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Synthetic calcium phosphate bone graft substitutes are widely recognized for their biocompatibility and resorption characteristics in the treatment of large bone defects. However, due to their inherent brittleness, applications in load-bearing situations always require reinforcement by additional metallic implants. Improved mechanical stability would eliminate the need for non-resorbable metallic implants. In this context a new approach to obtain calcium phosphate scaffolds with improved mechanical stability by texturing the material in specific crystal orientations was evaluated. Texture and reduction of crystal size was achieved by recrystallizing α-TCP blocks into calcium deficient hydroxyapatite (CDHA) under hydrothermal conditions. SEM and XRD analysis revealed the formation of fine CDHA needles (diameter ≈ 0.1-0.5 μm), aligned over several hundreds of micrometers. The obtained microstructures were remarkably similar to the microstructures of the prismatic layer of mollusk shells or enamel, also showing organization at 5 hierarchical structure levels. Brazilian disc tests were used to determine the diametral tensile strength, σdts, and the work-of-fracture, WOF, of the textured materials. Hydrothermal incubation significantly increased σdts and WOF of the ceramic blocks as compared to sintered blocks. These improvements were attributed to the fine and entangled crystal structure obtained after incubation, which reduces the size of strength-determining critical defects and also leads to tortuous crack propagation. Rupture surfaces revealed intergranular tortuous crack paths, which dissipate much more energy than transgranular cracks as observed in the sintered samples. Hence, the refined and textured microstructure achieved through the proposed processing route is an effective way to improve the strength and particularly the toughness of calcium phosphate-based ceramics., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Unlabelled: Zirconia is currently used as a framework material for posterior all-ceramic bridges. While the majority of research efforts have focused on the microstructure and corresponding mechanical properties of this material, clinical fractures appear to be largely associated with the appliance geometry., Objective: The objective of this study was to estimate the maximum stress concentration posed by the connector geometry and to provide adjusted estimates of the minimum connector diameter that is required for achieving 20 years of function., Methods: A simple quantitative description of the connector geometry in an all-ceramic 4-unit bridge design is used with published stress concentration factor charts to estimate the degree of stress concentration and the maximum stress., Results: The magnitude of stress concentration estimated for clinically relevant connector geometries ranges from 2 to 3. Using previously published recommendations for connector designs, adjusted estimates for the minimum connector diameter required to achieve 20 years of clinical function are presented., Significance: To prevent clinical fractures the minimum connector diameter in multi-unit bridges designs must account for the loads incurred during function and the extent of stress concentration posed by the connector geometry., (Copyright © 2010 Academy of Dental Materials. All rights reserved.)

Objectives: Evaluate the flexural strength (sigma) and subcritical crack growth (SCG) under cyclic loading of glass-infiltrated alumina-based (IA, In-Ceram Alumina) and zirconia-reinforced (IZ, In-Ceram Zirconia) ceramics, testing the hypothesis that wet environment influences the SCG of both ceramics when submitted to cyclic loading., Methods: Bar-shaped specimens of IA (n=45) and IZ (n=45) were fabricated and loaded in three-point bending (3P) in 37 degrees C artificial saliva (IA(3P) and IZ(3P)) and cyclic fatigued (F) in dry (D) and wet (W) conditions (IA(FD), IA(FW), IZ(FD), IZ(FW)). The initial sigma and the number of cycles to fracture were obtained from 3P and F tests, respectively. Data was examined using Weibull statistics. The SCG behavior was described in terms of crack velocity as a function of maximum stress intensity factor (K(Imax))., Results: The Weibull moduli (m=8) were similar for both ceramics. The characteristic strength (sigma(0)) of IA and IZ was and 466MPa 550MPa, respectively. The wet environment significantly increased the SCG of IZ, whereas a less evident effect was observed for IA. In general, both ceramics were prone to SCG, with crack propagation occurring at K(I) as low as 43-48% of their critical K(I). The highest sigma of IZ should lead to longer lifetimes for similar loading conditions., Significance: Water combined with cyclic loading causes pronounced SCG in IZ and IA materials. The lifetime of dental restorations based on these ceramics is expected to increase by reducing their direct exposure to wet conditions and/or by using high content zirconia ceramics with higher strength., (2010 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

All-ceramic dental restorations exhibit enhanced esthetics and biocompatibility as compared to traditional metal-based prosthesis. However, long-term fatigue and subcritical crack growth in the presence of water and cyclic loading can decrease the strength of ceramic components over time. We investigated the cyclic fatigue in water of three dental materials currently used as frameworks in all-ceramic restorations: a 3 mol%-yttria partially stabilized zirconia (3Y-TZP, Cercon, Degudent GmbH), a Al(2)O(3)-ZrO(2)-Glass composite (Inceram-Zirconia, Vita Zahnfabrik GmbH) and a Li(2)O.2SiO(2) glass ceramic (Empress 2, Ivoclar Vivadent AG). Fatigue and fast fracture tests were performed to determine the Weibull distribution of lifetime and initial mechanical strength for each framework component. In spite of its noticeable susceptibility to fatigue in water, the 3Y-TZP material was found to be particularly suitable for the preparation of posterior all-ceramic bridges due to its high initial mechanical strength. Guidelines are provided for the selection of materials and the design of all-ceramic posterior bridges exhibiting lifetime longer than 20 years under severe wet and cyclic loading conditions.

Objectives: Ceramic materials applied in dentistry may exhibit significant subcritical crack growth due to the severe cyclic loading in the aqueous environment encountered in the mouth during mastication. The authors report on the subcritical crack growth behavior of three dental restoration systems (Empress 2/IPS Eris, TZP/Cercon S and Inceram-Zirconia/Vita VM7) under cyclic loading in water, in order to establish guidelines for the use and design of long-lifetime all-ceramic posterior bridges., Methods: Inert strength and lifetime tests under cyclic loading in an aqueous environment were performed in a mechanical bending apparatus and evaluated with Weibull statistics., Results: Subcritical crack growth occurred predominantly in the outer veneer layer of the veneer-framework composites. The apatite-based veneer (IPS Eris) was more susceptible to subcritical crack propagation compared to the feldspathic glass veneers (Cercon S and Vita VM7)., Significance: Dental restoration systems containing apatite-based veneers and weak frameworks (Empress 2/IPS Eris) are not recommended for the fabrication of all-ceramic bridges in the molar region. Conversely, veneer-framework systems consisting of feldspathic glass veneers and tough zirconia-based frameworks (TZP/Cercon S and Inceram-Zirconia/Vita VM7) may exhibit lifetimes longer than 20 years if the bridge connector is properly designed.

Objectives: The aim of this study was to evaluate the cyclic fatigue behavior of zirconia (3Y-TZP) in water and derive guidelines for the design of zirconia-based dental bridges with extended lifetime., Methods: The subcritical crack growth parameters under aqueous and cyclic loading conditions were determined from Weibull distributions of the initial mechanical strength and of the lifetime of TZP specimens. The strength and lifetime data were obtained using a specially designed bending machine under simple and oscillatory loading conditions, respectively., Results: The TZP components submitted to cyclic loading in water exhibited subcritical crack propagation at stress levels significantly ( approximately 50%) lower than the critical stress intensity factor (K(IC)=5.6 MPam(1/2)). In spite of this susceptibility to subcritical crack growth, calculations based on the fatigue parameters and on the stress applied on the prosthesis indicate that posterior bridges with zirconia frameworks can exhibit lifetimes longer than 20 years if the diameter of the bridge connector is properly designed., Significance: This in vitro study indicates that partially stabilized zirconia (3Y-TZP) can withstand the severe cyclic loading and wet conditions typically applied in the molar region of the mouth and is therefore an appropriate material for the fabrication of all-ceramic multi-unit posterior bridges.

Objectives: High-strength ceramics are required in dental posterior restorations in order to withstand the excessive tensile stresses that occur during mastication. The aim of this study was to investigate the fracture behavior and the fast-fracture mechanical strength of three veneer-framework composites (Empress 2/IPS Eris, TZP/Cercon S and Inceram-Zirconia/Vita VM7) for all-ceramic dental bridges., Methods: The load bearing capacity of the veneer-framework composites were evaluated using a bending mechanical apparatus. The stress distribution through the rectangular-shaped layered samples was assessed using simple beam calculations and used to estimate the fracture strength of the veneer layer. Optical microscopy of fractured specimens was employed to determine the origin of cracks and the fracture mode., Results: Under fast fracture conditions, cracks were observed to initiate on, or close to, the veneer outer surface and propagate towards the inner framework material. Crack deflection occurred at the veneer-framework interface of composites containing a tough framework material (TZP/Cercon S and Inceram-Zirconia/Vita VM7), as opposed to the straight propagation observed in the case of weaker frameworks (Empress 2/IPS Eris)., Significance: The mechanical strength of dental composites containing a weak framework (K(IC)<3 MPam(1/2)) is ultimately determined by the low fracture strength of the veneer layer, since no crack arresting occurs at the veneer-framework interface. Therefore, high-toughness ceramics (K(IC)>5 MPam(1/2)) should be used as framework materials of posterior all-ceramic bridges, so that cracks propagating from the veneer layer do not lead to a premature failure of the prosthesis.