Fatigue Failure Load of a Bonded Simplified Monolithic Feldspathic Ceramic: Influence of Hydrofluoric Acid Etching and Thermocycling

Abstract

SUMMARY Objective: To evaluate the effect of hydrofluoric acid (HF) etching and thermocycling (Tc) on fatigue failure load of feldspathic ceramic restorations cemented with two resin cements. Methods: Disc-shaped feldspathic ceramic (Vitablocs Mark II; Ø=10 mm, 1.0-mm thick) and G10 epoxy resin (Ø=10 mm, 2.5-mm thick) specimens were made and randomly allocated considering three factors: ceramic etching (ie, with vs without 10% HF plus silane application), resin cement (ie, self-adhesive [RelyX U200; U200] or conventional [Multilink Automix; MA]), and Tc (ie, with vs without 5-55°C/12,000 cycles). Adhesive cementation followed each manufacturer's instructions. The fatigue test (n=20) was based on the staircase approach (250,000 cycles; 20 Hz). Contact angle, surface topography, and fractography analysis were also executed. Specific statistical tests were employed for each outcome (α=0.05). Results: The interaction of HF and Tc factors decreased the fatigue resistance for both cements (U200 542.63>U200/HF-Tc 495.00; MA 544.47>MA/HF-Tc 506.84). Comparing the cements associated with HF or Tc, there was statistical superiority for MA (U200-Tc 537.37<MA-Tc 561.32; U200/HF 535.79<MA/HF 557.11), and no statistical difference was detected when only cement type or its association with HF-Tc was compared (U200 542.63=MA 544.47; U200/HF-Tc 495.00=MA/HF-Tc 506.84). The fracture always originated from defects at the ceramic-intaglio surface as radial cracks. Conclusion: HF etching plus silane agent increased the ceramic surface free energy and its wettability, but it did not provide better results in terms of fatigue resistance compared with silane agent application only. The association of HF etching and aging significantly reduced the fatigue resistance of the material, regardless of the resin cement used.