Effect of Die Spacer Thickness on the Fracture Resistance of CAD/CAM Lithium Disilicate Veneers on Maxillary First Premolars

OBJECTIVE: The purpose of this study was to compare the fracture resistance of ceramic veneers with digital die spacer settings at 20 µm, 40 µm, and 100 µm. MATERIALS AND METHODS: Eighteen sound maxillary first premolars were divided into three groups (n=6) according to their digital die spacer settings: group A=20 µm, group B=40 µm, group C=100 µm. Each tooth was prepared to a depth of 0.5 mm to receive lithium disilicate veneers (IPS e.max CAD, Ivoclar Vivadent). All groups were thermocycled (2500 cycles at 5–55°C) and subjected to fracture resistance test using a universal testing machine until failure. Failure modes were examined using a stereomicroscope. RESULTS: The values (N) for group A=1181.34±301.33, group B=1014.29±291.12, and group C=841.89±244.59. One-way ANOVA showed no statistical difference among the three groups (p=0.145). However, chi-square test showed that a significant difference was present in the modes of failure (p=0.009). Tukey’s post hoc test indicated that the failure modes of group A were statistically different from those of group C, showing 83.3% adhesive failure for group A compared to 0% adhesive failures in group C. A p-value of ≤0.05 was considered as statistically significant. CONCLUSION: Digital die spacer thickness did not influence the mean fracture resistance values of CAD/CAM lithium disilicate veneers. However, the way the failure occurred differed significantly at various die spacer thicknesses.