{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T21:07:56Z","timestamp":1792789676400,"version":"4.5.0"},"reference-count":45,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kuraray Noritake"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Due to advantages such as avoidance of chipping, pulp-friendly tooth preparation and cost reduction, zirconia is increasingly being used monolithically without veneering. Nevertheless, to enable good aesthetics, various multilayer systems have been developed. The aim of this study was to investigate the impact of different zirconia multilayer strategies and yttria levels on fracture load, fracture pattern, stress distribution and surface roughness. (2) Methods: Monolithic three-unit anterior FDPs were made from three different color-gradient zirconia multilayer materials with different yttria levels corresponding to varying strength and degrees of translucency grades (Katana HTML, STML, UTML, Kuraray) and one strength-gradient zirconia multilayer material (Katana YML, Kuraray) and artificially aged in a chewing simulator (1.2 \u00d7 106 load cycles, 50 N, 2 \u00d7 3000 thermocycles, 5\u201355 \u00b0C). Analyses of fracture load, fracture pattern, fracture surfaces, stress distribution and roughness were performed after the fracture load test. Shapiro\u2013Wilk, Kruskal\u2013Wallis, Mann\u2013Whitney U-tests and one-way ANOVA were used (p &lt; 0.05). (3) Results: Fracture loads of the high strength color-gradient material HTML and the strength-gradient material YML were comparable after 5 years of aging (p = 0.645). Increasing yttria levels resulted in a decrease in fracture resistance of 42\u201357% (p &lt; 0.05). Surface roughness of different zirconia generations is comparable after polishing and aging. (4) Conclusions: Color-gradient multilayer zirconia materials and new strength-gradient zirconia materials with similar yttria levels in the basal layers show comparable mechanical properties and are suitable for anterior FDPs.<\/jats:p>","DOI":"10.3390\/jcm11174982","type":"journal-article","created":{"date-parts":[[2022,8,26]],"date-time":"2022-08-26T02:04:32Z","timestamp":1661479472000},"page":"4982","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Fracture Load and Fracture Patterns of Monolithic Three-Unit Anterior Fixed Dental Prostheses after In Vitro Artificial Aging\u2014A Comparison between Color-Gradient and Strength-Gradient Multilayer Zirconia Materials with Varying Yttria Content"],"prefix":"10.3390","volume":"11","author":[{"given":"Max L.","family":"P\u00f6ppel","sequence":"first","affiliation":[{"name":"Department of Prosthodontics, Geriatric Dentistry and Craniomadibular Disorders, Charit\u00e9 Universit\u00e4tsmedizin Berlin, A\u00dfmannshauser Str. 4-6, 14197 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6017-5529","authenticated-orcid":false,"given":"Martin","family":"Rosentritt","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9218-4510","authenticated-orcid":false,"given":"Richard","family":"Sturm","sequence":"additional","affiliation":[{"name":"Department of Dental Preservation, Preventive and Paediatric Dentistry, Charit\u00e9 Universit\u00e4tsmedizin Berlin, A\u00dfmannshauser Str. 4-6, 14197 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Beuer","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Geriatric Dentistry and Craniomadibular Disorders, Charit\u00e9 Universit\u00e4tsmedizin Berlin, A\u00dfmannshauser Str. 4-6, 14197 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremias","family":"Hey","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Geriatric Dentistry and Craniomadibular Disorders, Charit\u00e9 Universit\u00e4tsmedizin Berlin, A\u00dfmannshauser Str. 4-6, 14197 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8844-5087","authenticated-orcid":false,"given":"Alois","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4704-0467","authenticated-orcid":false,"given":"Franziska","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Geriatric Dentistry and Craniomadibular Disorders, Charit\u00e9 Universit\u00e4tsmedizin Berlin, A\u00dfmannshauser Str. 4-6, 14197 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"ref_1","first-page":"512","article-title":"Zirconia and its novel compositions: What do clinicians need to know?","volume":"50","author":"Guth","year":"2019","journal-title":"Quintessence Int."},{"key":"ref_2","first-page":"369","article-title":"Three generations of zirconia: From veneered to monolithic. Part I","volume":"48","author":"Stawarczyk","year":"2017","journal-title":"Quintessence Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1177\/0022034517737483","article-title":"Novel Zirconia Materials in Dentistry","volume":"97","author":"Zhang","year":"2018","journal-title":"J. Dent. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"103974","DOI":"10.1016\/j.jmbbm.2020.103974","article-title":"Mechanical and microstructural properties of ultra-translucent dental zirconia ceramic stabilized with 5 mol% yttria","volume":"111","author":"Harada","year":"2020","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.dental.2019.02.017","article-title":"New multi-layered zirconias: Composition, microstructure and translucency","volume":"35","author":"Kolakarnprasert","year":"2019","journal-title":"Dent. Mater."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/j.dental.2017.12.008","article-title":"Crystallographic and morphological analysis of sandblasted highly translucent dental zirconia","volume":"34","author":"Inokoshi","year":"2018","journal-title":"Dent. Mater."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.dental.2018.03.006","article-title":"Aging resistance, mechanical properties and translucency of different yttria-stabilized zirconia ceramics for monolithic dental crown applications","volume":"34","author":"Camposilvan","year":"2018","journal-title":"Dent. Mater."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.jmbbm.2018.05.029","article-title":"Mechanical reliability, fatigue strength and survival analysis of new polycrystalline translucent zirconia ceramics for monolithic restorations","volume":"85","author":"Pereira","year":"2018","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Rammelsberg, P., Meyer, A., Lorenzo-Bermejo, J., Kappel, S., and Zenthofer, A. (2020). Long-term chipping and failure rates of implant-supported and combined tooth-implant-supported metal-ceramic and ceramic fixed dental prostheses: A cohort study. J. Prosthet. Dent.","DOI":"10.1016\/j.prosdent.2020.05.020"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"602","DOI":"10.3109\/00016357.2015.1007479","article-title":"Fracture resistance of monolithic zirconia molar crowns with reduced thickness","volume":"73","author":"Nakamura","year":"2015","journal-title":"Acta Odontol. Scand."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Cho, Y.E., Lim, Y.J., Han, J.S., Yeo, I.L., and Yoon, H.I. (2020). Effect of Yttria Content on the Translucency and Masking Ability of Yttria-Stabilized Tetragonal Zirconia Polycrystal. Materials, 13.","DOI":"10.3390\/ma13214726"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"103970","DOI":"10.1016\/j.jmbbm.2020.103970","article-title":"Fatigue and wear behaviour of zirconia materials","volume":"110","author":"Rosentritt","year":"2020","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.dental.2019.10.008","article-title":"Probing the interfacial strength of novel multi-layer zirconias","volume":"36","author":"Kaizer","year":"2020","journal-title":"Dent. Mater."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"17057","DOI":"10.1016\/j.ceramint.2021.03.013","article-title":"Effect of hydrothermal aging on dental multilayered zirconiafor monolithic restorations: An in vitro study","volume":"47","author":"Ha","year":"2021","journal-title":"Ceram. Int."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.1016\/j.dental.2019.10.009","article-title":"High-translucent yttria-stabilized zirconia ceramics are wear-resistant and antagonist-friendly","volume":"35","author":"Zhang","year":"2019","journal-title":"Dent. Mater."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.prosdent.2017.08.004","article-title":"Comparison of the mechanical properties of translucent zirconia and lithium disilicate","volume":"120","author":"Kwon","year":"2018","journal-title":"J. Prosthet. Dent."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"102","DOI":"10.3109\/00016357.2011.654248","article-title":"Two-body wear of monolithic, veneered and glazed zirconia and their corresponding enamel antagonists","volume":"71","author":"Stawarczyk","year":"2013","journal-title":"Acta Odontol. Scand."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jmbbm.2017.09.010","article-title":"Low temperature degradation of single layers of multilayered zirconia in comparison to conventional unshaded zirconia: Phase transformation and flexural strength","volume":"77","author":"Wille","year":"2018","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.prosdent.2016.06.010","article-title":"Influence of aging on flexural strength of translucent zirconia for monolithic restorations","volume":"117","author":"Flinn","year":"2017","journal-title":"J. Prosthet. Dent."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.jmbbm.2018.11.009","article-title":"Load-bearing capacity under fatigue and survival rates of adhesively cemented yttrium-stabilized zirconia polycrystal monolithic simplified restorations","volume":"90","author":"Zucuni","year":"2019","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"103326","DOI":"10.1016\/j.jdent.2020.103326","article-title":"Laboratory performance and fracture resistance of CAD\/CAM implant-supported tooth-coloured anterior FDPs","volume":"96","author":"Zacher","year":"2020","journal-title":"J. Dent."},{"key":"ref_22","unstructured":"Kuraray (2021, October 08). Frequently Asked Questions Katana Zirconia YML. Available online: https:\/\/www.kuraraynoritake.eu\/pub\/media\/pdfs\/21445_2_Katana_YML_FAQ_LR_EN_1.pdf."},{"key":"ref_23","first-page":"465","article-title":"Influence of resilient support of abutment teeth on fracture resistance of all-ceramic fixed partial dentures: An in vitro study","volume":"24","author":"Rosentritt","year":"2011","journal-title":"Int. J. Prosthodont."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.dental.2017.03.004","article-title":"ADM guidance-Ceramics: Guidance to the use of fractography in failure analysis of brittle materials","volume":"33","author":"Scherrer","year":"2017","journal-title":"Dent. Mater."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"65","DOI":"10.2209\/tdcpublication.2015-0034","article-title":"Effect of Connector Design on Fracture Resistance in Zirconia-based Fixed Partial Dentures for Upper Anterior Region","volume":"57","author":"Ogino","year":"2016","journal-title":"Bull. Tokyo Dent. Coll."},{"key":"ref_26","first-page":"344","article-title":"Influence of the yttrium content on the fracture strength of monolithic zirconia crowns after artificial aging","volume":"50","author":"Elsayed","year":"2019","journal-title":"Quintessence Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/jopr.13242","article-title":"Fracture Load of Different Zirconia Types: A Mastication Simulation Study","volume":"29","author":"Abdulmajeed","year":"2020","journal-title":"J. Prosthodont."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.prosdent.2019.05.012","article-title":"Fracture load of two thicknesses of different zirconia types after fatiguing and thermocycling","volume":"123","author":"Alraheam","year":"2020","journal-title":"J. Prosthet. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"79","DOI":"10.4047\/jap.2018.10.2.79","article-title":"In-vitro performance and fracture strength of thin monolithic zirconia crowns","volume":"10","author":"Weigl","year":"2018","journal-title":"J. Adv. Prosthodont."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1016\/j.dental.2020.04.004","article-title":"Impact of high-speed sintering, layer thickness and artificial aging on the fracture load and two-body wear of zirconia crowns","volume":"36","author":"Wiedenmann","year":"2020","journal-title":"Dent. Mater."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.dental.2017.12.005","article-title":"Fatigue resistance of all-ceramic fixed partial dentures\u2014Fatigue tests and finite element analysis","volume":"34","author":"Heintze","year":"2018","journal-title":"Dent. Mater."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1111\/jopr.13088","article-title":"Effect of Surface Treatment and Cement on Fracture Load of Traditional Zirconia (3Y), Translucent Zirconia (5Y), and Lithium Disilicate Crowns","volume":"28","author":"Lawson","year":"2019","journal-title":"J. Prosthodont."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"888","DOI":"10.4012\/dmj.2013-147","article-title":"Influence of cementation and cement type on the fracture load testing methodology of anterior crowns made of different materials","volume":"32","author":"Stawarczyk","year":"2013","journal-title":"Dent. Mater. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"103977","DOI":"10.1016\/j.jmbbm.2020.103977","article-title":"Comparison between novel strength-gradient and color-gradient multilayered zirconia using conventional and high-speed sintering","volume":"111","author":"Michailova","year":"2020","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_35","unstructured":"Rosentritt, M., Preis, V., Schmid, A., and Strasser, T. (2020). Multilayer zirconia: Influence of positioning within blank and sintering conditions on the in vitro performance of 3-unit fixed partial dentures. J. Prosthet. Dent."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"104504","DOI":"10.1016\/j.jmbbm.2021.104504","article-title":"Fatigue resistance of monolithic strength-gradient zirconia materials","volume":"119","author":"Schonhoff","year":"2021","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.jdent.2018.04.012","article-title":"Fracture load of metal-ceramic, monolithic, and bi-layered zirconia-based posterior fixed dental prostheses after thermo-mechanical cycling","volume":"73","author":"Lynch","year":"2018","journal-title":"J. Dent."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1111\/jopr.13071","article-title":"Surface Roughness of Monolithic and Layered Zirconia Restorations at Different Stages of Finishing and Polishing: An In Vitro Study","volume":"28","author":"Baba","year":"2019","journal-title":"J. Prosthodont."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/jopr.13257","article-title":"The Effect of Aging on the Roughness and Bacterial Adhesion of Lithium Disilicate and Zirconia Ceramics","volume":"30","author":"Matalon","year":"2021","journal-title":"J. Prosthodont."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1016\/j.prosdent.2017.04.003","article-title":"Effect of grinding and polishing on roughness and strength of zirconia","volume":"119","author":"Khayat","year":"2018","journal-title":"J. Prosthet. Dent."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"132","DOI":"10.4047\/jap.2018.10.2.132","article-title":"The effect of various polishing systems on surface roughness and phase transformation of monolithic zirconia","volume":"10","author":"Caglar","year":"2018","journal-title":"J. Adv. Prosthodont."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1034\/j.1600-0501.1996.070302.x","article-title":"The influence of abutment surface roughness on plaque accumulation and peri-implant mucositis","volume":"7","author":"Bollen","year":"1996","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"217","DOI":"10.11607\/ijp.6686","article-title":"The Effect of a Polishing Protocol on the Surface Roughness of Zirconium Oxide","volume":"33","author":"Linkevicius","year":"2020","journal-title":"Int. J. Prosthodont."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.dental.2005.04.024","article-title":"Influence of stress simulation parameters on the fracture strength of all-ceramic fixed-partial dentures","volume":"22","author":"Rosentritt","year":"2006","journal-title":"Dent. Mater."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"717","DOI":"10.4012\/dmj.2013-344","article-title":"Influence of abutment model materials on the fracture loads of three-unit fixed dental prostheses","volume":"33","author":"Wimmer","year":"2014","journal-title":"Dent. Mater. J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/4982\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:15:06Z","timestamp":1760141706000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/17\/4982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,25]]},"references-count":45,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["jcm11174982"],"URL":"https:\/\/doi.org\/10.3390\/jcm11174982","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,25]]}}}