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Kingdom
d Department of Prosthodontics, UNIGRAN University, Dourados, MS, Brazil
a r t i c l e i n f o a b s t r a c t
Article history: Objective. To compare the fatigue life and damage modes of zirconia crowns fabricated with
Received 2 September 2013 and without framework design modification when porcelain veneered using a fast or slow
Received in revised form cooling protocol.
22 December 2013 Methods. Composite resin replicas of a first molar full crown preparation were fabricated.
Accepted 27 October 2014 Zirconia copings were milled as conventional (0.5 mm even thickness, Zr-C, n = 20,) or mod-
Available online xxx ified (lingual margin of 1.0 mm thickness, 2.0 mm height connected to two proximal struts
of 3.5 mm height, Zr-M, n = 20). These groups were subdivided (n = 10 each) according to the
Keywords: veneer cooling protocol employed: fast cooling (Zr-CFast and Zr-MFast) and slow cooling
Ceramics (Zr-CSlow and Zr-MSlow). Crowns were cemented and fatigued for 106 cycles in water. The
Fatigue number of cycles to failure was recorded and used to determine the interval databased 2-
Weibayes parameter probability Weibull distribution parameter Beta (ˇ) and characteristic life value
Cooling rate Eta ().
Fractography Results. 2-parameter Weibull calculation presented ˇ = 5.53 and ˇ = 4.38 for Zr-MFast and Zr-
Zirconia CFast, respectively. Slow cooled crowns did not fail by completion of 106 cycles, thereby
Weibayes calculation was applied. Increased fatigue life was observed for slow cooled crowns
compared to fast cooled ones. Groups Zr-MFast and Zr-MSlow presented no statistical differ-
ence. Porcelain cohesive fractures were mainly observed in fast cooled groups. Slow cooled
crowns presented in some instances inner cone cracks not reaching the zirconia/veneer
interface.
Significance. Improved fatigue life in tandem with the absence of porcelain fractures were
observed in slow cooled crowns, regardless of framework design. Crowns fast cooled chiefly
failed by porcelain cohesive fractures.
© 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
∗
Corresponding author at: Alameda Octávio Pinheiro Brisola 9-75, 17.012-901 Bauru, SP, Brazil. Tel.: +55 14 98153 0860;
fax: +55 14 3234 5805.
E-mail address: estevamab@gmail.com (E.A. Bonfante).
http://dx.doi.org/10.1016/j.dental.2014.10.005
0109-5641/© 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
http://dx.doi.org/10.1016/j.dental.2014.10.005
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Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
http://dx.doi.org/10.1016/j.dental.2014.10.005
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Fig. 1 – Proximal view of (a) standard and (b) modified core designs before veneering with porcelain.
Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
http://dx.doi.org/10.1016/j.dental.2014.10.005
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Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
http://dx.doi.org/10.1016/j.dental.2014.10.005
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Fig. 3 – (a) Probability Weibull 2P plot showing probability line for Zr-CFast and Weibayes line projection of group Zr-CSlow.
Note that 90%CB calculation for Zr-CFast did not allow confidence intervals. (b) Probability Weibull 2P plot showing
probability line calculation of Zr-MFast and Weibayes probability line projection of group Zr-MSlow. (c) Probability Weibull
plot showing the Zr-CSlow and Zr-MSlow Weibayes projection lines. Note the different inclination of the probability lines as
a result of the different Beta values: ˇ = 4.38 for Zr-MSlow and ˇ = 5.53 for Zr-CSlow.
from the Zr-MFast). Conversely, crowns subjected to the slow are shown in Fig. 3. For the results distribution, the groups
cooling protocol, regardless of framework design, (Zr-CSlow were plotted based on the core design varying the cooling rate
and Zr-MSlow) were suspended since they did not fail at the process as described in materials and methods. 2-Parameter
completion of 106 cycles. Results of the Weibull calculation Weibull calculation was performed for Zr-CFast and Zr-MFast.
Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
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Fig. 4 – (a) Light-polarized microscope and SEM images of a representative failed Zr-MFast crown. Palatal view of cohesive
porcelain fracture shows that the crack involved the lingual cusp. (b) SEM lingual view displaying the indentation area
(asterisk) and the dotted arrows shows the crack propagation toward the cervical and proximal areas. (c) and (d) The
concave portion of the arrest lines (pointer) points to the origin (asterisk). Continued propagation toward the margins is
suggested by the series of hackles (bowshot). (e) and (f) Magnification of wake-hackles (pointers) corroborating the origin
and direction of crack propagation along with twist-hackles (white arrows).
Groups Zr-CSlow and Zr-MSlow did not present any failure, the confidence bounds. Fig. 3 also presents the Weibayes prob-
and therefore Weibayes calculation was performed [36]. In our ability line calculations for groups Zr-MSlow and Zr-CSlow.
study we used the ˇ value from the respective counter group’s
design and ran Weibayes calculation. 2-parameter Weibull 3.1. Failure modes
calculation presented ˇ = 5.53 and ˇ = 4.38 for Zr-MFast and Zr-
CFast respectively. The Weibayes calculation using the same The chief failure mode observed for crowns subjected to the
ˇ values for the respective counter presented a shift to the fast cooling protocol was porcelain veneer cohesive fracture,
right of the Weibull probability lines (longer fatigue life). The 2- regardless of framework design (Zr-CFast, Zr-MFast), with-
parameter Weibull calculation for group Zr-CFast did not allow out exposing the Y-TZP surface. Of special interest was the
90% confidence intervals calculation as a result of the distri- fact that smaller chippings were consistently observed for
bution of the failed specimens. However there is a significant Zr-MFast relative to Zr-CFast group. In the Zr-MFast group,
shift to the right of the Weibayes probability line for its counter chippings were generally confined to the lingual cusp (Fig. 4),
part group. Groups Zr-MFast and Zr-MSlow presented no sta- whereas chip-off fractures extending to the proximal sur-
tistical difference as a result of overlap of the upper limit of faces were observed in Zr-CFast crows (Fig. 5). Qualitative
Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
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Fig. 5 – (a) Light-polarized microscope image of a Zr-CFast crown shows the extension of the fractured porcelain veneer.
Note that a layer of porcelain remained onto the Y-TZPs framework surface. (b) SEM lingual overview of the fractured crown
and indentation area (asterisk) where the fracture initiated and propagated toward margins and proximal areas (dotted
arrows). (c) Magnification of (b) showing the presence of a series of wake-hackles (pointers) confirming the fracture origin
and direction of the crack propagation (dotted arrow). (d) A series of twist-hackles (white arrows) that strongly suggests the
presence of residual thermal stress and further confirms the direction of crack propagation toward the margin of the fracture.
fractography performed in polarized-light microscopy and life within either the fast or slow cooled crowns. However
SEM showed the presence of quasiplastic deformation at the when intergroup comparisons were made, the relevance of a
indentation area. Telltale fractographic marks including hack- modified framework should not be overlooked since the Zr-
les, wake hackles, and arrest lines suggesting the direction of MFast crowns were not statistically different from slow cooled
crack propagation from the indentation area toward the mar- crowns of any framework design. Nevertheless, it appears that
gins of the fractured porcelain veneer were observed. Twist cooling protocols played a major role in fatigue life in the
hackles were only identified in those groups subjected to fast current study. As expected from previous studies [6,9,38], no
cooling. Y-TZP core fractures were detected. When porcelain veneer
Crowns subjected to the slow cooling protocol of both fractures occurred, they were always cohesive within the
framework designs (Zr-CSlow and Zr-MSlow) were consid- porcelain veneer, without exposing the Y-TZP core [3,5,39–42].
ered suspended since they did not present failures at the Crowns cooled slowly did not present porcelain chippings
completion of the 106 cycles. The subsurface damage inspec- within the established limit of one million fatigue cycles and
tion of these specimens revealed inner cone cracks as the the only observed failure mode was near-field damage (inner
dominant crack system mechanism in all samples from both cone crack), in both framework designs. It is likely that such
groups, although they did not reach the core/porcelain inter- fatigue performance improvement may be explained by a
face (Fig. 6). No radial crack and bulk fractures were observed. reduction in residual stress entrapment within the veneer
layer [16,20,23]. A recent investigation evaluated the influ-
ence of cooling protocols on thermal stress formation in Y-TZP
4. Discussion molar crowns showing that when samples were cooled slowly
the outer porcelain veneer surface did not become solid first
The present study evaluated the effect of cooling processes (due to the absence of thermal gradient) allowing residual
and framework designs on Y-TZP molar crowns fatigue thermal stress relaxation by viscosity flow [23]. As fatigue
life. The absence of statistical difference in fatigue life in testing was suspended at one million cycles to allow for dam-
crowns submitted to the slow cooling protocol, regardless age inspection of groups within the same range of cycles,
of framework design, lead us to reject the first postulated it must be acknowledged that extended fatigue could have
null hypothesis. The second null hypothesis was accepted provided a more clinically realistic failure scenario, although
since framework design modification did not improve fatigue increasing testing time to an unknown extent. In addition, as
Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
http://dx.doi.org/10.1016/j.dental.2014.10.005
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Fig. 6 – (a) Occlusal light-polarized micrograph shows the indenter contact area on the porcelain surface and the resulting
quasiplastic deformation on a Zr-MSlow crown. (b) Magnification of the square area showed in (a), reveals the presence of
quasiplatic deformation, which is a coalescing microcrak involving the indentation area (bowshot) after 106 cycles. (c)
Bucco-lingual section of the same crown, polished and examined throughout the damaged area, showing inner cone crack
formation immediately below the indentation area, not reaching the zirconia/veneer interface (d) Magnification of the inner
cone crack confirming its extension. (e) Bucco-lingual section micrograph of a polished Zr-CSlow crown showing the
indentation area in the blue square and in (f) its magnification revealing inner cone cracks (pointer) formed immediately
bellow the indentation area, also not reaching the interface. R = resin composite; Y-TZP = zirconia framework; V = veneering
porcelain.
sliding-fatigue was omitted, porcelain fractures revealed ori- reduce thermal gradients [12,23,46]. A comprehensive eval-
gin from the occlusal surface, but not related to surface uation of stress distribution within the veneering ceramic
roughness due to wear, as reported in clinical fractogra- as a function of depth toward the substructure material has
phy [43] and laboratory studies involving such methodology shown that zirconia veneered samples present tensile stresses
[2,44,45,47]. around 0.5 mm from the surface with magnitude varying
Regarding the slow cooling protocol used in this study, inversely to the cooling rate [26].
it must be emphasized that it is experimental for having Y-TZP crowns cooled fast resulted in similar fatigue life,
extended the slow cooling process below the Tg , in contrast to irrespective of framework design, but remarkable differences
what is currently recommended by most manufacturers (slow were observed in porcelain cohesive fracture sizes. Whereas
cooling in the last stain/glaze firing cycle until Tg ). Whereas fractures in the modified Y-TZP framework were confined to
the maintenance of the crowns into the furnace until 50 ◦ C lingual cusp, those in the conventional designed were more
demanded additional laboratory time, it may be important to extensive often involving both approximals in addition to the
Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
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buccal cusp. Despite such differences, from a clinical stand- a cohesive fracture from the extension of the inner cone crack-
point only crowns with modified framework would potentially ing [49–52]. Suspended crowns subjected to the slow cooling
be repaired, although ideally both would require replacement. protocol showed cone cracks formation virtually confined to
Such an observation questions the suitability of this partic- the quasiplastic zone beneath the indenter and therefore not
ular framework design modification since it results in an reaching the Y-TZP framework and are much less likely to lead
even porcelain thickness only on the lingual side. Perhaps, an to cohesive failure with continued loading.
anatomic core design that provides an even thickness in all As observed in clinical trials, the proximal region has been
cusps and proximal areas could be more relevant as recom- regarded as an area specially affected by chipping [6,14,30,53].
mended by several manufacturers. A recent study shows that In a natural occlusal scheme the mesio bucal cusp of the first
an anatomical support of the veneering ceramic resulted in mandibular molar may contact the marginal ridges of both
reduced veneer chip size fractures and significantly increased second premolar and first maxillary molar [54,55]. This sug-
reliability with press and hand-layer veneering ceramics and gests that future fatigue testing in the proximal areas may be
appears to be a promising tool to optimize long-term perfor- of clinical relevance.
mance of veneered Y-TZP crowns in clinical application [29].
One important fractographic finding was the consistent
presence of twist hackles in the groups cooled by the fast 5. Conclusions
protocol. Although it was not our aim to perform residual
thermal stress measurements, the presence of twist hackles, The first postulated null hypothesis which stated that cool-
strongly suggest the presence of significant thermal stress gra- ing protocols during glazing would not improve the fatigue
dients [47], which were induced in our study by the fast cooling life of Y-TZP crowns was partially rejected. Decreased fatigue
protocol [16,23,46]. life was observed only for crowns fast cooled of conventional
Our Weibayes use of an assumed beta value means that framework compared to any slow cooled crowns, whereas
always there is a “risk” of using a beta higher than the “true” modified framework fast cooled crowns were not signifi-
value [37]. In this context, the impact of a higher beta is being cantly different from slow cooled ones. The second null
overly optimistic in the interpretation of the demonstrate reli- hypothesis was accepted since framework design modifica-
ability and the possible exclusion of early failures. In our tion did not improve fatigue life within either the fast or
study the beta value employed is based upon the ˇ value from slow cooled crowns. Slow cooling protocol is recommended for
the respective counter group (fast cooled), which displayed a more predictable mechanical performance of layered-zirconia
higher number of failures than the slow cooled groups. More- restorations.
over, a way to investigate the effect of changes in an assumed
beta is by assuming two beta values (two beta lines), where
Acknowledgements
the higher the cumulative density function (CDF) level of the
beta line intersection point, the greater the risk of reaching
We thank Dr. Raphael Piazzarollo Loureiro for his input on
an overly optimistic conclusion for a fixed By life below that
ceramic processing engineering and the dental technician José
intersection point [37].
Carlos Romanini for crown fabrication. This study was sup-
Also, if two beta values were assumed, one as calculated
ported, in part, by CNPq, and FAPESP Grant 2010/06152-9. The
from results of the counter group and the other reduced by
authors acknowledge Hitachi S3500N SEM imaging that was
two units, one graphic including both beta lines would be
made possible by the New York University College of Den-
generated. For a given N = 10 (based on our sample size), the
tistry’s cooperative agreement with the NIH/NIDCR.
intersection of two beta lines is known as beta intersection
point and it most likely occurs at approximately CDF of 10%
(here the test time on each of the “N” samples is equal). For a references
larger “N”, the beta intersection point occurs at less than 10%.
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Please cite this article in press as: Paula VG, et al. Slow cooling protocol improves fatigue life of zirconia crowns. Dent Mater (2014),
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