ArticleBMC oral health2026
Thermo-mechanical loading of innovative "Mini-skirt" preparation design versus conventional full-coverage maxillary central incisor preparation design: an in vitro study.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundConventional full-coverage anterior crown preparations for zirconia often require substantial enamel and dentine reduction and may concentrate palatal-cervical stresses, risking marginal discrepancy and compromised seal. A conservative "Mini-skirt" (MS) design that positions the palatal finish line coronally (above the cingulum) could preserve tooth structure and enhance adhesive support, but its thermo-mechanical performance under thermal cycling and fatigue loading remains unclear. PURPOSE: To evaluate whether a conservative MS anterior preparation, with a palatal finish line above the cingulum, improves the thermo-mechanical behavior of generation-5 zirconia crowns compared with a conventional full-coverage (CF) design.
methodsSixty extracted maxillary central incisors were randomly assigned to MS or CF groups (n = 30). Monolithic 4Y zirconia crowns were CAD/CAM-manufactured, air-abraded and adhesively luted. Specimens were thermocycled 10,000 times between 5 °C and 55 °C, then obliquely loaded at 45° for 1.7 × 10⁶ cycles (50 N, 2 Hz); survivors underwent static fracture testing (0.5 mm·min⁻¹). Marginal gaps were quantified from silicone replicas; failures were classified Grades I-IV (restorable = I-III). Finite-element models (~ 1.3 M elements) reproduced boundary conditions to map stress.
resultsThe MS preparation endured thermo-mechanical ageing markedly better than CF: 93.3% (28/30) versus 53.3% (16/30) of crowns completed the fatigue protocol (χ² = 9.01, p = 0.003). Post-fatigue, median fracture load increased from 860 N (IQR 780-930 N) in CF to 1,140 N (1,030-1,260 N) in MS (p < 0.05). Mean marginal gap contracted from 112 ± 21 μm to 67 ± 14 μm (40% reduction, p < 0.001). Restorable fractures predominated in MS (83%) but were minority in CF (37%); catastrophic Grade IV failures fell from 63% to 17% (χ² = 13.6, p < 0.001). Finite-element analysis corroborated the laboratory data, showing a 40% drop in peak palatal-cervical von Mises stress (415 to 250 MPa) and parallel reductions in tensile dentine stress and cement-shear hotspots.
conclusionsWithin the limitations of this in vitro study, the MS preparation showed favorable biomechanical performance under simulated thermo-mechanical loading. These findings provide a preclinical rationale for further investigation of the MS design, although long-term clinical studies are required before definitive clinical recommendations can be made.
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