Journal of Dentistry 135 (2023) 104560

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Journal of Dentistry
journal homepage: www.elsevier.com/locate/jdent

Short communication

Stability and wear of zirconia crowns with micro-layering

Martin Rosentritt *, Dirk Bollin , Michael Benno Schmidt , Angelika Rauch
Department of Dental Prosthetics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, Regensburg 93053, Germany

A R T I C L E I N F O A B S T R A C T

Keywords: Objectives: To investigate stability and wear of tooth-supported zirconia single crowns with micro-layering in-
Wear vitro.
Stability Materials and methods: Molar crowns and specimens were fabricated from 5Y-TZP zirconia (Gen-X, Amann-
Fracture force
Girrbach). Three groups were investigated: ML I: 0.1 mm cutback/painted/glazed (MiYO, Jensen); ML II:
Chewing
TCML
occlusal 0.3 mm cutback/painted/veneered/glazed (MiYO), and a monolithic control group (polished). After
Microlayer thermal cycling and mechanical loading (TCML), crowns were loaded to failure in a universal testing machine.
Veneering Two-body wear test was performed. Wear (mean, maximum, antagonist) and roughness (Ra, Rz) were deter­
Zirconia mined with a 3D laser-scanning-microscope.
Results: All crowns survived TCML. In the control (2501.5 N) and ML II group (1775.3 N) significantly lower
fracture forces were observed than in ML I (3636.4 N) (p ≤ 0.003). Significant wear differences were found (p ≤
0.001) but not for antagonist wear (p ≥ 0.202). Lowest wear was observed in the control group 10.2 ± 1.5 µm/
28.8 ± 6.4 µm, ML I 112.8 ± 37.3 µm/152.9 ± 42.8 µm, and ML II 192.4 ± 49.1 µm/340.7 ± 54.2 µm.
Roughness was characterized by a Ra from 1.6 µm (control) to 3.0 µm (ML II), and a Rz from 11.8 µm (Control) to
24.0 µm (ML II). Roughness significantly differed between control group and ML I (p = 0.002) as well as ML I and
ML II (p = 0.020).
Conclusions: Good in-vitro performance and fracture stability without chipping or fracture were found for all
systems. Wear and roughness were comparable to conventional ceramic veneering systems.
Clinical Relevance: The micro-layering of zirconia restorations can be recommended, yet the micro-layering could
be worn during clinical application.

1. Introduction complication [8,9]. To overcome these disadvantages, modifications in

The use of zirconia for the fabrication of tooth- or implant-supported
restorations is very popular amongst dentists worldwide [1,2]. The
development of various zirconia formulations has made it even easier to
use zirconia in a monolithic approach in an esthetical context. However,
the colouring of restorations is often not sufficient to achieve esthetic
results. In addition, the wear of polished monolithic zirconia is minimal
under clinical conditions and does not reflect the natural change and
adaptation in occlusion [3–6]. Thus, the use of a veneering ceramic
might be favorable to better simulate the natural appearance and wear
of a restoration.
Even if the survival rates of both tooth-supported (5-year survival ≥
89.4%) and implant-supported (5-year survival ≥ 93.0%) zirconia res­
torations are high [7], the veneering of zirconia has shortcomings, since
an increased reduction of hard tooth substance is necessary in compar­
ison to monolithic restorations. Moreover, chipping is a very common
the composition of zirconia were made to achieve higher translucency.
These compositions determine a higher thickness of zirconia restora­
tions and a decreased span lengths of fixed partial dentures. This is a
relevant aspect, since, e.g., most zirconia materials with 5 mol% yttria
(5Y-TZP) are only available for use in 3-unit fixed dental prosthesis.
As of late, a new way of zirconia veneering was introduced that
combines anatomical design of the zirconia restorations and a thin
layering with veneering ceramic [10,11]. This veneering technique is
called heterogeneously, i. a., micro-layering, liquid ceramic system, in­
ternal stain technique. All terms include that the zirconia framework is
fabricated anatomically – sometimes minimally reduced in dimension -
and that a small veneering of 0.1–0.6 mm thickness is applied. In this
way, texture, shape and color of restorations can be modified. To date,
no investigations about wear or stability of restorations fabricated of
zirconia with micro-layering are available.
The aim of this study was to investigate the in-vitro performance of

* Corresponding author.
E-mail address: martin.rosentritt@ukr.de (M. Rosentritt).

https://doi.org/10.1016/j.jdent.2023.104560
Received 15 February 2023; Received in revised form 2 May 2023; Accepted 22 May 2023
Available online 30 May 2023
0300-5712/© 2023 Elsevier Ltd. All rights reserved.
M. Rosentritt et al.
tooth-supported zirconia single crowns with micro-layering in terms of
wear and stability. The working hypotheses were that zirconia crowns
with micro-layering reveal similar performance than monolithic zirco­
nia crowns.
2. Materials
All crowns and specimens were prepared from 5Y-TZP zirconia (Gen-
X, Amann Girrbach, Pforzheim, Germany; Austromat μSiC, Dekema,
Freilassing, Germany). Three groups were investigated:
• ML I: occlusal 0.1 mm cutback; painted and fired (MiYO High Opacy
Mamelon Coral, Jensen, Metzingen, Germany); glazed and fired
(MiYO Glaze),
• ML II: occlusal 0.3 mm cutback; painted and fired (MiYO High Opacy
Mamelon Coral); veneered and fired (MiYO® Ice); glazed and fired
(MiYO® Glaze),
• Control: anatomical design without cutback, polished (Panther,
Briegeldental, Sauerlach, Germany).
The occlusal cut-back is characterized by an occlusal reduction of the
zirconia frame and application of ceramic microlayer (Fig. 1). The
crystallization and glaze firing (Austromat 654 press-i-dent, Dekema,
Germany) were processed according to the manufacturers’ instructions.
For thermal cycling and mechanical loading (TCML), the roots of
artificial molars (elastic modulus: 18 GPa, flexural strength: 339 MPa;
Trinia, Bicon Europe, Büchenbeuren, Germany) were coated with a layer
of polyether impression material (1 mm thickness; Impregum, 3 M, Saint
Paul, MN, USA) to simulate the resilience of the human periodontium
and then fixed in resin bases (Palapress, Kulzer, Hanau, Germany). The
teeth were prepared according to ceramic guidelines and eight crowns
per group were designed with a thickness of 1.5 mm and milled. Both the
teeth and the intaglio surfaces of the crowns were sandblasted (Al203, 1
bar, 50 µm), steamed, cleaned for 3 min in an ultrasonic bath (99%
isopropanol), and dried. The inner surfaces of the crowns were pre­
treated with a bonding agent for 60 s (Monobond Plus, Ivoclar Vivadent,
Schaan, Liechtenstein). The crowns were adhesively bonded (Multilink
Automix; Ivoclar Vivadent) to the artificial molars. Light polymerization
was performed from four sides with a light curing unit for 40 s each side
(Elipar Trilight, 3 M).
TCML (2 × 3000 × 5 ◦ C/55 ◦ C, 2 min/cycle, H20 dist., 1.2 × 106
force á 50 N) was performed to simulate five years of intraoral service
Fig 1. Scheme of the cutback (molar crown dimension after polishing or with microlayer veneering (solid line) and dimension after reduction for 0.1 mm (striated
line) or 0.3 mm (dotted line) microlayer).
2
Journal of Dentistry 135 (2023) 104560
[12,13]. For all crowns that survived TCML, the fracture force was
determined by mechanically loading the crowns to failure in a universal
testing machine (Z010, Zwick, Ulm, Germany). The force was applied on
the center of the crowns by using a steel ball (diameter = 12 mm, testing
speed = 1 mm/min). A tin foil of 1 mm thickness was inserted between
the crown and the steel ball to guarantee equal force distribution. The
failure determination was set to a 10% loss of the maximum loading
force or an acoustic signal, i. e., crack. The fractures were examined
optically (digital microscope VHX-S550E, Keyence, Neu-Isenburg, D)
and the fracture patterns were roughly analyzed according to defect size
and spread as well as remaining fragments on the tooth.
For wear testing, eight specimens per group (8.3 × 8.2 mm, thick­
ness: 2 mm) were fixed on aluminum stubs. Two-body wear tests were
performed in a pneumatic pin-on-block design (Wear Tester, Inso,
Lonnerstadt, Germany, vertical load 50 N, 120,000 cycles, 1.6 Hz;
lateral movement = 1 mm, occlusal lift = 1 mm) with steatite balls
(radius = 1.5 mm; magnesium silicate, CeramTec, Plochingen, Ger­
many) as antagonists in a water bath. Mean and maximum vertical loss
as well as two parameters for roughness average height (Ra) and ten-
point height (Rz) were measured with a 3D laser-scanning-microscope
(KJ 3D, Keyence, Osaka, Japan). Antagonist wear was determined as
percent area of the projected antagonist area (Digital microscope, Key­
ence, Japan).
For statistical analysis, descriptives (mean, standard deviation, 95%
Confidence Interval [CI] were calculated (SPSS 29, Armonk, NY, USA).
Comparisons between groups were performed by using one-way ANOVA
and Bonferroni post-hoc-test. The level of significance was set to α =
0.05.
3. Results
During TCML any of the crowns failed. The fracture force (Table 1)
varied between 2501.5 N (Control), 3636.4 N (ML I), and 1775.3 N (ML
II). Significant differences in fracture force were observed (ANOVA p <
0.001) between control and group ML I (Bonferroni p = 0.003) as well as
between ML I and ML II (Bonferroni p < 0.001). All crowns showed
comparable fracture patterns characterized by one or more fractures of
the crown. In most cases, the cement and about 1/3 of the crown
remained on the tooth (Fig. 2).
Wear values were significantly different between all groups (ANOVA
p < 0.001, Bonferroni p ≤ 0.001; Table 2). Lowest values for mean and
maximum wear were observed in the control group 10.2 µm/28.8 µm.
M. Rosentritt et al. Journal of Dentistry 135 (2023) 104560

Table 1 micro-layering was higher than for the monolithic control in the present
Mean fracture force of crowns; Standard deviation (SD); Confidence Interval (CI) investigation. The wear values for micro-layering were comparable to
(Identical superscript letters in columns indicate significant differences between the wear of other monolithic silica-based ceramics or veneering ceramics [6,
results; p<0.050). 15]. However, mean and maximum wear values were correlated to the
Group Fracture force [N] Remaining applied layer thickness of the micro-layering. It might be suggested that
Mean ± 95% CI Minimum Maximum crown during clinical use, the micro-layering will be removed. The wear of the
SD on the tooth
antagonist was similar in all groups. Thus, after insertion, a more natural
ML I 3636.4 ± 3065.6;4207.1 2883.0 4857.0 1/3–1/2
682.7 a,b
wear behavior of micro-layered restorations (molar: 29 μm/year) might
ML II 1775.3 ± 1357.1;2193.4 1161.0 2382.0 0–1/2 be assumed than after the insertion of monolithic zirconia restorations
500.1 a (mean wear: 10.2 μm) [16].
Control 2501.5 ± 2033.3;2969.7 1437.0 3109.0 1/3–3/4 The roughness was highest in ML II group and reached mean values
556.0 b
of 0.3 μm (Ra). A threshold of Ra larger than 0.2 μm is often used in
investigations to describe that surfaces are more prone to biofilm for­
This was followed by group ML I 112.8 µm/152.9 µm. Highest wear was mation [17,18]. It is believed that the increased surface and the shelters
observed for group ML II 192.4 µm/340.7 µm. Antagonist wear values of the rougher surface might ease the colonization of microorganism. On
were not statically different (ANOVA p = 0.178, Bonferroni p ≥ 0.202) the other hand, other studies contradict this opinion and describe that
and yielded 21.3% (ML II), 26.9% (Control), and 31.1% (ML I). the acquired pellicle smoothens the surface of the material and that
Mean surface roughness (Table 3, Fig 1) of the materials (Ra) was 1.6 other parameters like the hydrophilicity of the restorative material are
µm (Control), 2.0 µm (ML I) and 3.0 µm (ML II). Significant differences more likely to have a relevant influence [19].
(ANOVA p < 0.001) were observed between control group and ML II
(Bonferroni p < 0.001) as well as between ML I and ML II (Bonferroni p 5. Conclusions
= 0.005). For Rz, values were 11.8 µm (Control), 14.8 µm (ML I), and
24.0 µm (ML I). The investigated materials showed significant differ­ All crowns survived the TCML. Fracture force was different among
ences in Rz (ANOVA p = 0.002) between control and ML I (Bonferroni p the groups and presented lowest values in the ML II group. Except for
= 0.002) as well as between ML I and ML II (Bonferroni p = 0.020). antagonist wear, mean and maximum wear were different between all
groups with ML II presenting highest values. Roughness parameters Ra
4. Discussion and Rz were significantly increased in the ML II group.

The results of the present in vitro investigation showed a principal 6. Clinical relevance
applicability of the investigated crowns, as none of the tested specimens
fractured during TCML. For fracture force, significantly different results The micro-layering of zirconia restorations might be an interesting
were obtained for the control group and ML I as well as for ML I and ML opportunity to avoid the monolithic application or the veneering of
II. Mean and maximum wear were different between all groups.
Regarding roughness, differences were observed between the control
and ML II group as well as for the ML I and ML II group. Thus, the Table 3
Mean roughness of specimen (Ra, Rz); Standard deviation (SD); Confidence In­
working hypotheses were rejected.
terval (CI) (Identical superscript letters in rows indicate significant differences be­
In terms of fracture force, significant differences were observed with
tween the results; p<0.050).
lowest values for the ML II group. However, even the ML II group yielded
values of ≥ 1161.0 N, which is clinically acceptable. On molars, a Group Ra [µm] Rz [µm]
Mean ± SD 95% CI Mean ± SD 95% CI
maximum loading of 1000 N was observed in patients with bruxism,
a
thus no restrictions in strength during clinical use of micro-layered zir­ ML I 2.0 ± 0.3 1.7;2.2 14.8 ± 3.3 a 12.1;17.5
a,b
ML II 3.0 ± 0.6 2.5;3.4 24.0 ± 8.2 a,b 17.1;30.8
conia crowns should be expected [14]. b
Control 1.6 ± 0.7 1.0;2.2 11.8 ± 5.9 b 6.9;16.7
The wear testing revealed that wear of specimen fabricated with

Fig. 2. Occlusal view on typical fracture pattern after fracture test (left: control, middle: ML1, right: ML2; cement (white) and about 1/3 to 1/2 of the crown
remained on the tooth).

Table 2
Mean and maximum wear of crowns and antagonist wear; Standard deviation (SD); Confidence Interval (CI) (Identical superscript letters in rows indicate significant
differences between the results; p<0.050).
Group Wear [µm] Maximum wear [µm] Antagonist wear [%]
Mean ± SD 95% CI Mean ± SD 95% CI Mean ± SD 95% CI
ML I 112.8 ± 37.3 a 81.5;144.0 152.9 ± 42.8 b 117.1;188.7 31.1 ± 7.6 24.8;37.4
ML II 192.4 ± 49.1 a 151.3;233.5 340.7 ± 54.2 b 195.3;386.0 21.3 ± 14.8 9.0;33.6
Control 10.2 ± 1.5 a 9.0;11.5 28.8 ± 6.4 b 23.5;34.1 26.9 ± 5.8 22.1;31.8

3
M. Rosentritt et al.
polycrystalline ceramics. The wear of the micro-layered restorations is
higher than that of monolithic zirconia. After a while of clinical appli­
cation, the micro-layering of the zirconia might be removed by wear.
Funding
This study was not funded.
Ethical approval
This article does not contain any studies with human participants or
animals performed by any of the authors.
CRediT authorship contribution statement
Martin Rosentritt: Conceptualization, Supervision, Writing – re­
view & editing. Dirk Bollin: Conceptualization, Writing – original draft,
Investigation, Data curation, Visualization. Michael Benno Schmidt:
Writing – review & editing. Angelika Rauch: Writing – review &
editing.
Declaration of Competing Interest
The authors declare the following financial interests/personal re­
lationships which may be considered as potential competing interests:
Prof. Dr. Martin Rosentritt declares that he has third-party research
projects with different dental companies. Dirk Bollin declares that he has
no competing financial interests or personal relationships. Micheal
Schmidt declares that he has third-party research projects with different
dental companies. Angelika Rauch declares that she has third-party
research projects with different dental companies.
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