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Background: Treatment of patients with severe tooth wear is complex. Treatments involving more tooth structure removal may be inappropriate for patients who have already lost a significant amount of dental tissue due to erosion. The aim of this study was to evaluate the effect of two modified occlusal veneer preparations on the fatigue resistance and stress distribution of bonded occlusal veneers, in comparison to the conventional preparation design. Methods: A total of 54 human mandibular molars were distributed into three equal groups of n=18 teeth each, according to the occlusal veneer preparation design, where group I (conventional design) received Planar occlusal veneer preparation, group II (occlusal veneer with circumferential finish line) and group III (occlusal veneer with intracoronal cavity extension). For the manufacture of all the veneers using machinable zirconium lithium silicate glass ceramic blocks, a computer aided design/manufacturing system was used. A dual cure, adhesive resin cement was used to bond all occlusal veneers to corresponding prepared teeth. After storage in water for one week, step-stress (accelerated life testing was performed for all samples. Finite element analysis was carried out as well to evaluate the distribution of stresses. Results: The highest values (mean±SD) were recorded for group II (890.57±211.53 N) followed by Group I values (883.54±135.91 N), while the lowest values were recorded for Group III (875.57±143.52 N). The difference between groups was statistically non-significant as indicated by ANOVA (P=0.9814>0.05). The stress values were generally found to be low and their distribution differed among groups. Conclusion: Group I and II showed comparable fatigue resistance and more favourable failure behaviour when compared to Group III based on the fractographic and 3D finite element analyses.

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Fatigue resistance and 3D finite element analysis of machine-milled ceramic occlusal veneers with new preparation designs versus conventional design: an in vitro study