Fatigue behavior of multilayer ceramic structures in traditional and reverse layering designs

Purpose This study evaluated the fatigue failure load (FFL) and the number of cycles for fatigue failure (CFF) of traditional (porcelain layer up) and reversed (zirconia layer up) designs of porcelain‐veneered zirconia samples prepared with heat‐pressing or file‐splitting techniques. Materials and Methods Zirconia discs were prepared and veneered with heat‐pressed or machined feldspathic ceramic. The bilayer discs were bonded onto a dentin‐analog according to the bilayer technique and sample design: traditional heat‐pressing (T‐HP), reversed heat‐pressing (R‐HP), traditional file‐splitting with fusion ceramic (T‐FC), reversed file‐splitting with fusion ceramic R‐FC), traditional file‐splitting with resin cement (T‐RC), and reversed file‐splitting with resin cement (R‐RC). The fatigue tests were performed using the stepwise approach at 20 Hz, 10,000 cycles/step, step‐size of 200 N starting at 600 N, and proceeding until failure detection or up to 2600 N if enduring. The failure modes (from radial and/or cone cracks) were analyzed in a stereomicroscope. Results The reversed design decreased the FFL and CFF of bilayers prepared with heat‐pressing and file‐splitting with fusion ceramic. The T‐HP and T‐FC reached the highest results, which were statistically similar between them. The bilayers prepared by the file‐splitting with resin cement (T‐RC and R‐RC) were similar to the R‐FC and R‐HP groups regarding FFL and CFF. Almost all reverse layering samples failed by radial cracks. Conclusions The reverse layering design did not improve the fatigue behavior of porcelain veneered zirconia samples. The three bilayer techniques behaved similarly when used in the reversed design.