Indentation of the cornea: A Bi-layer contact problem.

Histological observations of the cornea have identified the presence of multiple layers with differing thickness and function. The composition of the cornea consists primarily of collagen fibrils held together with proteoglycans but with an aqueous interstitial component being dominant. Indentation provides a means to quantify the spatial variation of the mechanical properties of the cornea, however the role of the different layers on the indentation response has barely been addressed. In addition, the response of the fluid content and its displacement during indentation has not been adequately considered. In this study indentation of the cornea with a relatively large spherical tipped indenter (R = 500 µm) is considered. It was observed that the initial phase of loading did not fit a classic Hertz elastic response but showed an initial steeper slope that gradually declines with increasing force and displacement. A relatively simple approach is developed that initially considers the cornea as a poro-elastic bi-layer contact problem, that is the presence of an outer thin stiffer Bowman's layer overlaying the thicker less stiff stroma.

Size or hierarchical dependence of the elastic modulus of three ceramic-composite CAD/CAM materials.

OBJECTIVE: To measure the elastic modulus of three ceramic-composite CAD/CAM materials at three different microstructural dimensions: macro, micro, and nano. METHODS: Three novel ceramic-composite CAD/CAM materials (Enamic, Lava Ultimate, and Cerasmart) were investigated. Rectangular cross-sections 10 × 5.7 × 1 mm3 (n = 30) were cut from standard sized milling blocks of each material prior to polishing. Specimens were macro-tested using three-point bending and with a dynamic mechanical analyzer (DMA), micro-tested using a nano-indentation system, and finally at the nano-level with an atomic force microscope (AFM). Data were analyzed with 1-way ANOVA (α = 0.05). RESULTS: At the macro level Enamic showed the highest elastic modulus, followed by Lava Ultimate and Cerasmart respectively (p < 0.001). Measurements at the micro and nano level resulted in bimodal distributions of the elastic modulus values associated with the various phases present with values higher and lower than measured at the macro level. Only at the nano-level were the various phases of Cerasmart able to be distinguished. CONCLUSIONS: The tested materials showed different elastic modulus at the different size or hierarchical levels that enabled comparison with the hierarchical values of enamel. SIGNIFICANCE: Studying the mechanical properties of these novel materials at different size or hierarchical scales can help to understand their potential clinical performance, such as structural durability and opposing tooth wear and lead to more biomimetic like dental restorative materials.

The dehydration effect on mechanical properties of tooth enamel.

Exploring the subtle mechanical property changes of tooth enamel in different conditions is important for dental research. However, some experimental results can be deceptive and may lead to misunderstanding. In particular, we show the dehydration associated with increased mechanical properties of tooth enamel as monitored by Nanomechanical System Testing (NST) can be misleading. The results indicate that the friction coefficient decreased with an increase of hardness of enamel upon dehydration, which appears to imply that dehydrated enamel has better mechanical properties than hydrated enamel. However, more critical scrutiny of the actual situation, suggests dehydrated teeth enamel are more prone to damage and greater wear. To appreciate the basis for the contrast between the experimental results and reality of natural hydrated enamel, which has better resistance to wear, and is critical for an understanding of the aetiology of enamel resistance to fracture.

Thermal induced deflection of a porcelain-zirconia bilayer: Influence of cooling rate.

OBJECTIVE: To determine the thermal expansion of a porcelain (VM9) and tetragonal zirconia (Y-TZP) as well as the deflection upon re-heating and cooling of a bilayer fabricated from these two materials after slow and rapid cooling during initial fabrication. METHODS: The coefficient of thermal expansion (CTE) of bulk porcelain and Y-TZP as well as bilayer beam deflection was measured with a novel non-contact optical dilatometer. The influence of cooling rate during initial fabrication of the porcelain-zirconia bilayer and the bulk porcelain during subsequent heating and cooling is investigated. Specimens were heated to 900°C in the dilatometer, well in excess of the glass transition temperature (Tg) and softening temperature (Ts) of the porcelain. RESULTS: The thermal expansion of the porcelain above Tg exhibits a threefold increase in CTE over that observed below Tg. Observations of the bilayer deflection reflect the difference in the CTE of the component materials and enable Tg and Ts temperatures for the porcelain to be estimated. Initial cooling rate of the porcelain and porcelain-YTZP bilayer was found to have a profound influence on the subsequent response to slow reheating and cooling as well as the resultant residual deflection. SIGNIFICANCE: The estimation of the residual stress and potential for chipping of porcelain-zirconia dental restorative systems should not be based solely on thermal expansion data measured below Tg.

Frictional coefficient during flossing of teeth.

OBJECTIVE: This in-vitro study aimed to develop a technique to measure the frictional forces and determine the frictional coefficient (µ) associated with the rubbing of dental floss against teeth. Incorrect flossing technique and the etiology of grooves at the cementoenamel junction (CEJ) of proximal area of teeth has long been a controversial topic. We hypothesized that the µ between teeth surfaces and dental floss is affected by contact angulation. MATERIALS AND METHODS: Tests were conducted using two different types of dental floss (waxed and unwaxed nylon) on different surfaces (enamel, dentine, smooth and rough glass rods) under different moisture conditions (dry and wet). The µ generated by performing C-shape flossing was measured, using the Capstan equation, at constant load (100g) over different flossing contact sliding angulations. In addition, the surface characteristics of intact and used nylon flosses were compared using a scanning electron microscope (SEM). RESULTS: The mean µ was highest with a smooth glass rod (0.42±0.11), followed by rough glass rods (0.30±0.07), dry enamel (0.27±0.08), wet enamel (0.23±0.06), then dentine (0.18±0.04). Moreover, higher µ was associated with waxed floss when used against dry enamel, smooth and rough glass rods (P<0.001). At different moisture conditions, waxed floss demonstrated greater µ with dry surfaces (P<0.03). No association was found between µ and dental floss contact angulation. Both floss types showed deterioration after usage; although waxed type exhibited markedly greater deterioration when used on dry surfaces. In conclusion, the magnitude of the µ was found to be influenced by surface roughness, moisture condition, and independent of the contact angulation area during sliding of dental floss. SIGNIFICANCE: It is important to consider the potential side effects of frictional forces on both tooth surface and dental floss during clinical application.

FTIR characterization of the setting reaction of biodentine™.

OBJECTIVE: To provide insight of the setting reactions of Biodentine™, a hydraulic calcium silicate cement, based upon observations using Fourier Transform Infra-Red (FTIR) spectroscopy. METHODS: FTIR spectra of components before and during the setting reaction were taken using the attenuated total reflectance (ATR) technique. Measurements over wavelengths 600-4000cm-1 were taken at regular intervals for two days. RESULTS: FTIR spectrum of Biodentine™ powder revealed a number of peaks from 650 to 1100cm-1 and a plateau from 1400 to 1500cm-1, indicative of SiO and CO3-bonding, while the mixing fluid exhibited water peaks. Results following mixing displayed three distinct regimes; (i) incubation phase, during the first 35min, when minimal change occurred, (ii) rapid transitory stage, between 35 and 90min, when major changes occurred, and (iii) slow sustained reaction stage for remaining 45h. Incubation appears to be associated with the presence of CO3-peaks. The transition region indicates formation of CaOH and Jennite OH-peaks, anticipated intermediate reaction phases. At 90min, the end of second stage, CaOH and Jennite are replaced by a dominant Portlandite (Ca(OH)2)-peak and minor presence of Tobermorite, another anticipated intermediate phase, and water reduction. During the following 45h Portlandite and Tobermorite decline while the water peak increases. SIGNIFICANCE: FTIR can be used to follow the chemical reactions in dental cements and provides insight into the relatively slow setting reactions of hydraulic calcium silicate cements.

Influence of ageing on glass and resin bonding of dental glass-ceramic veneer adhesion to zirconia: A fracture mechanics analysis and interpretation.

Adhesion plays a major role in the bonding of dental materials. In this study the adhesion of two glass-ceramic systems (IPS e.max and VITABLOCS) to a zirconia sintered substrate using a glass (for IPS e.max) and resin (VITABLOCS) before and after exposure to ageing for 14 days in distilled water at 37 °C are compared using two interfacial fracture mechanics tests, the 3 point bend Schwickerath (Kosyfaki and Swain, 2014; Schneider and Swain, 2015) and 4 point bend (Charalambides et al., 1989) approaches. Both tests result in stable crack extension from which the strain energy release rate (G, N/m or J/m2) can be determined. In the case of the 3 PB test the Work of Fracture was also determined. In addition, the Schwickerath test enables determination of the critical stress for the onset of cracking to occur, which forms the basis of the ISO (ISO9693-2:2016) adhesion test for porcelain ceramic adhesion to zirconia. For the aged samples there was a significant reduction in the resin-bonded strengths (Schwickerath) and strain energy release rate (both 3 and 4 PB tests), which was not evident for the glass bonded specimens. Critical examination of the force-displacement curves showed that ageing of the resin resulted in a major change in the form of the curves, which may be interpreted in terms of a reduction in the critical stress to initiate cracking and also in the development of an R-curve. The extent of the reduction in strain energy release rate following ageing was greater for the Schwickerath test than the Charalambides test. The results are discussed in terms of; the basic mechanics of these two tests, the deterioration of the resin bonding following moisture exposure and the different dimensions of the specimens. These in-vitro results raise concerns regarding resin bonding to zirconia. STATEMENT OF SIGNIFICANCE: The present study uses a novel approach to investigate the role of ageing or environmental degradation on the adhesive bonding of two dental ceramics to zirconia. This continues to be a major clinical problem but current approaches, till now, have relied upon a myriad of strength based tests to quantify the extent of environmental degradation with time. In this paper we use two fracture mechanics approaches, based upon simple 3 and 4 point bend testing procedures that enable stable debonding crack extension to occur. The paper provides a more critical approach to evaluate the role of environmental degradation of adhesion for dental materials.

Comparison of three and four point bending evaluation of two adhesive bonding systems for glass-ceramic zirconia bi-layered ceramics.

OBJECTIVES: To quantify the adhesion of two bonding approaches of zirconia to more aesthetic glass-ceramic materials using the Schwickerath (ISO 9693-2:2016) three point bend (3PB) [1] test to determine the fracture initiation strength and strain energy release rate associated with stable crack extension with this test and the Charalamabides et al. (1989) [2] four point bend (4PB) test. METHODS: Two glass-ceramic materials (VITABLOCS Triluxe forte, Vita Zahnfabrik, Germany and IPS.emax CAD, Ivoclar Vivadent, Liechtenstein) were bonded to sintered zirconia (VITA InCeram YZ). The former was resin bonded using a dual-cure composite resin (Panavia F 2.0, Kuraray Medical Inc., Osaka, Japan) following etching and silane conditioning, while the IPS.emax CAD was glass bonded (IPS e.max CAD Crystall/Connect) during crystallization of the IPS.emax CAD. Specimens (30) of the appropriate dimensions were fabricated for the Schwickerath 3PB and 4PB tests. Strength values were determined from crack initiation while strain energy release rate values were determined from the minima in the force-displacement curves with the 3PB test (Schneider and Swain, 2015) [3] and for 4PB test from the plateau region of stable crack extension. RESULTS: Strength values for the resin and glass bonded glass ceramics to zirconia were 22.20±6.72MPa and 27.02±3.49MPa respectively. The strain energy release rates for the two methods used were very similar and for the glass bonding, (4PB) 15.14±5.06N/m (or J/m2) and (3PB) 16.83±3.91N/m and resin bonding (4PB) 8.34±1.93N/m and (3PB) 8.44±2.81N/m respectively. The differences in strength and strain energy release rate for the two bonding approaches were statistically significant (p<0.05). SEM observations showed fracture occurred adhesively for the resin bonding and cohesively for the glass bonding. SIGNIFICANCE: The present results indicate 3PB and 4PB tests have very similar values for the strain energy release rate determination. However while strength tests reveal minimal differences between resin and glass bonding, strain energy release rates for the latter are superior for bonding CAD/CAM milled glass-ceramics to zirconia.

A simple basis for determination of the modulus and hydraulic conductivity of human ocular surface using nano-indentation.

This paper presents a simple analysis based upon Darcy's Law and indentation contact mechanics to determine the effective hydraulic conductivity and elastic modulus of fluid filled tissues. The approach is illustrated with the mechanical response of the human ocular surface using a 500µm radius spherical tipped indenter. Indentations of various regions of the ocular surface including the corneal stroma, limbal region and sclera have been conducted. Force-control indentations were made to a maximum force, which was maintained before unloading. Measurements of the indentation response of cornea at three different loading rates were also made. Elastic like response was observed during loading, which was followed by extensive creep prior to unloading. STATEMENT OF SIGNIFICANCE: This manuscript attempts to provide a relatively simply model for the contact loading of fluid containing tissues and materials. It shows that the response of such materials provides a basis for determining the effective modulus and effective hydraulic conductivity (permeability) in much the same manner that hardness and modulus do for the indentation of elastic-plastic materials. Eye tissue with its anisotropic elastic and permeability properties is used to illustrate the approach.

Immunolocalization and distribution of proteoglycans in carious dentine.

BACKGROUND: Collagen type I, proteoglycans (PG) and non-collagenous proteins represent important building blocks of the dentine matrix. While different PGs have been identified in dentine, changes in the distribution of these macromolecules with the progression of caries have been poorly characterized. The aim of this study was to compare the immunolocalization of three small collagen-binding PGs (biglycan, fibromodulin and lumican) as well as collagen (types I and VI) in healthy versus carious dentine. METHODS: Longitudinal demineralized sections of extracted teeth were stained with antibodies recognizing specific PG core proteins and collagens, as well as glycosaminoglycans (GAGs) with toluidine blue. RESULTS: In healthy dentine, PGs appeared to be more abundant near the tubule walls and directly under the cusps. Conversely, in carious dentine, specific locations appeared to be more prone to PG degradation than others. These degradation patterns were well correlated with the progression of caries into the tissue, and also appeared to trigger interesting morphological changes in the tissue structure, such as the deformation of dentine tubules near highly infected areas and the lower concentration of PG in tertiary dentine. CONCLUSIONS: This study presents new insights into the involvement of PGs in the progression of caries.

Interpenetrating network ceramic-resin composite dental restorative materials.

OBJECTIVES: This paper investigates the structure and some properties of resin infiltrated ceramic network structure materials suitable for CAD/CAM dental restorative applications. METHODS: Initially the basis of interpenetrating network materials is defined along with placing them into a materials science perspective. This involves identifying potential advantages of such structures beyond that of the individual materials or simple mixing of the components. RESULTS: Observations from a number of recently published papers on this class of materials are summarized. These include the strength, fracture toughness, hardness and damage tolerance, namely to pointed and blunt (spherical) indentation as well as to burr adjustment. In addition a summary of recent results of crowns subjected to simulated clinical conditions using a chewing simulator are presented. These results are rationalized on the basis of existing theoretical considerations. SIGNIFICANCE: The currently available ceramic-resin IPN material for clinical application is softer, exhibits comparable strength and fracture toughness but with substantial R-curve behavior, has lower E modulus and is more damage tolerant than existing glass-ceramic materials. Chewing simulation observations with crowns of this material indicate that it appears to be more resistant to sliding/impact induced cracking although its overall contact induced breakage load is modest.

The Schwickerath adhesion test: A fracture mechanics analysis.

OBJECTIVES: The Schwickerath three point bending adhesion test is the basis of the International Standard ISO 9693:1999 procedure for assessing porcelain bonding to metals [1]. It has also been used to evaluate the adhesion of porcelain to zirconia. The purpose of this paper is a fracture mechanics analysis of this test, which allows determination of the crack-length load-displacement and toughness dependence of cracks extending along or near the interface. METHODS: Linear elastic mechanics is used to develop expressions for the strain energy and compliance of Schwickerath geometry specimens as a function of crack extension along or near the interface. From the derivative of the compliance as a function of crack growth the strain energy release rate (G, N/m) is determined. RESULTS: The energy release rate for interface crack extension of Schwickerath geometry specimens is determined. It is found that a simple relationship between the minima of the force-displacement response and the strain energy release rate G exists. Further development enables the predicted force-displacement response as a function of crack length to be derived for different values of G. Experimental results of porcelain bonded to zirconia with and without notches of various lengths machined along the interface verify the expressions and analysis developed. SIGNIFICANCE: With the fracture mechanics analysis developed in this paper it is possible to determine the quality of adhesion in Schwickerath specimens by the interface toughness in addition to the nominal interface shear bond strength. As the toughness of brittle materials has much less scatter than its strength, the interface toughness characterization of the adhesion should allow for a better distinction between the adhesion quality of bonding.

Adhesion determination of dental porcelain to zirconia using the Schwickerath test: strength vs. fracture energy approach.

Two approaches to measure the fracture energy to delaminate four different porcelains from zirconia substrates are compared using Schwickerath adhesion strength test specimens. In all instances it was possible to stably extend the crack along or adjacent to the porcelain-zirconia interface. The fracture energy expended to delaminate the porcelain was found by determining the work of fracture upon loading to 12 N and then unloading. Additional tests were undertaken on specimens notched along the interface, which enabled the compliance of the cracked Schwickerath specimens to be calibrated. The strain energy and deflection of the Schwickerath specimen as a function of crack length were derived. On this basis a simple expression was determined for the strain energy release rate or interfacial fracture toughness from the minima in the force-displacement curves. Consequently two measures of the adhesion energy were determined, the work of fracture and the strain energy release rate. It was found that the ranking for the four porcelains bonded to zirconia differed depending upon the approach. The work of fracture was substantially different from the strain energy release rate for three of the porcelain-zirconia systems and appears to be directly related to the residual stresses present in the bonded structures. The relative merits of the strain energy release rate, work of fracture vs. the stress to initiate cracking in the case of the Schwickerath adhesion test, are discussed. The advantage of this test is that it enables three estimates of the adhesion for porcelain veneers bonded to zirconia.

Surface characteristics and microbial adherence ability of modified polymethylmethacrylate by fluoridated glass fillers.

BACKGROUND: The current study objectives were to evaluate the influence of fluoridated glass fillers loading on the surface roughness, wettability, and adherence of candida and bacteria with and without saliva presence to a polymethylmethacrylate (PMMA) denture base material surface. METHODS: Four concentrations of fluoridated glass fillers were added to PMMA: 1%, 2.5%, 5% and 10% by weight pre-polymerization and 0% was the control. Discs of each concentration were fabricated (n = 5 for each variable). Surface roughness (Ra ) was measured using atomic force microscopy (AFM). Wettability was assessed by measuring the contact angle of a sessile drop of water. Specimens were incubated with Candida albicans, or Streptococcus mutans with and without saliva coating. Adherence was presented as a percentage of the colonized surface area, counted using an optical microscope at x100 magnification. RESULTS: The 10% group showed significantly greater roughness than the control and 1% groups; however, no significant differences in contact angle values were detected. The microbial adhesion was inversely proportional to the fluoridated glass fillers concentration where 10% concentration significantly decreased candidal and bacterial adhesion compared to others. Saliva coating significantly decreased microbial adhesion. CONCLUSIONS: It was concluded that fluoridated glass fillers could decrease microbial adhesion to acrylic denture base without adversely affecting surface properties.

Fluoride release, recharge and flexural properties of polymethylmethacrylate containing fluoridated glass fillers.

BACKGROUND: The purpose of this study was to investigate the effect of fluoridated glass fillers on fluoride release, recharge and the flexural properties of modified polymethylmethacrylate (PMMA). METHODS: Specimens of PMMA denture base material with various loading of fluoridated glass fillers (0%, 1%, 2.5%, 5% and 10% by weight) were prepared. Flexural properties were evaluated on rectangular specimens (n = 10) aged in deionized water after 24 hours, 1 and 3 months. Disc specimens (n = 10) were aged for 43 days in deionized water and lactic acid (pH 4.0) and fluoride release was measured at numerous intervals. After ageing, specimens were recharged and fluoride re-release was recorded at 1, 3 and 7 days after recharge. RESULTS: Samples containing 2.5%, 5% and 10% glass fillers showed significantly (p < 0.05) greater levels of fluoride release compared with the control and 1% glass fillers specimens. All experimental specimens exhibited fluoride release in both media. The flexural strength of specimens decreased in proportion to the percentage filler inclusion with the modulus of elasticity values remaining within ISO Standard 1567. CONCLUSIONS: The modified PMMA with fluoridated glass fillers has the ability to release and re-release fluoride ion. Flexural strength decreased as glass filler uploading increased.

Projectile penetration into ballistic gelatin.

Ballistic gelatin is frequently used as a model for soft biological tissues that experience projectile impact. In this paper we investigate the response of a number of gelatin materials to the penetration of spherical steel projectiles (7 to 11mm diameter) with a range of lower impacting velocities (<120m/s). The results of sphere penetration depth versus projectile velocity are found to be linear for all systems above a certain threshold velocity required for initiating penetration. The data for a specific material impacted with different diameter spheres were able to be condensed to a single curve when the penetration depth was normalised by the projectile diameter. When the results are compared with a number of predictive relationships available in the literature, it is found that over the range of projectiles and compositions used, the results fit a simple relationship that takes into account the projectile diameter, the threshold velocity for penetration into the gelatin and a value of the shear modulus of the gelatin estimated from the threshold velocity for penetration. The normalised depth is found to fit the elastic Froude number when this is modified to allow for a threshold impact velocity. The normalised penetration data are found to best fit this modified elastic Froude number with a slope of 1/2 instead of 1/3 as suggested by Akers and Belmonte (2006). Possible explanations for this difference are discussed.

Microstructural analysis of Co-Cr dental alloy at the metal-porcelain interface: a pilot study.

OBJECTIVE: The purpose of the study was to observe whether conventional porcelain firings had an effect on the underlying microstructure of cobalt-chromium alloys used in porcelain-fused-to-metal systems. METHODS: One as cast (non-veneered) and two porcelain veneered Co-Cr specimens layered with and without tungsten(W)-metal conditioner were manufactured and analysed. Electron backscatter diffraction was used to determine the crystal structures and grain size across the porcelain-fused-to-metal interface. RESULTS: No difference was found in the microstructure of the alloy in both with and without W-metal conditioner. For the porcelain fired specimens, disparately sized granular structures were observed adjacent to the metal-porcelain interfaces compared to the bulk of the metal. Ellipsoid shaped grains at the alloy surface ranged between 1-11 µm in diameter and averaged 2.70 µm (SD: 2.17 µm) for the specimen layered with W-metal conditioner and 2.86 µm (SD: 1.85 µm) for the specimen layered without W-metal conditioner. Grains located in the bulk were > 200 µm with dendritic-like features. The depth of the fine grain structure adjacent to the surface had an average depth of 15 µm. The crystal structure of the surface layer was found to be predominantly hexagonal close-packed whereas the underlying bulk was a mixture of both face-centered cubic and hexagonal close-packed phases. For the as cast specimen, similar large grains of over 200 µm was observed but exhibited no dendritic like features. In addition, no fine grains were observed at the surface region of the as cast alloy. CONCLUSION: Conventional porcelain firings altered the interfacial and bulk microstructure of the alloy while the presence of the W-metal conditioner had no influence on the underlying alloy microstructure.

Gunshot induced indirect femoral fracture: mechanism of injury and fracture morphology.

INTRODUCTION: Indirect ballistic fractures occur when a projectile passes close to, but not contacting, the bone. The mechanism of how these fractures occur is not yet proven, but recently the acoustic shockwave has been excluded as a cause. The objective of this study is to determine whether the expanding temporary cavity, the collapse of this cavity or its oscillation causes these fractures. In addition, we describe the fracture morphology and biomechanical causes of this injury. METHOD: 40 fresh deer femora were strain gauged and embedded in ballistic gelatin before being shot with four different projectiles with varying distances off the bone. Pressure recordings, chronographs and radar allowed assessment of local pressures and energy transfer. High-speed video allowed the temporal relationship between the temporary cavity and fracture formation to be analysed, while sample dissection allowed the fracture morphology to be described. RESULTS: The fractures produced were consistently wedge-shaped and caused by the expansion of the temporary cavity, flexing the bone beyond its yield point, causing tension failure on the cortex opposite the expanding temporary cavity and a compression wedge on the side of the cavity. Local pressure was not predictive of fracture formation but the energy transfer to the gelatin block was predictive. CONCLUSIONS: Indirect fractures are caused by the expansion of the temporary cavity and relate to the proximity of this cavity to the bone. Fractures occur from flexion of the bone and classically display wedge-shaped fracture patterns with the apex of the wedge pointing away from the expanding cavity.

Identifying the source of bullet wipe: a randomised blind trial.

OBJECTIVE: To assess the usefulness of scanning electron microscopy and energy dispersive x-ray spectroscopy in matching bullet wipe to the bullet. HYPOTHESIS: Bullet wipe can be used to match a bullet type to a crime scene.

The all-ceramic, inlay supported fixed partial denture. Part 4. Fracture surface analyses of an experimental model, all-ceramic, inlay supported fixed partial denture.

BACKGROUND: In the previous three papers, the authors sought to conduct a thorough analysis of the feasibility for the use of zirconia in inlay supported, fixed partial dentures via finite element analysis (FEA). Correlating the response of the numerical model against the experimental model has never been satisfactorily performed for an anatomically accurate ceramic bridge; such validation is crucial if the results from the FEA are to be confidently relied upon. Part 4 of this series is a detailed fractographic analysis of the zirconia bridge that was the model for the experimental validation, performed in order to confirm the fracture origin/s and fracture trajectory as predicted from the FEA. METHODS: Established fractographic techniques involving optical examination followed by examination with scanning electron microscopy were conducted. The porous, granular surface of zirconia (both partially and fully sintered) does not lend itself to easy surface analysis but the classic fractographic signs (hackle lines, wake hackle lines and compression curl) are present. Use of linear fracture elastic mechanics allowed the calculation of theoretical critical flaw size and a comparison to two defects or inclusions found at the primary origin of fracture. RESULTS: Excellent agreement between the fracture sites and paths of travel as predicted in the numerical analysis exist with fractographic analysis. Furthermore, the calculated critical flaw size of 30 µm to 40 µm equates very well with defects seen at the general vicinity of the primary fracture origin and the general observed size of critical flaws in machined ceramics which range between 20 µm to 50 µm, thus providing further confirmation. CONCLUSIONS: The fractographic analysis detailed in this study provides validation of the 'zones of failure' as predicted in our FEA. Additionally, the excellent correlation between the calculated critical flaw size and the defects observed at the primary fracture site demonstrates that field of experimental mechanics is a powerful predictive tool.