Abstract
Background Prefabricated zirconia crowns are increasingly used in pediatric dentistry due to their aesthetic and mechanical advantages. The selection of luting cement significantly influences stress distribution at the crown-tooth interface, potentially affecting long-term clinical performance. Objective To evaluate and compare the stress distribution in prefabricated zirconia crowns luted with four different cements zinc phosphate cement (ZPC), zinc polycarboxylate cement (PC), glass ionomer cement (GIC), and resin cement (RC) using finite element analysis (FEA). Methods A three-dimensional finite element model of a primary mandibular second molar restored with a prefabricated zirconia crown was developed. The model was analyzed under vertical, oblique, and lateral masticatory loads using four types of luting cements. Stress distribution was assessed using von Mises stress criteria across the tooth, crown, and cement layers. Results ZPC exhibited the highest von Mises stress values across all loading conditions, especially in the cement and dentin layers.PC demonstrated the lowest stress values, indicating reduced mechanical strain on the underlying structures. Conclusion The choice of luting cement plays a critical role in stress distribution beneath zirconia crowns. Zinc polycarboxylate cement showed the most favorable biomechanical behavior in this finite element model under simulated masticatory forces. However, clinical studies are needed to validate these findings and assess long-term outcomes.