{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:20:02Z","timestamp":1791584402787,"version":"4.3.4"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare four different types of monolithic zirconia crowns in terms of survival rate and fracture resistance after thermocycling and\/or thermo\u2010mechanical loading in a chewing simulator.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Partially stabilized zirconia (PSZ) crowns with fiber\u2010reinforced resin die assemblies (<jats:italic>n<\/jats:italic>\u00a0=\u00a080) were fabricated using: multi\u2010yttria\u2010layered 5Y\u2010PSZ\/3Y\u2010PSZ, multi\u2010yttria\u2010layered 5Y\u2010PSZ\/4Y\u2010PSZ, monolithic 4Y\u2010PSZ, and monolithic 3Y\u2010PSZ as control (<jats:italic>n<\/jats:italic>\u00a0=\u00a020). Half of the samples in each group were subjected to thermo\u2010mechanical loading under 110\u00a0N, 1.4\u00a0Hz, 1.2 million cycles with simultaneous thermocycling (10,000\u00a0cycles, 5\u201355\u00b0C). The other half were subjected to thermocycling alone. The samples were loaded to failure to measure their fracture resistance. The data were analyzed using by two\u2010way ANOVA and Tukey's HSD post\u2010hoc test (<jats:italic>\u03b1<\/jats:italic>\u00a0=\u00a00.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All specimens survived the aging protocols. The yttria content significantly affected the fracture resistance of the crowns (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). The mean fracture resistance, from highest to lowest: 3Y\u2010PSZ, 4Y\u2010PSZ, followed by the two multi\u2010yttria\u2010layered systems. The mean difference between the two multi\u2010yttria\u2010layered systems were not statistically significant (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.98). The mechanical loading protocol did not affect the mean fracture resistance within each group (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.18).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Within each group, there was no difference in fracture resistance after thermocycling alone and thermo\u2010mechanical loading. However, increasing the yttria concentration at the occlusal third of the crown decreased its fracture resistance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Significance<\/jats:title><jats:p>The term \u201cmonolithic zirconia\u201d alone without specifying the actual yttria content is misleading. This term represents different materials with different mechanical properties. The yttria content has an inverse relationship with the fracture resistance of zirconia crowns. The fracture resistance of multi\u2010layer zirconia crowns is determined by the amount of the weaker zirconia phase at the occlusal part of the restoration rather than enforced by the stronger zirconia at the cervical part of the crown.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jerd.12907","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T12:29:09Z","timestamp":1647865749000},"page":"633-640","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Survivability and fracture resistance of monolithic and multi\u2010yttria\u2010layered zirconia crowns as a function of yttria content: A mastication simulation study"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5638-3288","authenticated-orcid":false,"given":"Zaid","family":"Badr","sequence":"first","affiliation":[{"name":"Department of Adult Restorative Dentistry University of Nebraska Medical Center, College of Dentistry  Lincoln Nebraska USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Culp","sequence":"additional","affiliation":[{"name":"Sculpture Studios  Cary North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Duqum","sequence":"additional","affiliation":[{"name":"Division of Comprehensive Oral Health University of North Carolina at Chapel Hill Adams School of Dentistry  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chek Hai","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Preventive and Restorative Sciences, School of Dental Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Preventive and Restorative Sciences, School of Dental Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3826-316X","authenticated-orcid":false,"given":"Taiseer","family":"A. 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