Mechanical properties and crown accuracy of additively manufactured zirconia restorations

Objectives: We evaluated the mechanical properties of zirconia restorations produced via additive manufacturing (AM) and the crown accuracy of zirconia crowns. Methods: Zirconia disks, bars, and crowns were manufactured via subtractive (CNC group) and additive manufacturing (AM group) techniques. Disk-shaped specimens in each group were autoclaved at 134 °C and 216 kPa for 5, 10, and 24 h. The phases of the specimens were analyzed using an X-ray diffractometer. The flexural strengths were measured via biaxial flexural tests. The morphologies were examined using a scanning electron microscope. The correlation between the m-phase fraction and biaxial flexural strength by autoclave time in each group was analyzed via linear mixed model and Pearson's correlation analysis. For each group, crown specimens were used to assess the marginal and internal gaps using the replica technique. Buccolingual and mesiodistal cross-sections were measured, and a repeated measures one-way ANOVA was performed. Results: Linear mixed model analysis indicated that for both groups, with an increase in the autoclave time, the flexural strength decreased, whereas the m-phase fraction increased. Pearson's correlation analysis revealed no correlation between the m-phase fraction and flexural strength for either group. A repeated measures one-way ANOVA was conducted on instrumented sections (buccal, lingual, mesial, and distal), revealing that the marginal and internal gaps of AM-produced zirconia crowns were less accurate than those of CNC-produced zirconia crowns. Significance: These findings suggest that additively produced zirconia restorations have mechanical properties comparable to those of conventionally produced ceramics and may be suitable for clinical applications.