An evaluation of the fatigue crack resistance of human dentin was conducted to identify the degree of degradation that arises with aging and the dependency on tubule orientation. Fatigue crack growth was achieved in specimens of coronal dentin through application of Mode I cyclic loading and over clinically relevant lengths (0 ≤ a ≤ 2 mm). The study considered two directions of cyclic crack growth in which the crack was either in-plane (0°) or perpendicular (90°) to the dentin tubules. Results showed that regardless of tubule orientation, aging of dentin is accompanied by a significant reduction in the resistance to the initiation of fatigue crack growth, as well as a significant increase in the rate of incremental extension. Perpendicular to the tubules, the fatigue crack exponent increased significantly (from m=14.2±1.5 to 24.1±5.0), suggesting an increase in brittleness of the tissue with age. For cracks extending in plane with the tubules, the fatigue crack growth exponent does not change significantly with patient age (from m=25.4±3.03 to 22.9±5.3), but there is a significant increase in the incremental crack growth rate. Regardless of age, coronal dentin exhibits the lowest resistance to fatigue crack growth perpendicular to the tubules. While there are changes in the cyclic crack growth rate and mechanisms of cyclic extension with aging, this tissue maintains its anisotropy.

Tooth fracture is a major concern in the field of restorative dentistry. However, knowledge of the causes for tooth fracture has developed from contributions that are largely based within the field of mechanics. The present manuscript presents a technical review of advances in understanding the fracture of teeth and the fatigue and fracture behavior of their hard tissues (i.e., dentin and enamel). The importance of evaluating the fracture resistance of these materials, and the role of applied mechanics in developing this knowledge will be reviewed. In addition, the complex microstructures of tooth tissues, their roles in resisting tooth fracture, and the importance of hydration and aging on the fracture resistance of tooth tissues will be discussed. Studies in this area are essential for increasing the success of current treatments in dentistry, as well as in facilitating the development of novel bio-inspired restorative materials for the future.

The crack growth resistance of human dentin was characterized as a function of relative distance from the DEJ and the corresponding microstructure. Compact tension specimens were prepared from the coronal dentin of caries-free 3rd molars. The specimens were sectioned from either the outer, middle or inner dentin. Stable crack extension was achieved under Mode I quasi-static loading, with the crack oriented in-plane with the tubules, and the crack growth resistance was characterized in terms of the initiation (Ko), growth (Kg) and plateau (Kp) toughness. A hybrid approach was also used to quantify the contribution of dominant mechanisms to the overall toughness. Results showed that human dentin exhibits increasing crack growth resistance with crack extension in all regions, and that the fracture toughness of inner dentin (2.2±0.5 MPa•m0.5) was significantly lower than that of middle (2.7±0.2 MPa•m0.5) and outer regions (3.4±0.3 MPa•m0.5). Extrinsic toughening, composed mostly of crack bridging, was estimated to cause an average increase in the fracture energy of 26% in all three regions. Based on these findings, dental restorations extended into deep dentin are much more likely to cause tooth fracture due to the greater potential for introduction of flaws and decrease in fracture toughness with depth.

The fatigue crack growth resistance of dentin was characterized as a function of depth from the dentino-enamel junction. Compact tension (CT) specimens were prepared from the crowns of third molars in the deep, middle, and peripheral dentin. The microstructure was quantified in terms of the average tubule dimensions and density. Fatigue cracks were grown in-plane with the tubules and characterized in terms of the initiation and growth responses. Deep dentin exhibited the lowest resistance to the initiation of fatigue crack growth, as indicated by the stress intensity threshold (ΔK th ≈ 0.8 MPa•m 0.5 ) and the highest incremental fatigue crack growth rate (over 1000 times that in peripheral dentin). Cracks in deep dentin underwent incremental extension under cyclic stresses that were 40% lower than those required in peripheral dentin. The average fatigue crack growth rates increased significantly with tubule density, indicating the importance of microstructure on the potential for tooth fracture. Molars with deep restorations are more likely to suffer from the cracked-tooth syndrome, because of the lower fatigue crack growth resistance of deep dentin.

Fracture of root‐filled teeth is not uncommon and appears to be a complex function of both the treatment and the patient's oral regimen. However, there have been few studies aimed at understanding the intrinsic mechanical behavior of dentin and its relevance to the incidence of these fractures. In addition, there has been some controversy over whether the fracture of root‐filled teeth is attributed primarily to loss of tooth structure or if there are other contributing factors. A comprehensive understanding of the structure and mechanical behavior of dentin is of substantial importance to the success of endodontic therapy. Specifically, the importance of fatigue on tooth fractures and the resistance of tissues to both the initiation and propagation of cracks have received scant attention. As well, regional variations in these properties and the contribution of changes in microstructure to the fatigue and fracture behavior are not well understood. This article reviews the importance of microstructure on the mechanical behavior of dentin and compares the mechanical properties of tissue from the root and crown. Also, the changes in microstructure with aging are discussed as well as their importance to the incidence of tooth fracture.