全瓷冠修复体的破坏机理研究
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摘要
全瓷材料因其稳定的生物相容性和良好的美学特征被广泛地应用于口腔修复中，然而它们是脆性材料易遭受拉伸破坏，临床成功率并不理想，研究全瓷冠的破坏机理对提高其使用寿命具有重要意义。由于当前测试方法的限制，在半透明全瓷冠中无法观察裂纹起始和扩展过程。本博士论文首先提出了独特的实验和数值分析方法，然后系统地研究了全瓷材料、粘接剂老化、粘接剂种类和树脂基体对全瓷冠承载能力的影响，旨在为临床选材提供指导。主要内容包括：
1、开发了研究全瓷冠修复体破坏机理的实验和数值方法。提出了2mm厚切片试件的制作方法，通过Hertz接触理论和对比实验论证了2mm厚切片试件模拟全瓷冠修复体的有效性。利用DIC实现了在加载过程中检测各瓷层的裂纹扩展过程。基于逆向工程技术建立了右下第一磨牙全瓷冠三维数值模型，并验证了模型的收敛性。
2、研究了全瓷冠IPS e.max系统和Zirconia系统的破坏载荷和破坏方式。DIC分析获得了饰瓷亚表面的屈服损伤行为，起裂于亚表面的裂纹可穿透IPS e.max Press核瓷，导致IPS e.max Press核瓷发生整体破坏，但裂纹不能穿透Zirconia核瓷，导致Zirconia系统饰面瓷脱离。结果表明：裂纹不能由低弹性模量、低断裂韧性的饰瓷Vita VM9扩展到高弹性模量、高断裂韧性的核瓷Zirconia。通过三维轴对称接触模型分析得出剪应力引起剪切滑移裂纹，并在拉应力的驱动下扩展。全瓷材料的三维数值模拟表明，高弹性模量的核瓷能承担更多的咬合力，可有效地保护饰瓷和基牙。
3、研究了疲劳载荷对核瓷断裂韧性的影响。对IPS e.max Press和Zirconia瓷块进行疲劳加载，然后进行压痕实验测试断裂韧性，结果表明：IPS e.max Press断裂韧性显著降低（P=0.001），而Zirconia断裂韧性几乎不受疲劳载荷的影响（P>0.05）。这说明Zirconia的抗疲劳性能比IPS e.max Press的强。经疲劳载荷作用后，静态触压抗折能力实验也表明：IPS e.max系统受疲劳载荷影响承载能力显著下降，而Zirconia系统的承载能力下降不具有统计学意义。两者的实验结论一致。
4、研究了树脂粘接剂老化对全瓷冠承载能力和破坏方式的影响。分别在干燥和在水中存放老化的全瓷冠试件的颊尖施加静态触压载荷。结果发现：干燥的试件主要发生饰瓷崩瓷破坏；而经水老化的试件在小载荷作用颈部肩台处出现明显脱粘，并且IPS e.max试件发生核瓷下表面放射状裂纹破坏，承载能力显著地下降（P=0.000）；Zirconia系统仍以饰瓷崩瓷破坏为主，承载能力下降不具有统计学意义（P>0.05）。数值模拟分析表明，粘接剂老化会导致核瓷下表面的拉应力集中系数增大，增加放射状裂纹破坏的风险。此研究成果合理地解释了实验室测试与临床结果的差异。
5、研究了粘接剂弹性模量（Panavia F E=18.3GPa和Variolink IIE=8.3GPa）对全瓷冠承载能力的影响。静态触压破坏实验表明，两种粘接系统的IPS e.max试件的承载能力具有显著差异（P<0.05），高弹性模量的粘接剂可提高全瓷冠的承载能力。数值模拟分析表明，弹性模量大的粘接剂可降低全瓷冠拉应力水平。同时研究了粘接剂4种厚度模型（60、90、120、150μm）的应力分布水平，结果表明90μm厚模型的全瓷冠应力水平最低。
6、研究了树脂基体模量（Z100E=16.6GPa和Surefil E=9.3GPa）对全瓷冠承载能力的影响。静态触压破坏实验表明，弹性模量大的树脂基体可提高全瓷冠的承载能力。数值模拟结果显示，弹性模量大的树脂基体降低全瓷冠的拉应力水平。
All-ceramic crowns have been widely used in prosthodontics because oftheir stable biocompatibility and aesthetic characteristics. However, asthey are brittle materials and vulnerable to tensile failure, the surviverate is not satisfied. It is important to study the failure mechanisms ofall-ceramic crowns to improve the service life. Due to limitations oflaboratory test methods, the initiation and propagation of cracksoccurring in opaque stressed all-ceramic crowns was unable to beexamined. This doctorial dissertation proposed a unique experimanentaland numerical method and then studied the influences of all-ceramicmaterials, cement aging, cement types and resin substrate on theload-bearing capacity of all-ceramic crowns with intention to provideguidance for clinical applications. The main contributions of the studyare listed as follows：
1. The experimental and numerical methods for studying failuremechanism of all-ceramic crown restorations have been proposed.Sectioned all-ceramic crowns with2mm thickness have been designedand fabricated to study the failure mechanisms of all-ceramic crowns. DIC was carried out to detect the crack initiation and propagation inlayer structures during loading. The3D numerical model is developedbased on the geometry of the first mandible molar using reverseengineering technology. The convergence of the model was verified.
2. The fracture modes and critical fracture loads of all-ceramiccrowns for IPS e.max and Zirconia have been studied. Sub-surface yielddamge occurring in veneer was detected by DIC analysis during thequasistatic contact loading. Cracks initiated from subsurface penetratedinto the IPS e.max Press core and led to bulk fracture in IPS e.maxspecimens,while deflected in Zirconia core and caused chipping in theveneer layer. It is found that cracks are unlikely to propagate fromveneer with low-modulus and low-toughness ceramic (Vita VM9) to theceramics with high-modulus and high toughness ceramic (Zirconia).Results of the three-dimensional axisymmetric contact model showedthat cracks were caused by shear stress and were driven by tensile stress.The three-dimensional numerical simulation of all-ceramic crownsshowed that the core ceramics with high elastic modulus can bear largebite forces and protect veneer and dental substrate.
3. The effect of fatigue on fracture toughness of ceramics has beenstudied. The laboratory studies indicated that the fracture toughness ofIPS e.max Press reduced significantly with fatigue loads, while noappreciable variation was found in Zirconia. The fatigue resistance ofZirconia is much stronger than that of IPS e.max Press. The quasistaticcontact tests also suggested that the load-bearing capacity of IPS e.maxspecimens can be significantly affected by fatigue loads. Bothexperimental results were consistent.
4. The influence of cement aging on load-bearing capacities andfracture modes of all-ceramics has been studied. Quasi-static contactload is applied on buccal cusp bridge of dry and water aging specimens.Chipping was the dominant failure mode for dry specimens regardless ofthe ceramic types. An apparent debonding between the core andsubstrate was detected at a low loading level in water aging specimens.The load-bearing capacity for IPS e.max crowns were significantlyreduced with bulk failure due to cement aging, while zirconia specimens still underwent chipping with a slight drop of the load-bearing capacity.Numerical results indicated that cement aging could lead to tensile stressconcentration on the lower surface of the core and increase the risk ofradial cracks, which was detrimental to low-strength dental ceramics.The results of this study rationally explained the differences in thelaboratory tests and clinical examinations.
5. The effect of the elastic modulus of cements (Pavavia F E=18.3GPaand Variolink II E=8.3GPa) on load-bearing capacities and fracturemodes of all-ceramic has been studied. Quasi-static contact tests showedthat there was a significant difference in load-bearing capacities in thetwo types of adhesive specimens. The cement with high elastic moduluscould improve load-bearing capacity of all-ceramic crowns. Numericalresults demonstrated that the high elastic modulus of cement coulddecrease the tensile stress level in core ceramics. The optimal cementthickness of90μm was suggested from the four enumerated thicknesses(60,90,120and150μm). 6. The effect of elastic modulus of the resin substrate (Z100E=16.6GPa和Surefil E=9.3GPa) on load-bearing capacity and fracture mode ofall-ceramic crowns has been studied. Quasi-static contact tests showedthat there was a significant difference in load-bearing capacities in thetwo types of resin substrates. Numerical results demonstrated that thehigh elastic modulus of the resin substrate could decrease tensile stresslevels in core ceramics.
1、开发了研究全瓷冠修复体破坏机理的实验和数值方法。提出了2mm厚切片试件的制作方法，通过Hertz接触理论和对比实验论证了2mm厚切片试件模拟全瓷冠修复体的有效性。利用DIC实现了在加载过程中检测各瓷层的裂纹扩展过程。基于逆向工程技术建立了右下第一磨牙全瓷冠三维数值模型，并验证了模型的收敛性。
2、研究了全瓷冠IPS e.max系统和Zirconia系统的破坏载荷和破坏方式。DIC分析获得了饰瓷亚表面的屈服损伤行为，起裂于亚表面的裂纹可穿透IPS e.max Press核瓷，导致IPS e.max Press核瓷发生整体破坏，但裂纹不能穿透Zirconia核瓷，导致Zirconia系统饰面瓷脱离。结果表明：裂纹不能由低弹性模量、低断裂韧性的饰瓷Vita VM9扩展到高弹性模量、高断裂韧性的核瓷Zirconia。通过三维轴对称接触模型分析得出剪应力引起剪切滑移裂纹，并在拉应力的驱动下扩展。全瓷材料的三维数值模拟表明，高弹性模量的核瓷能承担更多的咬合力，可有效地保护饰瓷和基牙。
3、研究了疲劳载荷对核瓷断裂韧性的影响。对IPS e.max Press和Zirconia瓷块进行疲劳加载，然后进行压痕实验测试断裂韧性，结果表明：IPS e.max Press断裂韧性显著降低（P=0.001），而Zirconia断裂韧性几乎不受疲劳载荷的影响（P>0.05）。这说明Zirconia的抗疲劳性能比IPS e.max Press的强。经疲劳载荷作用后，静态触压抗折能力实验也表明：IPS e.max系统受疲劳载荷影响承载能力显著下降，而Zirconia系统的承载能力下降不具有统计学意义。两者的实验结论一致。
4、研究了树脂粘接剂老化对全瓷冠承载能力和破坏方式的影响。分别在干燥和在水中存放老化的全瓷冠试件的颊尖施加静态触压载荷。结果发现：干燥的试件主要发生饰瓷崩瓷破坏；而经水老化的试件在小载荷作用颈部肩台处出现明显脱粘，并且IPS e.max试件发生核瓷下表面放射状裂纹破坏，承载能力显著地下降（P=0.000）；Zirconia系统仍以饰瓷崩瓷破坏为主，承载能力下降不具有统计学意义（P>0.05）。数值模拟分析表明，粘接剂老化会导致核瓷下表面的拉应力集中系数增大，增加放射状裂纹破坏的风险。此研究成果合理地解释了实验室测试与临床结果的差异。
5、研究了粘接剂弹性模量（Panavia F E=18.3GPa和Variolink IIE=8.3GPa）对全瓷冠承载能力的影响。静态触压破坏实验表明，两种粘接系统的IPS e.max试件的承载能力具有显著差异（P<0.05），高弹性模量的粘接剂可提高全瓷冠的承载能力。数值模拟分析表明，弹性模量大的粘接剂可降低全瓷冠拉应力水平。同时研究了粘接剂4种厚度模型（60、90、120、150μm）的应力分布水平，结果表明90μm厚模型的全瓷冠应力水平最低。
6、研究了树脂基体模量（Z100E=16.6GPa和Surefil E=9.3GPa）对全瓷冠承载能力的影响。静态触压破坏实验表明，弹性模量大的树脂基体可提高全瓷冠的承载能力。数值模拟结果显示，弹性模量大的树脂基体降低全瓷冠的拉应力水平。
All-ceramic crowns have been widely used in prosthodontics because oftheir stable biocompatibility and aesthetic characteristics. However, asthey are brittle materials and vulnerable to tensile failure, the surviverate is not satisfied. It is important to study the failure mechanisms ofall-ceramic crowns to improve the service life. Due to limitations oflaboratory test methods, the initiation and propagation of cracksoccurring in opaque stressed all-ceramic crowns was unable to beexamined. This doctorial dissertation proposed a unique experimanentaland numerical method and then studied the influences of all-ceramicmaterials, cement aging, cement types and resin substrate on theload-bearing capacity of all-ceramic crowns with intention to provideguidance for clinical applications. The main contributions of the studyare listed as follows：
1. The experimental and numerical methods for studying failuremechanism of all-ceramic crown restorations have been proposed.Sectioned all-ceramic crowns with2mm thickness have been designedand fabricated to study the failure mechanisms of all-ceramic crowns. DIC was carried out to detect the crack initiation and propagation inlayer structures during loading. The3D numerical model is developedbased on the geometry of the first mandible molar using reverseengineering technology. The convergence of the model was verified.
2. The fracture modes and critical fracture loads of all-ceramiccrowns for IPS e.max and Zirconia have been studied. Sub-surface yielddamge occurring in veneer was detected by DIC analysis during thequasistatic contact loading. Cracks initiated from subsurface penetratedinto the IPS e.max Press core and led to bulk fracture in IPS e.maxspecimens,while deflected in Zirconia core and caused chipping in theveneer layer. It is found that cracks are unlikely to propagate fromveneer with low-modulus and low-toughness ceramic (Vita VM9) to theceramics with high-modulus and high toughness ceramic (Zirconia).Results of the three-dimensional axisymmetric contact model showedthat cracks were caused by shear stress and were driven by tensile stress.The three-dimensional numerical simulation of all-ceramic crownsshowed that the core ceramics with high elastic modulus can bear largebite forces and protect veneer and dental substrate.
3. The effect of fatigue on fracture toughness of ceramics has beenstudied. The laboratory studies indicated that the fracture toughness ofIPS e.max Press reduced significantly with fatigue loads, while noappreciable variation was found in Zirconia. The fatigue resistance ofZirconia is much stronger than that of IPS e.max Press. The quasistaticcontact tests also suggested that the load-bearing capacity of IPS e.maxspecimens can be significantly affected by fatigue loads. Bothexperimental results were consistent.
4. The influence of cement aging on load-bearing capacities andfracture modes of all-ceramics has been studied. Quasi-static contactload is applied on buccal cusp bridge of dry and water aging specimens.Chipping was the dominant failure mode for dry specimens regardless ofthe ceramic types. An apparent debonding between the core andsubstrate was detected at a low loading level in water aging specimens.The load-bearing capacity for IPS e.max crowns were significantlyreduced with bulk failure due to cement aging, while zirconia specimens still underwent chipping with a slight drop of the load-bearing capacity.Numerical results indicated that cement aging could lead to tensile stressconcentration on the lower surface of the core and increase the risk ofradial cracks, which was detrimental to low-strength dental ceramics.The results of this study rationally explained the differences in thelaboratory tests and clinical examinations.
5. The effect of the elastic modulus of cements (Pavavia F E=18.3GPaand Variolink II E=8.3GPa) on load-bearing capacities and fracturemodes of all-ceramic has been studied. Quasi-static contact tests showedthat there was a significant difference in load-bearing capacities in thetwo types of adhesive specimens. The cement with high elastic moduluscould improve load-bearing capacity of all-ceramic crowns. Numericalresults demonstrated that the high elastic modulus of cement coulddecrease the tensile stress level in core ceramics. The optimal cementthickness of90μm was suggested from the four enumerated thicknesses(60,90,120and150μm). 6. The effect of elastic modulus of the resin substrate (Z100E=16.6GPa和Surefil E=9.3GPa) on load-bearing capacity and fracture mode ofall-ceramic crowns has been studied. Quasi-static contact tests showedthat there was a significant difference in load-bearing capacities in thetwo types of resin substrates. Numerical results demonstrated that thehigh elastic modulus of the resin substrate could decrease tensile stresslevels in core ceramics.
引文
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