ADM guidance-ceramics: Fatigue principles and testing.

BACKGROUND: Clinical failure of dental ceramics is usually reported as partial fracture of the restoration (chipping) or as catastrophic fracture of the whole structure. In contrast to metals, ceramics are linear-elastic, brittle materials exhibiting extremely low damage tolerance to failure. Well documented clinical and lab reports have shown this fracture event often occurs at loads far below their fracture strength due to intrinsic fatigue degradation via slow crack growth or cyclic fatigue mechanisms. The presence and development of surface flaws have a dominant role in damage accumulation and lifetime reduction of ceramic structures. AIMS: This ADM guidance document aims to summarize the aspects related to fatigue degradation of dental ceramics, reviewing the concepts of fatigue testing and furthermore aims to provide practical guidance to young scientists entering into fatigue related research. The description of fatigue strength is always accompanied by a clear understanding of the underlying fracture mechanisms.

Fracture Rates and Lifetime Estimations of CAD/CAM All-ceramic Restorations.

The gathering of clinical data on fractures of dental restorations through prospective clinical trials is a labor- and time-consuming enterprise. Here, we propose an unconventional approach for collecting large datasets, from which clinical information on indirect restorations can be retrospectively analyzed. The authors accessed the database of an industry-scale machining center in Germany and obtained information on 34,911 computer-aided design (CAD)/computer-aided manufacturing (CAM) all-ceramic posterior restorations. The fractures of bridges, crowns, onlays, and inlays fabricated from different all-ceramic systems over a period of 3.5 y were reported by dentists and entered in the database. Survival analyses and estimations of future life revealed differences in performance among ZrO2-based restorations and lithium disilicate and leucite-reinforced glass-ceramics.

Effect of different surface treatments on the hydrothermal degradation of a 3Y-TZP ceramic for dental implants.

OBJECTIVES: Implant surface modifications are intended to enhance bone integration. The objective of this study was to assess the effect of different surface treatments on the resistance to hydrothermal degradation, hardness and elastic modulus of a 3Y-TZP ceramic used for dental implants. METHODS: Samples grouped according to their surface morphologies (AS, as-sintered; C, coated; P, dry-polished; R, roughened; PA, polished and annealed; RA, roughened and annealed) were subjected to accelerated hydrothermal degradation (LTD) by exposure to water steam (134°C, 2bars) for 100h. The t-m phase transformation was quantified by grazing incidence X-ray diffraction (GIXDR) and by combined focused ion beam and scanning electron microscopy (FIB-SEM). Elastic modulus and hardness before- and after prolonged aging (100h) were assessed by nanoindentation. RESULTS: AS and C specimens presented a better resistance to hydrothermal degradation than P and R samples. After prolonged aging, the depth of the monoclinic transformed layer ranged from 11µm to 14µm. Hydrothermal degradation led to a significant decrease of elastic modulus and hardness. SIGNIFICANCE: Surface treatments affected the resistance to hydrothermal degradation of the 3Y-TZP ceramic. Dry mechanical surface modifications should be avoided since a high t-m transformation rate associated to the initial monoclinic content was observed. Annealing was useful to reverse the initial t-m transformation, but did not improve the resistance to hydrothermal degradation.

Post-hot isostatic pressing: a healing treatment for process related defects and laboratory grinding damage of dental zirconia?

OBJECTIVE: Processing parameters (powder granulation, compaction, debinding, greenbody shaping, sintering) and post-sinter rough, even fine grinding are influencing the final mechanical properties of 3Y-TZP. The hypothesis of this study was that post-sinter hot isostatic pressing (post-HIP) would be beneficial for improving reliability and strength of both sintered and coarse ground sintered zirconia by closing or reducing surface and/or small volume defects. METHODS: 75 sintered bars of an experimental 3Y-TZP (3mm×4mm×45mm) with chamfered edges and 15µm diamond surface finish were provided by the manufacturer (Ivoclar Vivadent) and randomly distributed in five groups of N=15 each. G1 served as control (as received); G2 was post-HIPed at 1400°C and G3 at 1350°C, both using a pressure of 195MPa in Ar for 1h; G4 was coarse ground with 120µm diamond disk grain size; G5 was ground 120µm and post-HIPed at 1350°C at 195MPa, 1h in Ar. The specimens were fractured in air in 4 point-bending. Weibull characteristic strength (σ0) in MPa, m parameter (reliability) and confidence intervals (CI) at 90% confidence level are reported. Identification of the critical flaw was performed by SEM on the fractured surface of all specimens and XRD performed in all groups. RESULTS: G1: σ0=973 (932-1016), m=10.6 (7.45-15.1); G2: σ0=930 (871-995), m=6.9 (4.87-9.9); G3: σ0=898 (848-952), m=7.94 (5.6-11.4); G4: σ0=921 (857-991), m=6.35 (4.48-9.11); G5: σ0=881 (847-918), m=11.4 (8.03-16.3). G5 had a significantly lower σ0 than G1. No significant differences were seen in the reliability (m) among the groups. Fractography revealed critical intrinsic subsurface flaws of 10-60µm present in all groups resulting from the processing parameters. No "healing" (i.e. closing of defects by densification) resulted after post-HIP. Grinding sintered zirconia with 120µm diamond disks induced radial cracks of 10-20µm and an important pseudo-cubic phase transformation (56wt%) that was not completely removed after post-HIP. Post-HIP increased slightly the relative density by 0.1% but without improving the strength and reliability. SIGNIFICANCE: Post-HIP was not efficient in closing large (10-60µm) subsurface (volume) processing defects.

Stimulating effect of implant loading on surrounding bone. Comparison of three numerical models and validation by in vivo data.

A number of algorithms have been proposed to model the adaptive behavior of bone under load. However, the predictions of several models have neither been compared nor have they been systematically related to in vivo data. To this end, the stress states of loaded implant-bone interfaces were analyzed before and after osseointegration using finite element (FE) techniques. In a preliminary step, an FE mesh of a cylindrical implant encased in a cancellous core surrounded by a cortical layer was constructed, and the stresses and strains that developed at the interface were determined. The implant was loaded with 100 N vertical and 30 N lateral loads. Using this structure, the peak compressive and tensile stresses were determined. Then bone remodeling predictions were assessed using three different models: von Mises equivalent strain, strain energy density and effective stress. Finally, a systematic search of the literature was conducted to relate the numerical predictions to existing in vivo data. The FE simulations led to the following conclusions: (1) calculated compressive stresses were lower than the ultimate compressive stresses of cortical and cancellous bone. (2) Calculated tensile stresses were generally superior to experimental data on the tensile strength of the bone-implant interface. (3) With one exception, the predictions of all models were homogeneously grouped on the stimulus scales. (4) The predictions of the models as to bone gain or loss were not consistent and at times contradictory. It is hypothesized that this effect is linked to a lazy zone that is too narrow. With respect to the application of the numerical models to in vivo data, peak strains and strain energy densities were consistent with in vivo data. No in vivo data were found that supported effective stress as a stimulus.

Mechanical characterization of bovine periodontal ligament.

This study is part of a research program that aims to develop a constitutive three-dimensional model of the periodontal ligament (PDL) through the identification of pertinent material parameters. As part of this program, bovine PDL was utilized to establish stress-strain responses under tensile and compressive loading conditions. Fresh bovine molars were secured, frozen and prepared to appropriate dimensional specifications. Bar-shaped specimens that comprised portions of dentine, PDL and bone were produced. Push-pull tests were conducted using a specifically constructed loading machine. Full range monotonic stress-strain diagrams were generated. The effect of a rate increase on cyclic S-E diagrams was also determined. The influence of specimen thickness was expressed in terms of modulus of elasticity, strength, uniaxial maximizer strain, and strain energy density. The overall load-response was heavily hysteretic in compression. On the tensile side, after a steep rise, the curve tended to flatten out asymptotically. Variations in rate that spanned four orders of magnitude had no effect on reciprocal load responses. The E-modulus was in the 4-8 MPa range, the strength of the PDL was 1-2 MPa, the maximizer strain was at 45-60% and the strain energy density ranged between 0.3 and 0.4 MPa.

Incidence of fractures and lifetime predictions of all-ceramic crown systems using censored data.

PURPOSE: To determine Kaplan-Meier survival estimates and Weibull lifetime predictions for four all-ceramic crown systems from long-term data (> 5 yrs). MATERIALS AND METHODS: Single unit crowns of Cerestore (n = 30), Dicor (n = 30), Hi-Ceram (n = 22) and In-Ceram (n = 68) were placed in 95 patients treated in a university clinic. They were cemented using glass-ionomer (GI) for Cerestore, zinc phosphate (ZP) for Dicor, and 75% ZP (n = 51), 20% GI (n = 13) and 5% resin-based cement (n = 4) for In-Ceram crowns. The follow-up times were 8 yrs for Cerestore, 7 yrs for Dicor, 6 yrs for Hi-Ceram and 5 yrs for In-Ceram. The statistical analyses were based on censored data sets. A progressively censored Weibull distribution allowing for lifetime predictions beyond the actual observation time was used as well as the Kaplan-Meier Survival Product Limit Estimate (PLE), which provides survival estimates up to the maximum time of follow-up. RESULTS: Cerestore, Dicor and Hi-Ceram demonstrated molar fractures in the first 2 yrs, whereas for In-Ceram these occurred during the third and fourth year of the study. The Kaplan-Meier Survival PLE was 69% for Cerestore at 8 yrs, 86% for Dicor at 7 yrs, 81% for Hi-Ceram at 6 yrs, 92% for In-Ceram at 5 yrs. The predicted Weibull characteristic time T0 (time at which 63% of the restorations would have failed) was 23 yrs for Cerestore, 34 yrs for Dicor, 31 yrs for Hi-Ceram, and 16 yrs for In-Ceram. However, when using data sets arbitrarily limited to the three first years of follow-up, T0 decreased significantly for Cerestore, Dicor and Hi-Ceram due to the number of early fractures. Such Weibull lifetime data illustrate the risk of predicting long-term (> 5 yrs) survival using short-term (< or = 3 yrs) data on ceramic restorations, which exhibit fracturing in the initial years.

Effect of water exposure on the fracture toughness and flexure strength of a dental glass.

OBJECTIVES: The low fusing dental glass (Duceram LFC) has been advertised as presenting a superior chemical resistance and augmented strength after 16h exposure to water or 4% acetic acid. The purpose of this study was to evaluate the effect of prolonged exposure to water on two mechanical properties (fracture toughness and flexure strength) of LFC. METHODS: Disks and bars were mirror polished and annealed prior to aging in: (1) air (control), (2) water for 24h at 80 degrees C and (3) water for 8 weeks at 80 degrees C. Fracture toughness (K(Ic)) was determined by indentation fracture (IF) and indentation strength (IS) using a 19.6N Vickers indentation load. Flexure strength values were obtained from three-point bending at 0.1mm/min. Statistical analysis was performed using the Weibull distribution, Tukey and Bartlett tests (P<0.05). RESULTS: Both techniques (IS and IF) showed a significant improvement in the K of Duceram LFC after 8 weeks in water (0.88 and 1.14MPa m(0.5)) as opposed to the 24-h values both in water and air (0.77-0.78MPa m(0.5)). However, for flexure strength the Weibull characteristic (S(0)) and the m parameter did not change significantly with water storage (S(0)=90-100MPa, Weibull m =7-8). SIGNIFICANCE: The increase in toughness of Duceram LFC after aging in water is an interesting and favorable observation for a restorative material exposed to the oral environment. Nevertheless, in comparison with other contemporary ceramics, the toughness of this LFC remains in the range of soda-lime-glass or classic feldspar porcelains.

Microstructures of brazings and welds using grade 2 commercially pure titanium.

PURPOSE: Microstructural analyses of commercially pure titanium (CpTi) are scarce. The present report presents the micrographs, fractographs, elemental characteristics, and hardness profiles of brazed joints and weldments using machined rods of CpTi. MATERIALS AND METHODS: CpTi rods were joined using four techniques: laser welding, electric-arc welding, electron-beam welding, and gold- and Ti-filler brazing. The specimens were then subjected to tensile and fatigue loading. After sectioning and patterning, optical micrographs of intact joints were obtained. Fractured surfaces were investigated using scanning electron microscopy (SEM). The joint's composition was determined by SEM-energy dispersive x-ray analysis. Hardness was determined at specific locations using a microindenter. RESULTS: While laser welding left the parent metal's equiaxed structure fairly intact, electric-arc welding, electron-beam welding, and brazing created a heat-affected zone in the vicinity of the joint. The extent and characteristics of the heat-affected zone depended on the amount of heat transferred to the specimens. In this respect, brazing essentially increased grain size and altered their shape. Electron-beam welding augmented this phenomenon, yielding grains that encompassed the full diameter of the joint. Electric-arc welding disrupted the granular pattern and generated highly lamellar/acicular structures. CONCLUSION: Hardness was not a good indicator of mechanical resistance, nor was the joint's structural continuity with the parent substrate. Still, acicular microstructures were characterized by a peculiar behavior in that such joints were highly resistant to tensile stresses while their fatigue strength ranged among the lowest of the joints tested.

Mechanical and structural characteristics of commercially pure grade 2 Ti welds and solder joints.

This study aimed at determining whether data previously gathered for a laser welds and IR brazings using a Au-Pd alloy were applicable to titanium joints. As to its resistance under fatigue loading, Au-Pd alloy had shown a poor response to pre-ceramic laser welding and post-ceramic brazing. The present study was designed to assess the mechanical resistance, the microstructure and the elemental diffusion of laser welded, electric arch welded and brazed joints using commercially pure titanium as substrate metal. Mechanical resistance was determined by determining the joints' ultimate tensile strength and their resistance to fatigue loading. Elemental diffusion to and from the joints was assessed using microprobe tracings. Optical micrographs of the joints were also obtained and evaluated. Under monotonic tensile stress, three groups emerged: (1) the GTAW and the native (i.e. as received) substrate, (2) the annealed substrate and the laser welds and (3) the brazed joints. Under fatigue stress, the order was: first the native and annealed substrate, second the brazings and laser welds, third the GTAW joints. No Au-filler brazing withstood the applied fatigue loading. The micrographs showed various patterns, an absence of HAZ cracking and several occurrences of Widmanstätten structures. Elemental diffusion to and from the Ti substrate was substantial in the Ti filler brazings and virtually nil in the Au-based brazings. Under fatigue stress application, the titanium-based brazings as well as the laser- and electric arc welds performed equally well if not better than a previously tested AuPd alloy. There was a definite increase in grain size with increased heat application. However, no feature of the microstructures observed or the elemental analysis could be correlated with the specimen's resistance to fatigue stress application.

Fracture toughness of aged dental composites in combined mode I and mode II loading.

Resin-based laboratory dental composites for prosthetic restorations have been developed in the past years as a cost-effective alternative to conventional porcelain-fused-to-metal or full ceramic restorations. The fracture toughness at different stress states (K(Ic), K(IIc), and mixed-modes K(I), K(II) ) was assessed for three laboratory dental composite resins used for prosthetic restorations that were aged up to 12 months in a food simulating fluid (10% ethanol) at 37 degrees C. The materials were mainly di- methacrylate based resins reinforced with submicron glass filler particles. The Brazilian disk test was used on precracked chevron-notched specimens, and different stress states were obtained by angulating the precracked chevron notch relative to the diametral compressive loading direction. The stress intensity factors were calculated using Atkinson et al.'s relation. For all three materials, mode I fracture toughness values ranged between 0.48-0.64 MPa. m(0.5) and mode II values ranged between 0.93-1.2 MPa. m(0.5). Overall, aging time and storage media had little effect on toughness. Considering the inherently low toughness of these restorative materials, their use should be limited to low stress masticatory areas.

A new method to quantify wear using implant supported restorations.

OBJECTIVES: To design a novel technique to assess the wear of prosthodontic veneering materials. Further to determine whether accurate transfer between the oral cavity and the measuring device is achievable and assess the reproducibility of the coordinates generated by the measuring system. METHODS: The system is based on the repositioning capacity of an octagonal connector of the ITI implant system. The same type of connector was screwed onto the clinical implants that supported the experimental restorations and secured to the x-y table of the measuring device. The measuring setup also comprised a z-axis LVDT displacement gauge that allowed the entire surface of the restorations to be profiled and digitized. The system was under the control of a PC equipped with custom-made software that set the position of the stepping motors, lifted and lowered the z-axis probe, and registered and wrote the x-, y- and z-axis coordinates. Final numerical adjustments and analyses were performed using a commercial array-oriented software package. Validation procedures were performed using a specially designed calibration surface. RESULTS: On repeated profile tracings, the measurement error was less than 2 microns. When the calibration surface was removed between measurements as during clinical trials, the measurement error increased to ca. 5 microns. SIGNIFICANCE: The measurement error of the testing procedure including transfer to and from the mouth is +/- 5 microns.

The effect of film thickness and surface texture on the resistance of cemented extracoronal restorations to lateral fatigue loading.

PURPOSE: The aim of the present study was to assess the effect of cement-film thickness and surface texture (roughness) on the resistance of cemented crowns to dynamic lateral loading. MATERIALS AND METHODS: Crown and abutment analogues were cemented using zinc-oxide-eugenol, zinc-phosphate, glass-ionomer, and composite cements. The space left for the cement lute was 0.02, 0.05, 0.1, 0.2, and 0.5 mm. The 3 degrees of surface texture subjected to investigation were (1) polished with up to 4,000-grit paper, (2) sanded using a 1,000-grit paper, and (3) sandblasted with 50-micron aluminum oxide. Testing was conducted according to the staircase procedure. The specimens were subjected to rotational fatigue loading until the cement bond failed or the components reached 1,000,000 stress cycles. RESULTS: The results showed that the relation between cement thickness and resistance to dynamic lateral loading is hyperbolic. For the zinc-oxide-eugenol, the zinc-phosphate, and the glass-ionomer cements increasing surface texture had a moderate effect. For composite cement, sandblasting doubled the resistance to dynamic lateral loading. For both parameters tested (cement thickness and surface texture), the ascending order of resistance was: zinc-oxide-eugenol, zinc-phosphate, and glass-ionomer cements. Crowns cemented with composite cement presented the highest resistance to dynamic lateral loading. CONCLUSION: Within the confines of the present experimental design, it is concluded that (1) decreasing the width of the cement layer increases the resistance to dynamic lateral loading, and (2) texturing the surface of the abutment and the restorations as after sandblasting increases the resistance to dynamic lateral loading.

Compressive and tensile zones in the cement interface of full crowns: a technical note on the concept of resistance.

PURPOSE: The objectives of the study were: 1) to map the stresses acting on the cement interface of crown and abutment analogs during loading; and 2) to provide a theoretical basis for the hypothesis that resistance to lateral dislodgment is a function of the distribution of compressive force vectors acting on the cement lute. MATERIALS AND METHODS: Three-dimensional finite element (FE) meshes of crown and abutment analogs were constructed and loaded in a direction perpendicular to the axes of symmetry of the abutments. Three parameters were investigated: taper (10 degrees and 20 degrees of convergence), abutment substrate (Ni-Cr alloy and dentin), and type of cement (zinc oxide eugenol, zinc phosphate, glass ionomer, and composite resin). The tensile and compressive components of the resulting force systems were plotted along two axes (z: parallel to the axis of symmetry of the crown/abutment complex; and y: perpendicular to z, i.e., parallel to the direction of loading). Von Mises stresses were also generated. RESULTS: First, it was shown that the restoration's axis of rotation was located inside the abutment cone and was perpendicular to and intersected the axis of symmetry of the crown/abutment complex. Second, stress distribution was dependent on the three parameters investigated. Varying taper led to shifts due mainly to alterations in specimen geometry, whereas the abutment substrate and the cement type had a bearing on the level of the axis of rotation. The smaller the modulus of elasticity of the abutment substrate or the cement lute, the farther apical the location of the axis of rotation. CONCLUSIONS: Conventional schemes for explaining crown dislodgment in which the restoration rotates around an axis located at the preparation margin should be reassessed. The results of the FE analysis are compatible with the hypothesis that resistance to lateral dislodgment is a function of the distribution of compressive force vectors acting on the cement interface.

Fracture toughness (KIc) of a dental porcelain determined by fractographic analysis.

OBJECTIVES: Fractographic analysis of indentation cracks is performed following flexure testing as part of the ASTM (1999) standard for fracture toughness, KIc, determination in advanced ceramics. This method depends on the conduciveness of the material towards fractographic interpretation. The purpose of this study was to evaluate the use of fractography in fracture toughness methods with a feldspathic dental porcelain, in which KIc was measured fractographically as well as numerically using two controlled-flaw beam bending techniques. METHODS: The following methods for KIc determination were applied to a dental porcelain containing a leucite volume fraction of 15-20%: (1) surface crack in flexure (SCF) (dependent upon fractographic analysis); and (2) indentation strength (IS) at indentation loads of 9.8 and 19.6 N (applying both standard numeric calculations and fractographic analysis). The testing environments were (1) ambient air (IS and SCF) and (2) flowing dry nitrogen (SCF). RESULTS: No significant differences were found between numeric and fractographic KIc values for the IS technique at both indentation loads (9.8 and 19.6 N) in ambient air, although KIc values were sensitive to indentation load. Due to the presence of residual stresses, stable crack extension was observed fractographically in all IS specimens, as evidenced by differences between initial (ainitial) and critical (acritical) crack dimensions. For the SCF method, there was a significant difference in toughness between specimens tested in air versus dry nitrogen, however no fractographic evidence for chemically assisted slow crack growth (SCG) was observed. SIGNIFICANCE: The SCF method as described by the ASTM standard was applicable to the feldspathic porcelain and produced very comparable results with the numeric toughness calculations of the IS procedure. However, fractographic analysis of the surface crack was somewhat difficult for this glassy ceramic compared with polycrystalline ceramics. Knowledge about stable crack extension or slow crack growth and its fractographic appearance is essential when estimating the toughness from examination of flaw dimensions on fractured surfaces since large calculation errors may occur if these effects are not taken into account.

Comparison of three fracture toughness testing techniques using a dental glass and a dental ceramic.

OBJECTIVES: Various methods aimed at determining the fracture toughness of ceramics in mode I (KIc) have been described in the literature. The accuracy, scatter and the interexaminer reproducibility of KIc depend strongly on the procedural approach, the test parameters used and the conditioning of the specimens. The purpose of the present study was to compare fracture toughness values obtained using two indentation methods as well as a newly established fracture mechanics test. METHODS: The following methods for KIc determination were applied: (1) indentation fracture (IF), (2) indentation strength (IS) and (3) the single-edge-V-notched-beam test (SEVNB). The materials tested were a low-fusing dental glass (Duceram LFC) and a feldspar-based porcelain (IPS classic). Data were compared by ANOVA and Tukey's multiple comparison test (p < or = 0.05). RESULTS: For both materials, KIc coefficients of variation ranged between 10 and 14% for IF and 7 and 10% for IS. The IS technique demonstrated a load dependency for the IPS porcelain which was not observed when using the IF method. The SEVNB test provided consistent results with coefficients of variation between 1 and 3%. SEVNB toughness values for the IPS porcelain were in agreement with the IS technique. However, halfpenny shaped cracks were observed at the tip of the notch of all LFC specimens thus leading to underestimated KIc values. SIGNIFICANCE: The overall aim of this type of study is to select testing procedures that are as expedient and reliable as possible. This study has shown that all three methods agreed within 10%. However none of the procedures proved absolutely straightforward. Decision on which method to use should be based on a sound understanding of the conceptual limitations and technical difficulties inherent to each technique.

Fracture resistance of human enamel and three all-ceramic crown systems on extracted teeth.

This in vitro study measured the fracture resistance of intact extracted molars and three types of all-ceramic crowns; feldspathic porcelain, glass-ceramic, and glass-infiltrated alumina. All crowns were of a simplified three-cusp occlusal configuration, and were placed on prepared, extracted third molars. The ceramic crowns were bonded to dentin with a resin composite cement, except for 10 of the feldspathic crowns, which were luted with zinc phosphate cement. The fracture resistances was measured using a spherical steel indenter that contacted the occlusal surface at three points. A total of 40 ceramic crowns and 50 extracted maxillary third molars were tested. The Weibull distribution was used for data analysis. Intact extracted teeth were significantly stronger than all-ceramic crowns. Of the ceramic restorations, the glass-infiltrated alumina crowns exhibited the highest fracture resistance.

Tensile bond strength of gold and porcelain inlays to extracted teeth using three cements.

This in vitro study compared the tensile bond strength of gold and porcelain inlays to extracted molars in standardized cavities. Three cements were used: zinc phosphate, glass-ionomer, and a resin composite cement. The gold inlays were cemented using zinc phosphate or glass-ionomer cement, and the porcelain inlays were luted using resin composite or glass-ionomer cement. Surface treatments included, for gold inlays, either no treatment (zinc phosphate cement) or airborne particle abraded and tinplated (glass-ionomer cement); and for porcelain inlays, either no treatment (glass-ionomer cement) or etched and silane-treated (resin composite cement). Statistical analysis was performed using the Weibull distribution. Results showed no significant differences between gold inlays cemented using zinc phosphate or glass-ionomer cements and porcelain inlays luted using glass-ionomer cements. The bonded porcelain inlays (resin composite cement) showed tensile bond strengths two to three times higher than those obtained for cemented gold inlays.

Effect of cement film thickness on the fracture resistance of a machinable glass-ceramic.

OBJECTIVES: The aim of this study was to determine the fracture resistance of a machinable glass-ceramic plate cemented to a resin composite block as a function of the cement film thickness for two types of cement. METHODS: Ceramic plates were cemented to resin composite blocks using either zinc phosphate cement or a resin composite cement. For the zinc phosphate cement, the film thickness was 33 +/- 8 microns or 128 +/- 8 microns; for the resin composite cement, the thickness ranged from 26 +/- 11 microns to 297 +/- 48 microns. The elastic modulus was determined for each of the cements. Fracture loads were obtained by using a spherical steel indenter in the center of the glass-ceramic plate. The Weibull distribution was used for the statistical analysis. RESULTS: For glass-ceramic plates cemented with zinc phosphate cement, the fracture resistance was independent of the film thickness. When the resin composite cement was used, a gradual decrease of the fracture strength was observed that became statistically significant at a cement thickness of 300 microns or more. The characteristic fracture strength of glass-ceramic plates cemented with the resin composite cement was about 75% higher than when using the zinc phosphate cement. This difference is attributed to the bonding of the resin cement to the ceramic plate and the supporting structure. SIGNIFICANCE: The findings of this study suggest that the resistance to fracture due to indentation of the glass-ceramic may not be affected by the cement film thickness as much as previously thought.

The fracture resistance of all-ceramic crowns on supporting structures with different elastic moduli.

This in vitro study evaluated the fracture resistance of all-ceramic crowns as a function of the elastic modulus of the supporting die. All-ceramic crowns were made for dies with three different elastic moduli and two different crown lengths. The occlusal surface was loaded in compression with a 12.7-mm steel ball. The fracture load increased markedly with the increase in elastic modulus. The largest increase was seen when only the occlusal surface of the crown was covered. The characteristic fracture load of the complete-crown restorations was more than double that of the occlusal-cover restorations in the dies with the lowest modulus of elasticity, while for the dies with the highest modulus of elasticity the difference in the characteristic fracture load for the two configurations was not significant.