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Jerman, Eva; Lümkemann, Nina; Eichberger, Marlis; Hampe, Rüdiger and Stawarczyk, Bogna (2021): Impact of varying step-stress protocols on the fatigue behavior of 3Y-TZP, 4Y-TZP and 5Y-TZP ceramic. In: Dental Materials, Vol. 37, No. 7: pp. 1073-1082

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Objective. To test the impact of three varying step-stress protocols on the fatigue behavior of two 3Y-TZP, one 4Y-TZP and one 5Y-TZP zirconia materials. Methods. Eight specimens per zirconia material (N = 32) were selected for static testing to determine the start load for dynamic tests (30% of the mean value of static fracture load). 45 specimens per material (N = 180) were used for dynamic load tests using three stepstress protocols: 1. 50 N/5000 cycles;2. 5% of static load/5000 cycles, and 3. 10 N/1000 cycles. Following materials were tested: 3Y-TZP((<0.25 Al2O3)) (O: opaque) 3Y-TZP((>0.05 Al2O3)) (T: translucent), 4Y-TZP((<0.01 Al2O3)) (ET: extra translucent) and 5Y-TZP((<0 01 Al2O3)) (HT: high translucent). The specimens (4 +/- 0.02 x 3 +/- 0.02 x 45 mm) were placed centrally on the support rolls and the load was applied perpendicularly over the 4 mm specimen side (similar to 4-point flexural strength according to the DIN 6872:2019). Data was analyzed with Kolmogorov-Smirnov-test, t-test, one-way ANOVA with post-hoc Scheffe-test, Chi-square-test, Kaplan-Meier with Log-Rank-test and two-parametric Weibull analysis (p < 0.05). Results. The step-stress protocols showed no impact on the fracture load or Weibull modulus within one zirconia material. However, the zirconia materials T, ET and HT showed differences in cycle number to fracture between the step-stress protocols (T: 3 > 2 > 1;ET: 2 > 3 > 1;HT: 2, 3 > 1) with lowest cycle number to fracture for protocol 1. Within one step-stress protocol, the cycle number to fracture varied according to the zirconia material as follows: 1: T, O >= O, ET > HT;2: ET > O, T, HT;3: O, T, ET > HT. Cracking started at the tensile side of the specimens at all times. All specimens showed typical compression curls (single or double). Fragmentation patterns were similar for all materials with a lot of crack branching and fragmentation due to secondary cracks indicating high energy fractures. Significance. Dynamic fatigue tests seem to provide important information on the long-term stability of zirconia materials. Zirconia materials with higher opacity seem to be more robust towards varying step-stress protocols than translucent zirconia materials. Regarding expenditure of time, a step-stress protocol with a load increase of 50 N every 5000 cycles seems favorable to gain information on the long-term stability of zirconia materials. (C) 2021 The Academy of Dental Materials. Published by Elsevier Inc. All rights reserved.

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