Purpose: To evaluate the effect of restoration design on fracture resistance and stress distribu0on of veneered and monolithic three-unit zirconia fixed partial dentures (FDPs) using finite element analysis (FEA). Materials and Methods: Identical epoxy resin replicas of mandibular second premolars and second molars (to serve as abutments for the three-unit bridges) were divided into four groups (n = 10): monolithic zirconia (MZ) restorations; conventional layering veneering technique (ZL); heat pressed-on technique (ZP); or CAD/CAM lithium-disilicate glass-ceramics (CAD-on). Specimens were subjected to compressive cyclic loading on the mesio-buccal cusp of the pontic (load range 50 to 600 N; aqueous environment; 500,000 cycles) in a universal testing machine. Data were statistically analyzed at 5% significance level with Fisher exact test and Kaplan-Meier survival analysis. 3D models were constructed in accordance with experimental groups. The stress distribution in each model was analyzed and evaluated according to the location and magnitude of the maximum principal stresses (MPSs) using ANSYS so\ware. Results: Specimens from ZL and ZP groups failed at different stages of the 500,000 cycles fatigue, while CAD-on and MZ restorations survived the fatigue test. Statistically, there was a significant difference between the groups (P < .001). The MPS were located under the mesial connector in both monolithic and bilayered three-unit zirconia FDPs. These stresses were found to be higher in monolithic geometries compared to bilayered zirconia FDPs. Conclusions: Monolithic threeunit zirconia and CAD-on zirconia frameworks resulted in superior fracture resistance. Restora0on design significantly affected the stress distribu0on of three-unit zirconia FDPs.
