Mitchell S. Pines

Fracture of Porcelain-veneered Structures in Fatigue

Porcelain-veneered crowns are widely used in modern dentistry, and their fracture remains problematic, especially in all-ceramic systems. We hypothesized that substructure properties have a significant effect on the longevity of porcelain-veneered crowns. Flat porcelain/metal or porcelain/ceramic structures were cemented to dentin-like composite, and a mouth-motion cyclic load of 200 N was delivered by means of a tungsten carbide spherical indenter (r = 3.18 mm), emulating occlusal loading on crowns supported by dentin. Findings indicated that porcelain on a low-hardness gold-infiltrated alloy was vulnerable to both occlusal surface contact damage and porcelain lower surface radial fracture, while porcelain on a higher-hardness palladium-silver alloy fractured chiefly from occlusal surface damage. The advantage of a high-modulus metal substructure was less pronounced. Fracture in the porcelain/zirconia system was limited to surface damage in the veneer layer, similar to that in the porcelain/palladium-silver system. Bulk fracture, observed in veneered alumina layers, was not found for zirconia.

Damage Maps for Layered Ceramics under Simulated Mastication

Ceramic restorations, whether monolithic (single layer) or porcelain-veneered, often chip and fracture from repeated occlusal loading. Occlusion involves the opposing tooth sliding along the cuspal incline surface with an applied biting force (off-axis loading). We hypothesized that off-axis contact–load–slide–liftoff fatigue, as compared with normal axial fatigue loading, produces different fracture modes and fatigue lifespans of layered ceramics. Monolithic glass plates were epoxy-bonded to polycarbonate substrates as a transparent model for an all-ceramic crown on dentin. Off-axis and axial (control) cyclic loading was applied through a hard sphere in water, with a mouth-motion machine. The off-axis loading is more deleterious for contact-induced occlusal surface fracture, but less harmful for flexure-induced cementation surface fracture of brittle layers than the axial loading. This is because of the tangential load component associated with the off-axis loading. Clinical relevance is discussed.

Comparison of fatigue for three prefabricated threaded post systems

Post designs may have a direct effect on fracture resistance of endodontically treated teeth. This in vitro study compared the resistance of three prefabricated threaded post systems with lateral shearing forces. After endodontics were completed, prefabricated posts were inserted according to the manufacturers instructions. A silver amalgam core was placed, and extracted human teeth were prepared to a standard size with a 1 mm gingival chamfer finished on sound dentino A cast was fabricated and cemented, and the specimens were thermocycled. The test samples were secured to an Instron testing machine and loaded until failure. Fracture patterns were recorded, fractured surface areas were measured, and compressive stresses were calculated. However, there were no statistically significant differences among threaded posts in each test group.

PROVISIONAL AND DEFINITIVE PROSTHESES FOLLOWING SINUS LIFT AND AUGMENTATION PROCEDURES

Sinus lift and augmentation procedures with simultaneous insertion of cylindrical root form implants can be used to treat the atrophic posterior maxilla. The long-term use of a second stage provisional prosthesis is emphasized. The recommended metal-reinforced acrylic resin provisional restoration allows treatment and/or removal of a failing implant and progressive loading before fabrication of the definitive prosthesis. Modifications in prosthesis fabrication after sinus lift surgery and augmentation procedures are discussed. (Implant Dent 1994;3:24—28)