Fractographic analyses of all-ceramic crowns: A study of 27 clinically fractured crowns

Øilo, Marit; Gjerdet, Nils Roar

doi:10.1016/j.dental.2013.03.018

Cited by 62 publications

(62 citation statements)

References 25 publications

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“…While FPDs fail predominantly from the gingival side of the connector [7], single crowns most frequently show their weakest link either at the gingival margins [8] or at the occlusal surface due to wear degradation. The underlying failure modes are thereby based on stress concentration associated with high bending moments [9], occlusal impact loading, resulting in either Hertzian cone cracks [7,10] or chipping fractures originating from the contact loading site [11].…”

Section: Interfacial Strength Testingmentioning

confidence: 99%

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ADM guidance-Ceramics: all-ceramic multilayer interfaces in dentistry

et al. 2017

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Section: Interfacial Strength Testingmentioning

confidence: 99%

“…In order to reduce stresses in the marginal area, butt joints with shoulders or large chamfer finish lines are recommended [49]. A fractographic approach to clinically failed alumina veneered bilayer crowns identified the fracture origins consistently to be located at the cervical margins [8].…”

Section: Testing Of Complex Geometriesmentioning

confidence: 99%

ADM guidance-Ceramics: all-ceramic multilayer interfaces in dentistry

et al. 2017

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“…The application of fractographic analysis to determine the fracture origins of crowns that have failed in service has been reported in numerous publications (Kelly et al 1990; Thompson et al 1994;Quinn et al 2005;Øilo and Gjerdet 2013;Moráguez et al 2015;Øilo and Quinn 2016). These analyses identified a number of fatigue fracture modes and the mechanisms that lead to these failures are well summarized (Zhang et al 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Fractographic analysis of failed Dicor crowns indicated that most fractures originated from the intaglio surface (Thompson et al 1994). Interface-initiated fractures that originated from cervical margins have been identified as an important mode of failure for many all-ceramic systems (Quinn et al 2005;Øilo and Gjerdet 2013;Øilo et al 2014). Chai et al (1999) were the first to identify that during indentation loading, median-radial cracks can initiate from the interface away from the top surface contact zone when a brittle layer is supported by a compliant substrate.…”

Section: Introductionmentioning

confidence: 99%

Survival Predictions of Ceramic Crowns Using Statistical Fracture Mechanics

et al. 2017

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This work establishes a survival probability methodology for interface-initiated fatigue failures of monolithic ceramic crowns under simulated masticatory loading. A complete 3-dimensional (3D) finite element analysis model of a minimally reduced molar crown was developed using commercially available hardware and software. Estimates of material surface flaw distributions and fatigue parameters for 3 reinforced glass-ceramics (fluormica [FM], leucite [LR], and lithium disilicate [LD]) and a dense sintered yttrium-stabilized zirconia (YZ) were obtained from the literature and incorporated into the model. Utilizing the proposed fracture mechanics-based model, crown survival probability as a function of loading cycles was obtained from simulations performed on the 4 ceramic materials utilizing identical crown geometries and loading conditions. The weaker ceramic materials (FM and LR) resulted in lower survival rates than the more recently developed higher-strength ceramic materials (LD and YZ). The simulated 10-y survival rate of crowns fabricated from YZ was only slightly better than those fabricated from LD. In addition, 2 of the model crown systems (FM and LD) were expanded to determine regional-dependent failure probabilities. This analysis predicted that the LD-based crowns were more likely to fail from fractures initiating from margin areas, whereas the FM-based crowns showed a slightly higher probability of failure from fractures initiating from the occlusal table below the contact areas. These 2 predicted fracture initiation locations have some agreement with reported fractographic analyses of failed crowns. In this model, we considered the maximum tensile stress tangential to the interfacial surface, as opposed to the more universally reported maximum principal stress, because it more directly impacts crack propagation. While the accuracy of these predictions needs to be experimentally verified, the model can provide a fundamental understanding of the importance that pre-existing flaws at the intaglio surface have on fatigue failures.

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“…These intrinsic defects may induce the initiation of cracks during clinical loading. As a result, crack-propagation can lead to chipping of the veneering ceramic and even frameworkfractures of the all-ceramic FDP [14].…”

Section: Introductionmentioning

confidence: 99%

A randomized controlled clinical trial of 3-unit posterior zirconia–ceramic fixed dental prostheses (FDP) with layered or pressed veneering ceramics: 3-year results

Naenni

Bindl

Sax³

et al. 2015

Journal of Dentistry

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A B S T R A C TObjectives: The aim of the present pilot study was to test whether or not posterior zirconia-ceramic fixed dental prostheses (FDPs) with pressed veneering ceramic exhibit less chipping than FDPs with layered veneering ceramics. Methods: Forty patients (13 female, 27 male; mean age 54 years (range 26.1-80.7 years) in need of one maxillary or mandibular three-unit FDP in the second premolar or molar region were recruited and treated at two separate centers at the University of Zurich according to the same study protocol. The frameworks were made out of zirconia using a CAD/CAM system (Cerec Sirona, Bensheim, Germany). The patients were randomly assigned to either the test group (zirconia frameworks veneered with pressed ceramic; IPS e.max ZirPress, Ivoclar Vivadent AG, Schaan, Liechtenstein; n = 20) or the control group (layered veneering ceramic; IPS e.max Ceram, Ivoclar Vivadent AG, Schaan, Liechtenstein; n = 20). All FDPs were adhesively cemented and evaluated at baseline (i.e., cementation), at 6 months and at 1 and 3 years of clinical service. The survival of the reconstruction was recorded. The technical outcome was assessed using modified United States Public Health Services (USPHS) criteria. The biologic parameters analyzed at abutment teeth and analogous non-restored teeth included probing pocket depth (PPD), plaque control record (PCR), bleeding on probing (BOP), and tooth vitality (CO 2 ). Data was descriptively analyzed and survival was calculated using Kaplan-Meier statistics. Results: 36 patients (25 female, 11 male; mean age 52.3 years) with 18 test and 18 control FDPs were examined after a mean follow-up of 36 months (95% CI: 32.6-39.1 months). Comparison of groups was done by Crosstabulation showing even distribution of the respective restored teeth amidst the groups. Survival rate was 100% for both test and control FDPs. Chipping of the veneering ceramic tended to occur more frequently in test (n = 8; 40%) than in control (n = 4; 20%) FDPs, albeit not significantly (p = 0.3). No further differences of the technical outcomes of test and control FDPs occurred.In both test and control group healthy conditions and no difference of the biologic parameters at the abutment and un-restored teeth was found. Conclusion: Zirconia FDPs with pressed and layered veneering ceramics exhibited similar outcomes at 3 years. A trend to more chipping of the pressed veneering ceramic, however, was observed. Clinical significance: Posterior restorations with zirconia frameworks are a viable treatment method. When restoring posterior teeth with all-ceramic restorations, care providers should be aware of the higher rate of chipping compared to the published data on conventional metal-ceramic restorations.

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Fractographic analyses of all-ceramic crowns: A study of 27 clinically fractured crowns

Cited by 62 publications

References 25 publications

ADM guidance-Ceramics: all-ceramic multilayer interfaces in dentistry

ADM guidance-Ceramics: all-ceramic multilayer interfaces in dentistry

Survival Predictions of Ceramic Crowns Using Statistical Fracture Mechanics

A randomized controlled clinical trial of 3-unit posterior zirconia–ceramic fixed dental prostheses (FDP) with layered or pressed veneering ceramics: 3-year results

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