[Fatigue damage analysis of porcelain in all-ceramic crowns]

To investigate the fatigue damage mechanism of porcelain, and its relation with the microscopic defects in clinically failed all-ceramic crowns.

Collecting the bilayered all-ceramic crowns failed in vivo. The fractured surfaces and occlusial surfaces of failed crowns were examined by an optical microscope followed by detailed fractography investigations using a field emission scanning electron microscope. When chemical impurities were of concern, energy-dispersive X-ray spectroscopy analysis was performed to examine chemical composition. A standard practice for fractography failure analysis of advanced ceramics is applied to disclose the fracture mode, and damage character.

Three types of fracture features are defined as breakdown of the entire crown, and porcelain chipping-off/delamination. Alumina crowns were usually characterized by breakdown of the entire crown, while zirconia crowns by porcelain chipping-off and delamination. The fatigue damage of porcelain was classified into surface wear, cone crack, and porcelain delamination. The observed microscopic defects in this study included air bubbles and impurity particles.

The multi-point occlusial contacts were recommended in all-ceramic restorations clinically. The thickness of porcelain is important for the anti-fatigue ability of porcelain. Cautions have to be taken to avoid contaminations during the veneering processes.