Fracture resistance of CAD/CAM endocrowns made from different materials in maxillary premolar interproximal defects

Clin Oral Investig. 2024 Mar 16;28(4):220. doi: 10.1007/s00784-024-05605-6.


Objectives: This in vitro study aims to compare the fracture resistance of three CAD/CAM materials used in endocrown restoration of interproximal defects in maxillary premolars.

Materials and methods: 45 maxillary premolars extracted as part of orthodontic treatment were included. Following standardized root canal treatment, all teeth were prepared into Mesial-Occlusal (MO) cavity types. The samples were then randomly divided into three groups: LD [repaired with lithium disilicate glass ceramics (IPS e.max CAD)], VE [treated with polymer-infiltrated ceramics (Vita Enamic)], and LU [repaired with resin-based nanoceramics (Lava Ultimate)]. Axial static loading was applied using a universal testing machine at 1 mm/min until fracture, and fracture resistance and failure modes were recorded.

Results: Regarding Fracture Resistance Values (FRVs), the LD group exhibited significantly higher values than the other two groups, VE (P = 0.028) and LU (P = 0.005), which showed no significant difference (P = 0.778). On the other hand, regarding failure modes, the LD group had a higher prevalence of irreparable fractures compared to the other two groups, VE (P < 0.001) and LU (P < 0.001), which showed no significant difference.

Conclusions: Although lithium disilicate glass ceramics exhibited higher FRVs, they had a lower repair probability. In contrast, polymer-infiltrated ceramics and resin-based nanoceramics contributed to tooth structure preservation.

Clinical relevance: For maxillary premolars with interproximal defects following root canal treatment, resin ceramic composites are recommended for restoration to enhance abutment teeth protection.

Keywords: Composite resins; Endocrown; Fracture strength; Lithium disilicate; Premolar.

MeSH terms

  • Bicuspid
  • Ceramics* / chemistry
  • Composite Resins / chemistry
  • Computer-Aided Design
  • Crowns*
  • Dental Porcelain / chemistry
  • Dental Restoration Failure
  • Dental Stress Analysis
  • Materials Testing
  • Polymers


  • Dental Porcelain
  • Composite Resins
  • Polymers