Masao Yosblnari, PhD'

Tokyo Dental College

Chiha, lapan

Fracture Strength of Tore Dérand, PhD"

University of Lund
All-Ceramic Crowns Malmö, Sweden

The fracture strengths of four types of all-ceramic premolar crowns

(conventional Vita-Dur, In-Ceram, Dicor, and IPS-Empress) were compared
after a preload cycling in aqueous atmosphere. Preload cycling significantly
decreased the strength of Vita-Dur crowns, Fracture strength of Vita-Dur
crowns was improved when they were luted with either polyalkenoate or
adhesive resin cement. The average (standard deviation) of load to fracture of
ceramic crowns luted using zinc phosphate cement and after appiied preioad
cycling in distilled water were: Vila Dur, 770 (237) N; Vila In-Ceram, 1060
(341 ] N; Dicor, 840 (226) N; and IPS-Empress: 891 (185) N, The In-Ceram
crowns fractured in two modes: complete fractures at 1276 (207) N; artd
fractures with the core remaining intact at 808 (292¡ N.
Int J Prosthodont 1994:7:329-336.

A number of ceramic materials offering higher

strengths are available and are stated as being
indicated for use as posterior restorations.'"" The
materials have favorable properties and offer good
esthetics and patient acceptance.
Ceramic materials are brittle, have limited tensile
strength, and are subject to time-dependent stress
failure. These shortcomings are attributable to the
presence of microdefects within the material and a
degradation in aqueous environment resulting from
subcritical crack growth (stress corrosion). There-
fore, it is of increasing interest to investigate fatigue
properties of dental ceramics in an aqueous envi-
ronment,'-'"" There are, however, few in-vitro
reports concerning the fatigue properties of ail-
ceratTtic crowns in a simulated clinical environment.
The required optical properties limit the strength
of a ceramic material, and various methods of
strengthening have been offered. Increased core
-Assistant Professor, Department of Dental Materials Science.
"Professor, Department of Oral Technology, Faculty of
Dentistry.
Reprint requests: Dr Masao Yoshinari, Department of Dents!
Materials Science, Tokyo Dental College. 1-2-2 Masago,
Mihama-ku, Chiba 26!, lapan.
strength has been obtained using a shrink-free
ceramic core with magnesium aluminate spinel
(Cerestore, Coors Biomaterial, Denver, CO),'"""
and an alumina reinforced core having approxi-
mately 40% ALOj and fabricated directly the
refractory die (Hi-Ceram, Vita Zahnfabrik,
Sackingen, Germany),'" Slip-casting of alumina
ceramics (In-Ceram, Vita Zahnfabrik),''''-""" was
introduced as a method of fabricating a material
having a fiexural strenglh of approximately 400
MPa, The highly sintered core was composed of
approximately 85% AhOs and was strengthened by
lanthanum-silicate glass infiltration in a second fir-
ing process, A castable glass-ceramic system using
tetrasilicic fluoramica (Dicor, Dentsply, York,
p^)2,û,24.;; ^ygj introduced and was fabricated using a
conventional casting procedure. Other strengthen-
ing methods used leucite-reinforced porcelains
either fabricated directly on the refractory die
(Optec-HSP, leneric Pentron, Wallingford, CT)'"' or
a heat pressure technique (IPS-Empress, Ivoclar,
Schaan, Liechtenstein),"*'-""'"
Clinical porcelain crown strength is also influ-
enced by the shape of the tooth preparation and
the method of luting. The purpose of this study was
to evaluate the strength of ceramic crowns under
conditions that included cyclic preloading in an

" 'ume7. Number 4, 1954 329 The Inlernationallournal of Prosthodontii

 Mclurc Streiigdi of All-Ceramic Craw

Fig 1 Cross-sectional diagram

1.5 -^
Dentin
Core
".r of master die and ai' i^e'arnic
crowns.
2.0
i.

II ' \\ / \
50
Die '£y
// °'^ \\ /
\
\

]—
^0 3

Vita-Dur Dicor
In-Ceram Empress

Table 1 Materials Used in This Study

C lass iticat ion Produot Manufacturer Type Batch No. Code
Ceramics Vita Dur-N Vita Zahnfabrik Core 345N(A4D3) Vita-Dur
Dentine 363N(D3)
Vita In-Ceram Vila Zahnfabrik Core Alumina powder In-Ceram
Vita Alpha Opaque dentine 1036(B1)
Dentine 1056(B1)
Dicor Dentsply Dicor
IPS-Empress Ivoclar Empress
Luting material Zinc Phosphate DeTrey Zinc phosphate BF117 (powder) ZP
Cement type 1 0G1 (liquid)
Ketac Cem ESPE Polyalkenoate 0900 (powder) Gl
Cement 0008 (liquid)
Scotchbond 3M Etchant. primer P920319 AR
M uiti-Purpose Adhesive (No. 7540)
Scotch Prime 3M Ceramic primer 19921228
(No. 2721)
Variolink Vivad en t Dual/Light-polymerized 460399 (base, 20)
luting composite 460402 (catalyst, low)

aqueous atmosphere. Three elements were studied:
the influence of preload on the strength on a con-
ventional aluminous porcelain system (Vita-Dur,
Vita Zahnfabrik): the influence oí [he lutinj; agent
on the strength on the same material; and the
Strength of various all-ceramic materials.
Materials and Methods
Cross-sectional diagrams of master dies and all-
ceramic crowns are shown in Fig 1. Master dies
having approximately the same dimensions as a
premolar prepared to receive a porcelain crown
were produced in bovine dentine. The taper was
10 degrees and the shoulder width was 1 tnm.
Although an occlusal convergence of less than 10
degrees has been recommended for fixed restora-
tions to enhance resistance iorm, the average
occlusal convergence in clinical tooth preparations
is often greater. It has been reported that there is
no difference in the strength of Dicor crowns made
on preparations having 10- and 20-degree conver-
gence angles and rounded axiogingival line
angles." Twelve such bovine teeth were fixed in
brass holders (Eig 2) and machined.
Cylindrical crowns having a diameter of 8.8 mm
and a total height of 7.9 mm were fabricated using
the dental porcelains listed in Table 1.
Impressions were made of the prepared bovine
dies using an addition polymerization putty/wash
elastomeric impression material (Provil, Bayer,
Germany). Epoxy casts (Epoxy-Die, Ivoclar,
Germany) and stone casts (Velmix stone, Kcrr,
Romulus, Ml) were then fabricated. The prepared
bovine teeth and the epoxy casts were used as a
master die for luting of ceramic crowns. The stone
casts were used for a working model.

330 •7, Number 4, 1994

 Yoihinari and Oér.iiicl
Fig 2 Master die machined from bovine tooth.
Fabrication of Specimens
All-ceramic crowns were fabricated from ihe
various materials in the following manner:
Vita-Dur N. Platinum foils (25 \im) were
adapted and burnished onto the stone dies. A layer
of Vita-Dur N core porcelain, approximately 0.5
mm thick, was applied to the foils using a wash
technique. A brass template was used to establish a
uniform shape for each core (Fig 3). After the first
core firing, the specimens were visually inspected
for cracks. When present, cracks were filled using
additional core porcelain. The veneering porcelain
(Vita-Dur N Dentine, Vita Zahnfabrik) was then
applied to the cores and built to a uniform thick-
ness by using an acrylic resin assembly (Fig 4).
Two bakes were necessary to compensate for firing
shrinkage. Identical crown sizes were checked
using digital calipers and controlled by removing
or adding porcelain. The average (standard devia-
tion) of thicknesses at the cervical side and
occiusal surface were 1.01 (0.06) mm and 2.08
(0.13) mm, respectively. Finally, the crowns were
subjected to a self-glazing cycle, and the platinum
foils were removed.
Vita In-Ceram. In this system, three coats of
die spacer {In-Ceram, Vita Zahnfabrik) were
applied to the axial walls ofthe stone die (approxi-
mately 45 |jm) but not on the shoulder. Im-
pressions were made with using addition polymer-
ization silicone impression material (Provil, Bayer)
and filled with the In-Ceram special plaster using
a w/p ratio of 4.6 mL/20 g to make refractory
models. In-Ceram powder slip, mixed according to
manufacturer recommendations, was applied to
the models. The slip core was then carved to a
thickness using the same template as earlier
lime 7, Number 4, 1994
rL'S[r,.nmli „t All-Cer,.mic Cruwrb
Fig 3 Brass template for core preparation.
Fig 4 Resin assembly for forming dentine porcelain
described (Fig 3). After applying stabilizer, the
trimmed cores were fired and glass-infiltrated
according to manufacturer's directions. The
veneering porcelains (Vita Alpha, Opaque-dentine,
and Dentine porcelain) were then applied to the
cores and built up to a uniform thickness. The
average (standard deviation) thicknesses at cervical
and occiusal surfaces were 1.03 mm (0.05) and
2.05 mm (0.13), respectively. Finally, the crowns
were subjected to a self-glazing cycle.
Dicor. Wax patterns of the crown were fabri-
cated on the stone die to a uniform thickness by
using the resin assembly (Fig 4). The specimens
were cast in glass and then heat treated
(cerammed). The outer surfaces were polished and
the inner surfaces remained untreated. Specimens
were subjected to loading without any surface col-
oration layer or veneer technique.
IPS-Empress, Wax patterns of the crown were
fabricated on the stone die. The heat-pressed
33Í The intórnational fournal o( PtoithodonUi
 Frattlure SlrenRth of Aii-Ceramic Croii
Fig 5 Cyclic preloading apparatus.
Fig 7 Schematic diagram of mechanical testing.
ceramic crowns were fabricated according to fiie
manufacturer's insfructions. Specimens were also
evaluated withouf any surface coloration or
veneering.
Luting
The crowns were luted on fhe bovine teeth mas-
fer dies using various luting malerials (Table 1).
When fine crown was luted using an adhesive resin
cement (AR), fhe bovine denfin was prefreafed
witb Scotchbond Multi-Purpose sysfem (efchanf for
The i niernational lournsl of Croslhodonlii
Fig 6 Close-up of Fig 5, (Although in this illustration the
specimen is depicted as being exposed to the air, the practi-
cal test was conducted in distilled water.)
15 seconds, primer and adhesives wifh ligbt activa-
tion), and the ceratnic crown was efched wifh 8%
HF for 15 seconds and treated wifh Scotch Prime
(silanel. The treated crown was luted using dual
polymerizing resin. For fhe specimens iuted using
zinc phosphate cements, half of fhe specimens
were luied on epoxy dies because it had been
determined in fhe pilot study that there were no
significant differences of fracture strength between
crowns iuted to bovine dentine and thoiiC luted to
epoxy resin die. Both have approximately the same
modulus of eiasticity. All luted specimens were
stored for 1 day in distiiled water before testing.
Mechanical Testing of Crowns
The Vifa-Dur N crowns were divided info two
groups. One group was loaded until fracture
occurred without preioading. The second group
and ail other ceramic crowns were subjected to a
cyclicaliy appiied preload. This cyclic preload was
applied to the inclined crown (10 degrees) for
10,000 cycles. Minimum and maximum loads of 30
and 300 N were applied with the force profile in
the form of sine wave at 1 FHz (Figs 5 and 6). All
specimens were stored in distilled water during pre-
load and for 1 to 7 days before mechanical testing.
The specimens mounted in tbe testing jig also
were inclined 10 degrees (Fig 7). Load was applied
using a cross-head speed of 0.255 mm min-' to the
occlusal surface using a mechanical testing
machine (Alwetron Type F1000, Sweden). The
point of force application was between the periph-
ery and center on the occlusal surface of the crown
(Fig 7). A 4.8-mm diameter slainiess steel bali bear-
ing was used to fracture the specimens in this test.
332 Volume 7, Number 4, 1994
 Fracture Slrenglh of All-Ceramit Crowns

Table 2 Loads at Complete Fracture of Crowns

Crowns Mean load (SD) Max Min
Material Cement Pre-load (n) ¡N) (N) (N) Fracture mode
V Ita-Uur ¿P without 5 1022(135) 1245 910 Total fracture
Vita-Dur ZP with 7 770 (237) 1070 330 Total fracture
Vita-Dur Gl with 5 881 (190) 1130 670 Total fracture
Vita-Dur AR with 8 1007(157) 1160 740 Total fracture
In-Ceram ZP with 13 1060(341) 1560 365
7 1276(207) 1560 1105 Total fracture
6 808 (292) 1140 365 Core remained
Dicor ZP with intact
8 840 (226) 1125 410 Total fracture
Empress ZP with 9 891 (185) 1105 575 Total fracture

_
N

1000
ract

o
•o
g 5O0

without with

Fig 8 Influence of preload on the fracture strength of Fig 9 Influence of luted malenats on the fracture strength of
Vita-Dur N luted using zinc phosphate oement. Vita-Dur N using a cyclic preload stross

The fractured Vita-Dur crowns luted with various
lufing materials and the two fracture modes of In-
Ceram specimens were observed using an optical
rTiicroscope (Olympus, Tokyo, Japan), and the frac-
ture surfaces of In-Ceram crowns were observed
using a scanning electron microscope (5EM, .515
Philips, The Netherlands),
Results
The fracture loads of the ceramic crowns are
given in Table 2, Some of the Vita-Dur crowns
were fractured during preloading and were elimi-
nated from the data.
When comparing the fracture strength of Vita-
Dur crowns (ZP cement) without and with a pre-
loading component, the strength was significantly
lower after preloading (Fig 8, P< ,05),
The influence of luting agents on the strength of
Vita-Dur crowns subjected to cyclic preloading is
shown in Fig 9, Crowns luted using ZP, Gl, and AR
had increasing fracture strengths in that order.
There were significant differences of the strength
between with ZP and AR (P< ,05), It was observed
that the cement layers fractured in different pat-
terns (Fig 10], with the Gl cement staying more
intact around the prepared tooth than ZP cement.
Some chips of porcelain were observed near the
cervical portion of crowns luted with AR cement.
The strength of various crowns that were luted
with ZP cement and with preload are shown in Fig
11, There were no significant strength differences

7. Number 4, 7994 333 The Irternational lournal oí Proíthodontii

 l-r.ii.lurt' SIrenRlli or All.Cerjniic Cron
Fig 10 Typical tracture patterns ol Vita-Dur crown with ttiree types at luting materials: (left) zinc phosphate; (tnidóle)
polyalkenoate; (right) adhesive resin cement.
Fig 11 Comparison in strengtti ot all-ceramic crowns luted
with zinc phosphate cement (atter preload). (A: total tracture,
B: core remained intact.)
among Vita-Dur, Dicor, and Empress crowns, In-
Ceram fracture strengtb was significantly greater
than the other three materials (P < .05) but had a
large standard deviation. In-Ceram crowns frac-
tured in Iwo modes: complete fractures and frac-
tures of the dentin porcelain only (core intact), as
seen in Fig 12, Scanning electron microscopic
(SEM) images of fractured In-Ceram crowns with
different magnifications of the same specimen are
shown in Figs 13 to 15. The good bonding between
core and veneered dentine was observed in Fig 13
at low magnification. The crack propagation was
observed at the angle in (he dentine, and many
porosities of less than 50 jjm are seen in the dentine
layer at moderate magnification (Fig 14), The poros-
ity and the crack line at the interface between
dentine and core near the crack propagation were
recognized on the bighest magnification (Fig 15),
Tlie Internalional lourrial ol Prosthodontii
Discussion
The strength of a clinical ceramic crown is influ-
enced by several faclors such as !he shape of the
prepared tooth, the material, tbe way of luting, and
the loading conditions. The shape of the prepared
tooth impacts on the stress distribution" " and is
also influenced by an adhesive luting agent,"•'^•"""
It is also possible that repeated loadings of porce-
lain crowns alter the support and increase the risk
of crown fracture."'
There are many ways to simulate the clinical
environment in vitro. To do so, not only must fac-
tors such as preparation; master die design and
material; and the size, shape, and thickness of the
fabricated crown be considered; but also testing
conditions such as the atmosphere in which the
specimens are fabricated, stored, and tested; the
type of fatigue test used; the direction and location
of load application; and the mechanical testing
conditions must all be defined and controlled. In
this study, bovine dentine was used for the die
material, as it closely represents the mechanical
and surface properties of the human tooth. The
ceramic crown form was controlled by using a
brass template for core fabrication and a resin
assembly for control of the body porcelain.
As the cycling preload, an occlusal load was
applied onto the inclined crown simulating the
axial inclination of the natural tooth. The mean
maximal posterior occlusal biting force may vary
between 200 and 540 N.'-^> The inherent fatigue life
of a material is determined by observing SN curves,
in which S is defined as specific stress without
exceeding the elastic limit and N is defined as the
number of cycles for 10' to 10» cycles, tbe equiva-
lent of 10 years in vivo,» In this study, the maximum
force of 300 N for 104 cycles was applied during
the preloading test. This is typical of bruxism and
334 Í 7, Number 4, 1994
 SlrcriKili ül All-Cer.imic Cn

Fig 12 Two different tracture modes

observed on In-Ceram crowns; (left)
total fracture; (righi) core remained
intact.

other unfavorable occlusal conditions." ^" A cycling

rate of 1 Hz was selected as being equivalent to the
average masticatory cycle of 0.8 to 1.0 seconds." In
this study, the significant differences in strength
were shown between the Vita-Dur N group with
and without preload (Eig 8). The degradative effect
of an aqueous atmosphere on dental ceramics was
investigated by Drummond et al," and the fatigue
limit of the In-Ceram was reported by Kappert et
al.' However, Kern et al" reported that the fracture
strength of a resin-bonded In-Geram fixed partial
denture did not decrease after testing under dy-
namic loading with a maximum force of 22 N in an
artificial oral environment. It was postulated that
Vita-Dur crowns were weakened by deterioration
of the zinc-phosphate luting agent, resulting in a
change of the crown support. This phenomenon
was reported earlier.'" Also, ceramic fracture
strength may be affected by crack propagation
when tests are conducted in distilled water. The Fig 13 SEM image ot fractured In-
Ceram crowns (original magnification
crack growth speed in this study was accelerated by X 18.7).
the comparatively high preload value of 300 N.

Fig 14 SEM image ot Iractured In-Ceram crowns (same Fig 15 SEMI image ot tractured In-Ceram crowns with nigh
magnitication of core/dentine interface (same specimen as
Specimen as Fig 12, original magnification ;< 75).
Fig 13, original magnitication x 2400).

(7, Number 4, 1994 335 The Inlernational lournal ol" Prosthodoriik

 The apparent fracture strength increase of
ceramic restorations resin bonded to dentin has
been reported by many researchers."^'"-'" The sug-
gested reasons for this are (aj a reduction of the
stress associated with an increased radius of curva-
ture at the flaw tip in the ceramic surface by the
acid etching treatment; (b) a reduction of stress at
the flaw tips by completely coating these areas
with a silane bonding agent and resin cement; and
(c) a decrease in the strain (deflection) along the
internal surface of thé crowns, the area subjected
to the highest tensile stress, through a chemical
bond between the cement, crown, and prepared
tooth." Following finite element analysis, it was
also reported that the stress reduction was not the
result of the low elastic modulus of the luting
material but the complete adhesion between the
restoration and tooth structure."" Fracture strength
Improvement resulting from adhesion was ob-
served in this study. A small amount of cement
remained in the crowns luted using ZP cement,
while crowns luted using Gl cement were com-
pletely covered with cement. Cohesive failure of
the porcelain was observed in the crowns luted
with adhesive resin cement (Fig 10), resulting in
higher fracture strengths. These strength increases
were only significant between crowns luted using
ZP and resin.
The flexural strength of the ceramic materials
used in this study can be estimated from the litera-
ture as'^-'"^'": Vita-Dur N dentine porcelain, 60 to
80 MPa; Vita-Dur N core, 90 to 120 MPa;
In-Ceram, 320 to 490 MPa; Dicor, 80 to 150 MPa;
and Empress, 160 to 180 MPa. The fracture tough-
ness values (Ki,:l are'': Feldspathic (Vita-VMK den-
tine), 0.93 (0.15) MNm '•-; and aluminous (Vita-Dur
N core), 1.48 (0.29) MNm."''- The strength of
In-Ceram core material is approximately 6 to 8
times greater than that of conventional feldspathic
porcelain and 2 to 5 times higher than that of other
glass-ceramics. Ceramic strength is directly related
to Kic and is inversely related to the square root of
tbe flaw size, as shown in the following equation:
where of is fracture strength, K|c is fracture tough-
ness, C is flaw size, and Y is the geometric con-
stant."" Practical ceramic strength is, therefore,
extremely influenced by flaw size, number, and dis-
tribution of flaws in the area of the highest tensile
stress. The strength decreases very sharply for flaws
25 to 125 pm." The high strength of In-Ceram is
thought to be the result of the In-Ceram core com-
position of approximately 85% AbOj crystals com-
i of Pnísthodortii
nternational I ou
pared with only 40% for aluminous porcelain core
material. Also, the voids or flaws can be almost
completely filled with molten glass durir:« tbe infil-
tration process. Since clinically the In-Ceram crown
core is laminated using feldspathic porcelain, it
could not be expected that the total strength was
derived only from tbe core. The flexural strength of
veneered In-Ceram (thickness ratio of core/dentin
porcelain is 1/3) was reduced to 262 MPa (coreiful-
crum side) and 139 MPa (dentine:fulcrüm side)
compared to the core strength of 364 MPa."
The fracture strengths of two all-ceramic crowns
and metal ceramic incisor crowns tested with load-
ing perpendicular to the long axis' were compared:
964 N for In-Ceram; 814 N for surface-colored IPS-
Empress; 750 N for veneered IPS-Fmpress; and
1494 N for metal ceramic. Incisor crowns tested
with the load inclined™ yielded values of 380 N for
In-Ceram with 0.5 mm core, 450 N for In-Ceram
with 0.7-mm core, 220 N for surface colored IPS-
Empress, and 160 N for veneered IPS-Fmpress. For
premolar crowns tested w i t b perpendicular
loading^: 1609 N for In-Ceram with 0.7-mm core
and 1557 N for metal ceramic. In this study, the
fracture strength of premolar crowns tested with
inclined loading after cyclic prestressing in water
was 1060 N for In-Ceram with 0.5-mm core and
891 N for IPS-Empress. In-Ceram had two modes
of fracture with values of 1276 N for complete
fracture and 808 N for dentin porcelain fracture
with core remaining intact.
Kelly et a l " evaluated clinically failed all-
ceramic crowns using fractography and observed
that a majority of the crown failures were appar-
ently initiated at the internal surface, indicating this
surface was placed under the greatest tensile stress
and/or was the location of the largest flaws.
Anusavice et a l " used finite element analysis to
evaluate the tensile stress in all-ceramic crowns
and found that the stress was concentrated at the
internal surface having flaws and a void, while
tensile stress at the marginal area was comparative-
ly low and homogeneous.
In this study using SFM, porosities and the crack
lines were observed in the dentin porcelain and at
the interface between dentin and core on the frac-
tured In-Ceram crowns (Fig 15). Therefore, for the
fractured In-Ceram crowns in which the core
remained intact, if voids or flaws were present
around the interface between core and dentine
porcelain at locations with high tensile stress, the
crack would propagate through the interface
between the core and dentine. This phenomenon
might be accelerated by corrosion fatigue of the
preloading in water. It is suggested that further
336 : 7, Number 4, 1994
 Yoshin.iri and Déríind
investigation be conducted to determine the most
suitable core shape, methods of bonding the den-
tine porcelain on the core, and development of
stronger dentine porcelain to ensure tbe practicali-
ty of all-ceramic crowns.
Conclusions
The load to fracture of inclined premolar crowns
was determined for four types of all-ceramic units:
conventional Vita-Dur N; In-Ceram; Dicor cast
glass-ceramic; and IPS-Empress. The specimens
were tested after preload to fracture cycling in an
aqueous atmosphere. Under the conditions of this
study, the following conclusions can be made;
1. The strength of Vita-Dur crowns decreased sig-
nificantly after being subjected to a preload
cycling. The average (standard deviation) of
load to fracture of Vita-Dur crowns luted using
zinc phosphate cement were; 1022 (135) N
without preload, and 770 (237) N with preload.
2. Vita-Dur N crowns luted with polyalkenoate
cement and adhesive resin cement had higher
loads to fracture than did crowns luted using
zinc phosphate cement. Values achieved using
a resin cement were significantly greater than
those using zinc phosphate but were not signifi-
cant when compared to the polyalkenoate
luting agent. The values of the polyalkenoate
material were not significantly greater than
those achieved using zinc phosphate. Load to
fracture of Vita-Dur crowns w i t h preload
cycling were; 770 (237) N luted using zinc
phosphate cement; 881 (1901 N luted using
glass-ionomer cement; and 1007 (157) N luted
with adhesive resin cement.
3. There were no significant strength differences
among Vita-Dur, 770 (237) N; Dicor, 840 (226)
N; and Empress crowns, 891 (185) N in com-
parison of the strength of various crowns luted
using ZP cement and preload. In-Ceram frac-
ture strength (1060 N) was significantly higher
strength than tbe other three materials {P < .05)
but had a large standard deviation (341 N).
4. In-Ceram crowns had two modes of failure:
total fractures at 1276 (207) N and fractures in
wbich the core remained intact under loads of
808 (292) N.
Acknowledgment
The author would like to thank Mrs Kerstin von Bahr,
Mr Alvar Svensson, and Mr fiâkan Fransson for theii technical
assistance.
r(e7,Number4,1994
Fracture Slienglli of Ali-Ce
References
1. Kappert HF, Knode H, Schultheiss R. Fcsligkeitsverhallen
der In-Ceram Keramik bei mechanischer und thermischer
Wechsellast im Kunsispeichel. DIsch Zahnärzll Z 1991;
46:129-131.
2. Josephson BA, Schulman A, Dunn ZA, Hiirwit2 W. A com-
pressive strength study of complete ceramic Liowns, Part
11.1 Prosthel Denl 1991 ;65:3a8-391.
3. Ching-Cheng L, O'Biien W|. Strength of magnesiacore
crown with different body porcelain, Int J Prosthodort
1 99.^:6:60-64.
4. Probste: L. Compressive strength of two modern all-
ceramic crowns. IntJ Prosthodont 1992;5:4O9-414.
5. Grey N|A, Piddock V, Wilson MA. In vitro comparison of
conventional crowns and a new ail-ceramic system. |
Dent I993;21 47-51,
6. Friedlander LD, Munoz CA, Goodacre C), Doyle MC,
Moore BK. The effect of looth preparation design on the
breaking strength of Dicer crowns. Int ) Prosthodont
199O;3:159-168.
7. DeLong R, Douglas WH. Development of an artificial oral
environmeni for the testing of dental restoratives; Bi-axJal
force and movement conlrol. | Dent Res 1983;62;32-36.
S. DeLong R, Goodkind R|, Douglas WH, Corros ion-fatigue
of the bond belween nickel-chrome casting alloys and
porcelain. J Proslhet Dent 1984;52:344-348.
9. Drummond JL, Novickas D, Lenke ]W. Physiological aging
of an all-ceramic restorative maleriai. Denl Mater
1991,7:133-137.
10. Yoshimura N. Corrosion and fatigue of fine-ceramics.
Kinzoku 1992.25:52-59.
11. Kern M, Dougias WH, Feclitig T, Strub |R, DeLong R.
Fracture strength of all-porcelain, resin bonded bridges
after testing in an artificial oral environment. | Dent
1993;21:n7-ia:.
12. Fairhurst CW, Lockwood PF, Ringle RD, Twiggs SW.
Faligue parameters of a model feldspathic porcelain
labstractl. J Dent Res 1993;72:573.
13. Myers ML, Ergle |W, Fairhurst CW, Ringle RD. Effect of
stressing rate and environment on fracture strength of
porcelain [abslract). | Dent Res 1993,72:575.
14. Smith CA, Wilson NHF. The Surface finish of trimmed
porcelain. Br Dent J 1 981 ;1 51:222-224.
15. Sozio RB, Riley F|. The shrink-free ceramic crown. |
Prosthel Dent 1 9S3;49:1 82-187.
16. Philp GK, BrukI CE. Compressive strengths of convention-
al, twin foil, and all-ceramic crowns. | Proslhel Dent
19a4;52:21 5-220.
17. losephson BA, Schulman A, Dunn ZA, Fljrwilz W. A com-
pressive strength study of an all-ceramic crown. J Prostbet
Denl 1985;53:301-303.
18. Piddock V, Marquis PM, Wilson FHJ. The mechanical
strength and microstructurc of all-ceramic crowns, | Dent
1987;15:153-15Ö.
19. Seghi RR, Daher T, Caputo A. Relative flexural strength of
denial restorative ceramics. Dent Mater 1 990;6:18i-i84.
20. Schwickerath H, Die In-Ceram Alummiumo^id-Keramiken
innovativer dentalkelamischer Werkstoff. Dent Labor
1989;37:1597-1599,
21. Clans H. Vita In-Ceram. ein neues Verfahren zur
Herstellung oxidkermischer Gerusie Im Kronen und
Brücken, Quintessenz Zahntech 1990.16:35-46.
22. Pröbster L, Diehl ]. Klinik und Technik des keramischen
Kronen-und Bruckensystems in-Ceram. Quintessenz
Zahnärztl Lit 1 990;41:61 3-620.
337 Tlie inlcrnalional ¡ournai o( Proslhodontii
 Srenglll oí AN-tersrriíc Cn

23, Kappert HF, Knode H, Manzotti L, Netallíreie Brücken fur
den Seilenîahrbereich. Dent L^ibor 199O;3!Î:177-,l B3,
24, Adair PJ, Grossman DC. The castahle cersniic crown. ln[ |
Periodont Rest Denl l984;2:33-45,
35. Miller A, Long |, Miller B, Cole |, Comparison of the frac-
tLire strengths of ceramometal crowns versus several all-
ceramic crowns, I Prosthet Dent 1992;fiö:J8-41,
26, Carnpbeil SD. A comparative strength study of metal
ceramic and all-ceramic esthetic materials: Moduius o(
rupture, 1 Prosthel Dent 1 989;62:476-479.
27, Vaidyanathan TK, Vaidyanathan J, Prasad A, Properties of
a new dentai porcelain. Scanning Microscopy 19S9;3:
1023-1033,
28, Wohlwend A, Strub P, Scharer P. Metal ceramic and all
porcelain restoratiori: Current considerations, int | Pros-
thodont 1990;2:13-26,
29, Dong |K, Luthy H, Wohiweiid A, Schaier P. heat-pressed
ceramics; Teclinology and strength, Int | Prosthodont
1992;5:9-16,
30, Schwickerstfi H. Was dei Zafintechniker beachten sollte
Heisteilung von voilkeramischem Zahnersati, Dental
Labor 1992;40;1501-1506.
31, Dérand T. Effect of variation ol the shape of ihe core tin
stresses in a loaded model of a porceiain crüwn. Odont
iiev l974;25:11-26.
32, Dérand T, Analysis ot stresses in loaded models of porce-
lain crowns, Odont Rev 1 974;25:1 89-205.
33, Anusavice K|, Hojjatie B, Tensile stress m glass-ceramic
crowns: Effect of flaws and cement voids, Int | Pros-
thodont 1992;5:35l-3i8.
34, Dérand T, Ultimate strength of porcelain crowns, Odont
Rev 19r4;2S:39.i-4a2,
35, Dérand T, Stress analysis of cemented or rcsin-bonded
loaded porcelam inlays. Dent tvi^ter 1992;7:2l-24,
36, Shinohara N, Minesaki Y, Mukoyoshi N, Moriyama H,
limi T, The effect of the cementing material on the
strength of the all-ceramic crown, J |pn Prosthodont Soc
1989;33:41 6-421,
37, Butthibu H, Nathanson D, Effect of ionomer base on
ceramic resistance to fracture labstract], | Dent Res
I99i;72:572,
38, Dérand T, The influence of the cement layer on strength
of the porcelain crowns subjected to frequent ioading,
Odont Rev I975;26:239-243.
39 Nichoils II. Tensile bond of resin cements to porcelain
veneers. | Prostliet Dent ]988;60:443-445,
40. Calamia J, High-strength porcelain bonded restorations:
Anterior and posterior. Quintessence Int 1989;20:717-726.
41. Probster L, Diehl |, Slip casting ceramics for crown and
bridge restorations. Quintessence Int 1992;23:25-31.
42. Morena R, Lockwood PE, Eairhurst CW, Eracture tough-
ness of commercial dental porcelains. Dent Mater
1986;2;S8-62.
43. Kinsjrey WD, Bowen HK, Uhlmann DR, introduction to
Ceramics, ed 2, New York: lohn Wiley, 1976:768-814,
44. Keiiy JR, Giordano R, Pober R, Cima Mj, Fracture surface
analysis of denial ceramics: Clinically failed restorations,
Int I Prosthodont 1 990;3:430-440,

Computed Tomography and Complele Dentures

Intimate contact between the supporting tisiucs (ie, bone and oral rTiui.o5a) and denture bases must be main-
tained 50 that retention and stability requirements can be met for the complete denture patient. As acrylic resin
dentures do not generate artifact, computed tomography (CT) offers the potentlai for demonstrating relation-
ships between dentures, supporting tissues, and lingual and buccal musculature. The present investigation eval-
uated these reiationships using singie CT slices made for multiple jaw positions in compiete denture wearers.
Ten edentulous patients (6 women and 4 men; mean age 62 years) who reported denture dispiacement during
mastication were studied. Single coronai CT sections passing through thei'irst molar region were made for rest,
maximum intercuspation, and iateral excursive positions, as well as centric and eccentric simulated masticato-
ry positions. Measurements were taken from the CTs to determine denture movement and soft tissue or bony
deformation. Results demonstrated the maintenance of intimale contact between the dentures and supportine
tissues in rest, maximum intercuspaticn, and iateial excursive positions. However, during simuiated uniiateral
mastication, displacement of the contraiateral denture base was evident. This dispiacement was compensated
for by close contact between the peripheral seai/vestlbular polished denture surface and the buccal mucosa.
The tongue did not contact the dentures during ialerai simulated funcliori. Tlie aulhors suggest that this evalu-
ation procedure may be used to diagnose persistent problems with denture stability in a selett group of com-
plete denture patients.

Quéguiner I, Orai Sura Ool Med Orsi R-Ihoi 1994;77:90-94. References: 13. Reprints: Isabe
If Quéguinor, 2 bis. Chemin de
iavallé?, 9I320VVI55OUS, Frsnte.—Dawe/fi. Cjgo,', DMD.TheUiiive'iityofTeasiHeallhSc ;nce Center at San Antonio, San
Antonio, Texss.

Tiie International lournal " Í Prü5thodonli< 338 Volume 7, N'jniber 4, 1994