Fracture load of milled polymeric fixed

dental prostheses as a function of

connector cross-sectional areas
Timea Wimmer, Dr med dent,a Andreas Ender, Dr med dent,b
Malgorzata Roos, PhD,c and Bogna Stawarczyk, Dipl Ing MScd
Dental School, Ludwig-Maximilians-University of Munich,
Munich, Germany; Center of Dental Medicine, University of
Zurich, Zurich, Switzerland
Statement of problem. Polymeric computer-aided design/computer-aided manufacturing (CAD/CAM) blocks exhibit
various advantages in contrast to conventionally processed resin restorations. However, the influence of connector
dimensions on resin fixed dental prostheses (FDPs) has not yet been investigated.
Purpose. This study evaluated the impact of connector cross-sectional area (CSA) on the fracture load of 3-unit CAD/
CAM FDPs and compared this with conventionally fabricated ones.
Material and methods. Anatomically shaped 3-unit FDPs with the CSAs of 6, 9, 12, and 16 mm2 (N=240, n=15 per
material and per CSA) were fabricated from the following CAD/CAM materials: artBloc Temp (AT), TelioCAD (TC),
CAD-Temp (CT), and one conventional resin material, CronMix K (CMK) as the control group. The fracture load was
tested and the data were analyzed with 2-way ANOVA, 1-way ANOVA, the Scheff post hoc test, and Weibull statistics
(D=05).
Results. CMK showed the significant lowest values for all CSAs followed by CT, except for the 12 mm2 connector
(P<.001). The CAD/CAM FDPs exhibited a significant increase in fracture load with the increase of CSA (P<.001).
Conventionally fabricated FDPs presented an increase of values up to the CSA of 12 mm2. For TC, the shape increased
with a larger CSA. The other materials exhibited no tendencies in this regard. Among the 12 mm2 groups, AT exhibited
the highest shape value (19.1), and among the 16 mm2 groups, TC showed the highest shape value (17.0). The CMK
FDPs with a CSA of 16 mm2 showed almost half as high a shape parameter (6.4) than the other three CSAs.
Conclusions. CAD/CAM resin FDPs revealed significantly higher fracture load values than conventionally fabricated FDPs
and showed a significant increase in fracture load with the increase of the CSA. (J Prosthet Dent 2013;110:288-295)

Clinical Implications

A connector cross-sectional area of at least 9 mm2 is recommended

for artBloc Temp and Telio CAD and at least 12 mm2 for CAD-Temp.
Computer-aided design/manufacturing (CAD/CAM) techniques for fixed
dental prostheses (FDPs) are becoming more popular for the production
of tooth-colored restorations.1 Polymeric CAD/CAM blocks are available
for the manufacture of interim restorations. These blanks are fabricated at

high temperature and pressure in a reproducible process2 resulting in dense

materials of high-quality.3 In addition,
CAD/CAM resins exhibit similar color
stability to glass ceramics.4 As these
restorations can also be produced
chairside, interim prostheses are not
needed and treatment time is re-

duced. Moreover, the restorations are

superior to conventionally processed
resin restorations,1,5 made with chemically polymerized resins,2 which are
associated with inferior mechanical
and esthetic properties, surface quality, and fit.1,6-8 Unlike CAD/CAM, the
quality of these manually fabricated

Assistant Professor, Department of Prosthodontics, Dental School, Ludwig-Maximilians-University of Munich.

Clinical Lecturer, Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich.
c
Senior Statistician, Division of Biostatistics, Institute of Social and Preventive Medicine, University of Zurich.
d
Materials Scientist, Department of Prosthodontics, Dental School, Ludwig-Maximilians-University of Munich.
b

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Wimmer et al

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October 2013
FDPs may be dependent on the operator, the mixing procedures,5 the polymerization device, and duration.2,9
FDPs produced from polymeric
resin blanks with CAD/CAM technology have even been shown more resistant to fracture than glass ceramic
materials.2,10,11 Moreover, there is increasing interest in polymeric resin
blocks as these materials cause less wear
in the antagonist enamel than glass ceramics3,12 feature optimal stiffness,13,14
and enable easier and safer repair and
adjustment than ceramic FDPs.11,15
However, only a few long-term results
concerning their mechanical performance have been published.1,2,5
Several studies have found that
the complex geometry of an FDP has
a bearing on fracture load.16-19 The
magnitudes and locations of stress
concentrations in FDPs in fracture load
tests differ from those in bars.16 The effect of geometry was assessed in a study
by Kamposiora et al,17 who compared
the overall 2-dimensional (2D) finiteelement analysis (FEA) for 3-unit FDPs
with a connector height of 3.0 mm with
simple flexed beams of different thicknesses. Furthermore, Quinn et al18 concluded that FDP design is important for
the amount of maximum stress and the
associated probability of failure. Kamposiora et al17 used 2D FEA to study the
stress distribution within 3-unit FDPs
and found stresses up to 50% lower
for 4.0-mm connectors than for 3.0-

mm connectors. Similar results were

obtained by Larsson et al.20 Likewise,
Onodera et al21 stated that the fracture
load of a 3-unit zirconia FDP increased
as the cross-sectional area of the connector became larger. The fracture load
of a FDP with a cross-sectional area of
9.0 mm2 or 7.0 mm2 amounted to 880
N. Larsson et al20 tested 4-unit zirconia
FDPs with varying connector diameters
and observed a mean fracture load of
897 N for a 4.0-mm diameter in comparison to 428 N for a 3.0 mm one.
However, when designing FDPs the
forces acting on the FDP in the oral
cavity have also to be considered.22-24
For posterior FDPs, increased fracture
load is required to withstand the higher occlusal forces and greater span
lengths.16 Moreover, connector height
is mostly limited in these areas because of short clinical molar crowns.16
Several in vitro studies have reported
that the connector regions of FDPs
have to withstand the highest tensile
and shear forces.17,25,26 Likewise, in a
clinical study by van Heumen et al,15
the authors showed that, in most restorations, fracture affected the connector area. To improve the fracture
resistance of FDPs, the cross-sectional area of the connectors should be as
large as possible, irrespective of the
material used,21 although, in clinical
service, an excessively large connector
cross-section is unfavorable regarding
access for hygiene and esthetics.21

Therefore, the purpose of this

study was to determine the minimum
acceptable connector cross-sectional
area (CSA) in polymeric 3-unit FDPs.
CAD/CAM fabricated FDPs versus
identical manually produced FDPs
were investigated. The first null hypothesis tested was that CAD/CAM
fabricated polymeric FDPs achieve
similar fracture loads than conventionally processed ones. The second
null hypothesis tested was that an
increase in CSAs does not affect the
fracture load results, regardless of the
polymeric material.

MATERIAL AND METHODS

This study tested the impact of CSA
on the fracture load of 3 different CAD/
CAM-fabricated FDPs and 1 conventionally fabricated FDP. The tested materials are presented in Table I.
Fifteen identical anatomically shaped
3-unit FDPs replacing a first molar
with abutments on a second premolar and a second molar were fabricated from each polymeric material and
with CSAs of 6, 9, 12, and 16 mm2.
The occlusogingival height, the buccolingual width, and the radius of
curvature at the occlusal and gingival
embrasure of each connector size are
summarized in Table II. All connectors had an elliptical shape (radius of
curvature at the occlusal embrasure =
radius of curvature at the gingival em-

Table I. Summary of materials evaluated

Group
CAD/CAM

Abbreviation

Name

Composition

Manufacturer

Lot No.

AT

artBloc Temp

PMMA, OMP=organic modified

Merz Dental, Ltjenburg,

23808

polymer network

Germany

99.5% PMMA Polymer

Ivoclar Vivadent, Schaan,

Acrylpolymer with 14% microfiller

Liechtenstein

MRP=microfilled reinforced

VITA Zahnfabrik, Bad

polyacrylic

Sckingen, Germany

UDMA-based polymerization:

Merz Dental

fabricated FDP
TC
CT
Conventionally

CMK

fabricated FDP

Telio CAD
CAD-Temp
CronMix K

autopolymerized,
polymerization time: 7 min

PMMA: Poly(methyl methacrylate)

UDMA: urethane dimethacrylate

Wimmer et al

MM1068
19180
592308

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Volume 110 Issue 4

Premolar connector

CSA

Molar connector

6 mm2

9 mm2

12 mm2

16 mm2
1 Standardized geometries of premolar and molar connectors.

Table II. Connector dimensions

CSA (mm) Height (mm) Width (mm) Radius of Curvature (mm)
Premolar connector

Molar connector

brasure) (Fig. 1). In total 240 FDPs

were fabricated. For the production of
the FDPs, a steel model was used with
2 abutments, which were also made
of steel to minimize their residual deformation during loading. For simulation of the periodontium, the abutments were surrounded by a 0.5 mm
layer of silicone.27,28 The abutments
had a 1-mm circular shoulder and
6-degree taper and were designed to
be cylindrical with the premolar with
a diameter of 7 mm and the molar of
8 mm.29 The holder of the experimental device was made of an aluminum
alloy and had cylindrical holes of 7.8
and 8.8 mm in diameter at a distance
of 16.5 mm measured from the centers of the holes.2
The polymeric CAD/CAM FDPs
were designed with CAD software

2.8

2.7

1.3

3.4

3.3

1.7

12

4.0

3.9

1.9

16

4.5

4.4

2.3

2.9

2.4

1.2

3.4

3.7

1.7

12

3.9

3.8

2.0

16

4.5

4.4

2.3

(Cerec InLab 3.60; Sirona Dental Systems GmbH, Bensheim, Germany).

Thus, for each connector size, with
the help of the software, both the
connector dimension (height and
width) and the connector radius of
curvature were standardized (Table
II). The FDPs were milled with diamond rotary instruments with the
Cerec InLab MC XL system (Sirona
Dental Systems GmbH). After the
milling process, the FDPs were fitted
onto the steel abutment model. For
the conventionally fabricated FDPs, 1
silicone key with the standard shape
and size of each CSA was used. The
autopolymerized resin (paste-paste
system) was shaped with the silicone
key and polymerized for 10 minutes at
37C in an incubator (ED 240; Binder, Tuttlingen, Germany) according

The Journal of Prosthetic Dentistry

to the manufacturers instructions. All

FDPs had a radial thickness of up to 1.0
mm and an occlusal thickness between
1.87 and 2.2 mm. The surfaces of all
FDPs were polished for 60 seconds
with a goat-hair brush and polishing
paste (Dia-Glace; Yeti Dental Products
GmbH, Engen, Germany). All FDPs
were tested directly after fabrication.
The FDPs were placed on the abutment without cement and loaded with
a ball (diameter 4 mm) at the center
of the pontic from the occlusal-gingival direction until fracture occurred
with a crosshead speed of 1 mm/min.
In order to avoid force peak, a piece
of 0.3 mm Teflon foil (Angst + Pfister AG, Zurich, Switzerland) was positioned between the pontic and the
loading jig. The design of the fracture
load test with fracture localization is

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October 2013

2 Design of fracture load test with fracture localization.

Table III. Descriptive statistics of fracture load of different CSAs and FDP materials
CSAs
9 mm

6 mm

95% CI

One-way
Anova
between
CSAs

783d, C (64)

(747, 819)

<.001

(661, 740)

819d, C (55)

(788, 849)

(540, 593)

668d, B (64)

(632, 705)

12 mm

16 mm

FDP
material

Mean (SD)

AT

357a, C (29)

(341, 374)

528b, C (59)

(495, 562)

616c, B (37)

(595, 636)

TC

425a, D (48)

(398, 452)

567b, C (66)

(530, 604)

700c, C (70)

CT

298a, B (59)

(265, 331)

409b, B (52)

(380, 439)

567c, B (47)#

CMK

a, A

186

(18)

95% CI Mean (SD)

(176, 197)

246

b, A

(27)

95% CI Mean (SD)

(230, 261)

c, A

306

(30)

95% CI Mean (SD)

(289, 323)

c, A

331

(53)

(301, 360)

*Upper case superscripted letters reflect the results from 1-way ANOVA. Lower case superscripted letters represent significant post hoc Scheff test
between CSAs. Upper case superscripted letters represent significant post hoc Scheff test between FDP materials.
#

not normally distributed, but without outliers.

depicted in Figure 2.
The descriptive statistics such as
means, standard deviations (SD), and
the corresponding 95% confidence
intervals (95% CI) were computed.
Normality of data distribution was
tested with the Kolmogorov-Smirnov
and Shapiro-Wilk tests. The fracture
load data were analyzed with 2-way
and 1-way ANOVA, followed by a
post hoc Scheff test based on the
assumption of normal data distribution. The Weibull statistics, such as
scale (characteristic load) and shape
(Weibull modulus), were calculated.
Statistical software (Statistical Package for the Social Science v20; SPSS
Inc, Chicago, Ill) was used30 (D=.05).

RESULTS
The Kolmogorov-Smirnov and Shapiro-Wilk tests indicated no violation

Wimmer et al

of the assumption of normality for 94%

of the tested groups. Only 6% were not
normally distributed (1 group out of 16
containing no outliers), which is close
to the primary error for a statistical test.
Therefore, for all statistical tests, the assumption of normal distribution was
used. Table III provides the descriptive
statistics and 1-way ANOVA results between the different CSAs for each polymeric material. The 2-way ANOVA interaction (FDP resin materials versus CSA)
was significant (P<.001). Also, the interaction between FDP resin materials and
CSAs significantly affected the results
(P<.001). Therefore, the fixed effects
of FDP materials and CSAs cannot be
compared directly as the higher order interactions were found to be significant.
Consequently, several different analyses
were computed and divided by levels of
FDP materials and CSAs depending on
the hypothesis of interest. The results

of the descriptive statistics (Mean, SD,

95% CI) with 1-way ANOVA results for
the fracture load of each tested group
are presented in Table III and depicted
as a box-plot diagram in Figure 3.
The conventionally fabricated groups
showed the significant lowest values for
all 4 CSAs, followed by the polymeric
CAD/CAM FDPs of the group CT, although there was one exception: For
the CSA of 12 mm2 the difference from
AT was not significant. In all groups
AT exhibited lower fracture load values
than TC; however, the differences were
only significant for the CSAs of 6 mm2
and 12 mm2.
The CAD/CAM fabricated FDPs
showed a significant increase in fracture
load with the increase of the CSA. Conventionally fabricated FDPs presented
an increase of values up to the CSA of 12
mm2. The 12 and 16 mm2 CSAs showed
no differences as to fracture load.

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Volume 110 Issue 4

1000

Fracture Load (N)

800

600

400

200

9 12 16
AT

9 12 16
TC

9 12 16
CT

9 12 16
CMK

CSA (mm2)
3 Fracture load of 3-unit FDPs as function of CSA.

Table IV. Weibull statistics (scale, shape) of fracture load

CSAs
6 mm

9 mm

12 mm

16 mm

FDP
material

Scale

Shape

Scale

Shape

Scale

Shape

Scale

Shape

AT

371

13.8

554

10.2

633

19.1

811

14.0

TC

447

9.9

596

9.8

732

11.3

844

17.0

CT

322

5.5

432

8.8

589

13.1

698

11.4

CMK

194

11.5

258

10.0

319

11.6

355

6.4

The highest Weibull shape parameter (Weibull modulus) among all

groups was seen in the AT group with
a CSA of 12 mm2 (19.1). CT with a
CSA of 6 mm2 exhibited the lowest
value (5.5). For TC the Weibull shape
parameter increased with larger CSAs.
The other materials exhibited no tendencies in this regard. Among the
groups with a CSA of 12 mm2, AT exhibited the highest Weibull shape parameter (19.1), and among the groups
with a CSA of 16 mm2, TC showed the
highest shape value (17.0). The CMK
FDPs with a CSA of 16 mm2 showed
almost half as high shape parameter
(6.4) as the other 3 CSAs (Table IV).

DISCUSSION
Generally, the CAD/CAM FDPs
exhibited significantly higher fracture
loads than the conventionally fabricated FDPs. Thus, the first null hypothesis was rejected. For all CAD/
CAM restorations, thicker CSAs were
found to increase fracture loads.
Among the conventionally fabricated
FDPs, only the CSAs of 12 mm2 and
16 mm2 were not significantly different. Thus, the second null hypothesis
that an increase in CSAs does not affect the fracture loads, regardless of
the polymeric material, was rejected.
To rate the results, the magnitude
of the obtained values has to be con-

The Journal of Prosthetic Dentistry

sidered. Occlusal forces used during

mastication depend on individual
anatomic and physiologic characteristics and vary with the region in the
oral cavity. The highest occlusal force
was found in the posterior region.
Moreover, men often exert significantly greater occlusal forces than women.31,32 In the molar region the mean
measured occlusal force for adult
men was measured at approximately
400 N.22 The maximum occlusal force
of men in the posterior region was
found to be around 600 N.23,24 The
heights of the measured values in the
present study are mixed. In the main,
the CAD/CAM FDPs presented significantly higher fracture loads than

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293

October 2013
conventionally fabricated FDPs. This
result is in agreement with a study of
Stawarczyk et al,2 who investigated
the fracture load of 3-unit FDPs with
a CSA of 7.36 mm2 fabricated from
the same materials as in the present
study, among others, after different
aging regimens. Significant differences were found between the CAD/
CAM FDPs and the conventionally
fabricated FDP. The obtained initial
mean fracture load values for the AT
restorations amounted to 384 N, for
TC 420 N, for CT 289 N, and for the
conventionally fabricated CMK FDPs
180 N.2 All 4 values coincide with the
present results. Also, 2 other studies
have reported the fracture strength
of CAD/CAM fabricated FDPs. Both
investigations observed that CAD/
CAM milled FDPs showed significantly higher load bearing capacity than
conventionally fabricated FDPs.1,5
In the present study, the CAD/
CAM resin CT showed the lowest values for all 4 CSAs among the CAD/
CAM resins, with the differences being significant except for the CSA of
12 mm2. This outcome also coincides
with the results of Stawarczyk et al2
who found significantly lower fracture
load values for CT than for AT and TC
for a CSA of 7.36 mm2.
Regarding the mean measured occlusal force of 400 N all 4 conventionally fabricated FDP groups, all FDP
groups with a CSA of 6 mm2, and the
CT FDPs with a CSA of 9 mm2 exhibited results below this value. Therefore,
they will probably not be able to withstand the occlusal forces in the posterior region. It should be noted that for
the CAD/CAM FDPs the 6 mm2 CSA
is smaller than that recommended by
the manufacturer. The recommended
CSA for AT is 9 mm2; for the 2 other
materials, TC and CT, 12 mm2 each.
Therefore, the suggestion is that TC
can be reduced to a value of 9 mm2.
However, the Weibull shape parameter for TC with a cross-sectional area
of 12 mm2 was higher (11.3) than for
the 9-mm2 connector (9.8), indicating that the material is more reliable
if the connector is larger. AT exhibits

Wimmer et al

an almost twice as high shape parameter (19.1) for the CSA of 12 mm2 in
contrast to the 9-mm2 CSA. Among
the groups with a CSA of 12 mm2 AT
exhibited the highest Weibull shape
parameter (19.1). Among the groups
with a CSA of 16 mm2, TC showed the
highest shape value (17.0) (Table IV).
Higher local stress concentrations
can induce a significant increase of
stress in the connector areas as these
regions show abrupt changes in the
shape of an FDP and are the regions
of least diameter across the restoration.16 As expected, thicker CSAs were
found to increase fracture loads both
for the CAD/CAM milled FDPs and
conventionally fabricated FDPs. However, conventionally fabricated FDPs
only presented an increase of values
up to the CSA of 12 mm2. No significant differences on fracture load were
observed for the CSAs of 12 and 16
mm2. Similar results were obtained
by various authors,17,20,21 although
these studies were concerned with
ceramic materials or gold alloys. No
investigations on connector dimensions of FDPs made of resin could be
found. Moreover, the test conditions
were quite different from the present
investigation. In the study by Larsson
et al,20 fracture load of 4-unit ceramic FDP cores with diameters ranging
from 2.5 to 4.0 mm were investigated.
The obtained values were significantly
higher for each increase in CSA. Onodera et al21 investigated zirconia FDP
frameworks and found frameworks
with larger connectors exhibiting
higher fracture loads. Another study
by Kamposiora et al17 used 2D FEA to
investigate stress distribution within
3-unit FDPs. The obtained stress levels were dramatically reduced in FDPs
with a connector diameter of 4.0 mm
in comparison to 3.0 mm. Likewise, in
the present study, significant reductions of fracture load values were obtained with increasing CSAs: The 16
mm2 connector of the CAD/CAM fabricated FDPs exhibited about twice as
high values compared to the 6-mm2
connector and still over 30% higher
values than the 9-mm2 cross-section-

al area. The differences between the

values obtained with the 6, 9, and 12
mm2 connectors were less. However,
the conventionally fabricated CMK
FDPs with a cross-section of 12 mm2
showed an over 20% higher fracture
load than the 9 mm2 and 64% higher
value than the CSA of 6 mm2. Moreover, the CMK group with a CSA of
16 mm2 showed almost a half as high
Weibull shape parameter (6.4) than
the other three CSAs (Table IV).
However, realizing a sufficient
CSA is sometimes difficult, particularly in the molar regions because of
the lack of space. If the interproximal
embrasures are closed to achieve an
adequate connector width, periodontal problems might arise from the hindered oral hygiene. In such situations,
other materials should be considered,
especially when excessive forces are
expected. Patients with bruxism, with
a deep horizontal overlap or patients
who have previously fractured restorations are at risk. Yet, CAD/CAM
milled FDPs might be an appropriate
choice and long-term clinical investigations are needed to follow to support these statements.
Fractures of FDPs typically occur between the abutment and the
pontic.21 The fracture patterns in this
study showed that fracture occurred
in most specimens at the distal connector (Fig. 2). This finding corresponds to the results of Onodera et
al.21 The authors observed fracture at
the distal connector in 82.2% of all
FDPs.21 Similarly, several FE analyses
revealed tensile stress concentrations
on the basal surface of the connectors,16,33 which are primarily responsible for the crack propagating from
the high tensile stress area and veering
toward the occlusal region.16
Concerning the experimental design, there are limitations to this study.
Fracture load was tested on steel abutments having a higher Young modulus
compared to natural teeth. According
to Scherrer and de Rijk,34 increased
Young moduli of supporting structures cause increased fracture loads.
However, in this study, a 0.5-mm layer

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Volume 110 Issue 4

of silicone simulated the periodontal
ligament, which permits tooth mobility to a certain degree. Mean fracture
strengths were reported to be lower
when nonrigidly mounted abutments
were investigated compared to rigidly
mounted abutments.35,36 Anotherconsideration is the possible effect
of the cement. In the present study,
the FDPs were not cemented on the
abutments, which may have resulted
in inferior bending forces along with a
less damping effect.2 Nonetheless, as
reported in several studies the shape
of the specimens is of importance.16-19
The tested specimens in this investigation were anatomically designed with
dimensions analogous to those of
FDPs in clinical use.
Based on the presented results, a
CSA of at least 9 mm2 is suggested
for AT and TC. For CT, a minimum
CSA of 12 mm2 should be used. The
remaining cross-sectional areas of the
CAD/CAM FDPs and those of the test
series examining the conventionally
fabricated FDPs exhibited fracture
load values lower than the mean occlusal force and may not be able to
cope with clinical demands.
However, the values were obtained
without aging regimens. In a study by
Stawarczyk et al,2 the conventionally
fabricated resin CMK exhibited an
increase of fracture load after 1-day
saliva storage at 37C. Another study
obtained similar results after 1-day
storage in saliva and a masticatory
simulator.27 A postpolymerization of
the monomer might be a reason for
the increase. Burtscher29 reported
that radicals might be active over a
period of 7 days, inducing significant
postpolymerization. Limitations of
this study concerning the oral environment must also be considered. Cyclic fatigue loading and the wet environment in the oral cavity are factors
which can significantly weaken the
fracture resistance of resins.2 Thus,
clinical studies are required to support the use of CAD/CAM resins in
long-term restorations.
To determine the study power,
the measured fracture load results

were calculated (nQuery Advisior

v6.04.10; Statistical Solutions, Saugaus Mass). For the calculation of the
power analyses, the polymeric CAD/
CAM AT group with a CSA of 9 mm2
was chosen, as this was the smallest
connector size recommended on the
basis of the present results. A sample
size of 15 in each group will have a
94% power to detect a difference in
means of 106 N (20% decrease or
increase of 528 N) caused by different CSAs. This assumes that the common standard deviation is 64 N with
a 2-group t test with .008 Bonferroni
corrected 2-sided significance level
due to 6 different pair comparisons.
Therefore, the sample size used seems
to be large enough to support the hypothesis that the CSA size affects fracture load results of the FDPs.

CONCLUSION
CAD/CAM manufactured resin
FDPs revealed significantly higher
fracture load values than conventionally fabricated FDPs and showed a
significant increase in fracture load
with the increase of CSA. Regarding
the limitations of in vitro studies, only
the CSAs of at least 9 mm2 for AT and
TC and 12 mm2 for CT exhibited values which might be able to withstand
the occlusal forces in the posterior region. Yet, for AT, a considerably higher shape value was obtained for the
12-mm2 connector, indicating that
this larger CSA may be more reliable.

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Corresponding author:
Dr Timea Wimmer
Goethestrasse 70
80336 Munich
GERMANY
E-mail: timea.wimmer@med.uni-muenchen.de
Acknowledgments
The authors thank Merz Dental, Ivoclar Vivadent, and VITA Zahnfabrik for supporting this
study with materials.
Copyright 2013 by the Editorial Council for
The Journal of Prosthetic Dentistry.

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