees to the long axis of the tooth. The independent variable measured was the number of load fatigue cycles required for failure of the crown cement. The data were subjected to the Kruskal-Wallis test to detect overall significance and the Mann-Whitney U test for pairwise comparisons with Bonferrom correction (alpha=.017). Results. The mean (SD) number of cycles to failure for each group was: no-ferrule group, 213 (317); 0.5-mm ferrule group, 155,137 (68,991); and 1.0-mm ferrule group, 262,872 (21,432). None of the specimens in the 1.0-mm ferrule group failed. Significant differences were found between the no-ferrule group and the 0.5-mm ferrule group, and the no-ferrule group and the 1.0-mm ferrule group (P<.017), but not between the 0.5-mm ferrule group and the 1.0-mm ferrule group (P>.017). Conclusions. Specimens with a 0.0-mm ferrule survived few fatigue cycles despite the fact that both the post and crown were bonded with resin cement. Teeth with a 0.5-mm ferrule showed a significant increase in the number of fatigue cycles over the 0.0-mm group, whereas teeth with the 1.0-mm ferrule exhibited a significantly higher fatigue cycle count over the 0.0-mm but not the 0.5-mm group. (J Prosthet Dent 2009-102:229-234)