Evaluation of the fracture resistance of all-ceramic zirconia posts by 3 different methods

Statement of the problem. All-ceramic post-and-core restorations offer a number of advantages compared with systems that use metal build-ups. In certain clinical cases, however, fractures at the joint between the post and core build-up have been reported. Purpose. The objective, therefore, is to improve the joint between the post and the core build-up. Material and methods. Three different methods were used to prepare all-ceramic post-and-core restorations; pressing IPS Empress core build-ups to CosmoPost zirconia posts, cement-ing IPS Empress core build-ups to CosmoPost zirconia posts and Celay-milling of zirconia blanks. A series of ten restorations was prepared for each of the three methods. The post-and-core complexes were tested to failure with the load applied perpendicular to the post axis. The load and deflection at fracture were recorded. Results. The highest breaking load and highest deflection were recorded for the cementing technique with values of 25.3 N and $394{\mu}m$, respectively, The corresponding values for the pressed core build-ups and the milled zirconia core build-ups were 22 N and $301{\mu}m$, and 13 N and $160{\mu}m$, respectively. All the differences are statistically significant (p=0.05). Regarding the load-dependence of the deflection, the cemented core build-ups again demonstrated the highest value with $15.5{\mu}m/N$. The difference in the values of $13.6{\mu}m/N\;and\;13{\mu}m/N$ recorded for the pressed-on and milled core build-ups, respectively, were statistically insignificant. Conclusion. In regard to the high fracture resistance of zirconia post, adhesive cementing the core build-up to the post offers a viable alternative to the conventional pressing technique. The elastic bond between the rigid high-strength zirconia post and the core build-up presents an additional advantage.