journal of the mechanical behavior of biomedical materials 59 (2016) 279–290

Available online at www.sciencedirect.com

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Research Paper

Fracture behavior of inlay and onlay fixed partial

dentures – An in-vitro experimental and XFEM
modeling study

Zhongpu Zhanga, Mark Thompsonb, Clarice Fielda, Wei Lia, Qing Lia,
Michael V. Swainb,n
a
School of Aerospace, Mechanical and Mechatronic Engineering, University of Sydney, NSW 2006, Australia
b
Discipline of Biomaterials, Faculty of Dentistry, University of Sydney, NSW 2010, Australia

art i cle i nfo ab st rac t

Article history: Objectives: This study aimed to explore the “sensitivity” of the fracture load and initiation
Received 11 September 2015 site to loading position on the central occlusal surface of a pontic tooth for both all-ceramic
Received in revised form inlay retained and onlay supported partial denture systems.
10 January 2016 Materials and methods: Three dimensional (3D) finite element (FE) inlay retained and onlay
Accepted 12 January 2016 supported partial denture models were established for simulating crack initiation and
Available online 6 February 2016 propagation by using the eXtended Finite Element Method (XFEM). The models were
Keywords: subjected to a mastication force up to 500 N on the central fossa of the pontic. The loading
All-ceramic position was varied to investigate its influence on fracture load and crack path.
Inlay retained Results: Small perturbation of the loading position caused the fracture load and crack
Onlay supported pattern to vary considerably. For the inlay fixed partial dentures (FPDs), the fracture origins
XFEM changed from the bucco-gingival aspect of the molar embrasure to the premolar
Crack embrasure when the indenter force location is slightly shifted from the mesial to distal
Fracture load side. In contrast, for onlay FPDs, cracking initiated from bucco-gingival aspect of the
premolar embrasure when the indenter is slightly shifted to the buccal side and from
molar embrasure when the indenter is shifted to the lingual side.
Conclusions: The fracture load and cracking path were found to be very sensitive to loading
position in the all-ceramic inlay and onlay FPDs. The study provides a basis for improved
understanding on the role of localized contact loading of the cusp surface in all-
ceramic FPDs.
& 2016 Elsevier Ltd. All rights reserved.

n
Correspondence to: Disciplines of Biomaterials, Faculty of Dentistry, The University of Sydney, Sydney Dental Hospital, 2 Chalmers
ST, Surry Hills, Sydney, NSW 2010 Australia. Tel.: þ61 2 9351 8375.
E-mail addresses: leo.zhang@sydney.edu.au (Z. Zhang), thompsons@iinet.net.au (M. Thompson),
cfie3540@uni.sydney.edu.au (C. Field), wei.li@sydney.edu.au (W. Li), qing.li@sydney.edu.au (Q. Li),
mswain@mail.usyd.edu.au (M.V. Swain).

http://dx.doi.org/10.1016/j.jmbbm.2016.01.035
1751-6161/& 2016 Elsevier Ltd. All rights reserved.
280 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290
1. Introduction
In contrast to traditional metallic materials commonly used
in prosthetic dentistry, ceramics are considered superior in
translucency and tooth like appearance, which are particu-
larly attractive to the patients who have a high esthetic
requirement (Denry and Kelly, 2008; Zarone et al., 2011). For
this reason, ceramics have emerged as one of the major
dental biomaterials in the state-of-the-art prosthodontic
clinic over the last two decades. Nevertheless, a major
concern for these sophisticated all-ceramic restorations is
their limited loading capability due to the relatively low
fracture toughness (Guazzato et al., 2004) and time-
dependent strength decrease caused by progressive crack
growth (van Dijken, 1999). Generally, catastrophic fracture
of all-ceramic restorations and chipping of veneering materi-
als are typical failure modes in the daily clinical practice,
which may necessitate repair or replacement (Swain, 2009;
Wolfart et al., 2009). This has become a major barrier limiting
more extensive exploitation of ceramic materials to fully
replace metals in major dental restorative procedures such
as multi-unit fixed partial dentures (FPDs), where tensile
stresses may be substantial.
The full zirconium dioxide dental restorations, now more
commonly generated by computer-aided design/computer-
aided manufacturing (CAD/CAM) technique, have been
widely used in the posterior region, where the occlusal forces
are higher (Rafferty et al., 2010; Rekow et al., 2009). Although
zirconia is somewhat a whitish opaque core material and
may not be entirely suitable for high esthetic requirements
(Baldissara et al., 2010), a number of in-vitro studies have
evaluated its clinical appearance and strength. For exam-
ple, Perry et al. (2012) reported a 2-year in-vivo study on
performance of three- or four-unit (Lava) zirconia bridges.
They found that the outcomes were clinically acceptable in
terms of color stability and matching, marginal discoloration,
incidence of caries, changes in restoration–tooth interface
and surface texture, postoperative sensitivity, marginal integ-
rity, and maintenance of periodontal health. Beuer et al.
(2012) evaluated single crowns with full-contour zirconia in
terms of esthetics, wear and load-bearing capacity; and they
found that milling zirconia to full-contour with a thinly
glazed surface can be an alternative to traditional porcelain
bonded to zirconia based restorations. Another in-vitro study
by Tinschert et al. (2001) determined the fracture resistance
of three-unit FPDs with a maxillary premolar and molar
abutments, indicating that the FPDs cores made of sintered
zirconia (DC-Zirkon) exhibited the highest fracture resistance
and were suitable for making highly loaded all-ceramic
prostheses.
Note that all-ceramic FPDs exhibit different mechanical
status and complex damage/fracture modes, which chal-
lenges the design principles established with traditional
metal based FPDs. In the context of structural analysis, a
number of in-vivo and in-vitro studies have been reported,
where restorative failure is a consequence of crack initiation
that begins at the gingival connector embrasure. Hence the
connector shape of inlay retained and onlay supported partial
dentures is a key concern; and its size should be adjusted in
height and width in order to provide the highest possible
structural strength for enhancing restorative longevity. In
this regard, Oh et al. (2002) investigated the effect of bridge
design on fracture resistance by testing a range of connector
radii experimentally. More recently, Sailer et al. (2007)
reported an in-vivo study to determine the success rate of
three- to five-unit zirconia posterior FPDs over a 5 year
clinical follow-up. An in-vitro study by Studart et al. (2007b)
revealed that the minimum diameter of the connector should
be at least 4.2 mm, 5.6 mm and 6.4 mm due to clenching
generating an intermittent critical loading (800 N) for the
three-, four- and five-unit FPDs, respectively, on the basis of
evaluating the fatigue behaviors of prostheses. In their
following study they further assessed the fatigue failure of
zirconia components subjected to cyclic stresses under water
(Studart et al., 2007a). It was recommended that the mini-
mum area of the connector should be at least 5.7, 12.6 and
18.8 mm2 for the three-, four- and five-unit FPDs, respectively.
Another in-vitro study by Kohorst et al. (2008) investigated
the influence of artificial aging on the load-bearing capacity
of four-unit bridges. They found that the mean fracture load
of undamaged and non-aged zirconia FPDs was 1525 N,
significantly higher than the artificially aged groups with
the means of 904 N, 924 N and 952 N. From a mechanical
perspective, it would be preferable to increase the size of the
connector as much as possible, but it may cause clinical
problems to the periodontium as it is difficult to implement
adequate oral hygiene procedures with overly large connec-
tors of FPDs.
In addition to extensive experimental studies as to the
fracture mechanisms and strength of all-ceramic prostheses,
computational modeling (in-silico) approaches have been
drawing increasing attention for their proven predictive
ability. To avoid having to manually prescribe initial cracks
in the ceramic materials and structures, two numerical
techniques, namely continuum-to-discrete element method
(CDEM) and eXtended Finite Element Method (XFEM), have
proven highly effective in predicting the location of initiation
and subsequent direction of cracking. Using CDEM, Ichim
et al. (2007b, 2007c) developed a 2D model for replicating non-
carious cervical lesions, which enabled an automatic transi-
tion from a continuum solid to discrete cracks at a highly-
stressed region, thereby simulating dental abfraction lesion
process effectively. Their further study (Ichim et al., 2007a; Li
et al., 2006) modeled crack initiation and propagation for a
range of dental settings, such as failure of dentine, enamel, a
restored tooth, a three-unit all-ceramic FPD structure and
contact-induced damage in the layered material systems. In
both these studies, correlation with experimental data was
presented.
As a relatively new numerical technique, the eXtended
Finite Element Method (XFEM) has also been employed to
model crack initiation and growth in traditional engineering
fields (Bordas et al., 2007; Meschke and Dumstorff, 2007; Xu
et al., 2010). Recently, it has been successfully extended to
fracture modeling of dental prostheses (Barani et al., 2012,
2011; Zhang et al., 2013, 2016). Our comparative study of an
all-ceramic dental bridge showed that XFEM did not only
correlate to CDEM fracture well, but also enabled simulation
 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290
of fracture without remeshing, thereby better facilitating 3D
crack modeling in sophisticated FPD structures.
Maximum bite force is a typical indicator to the functional
state of the masticatory system and key mechanical factor of
teeth. It can be measured unilaterally or bilaterally in either
anterior or posterior teeth. The maximum forces developed in
the molar teeth are higher than those in incisors (Tortopidis
et al., 1998). Gender and age differences in bite force have also
been reported in literature. It was found that the mean bite
force values were significantly higher in males than in
females. Varga et al. (2010) reported the mean maximum
biting force in subjects aged 18 years (males 777.7778.7 N and
females 481.67190.42 N) and aged 15 years old (males
522.37181.7 N and females 465.17243.55 N). Braun et al.
(1996) reported the bit force in the same age range (18–20
years) was 176 N higher than those found in Varga et al.'s
study, but their finding in an older age group (18–20 years)
was 738 N (Braun et al., 1995), which were close to the results
observed by Varga et al. (778 N) and Sasaki et al. (720 N)
(Sasaki et al., 1989).
Despite these abovementioned in-vivo, in-vitro and in-
silico studies, two major issues remain concerning FPD
fracture. First, previous researchers have largely concentrated
on clinical assessment in the performance and longevity of
various FPDs; and limited attention has been paid on the
fracture mechanics underlying different failure types, e.g.
contact-driven Hertzian cracking beneath the indenter
(Kohorst et al., 2008), crack initiated at a point close to the
gingival side of either mesial or distal connector (Sundh et al.,
2005), etc. Although some finite element analyses (FEA) were
conducted to help quantify stress concentration and distribu-
tion in an FPD, it does not inherently accommodate the
failure criteria from a fracture mechanics perspective. Sec-
ond, the in-vitro studies showed some diverse fracture
patterns taking place even for comparable FPD structures
with nominally similar loading. A major concern is whether a
loading position has significant influence on the fracture path
and strength in all-ceramic inlay and onlay bridge structures.
To address the above two issues, this paper adopts XFEM
to simulate crack initiation and propagation in both all-
ceramic inlay and onlay fixed partially denture (FPD), respec-
tively. The modeling validation is performed by comparing
the XFEM simulation results with the in-vitro experiment.
The hypothesis tested here was to test how loading position
would influence fracture path and failure load, in turn
providing some insights into the design of FPD structures.
2. Materials and methods
2.1. Preparation of inlay-retained and onlay supported
partial dentures
An in-vitro experiment was conducted for all-ceramic inlay-
retained and onlay supported FPDs in this study. The STL files
of the inlay and onlay supported FPD models, created in
SolidWorks (Dassault Systèmes SolidWorks Corp., USA), were
sent to a specialized ceramics laboratory that was able to
fabricate bridge replicas in partially sintered Y-TZP through a
CAD/CAM system. The abutment teeth beneath the inlay and
281
onlay bridges were made from Filtek P60 composite resin for
its similarity of Young's modulus to human dentine (Kikuti
et al., 2012). The Filtek P60 composite resin was not soaked in
water for a week prior to cementation. In the experiment,
there was no significant swelling or shrinkage developed in
composite resin within the time frame. The adjacent teeth
were fabricated by using a sectioned silicone impression of a
typical human mandibular second molar and second premo-
lar. The support base was made from self-curing acrylic
(PMMA) with the alveolus of the abutment teeth (Kuehn
et al., 2005). The natural resilience of the periodontal liga-
ment (PDL) of adjacent model teeth was constructed using a
thin layer of poly vinyl siloxane (3M Imprint II). The abut-
ments were etched with 37% phosphoric acid for 20 s, in order
to produce the highest bond strengths to zirconia FPDs. The
cavity preparation and the bridge components were treated
with an adhesive (3M Single Bond II) to ensure all compo-
nents of the specimens were fully bonded. A hardened
stainless steel ball was placed so as to achieve stable contact
in the central fossa of the pontic, and then loaded at a cross
head speed of 0.5 mm/min in a universal testing machine
(Instron) until fracture took place.
2.2. Finite element models
The computational in-silico study was conducted using
eXtended Finite Element Method (XFEM) for both inlay-
retained and onlay supported FPDs. The finite element (FE)
models used in this study were constructed based on com-
puter tomography (CT) images of the right mandibular region.
The anatomies of cortical bone, cancellous bone, enamel and
dentin were captured by using the image processing program
ScanIP (Version 6.0, Simpleware Pty. Ltd., UK). The surface
refinements of the dental structures were conducted in
ScanIP þNURBS module. After a smoothing operation, all
intersecting vertices within the surface were fixed. Once
surface refinement had been completed, the solid models
were exported as IGES files for further manipulation in
SolidWorks. The PDL was created by offsetting the root of
the dentin surface, and an assumption of 0.3 mm uniform
thickness was made (Nanci and Bosshardt, 2006; Nanci and
Somerman, 2003). The PDL cushions the abutment teeth from
direct contact with the cortical and cancellous bone that form
the bone sockets.
The inlay and onlay preparations involved partial/full
cutting of the occlusal surfaces of the abutment teeth. In
the modeling, special considerations were taken for deter-
mining the taper angles within the crowns in the cutting
process to match clinical conditions. The geometry of abut-
ment teeth were subtracted for the inlay and onlay prepara-
tions from the dental structures. Consequently, the 3D inlay
retained FPDs at both abutment teeth consisted of an inlay
bridge, abutment teeth, periodontal ligament (PDL), cortical
bone, cancellous bone, and ball indenter as shown in Fig. 1a.
The 3D onlay model was constructed by the bridge, abutment
teeth, PDL, cortical bone, cancellous bone, and ball indenter
as shown in Fig. 1b. Such FE models were exported to Abaqus
(Version 6.12, SIMULIA, Providence, RI, USA) for further pre-
processing and XFEM computation.
282 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290
Fig. 1 – 3D FE models with dimensions, loading and boundary conditions.
The 3D FE models were meshed using 4-node linear
tetrahedral elements. Unlike conventional FE studies where
total strain energy, stress and/or displacements were typi-
cally adopted as convergence indicators (Li et al., 2004b, 2005),
different measures are required for XFEM convergence. In this
fracture study, the initial cracking site was considered appro-
priate to ensure that the mesh size had minimal effect on
fracture analysis. To do so, several different mesh sizes were
tested here. It was found that the element sizes of 1 mm for
cortical and cancellous bones, 0.3 mm for PDL, 0.36 mm for
teeth abutments and bridges were considered adequate. As
such, the inlay and onlay models had a total number of
300,173 (185,346 degree of freedom (d.o.f.)) and 268,525 ele-
ments (177,483 d.o.f.), respectively.
2.3. Boundary and loading conditions of the FE models
As shown in Fig. 1. the kinematic boundary conditions for the
inlay and onlay FE models were the same; namely the
sectioned bony faces were fully fixed (Field et al., 2012). The
force acting vertically through a cylindrical indenter of
approximately 5 mm2 was applied to the central fossa of
the pontic. The mating surfaces of the inlay/onlay retainers
and abutments are at a distance of 0.005 mm apart for
contacting. In the analysis, a ramped load to a maximum of
500 N was applied, which increased linearly during the pre-
scribed loading time of 1 s. The loading position was chosen
as a variable here, and its variation is illustrated in Fig. 2.
In the FEA study, loading position Δd stands for the
distance from the center of each loading case to the central
fossa of control case, as summarized in Table 1, which will be
used to investigate sensitivity of loading position to the
fracture behaviors. The distance Δd between the central fossa
point A ¼(xc, yc, zc) of control case and the center point B ¼(xn,
yn, zn) of indenter area acting on the occlusal surface is
calculated as:
qffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi
Δd ¼ ðxn  xc Þ2 þ ðyn yc Þ2 þ ðzn  zc Þ2 ðn ¼ 1; 2; 3; 4; 5; 6; 7; 8Þ
ð1Þ
2.4. Materials properties
All the materials involved in this study were considered to be
isotropic, homogeneous, and linearly elastic (Ichim et al.,
2007a, 2007c; Zhang et al., 2016). The material properties of
ceramics, bone and tooth tissues are summarized in Table 2.
The fracture toughness of FPD ceramic made of partially
sintered zirconia was determined from the single-edge V
 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290 283

Fig. 2 – Variation in loading position on the central fossa of pontic. The center coordinate of contact area for all loading cases
are given on the right.

Table 1 – Distance Δd between the centers of each load

case and that of the control case. Power law criterion as summarized in the following
equation (Giner et al., 2009),
To load control case Δd (mm)  α    
GI GII α GIII α
þ þ ¼1 ð3Þ
Load case 1 1.020 GIC GIIC GIIIC
Load case 2 0.680
Load case 3 1.101 where GI, GII, GIII represents the energy release rates of crack
Load case 4 0.818 extension modes I, II and III, respectively. GIC, GIIC, GIIIC are the
Load case 5 0.858 predefined critical energy release rates at modes I, II and III,
Load case 6 1.469 respectively. In this study, the power α¼ 1 was taken
Load case 7 1.020
(Thompson et al., 2013b; Zhang et al., 2013).
Load case 8 1.224

3. Results
notch beam test from our previous study (Thompson et al.,
2012). As a result, the fracture toughness of FPD ceramic was
3.1. Experimental validations of the inlay-retained and
0.456 MPa√m with a standard deviation of 0.076 MPa√m. The
onlay FPDs
critical energy release rate indicates a parameter related to
fracture toughness which is defined as the energy required
Fig. 3 compares the numerical with experimental force–displace-
for propagating the crack through a unit area of the material
ment curves for the fracture failure of the pre-sintered ceramic
under mode I fracture (Cherepanov, 1967).
inlay FPDs under controlled loading condition. In the experi-
mental force–displacement curve (in blue), the force suddenly
2.5. Fracture criteria for XFEM
dropped after it reached the ultimate tensile strength of the
ceramic and the sample began cracking. It can be seen that the
The XFEM was applied to simulate crack initiation and
inlay FPD model exhibited almost linear force–displacement
propagation of the inlay and onlay FPDs, respectively. The
behavior. Comparing the XFEM simulation with the experimen-
basis for damage initiation was per the criterion of the
tal test, correlation can be identified, in which both the experi-
maximum principal stress (s1) as indicated in Eq. (2). Cracking
mental Fig. 3a and simulated Fig. 3b crack initiation occurred
occurs when the maximum principal stress exceeds the
  from the gingival connector between the second molar and
tensile strength of the ceramic material smax (47 MPa)
e pontic, and then propagated towards the loading position on the
(Maiti and Smith, 1983), factor f refers to the stress ratio in
pontic. Furthermore, initiation of the secondary crack arose at
an element (e):
the occlusal surface of the pontic and then chipped off the cusp
se
fe ¼   1  ð2Þ of the pontic as shown in Fig. 3a (experiment) and c (simulation).
smax
In the XFEM simulation, the loading for the onset of the
Crack extension depends on the calculated stresses and dominant crack initiation and the secondary crack initiation
should be perpendicular to the direction of the maximum are indicated by arrows on the red loading curve (simulation) in
principal stress. The energy-based damage evolution criter- Fig. 3. Clearly, the XFEM results exhibited reasonable agreement
ion is applied in this study. It can be defined as a function of with the experimental results for both the force–displacement
the crack initiation mix-mode using a tabulated form of the curves and fracture patterns (initiation and path).
284 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290
Table 2 – Material properties used for XFEM fracture analyses.
Material Elastic modulus (GPa) Poisson's ratio
Abutment teeth 84.1 0.2
Cortical bone 12.2 0.26
Cancellous bone 1.22 0.31
Periodontal ligament 0.07 0.45
FPD partially sintered ceramic 15.6 0.28
Steel Indenter 200 0.3
Fig. 3 – Comparison of force–displacement curves for the
experimental and XFEM results as well as their fracture
patterns of the inlay FPD with the control (loading) case:
(a) Cracking pattern from experimental test; (b) Cracking
initiation predicted from XFEM; (c) Secondary crack initiation
occurred in the occlusal region of pontic from XFEM. (For
interpretation of the references to color in this figure legend,
the reader is referred to the web version of this article.)
Fig. 4 compares the XFEM fracture with the experimental
results of the onlay FPD model under the controlled loading
condition. The simulated crack initiation occurred at the
gingival connector between the second molar and pontic as
seen in Fig. 4b. In the XFEM force–displacement curve (red),
the load for the onset of crack initiation (Fig. 4b), and its
nearly complete extension toward the loading point on the
pontic (Fig. 4c) are indicated by the black arrows. Again, good
agreement between the XFEM and experimental results was
obtained, indicating that the proposed damage and energy
release model was able to the simulate crack initiation and
propagation of the onlay FPD accurately.
In our previous in-vitro study (Thompson et al., 2013a), the
fracture surfaces of all-ceramic inlay FPDs were examined via
optical microscopy and scanning electron microscopy (SEM),
enabling to determine the crack origin and propagation
directions from the observed fractographic features such as
the hackle and arrest lines. The primary crack initiation site
at the bucco-gingival aspect of the molar embrasure or
premolar embrasure on the pontic had an occluso-lingual
trajectory with a secondary crack origin occurring from the
indenter contact. The critical flaw size of 3379 mm was
overserved from fractographic analysis (Thompson et al.,
2013a) which was largely related to the defect size of the
Tensile strength (MPa) Energy release rate (J/m2)
47 13.3
Fig. 4 – Displacement vs force curves and fracture patterns
for the onlay FPD experiment and XFEM simulation:
(a) fracture pattern from the experimental test; (b) crack
initiation from XFEM simulation; (c) XFEM fracture
propagation in the pontic. (For interpretation of the
references to color in this figure legend, the reader is
referred to the web version of this article.)
ceramic and to a lesser degree surface finish and grain size
(approximately 0.2 mm). In the present XFEM analysis, the
crack initiated at the bucco-gingival aspect of the molar
connector or premolar connector where the highest first
principal stresses happened to reach the fracture strength;
and then the crack propagated obliquely through the body of
the pontic. From Figs. 3 and 4, it was clearly seen that the
XFEM crack origins and growth agreed well with the experi-
mental fracture patterns.
In Table 3, the XFEM predictions of fracture origins were
marked and crack propagation directions were indicated by
the black arrows for both the inlay and onlay models. From
the XFEM analysis it is clearly seen that loading position
largely affects the resultant fracture origins and paths. This is
consistent with the fractographic measurements, where the
crack initiated at the bucco-gingival aspect of the molar
embrasure or from premolar embrasure; and extended obli-
quely to the loading position of pontic in the onlay model.
3.2. Effects of loading position on the fracture path and
fracture loads
Table 4 compared the fracture patterns of the inlay retained
FPDs for different loading positions. When the loading
 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290 285

Table 3 – Comparison of different XFEM fracture paths for the inlay and onlay FPDs models.

Model Fracture pattern Cracking origin Crack propagation direction

Pattern 1
(Control loading case)

Inlay
FPD

Pattern 2
(Loading case 6)

Pattern 1
(Control loading case)

Onlay
FPD

Pattern 2
(Loading case 5)

position was slightly shifted from the control (central) to the
distal side (loading cases 6 and 7), the crack initiated from the
bucco-gingival aspect of the premolar embrasure. It should
also be noted that an unstable fracture pattern (loading case
8) occurred when the loading position shifted to the linguo-
distal side, because the retainers are one of the weakest
aspects of inlay FPDs (Thompson et al., 2013a). The cracking
patterns were fairly similar in cases 1–5 and control case,
indicating the similar location of critical stresses.
Table 5 shows the fracture patterns of the onlay FPDs
under different loading positions. The fracture originates at
the bucco-gingival aspect of the molar embrasure for most of
the loading cases. When the loading position was shifted
towards the lingual side, cracking initiated from the gingival
connector between the pontic and premolar abutment in
loading cases 3, 5 and 8. It should be noted that such a
pattern differs from that for the inlay FPDs. In the inlay
models, the fracture origin occurred at the premolar embra-
sure when loading position shifted to the distal side.
When cracking occurred, the fracture loads (in N) for the
inlay models are graphically plotted in Fig. 5a for the different
loading positions. Clearly, the load-bearing capacity varies
with loading positions. The models with loading position
close to the distal side resulted in substantially higher
load-bearing capacities (209 N, 212 N, 216 N) than those at
the mesial side (149 N, 160 N, 156 N). This indicates that the
fracture resistance of the inlay FPDs is higher when the
loading position was shifted from the mesial to the
distal side.
Fig. 5b illustrates the fracture loads at crack initiation for
the onlay FPD models at the different loading positions. In
load case 7, the contact center of indenter was moved
0.888 mm towards the distal side from the central fossa of
pontic, which led to the highest fracture resistance (353 N) of
all loading cases. The failure mode under load case 7 was
similar to load cases 1, 2, 4, 6, and control case, but differs
from that under load cases 3, 5, 8, where the loading positions
were close to the lingual side. As a result, the crack origins
and propagation directions were different due to the slight
shifting of loading positions between these two groups. It
should be pointed out that the onlay model is able to bear
substantially higher fracture loading than the inlay model as
shown by comparing Fig. 5a and b.
4. Discussion
On the basis of this study, XFEM has demonstrated to be a
powerful simulation tool for predicting both crack initiation
286 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290
Table 4 – XFEM fracture patterns for different loading positions in the inlay FPDs model.
Case 1 Case 2
Control
Case 4
Case
Case 6 Case 7
and propagation in the inlay and onlay FPDs with different
occlusal loading positions. The previous studies investigated
the fracture origins and crack propagation in FPDs using
different in-vitro tests (Thompson et al., 2012; Thompson
et al., 2013a). These diverse fracture patterns observed in the
in-vitro experiments often made it difficult to clarify and
rationalize the fracture mechanism from the fractographic
features. XFEM, on the other hand, facilitates a more succinct
investigation into the mechanical causes for the apparent
inconsistency in fracture patterns. This in-silico study allows
us to explore the effects of loading position on fracture
strength and cracking patterns for different all-ceramic FPDs.
The in-vitro experiments and the XFEM modeling showed
good correlation for both the force–displacement curves and
fracture patterns as shown in Figs. 3 and 4. The maximum
difference in the fracture load was less than 12% (187 N vs
211 N). This incongruity might be due to the discrepancy
between the experimental specimens and XFEM models used
in this study, which particularly included geometric error,
difference in material properties, material defects, as well as
contact loading and boundary conditions specified. It must be
noted that only a small number of specimens were used in
the in-vitro test for obtaining the fracture loads in our in-
house experiments, which may not be sufficient statistically.
XFEM, on the other hand, provided a feasible approach to
Case 3
Case 5
Case 8
quantifying the mechanical behaviors as well as the loading
influence on fracture responses of the inlay and onlay FPDs.
From an overall fracture perspective, the XFEM analysis
provided a more complete basis for prediction of the failure
mode. The previous studies revealed that the gingival con-
nector was a strong stress concentration site, thereby deter-
mining the fracture resistance of the FPD structures (Oh and
Anusavice, 2002). In this study, the fracture origins and crack
propagation directions from the in-vitro tests and XFEM
simulations were consistent with the previous clinical and
other numerical studies (Mehl et al., 2010; Sundh et al., 2005;
Taskonak et al., 2008; Wolfart et al., 2007). In this regard, Oh
et al. (2002) carried out an FE and fractographic study, and
they found that fracture initiated at the gingival embrasure of
the connector, and then the crack propagated toward the
loading point. Li et al. (2006) showed the same results using
so-called continuum-to-discrete element method (CDEM) and
found that the fracture of all-ceramic onlay FPDs originated
from the connectors. In their study, the fracture path simply
connected the weakest connector area with the occlusal
loading point. Ichim et al.’s further CDEM study (Ichim
et al., 2007a) showed a similar fracture path from the
connector to the loading point. However, the fracture from
the CDEM prediction did not consistently show the secondary
vertical fracture as observed in the experimental results
(Thompson et al., 2012). This phenomenon could only be
 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290
Table 5 – XFEM fracture patterns for different loading positions in the onlay FPDs model.
Case 1 Case 2
Control
Case 4
Case
Case 6 Case 7
explained by catastrophic fracture occurring in the pontic
before secondary fracture finally appeared.
The determination of the fracture load is always of con-
cern for prosthodontists, dental technicians and patients. In
this study, the maximum load 500 N was applied in a ramp
fashion in the XFEM fracture analysis. During the ramped
loading process, the fracture load was quantified when the
first cracking event took place. Such a loading is similar to
other studies reported in the literature. For some in-vitro
studies, Luthy et al. (2005) tested four-unit bridges made of
IPS Empress 2 with a connector cross-sectional area of
7.3 mm2 under a mastication force up to 500 N. Rezaei et al.
(2011) used an even higher maximum bite force of 600 N to
examine the effect of increased connector width on the stress
distribution in the posterior FPDs.
The fracture load at crack initiation for the inlay FPD
(174 N for control loading case) is almost 50% lower than that
of an onlay FPD (341 N). For the zirconia inlay retained FPD
the mean fracture load was reported to be 12487263 N when
the interabutment distance was 10 mm (Kilicarslan et al.,
2004). Since the zirconia ceramic used in our study was not
fully sintered in order to ease of milling, accurate replication,
fully isotropic and homogeneous material behavior, the
Young’s modulus and ultimate tensile strength of FPD cera-
mic is much lower. This is also the reason why the fracture
287
Case 3
Case 5
Case 8
load of the inlay FPD observed here is much lower than those
previously reported in the literature.
The XFEM studies presented here show a strong effect of
loading position on the fracture path and fracture load. The
influence of loading position on the resultant stress concen-
tration was considered in the previous cantilever FPD struc-
tures (Li et al., 2004a, 2004b). In Oh et al.'s experimental study
on the onlay FPDs (Oh and Anusavice, 2002), the fracture path
was oblique gingivo-occlusally through the molar connector
and pontic. Ichim et al.'s CDEM study (Ichim et al., 2007a)
showed the same path, whereas Li et al.'s CDEM simulation
(Li et al., 2006) predicted a different path, specifically from the
premolar connector to the loading point. From these three
studies, cracks developed either in the mesial area or in the
distal area of the pontic. The different locations for the
origins of cracking may be explained as the consequence of
occlusal contact variations, geometry of connectors and
length of the moment arm relative to the contact areas. Such
significant discrepancy necessitates further understanding of
the associated loading induced fracture mechanics.
This study demonstrated that XFEM was suitable for
simulating crack initiation and propagation in the all-
ceramic fixed partial dentures with inlay and onlay config-
urations. Nevertheless, a number of limitations still need to
be addressed. First, some fracture paths did not completely
extend to the occlusal surface of the pontic tooth. This can be
288 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290
Fig. 5 – Fracture loads at crack initiation under different loading positions: (a) Inlay bridge models; (b) Onlay bridge models.
explained as the complexity of 3D modeling adopted here
and the stipulated analysis convergence conditions became
very difficult to satisfy in XFEM upon cracking to a certain
extent. ABAQUS provides a viscous regularization capability
that could help improve the convergence when material
models exhibiting stiffness degradation and softening beha-
vior (Liu and Zheng, 2010). Another approach to help with
such a convergence problem is to use automatic stabilization
(Loehnert, 2014). Second, the assumption of PDL was made as
linear elastic similarly to numerous studies in the literature
(Field et al., 2009; Sarrafpour et al., 2013; Zhang et al., 2016). As
a soft tissue, the PDL is non-linear material which may better
buffer mechanical loading (Chen et al., 2014; Qian et al., 2009;
Ziegler et al., 2005). Its role on fracture analysis of FPD should
be further studied. Third, the abutment tooth structures were
not modeled in detail. The enamel, dentine and pulp struc-
tures remaining in the abutments may affect the fracture
resistance of the pontic (Li et al., 2006). Although the volume
of the pulp is only a very small part of the entire abutment
tooth, the lack of this feature in the in-vitro sample and the
FE model may not replicate the real clinical situation. Fourth,
like many other modeling analyses, material heterogeneity
and presence of defects in the ceramic samples were not
modeled in this XFEM study, which may to a certain extent
influence the results. Note that XFEM allows pre-inserting
micro-cracks and defects efficiently, which will enable us to
take into account these inhomogeneities in future modeling
studies upon availability of the microscopic details of the
specific ceramic materials investigated (Grogan et al., 2015).
Fifth, the load-bearing capacities of the specimens were
tested using monotonic load to fracture in the in-vitro study,
which simulates the bite force and predominantly causes the
stresses in the zirconia fixed partial dentures. It however
neglected the cyclic nature of chewing functions in oral
environment. Sixth, it is assumed that the components were
fully bonded at the interface, so bonding strength of the
cement layer between retainer and abutment was not speci-
fically considered in the XFEM analysis. In future study,
debonding of the FDPs due to early failure of the adhesive
interface between retainer and cement layer needs to be
addressed. Likely fracture would be caused by such unfavor-
able stress location in combination with direct exposure to
the oral environment. Seventh, the partially-sintered ceramic
was used in the in-vitro experiments for reducing fabrication-
induced discrepancy in material and structural geometry
from in-silico models. While it may not affect the relative
sensitivity analysis of loading position, a study on fully-
sintered ceramic structures would be of more direct clinical
relevance. It should be pointed out that overcoming these
limitations could enhance the reliability of the numerical
simulation. From mechanical point of view, this study has
established a feasible numerical approach to explore the
fracture behavior of all-ceramic FPDs, potentially providing
a new tool for the design and fabrication of more reliable
prostheses.
5. Conclusions
XFEM with its ability to simulate cracking initiation and
propagation was demonstrated to be effective for fracture
analysis of all-ceramic dental restorations. The XFEM crack
patterns and fracture loads were validated through the good
agreement with the in-vitro experiments. The primary goal of
this paper was to explore the sensitivity of the fracture
 journal of the mechanical behavior of biomedical materials 59 (2016) 279 –290
behaviors to the loading position in the three-unit all-ceramic
inlay and onlay FPDs. Within its limitations, the XFEM
fracture analysis clearly indicated the strong association of
fracture patterns and failure loads with the loading position.
The data generated from this study is considered indicative
for better understanding of failure modes of different ceramic
FPDs, which is of implication for developing mechanically
more reliable dental prostheses.
Acknowledgment
The support from Australian Research Council (DP1095140) is
grateful.
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