Analysis of fracture and deformation modes in teeth subjected to occlusal loading

Nacre-like ceramic composites: Properties, functions and fabrication in the context of dental restorations

Dental restorations are in increasing demand, yet their success rate strongly decreases after 5-10 years post-implantation, attributed in part to mismatching properties with the surrounding buccal environment that causes failures and wear. Among current research to address this issue, biomimetic approaches are promising. Nacre-like ceramic composites are particularly interesting because they combine multiple antagonistic properties making them more resistant to failure in harsh environment than other materials. With the rapid progress in 3D printing producing nacre-like structures has open up new opportunities not yet realised. In this paper, nacre-like composites of various compositions are reviewed in the context of hypothetical biomimetic dental restorations. Their structural, functional and biological properties are compared with those of dentin, enamel, and bone to determine which composition would be the most suitable for each of the 3 mineralized regions found in teeth. The role of complex microstructures and mineral orientations are discussed as well as 3D printing methods that allow the design and fabrication of such complex architectures. Finally, usage of these processes and anticipated prospects for next generation biomimetic dental replacements are discussed to suggest future research directions in this area. STATEMENT OF SIGNIFICANCE: With the current ageing population, dental health is a major issue and current dental restorations still have shortcomings. For the next generation of dental restorations, more biomimetic approaches would be desirable to increase their durability. Among current materials, nacre-like ceramic composites are interesting because they can approach the various structural properties found in the different parts of our teeth. Furthermore, it is also possible to embed self-sensing functionalities to enable monitoring of oral health. Finally, new recent 3D printing technologies now permit the fabrication of complex shapes with local compositions and local microstructures. With this current status of the research, we anticipate new dental restorations designs and highlight the remaining gaps and issues to address.

Changes in the distribution of occlusal forces in the course of the orthodontic retention phase : A prospective cohort study

PURPOSE

Aim of the present study was to assess the relative distribution of occlusal forces after orthodontic treatment and during the first 3 months of the retention phase using a computerized occlusal analysis system (T-Scan, Tekscan Inc., Norwood, MA, USA).

MATERIALS AND METHODS

A total of 52 patients were included in this prospective cohort study and underwent analysis of occlusal forces on the level of tooth, jaw-half, and -quadrant during a 3-month period. Furthermore, differences between three retention protocols (group I: removable appliances in both jaws; group II: fixed 3-3 lingual retainers in both jaws; group III: removable appliance in the maxilla and fixed 3-3 lingual retainer in mandible) were assessed with Wilcoxon signed-rank tests at 5%.

RESULTS

Directly after debonding, measured forces distribution were similar to published references for untreated samples. In the following, no significant difference was found between retention protocols II and III with regard to the asymmetry of the anterior occlusal forces. Both groups maintained an asymmetric force distribution in the anterior segment during the study period. There was also no difference between groups II and III in the distribution of occlusal forces for the posterior segments. Both retention concepts kept the symmetrical distribution of occlusal forces stable over the observation period. The retention concept of group I demonstrated a symmetrical distribution of occlusal forces in the anterior segment after debonding and this remained stable during the 3‑month period. In the posterior segment, no improvement of the initially asymmetric masticatory force distribution could be observed.

CONCLUSIONS

All three studied retention protocols showed stability in retaining their original symmetrical or asymmetrical occlusal force distribution posteriorly/anteriorly during the 3‑month observation period. Therefore, an even distribution of occlusal forces should be the aim of the finishing phase, as no relative benefit of any single retention scheme in terms of post-debond improvement during the retention phase was seen.

The biomechanics of tooth strength: testing the utility of simple models for predicting fracture in geometrically complex teeth

Teeth must fracture foods while avoiding being fractured themselves. This study evaluated dome biomechanical models used to describe tooth strength. Finite-element analysis (FEA) tested whether the predictions of the dome models applied to the complex geometry of an actual tooth. A finite-element model was built from microCT scans of a human M3. The FEA included three loading regimes simulating contact between (i) a hard object and a single cusp tip, (ii) a hard object and all major cusp tips and (iii) a soft object and the entire occlusal basin. Our results corroborate the dome models with respect to the distribution and orientation of tensile stresses, but document heterogeneity of stress orientation across the lateral enamel. This implies that high stresses might not cause fractures to fully propagate between cusp tip and cervix under certain loading conditions. The crown is most at risk of failing during hard object biting on a single cusp. Geometrically simple biomechanical models are valuable tools for understanding tooth function but do not fully capture aspects of biomechanical performance in actual teeth whose complex geometries may reflect adaptations for strength.

Aspects of molar form and dietary proclivities of African colobines

This study investigates aspects of molar form in three African colobine species: Colobus polykomos, Colobus angolensis, and Piliocolobus badius. Our samples of C. polykomos and P. badius are from the Taï Forest, Ivory Coast; our sample of C. angolensis is from Diani, Kenya. To the extent that protective layers surrounding seeds are hard, we predicted that molar features related to hard-object feeding would be more pronounced in Colobus than they are Piliocolobus, as seed-eating generally occurs at higher frequencies in species of the former. We further predicted that among the colobines we studied, these features would be most pronounced in Taï Forest C. polykomos, which feeds on Pentaclethra macrophylla seeds encased within hard and tough seed pods. We compared overall enamel thickness, enamel thickness distribution, absolute crown strength, cusp tip geometry, and flare among molar samples. Sample sizes per species and molar type varied per comparison. We predicted differences in all variables except overall enamel thickness, which we expected would be invariant among colobines as a result of selection for thin enamel in these folivorous species. Of the variables we examined, only molar flare differed significantly between Colobus and Piliocolobus. Our findings suggest that molar flare, an ancient feature of cercopithecoid molars, was retained in Colobus but not in Piliocolobus, perhaps as a result of differences in the seed-eating proclivities of the two genera. Contrary to predictions, none of the aspects of molar form we investigated tracked current dietary differences in seed-eating between the two Colobus species. Finally, we explored the possibility that molar flare and absolute crown strength, when analyzed together, might afford greater differentiation among these colobine species. A multivariate t test of molar flare and absolute crown strength differentiated C. polykomos and P. badius, possibly reflecting known niche divergence between these two sympatric Taï Forest species.

Fatigue and wear of human tooth enamel: A review

Human tooth enamel must withstand the cyclic contact forces, wear, and corrosion processes involved with typical oral functions. Furthermore, unlike other human tissues, dental enamel does not have a significant capacity for healing or self-repair and thus the longevity of natural teeth in the oral environment depends to a large degree on the fatigue and wear properties of enamel. The purpose of this review is to provide an overview of our understanding of the fatigue and wear mechanisms of human enamel and how they relate to in vivo observations of tooth damage in the complex oral environment. A key finding of this review is that fatigue and wear processes are closely related. For example, the presence of abrasive wear particles significantly lowers the forces needed to initiate contact fatigue cracking while subsurface fatigue crack propagation drives key delamination wear mechanisms during attrition or attrition-corrosion of enamel. Furthermore, this review seeks to bring a materials science and mechanical engineering perspective to fatigue and wear phenomena. In this regard, we see developing a mechanistic description of fatigue and wear, and understanding the interconnectivity of the processes, as essential for successfully modelling enamel fatigue and wear damage and developing strategies and treatments to improve the longevity of our natural teeth. Furthermore, we anticipate that this review will stimulate ideas for extending the lifetime of the natural tooth structure and will help highlight where our understanding is too limited and where additional research into fatigue and wear of human tooth enamel is warranted.

Estimates of absolute crown strength and bite force in the lower postcanine dentition of Gigantopithecus blacki

Gigantopithecus blacki is hypothesized to have been capable of processing mechanically challenging foods, which likely required this species to have high dental resistance to fracture and/or large bite force. To test this hypothesis, we used two recently developed approaches to estimate absolute crown strength and bite force of the lower postcanine dentition. Sixteen Gigantopithecus mandibular permanent cheek teeth were scanned by micro-computed tomography. From virtual mesial cross-sections, we measured average enamel thickness and bi-cervical diameter to estimate absolute crown strength, and cuspal enamel thickness and dentine horn angle to estimate bite force. We compared G. blacki with a sample of extant great apes (Pan, Pongo, and Gorilla) and australopiths (Australopithecus anamensis, Australopithecus afarensis, Australopithecus africanus, Paranthropus robustus, and Paranthropus boisei). We also evaluated statistical differences in absolute crown strength and bite force between the premolars and molars for G. blacki. Results reveal that molar crown strength is absolutely greater, and molar bite force absolutely higher, in G. blacki than all other taxa except P. boisei, suggesting that G. blacki molars have exceptionally high resistance to fracture and the ability to generate exceptionally high bite force. In addition, G. blacki premolars have comparable absolute crown strength and larger bite force capabilities compared with its molars, implying possible functional specializations in premolars. The dental specialization of G. blacki could thus represent an adaptation to further facilitate the processing of mechanically challenging foods. While it is currently not possible to determine which types of foods were actually consumed by G. blacki through this study, direct evidence (e.g. dental chipping and microwear) left by the foods eaten by G. blacki could potentially lead to greater insights into its dietary ecology.

Probability of survival and failure mode of endodontically treated incisors without ferrule restored with CAD/CAM fiber-reinforced composite (FRC) post-cores

PURPOSE

This study evaluated the probability of survival and failure mode of endodontically treated incisors without ferrule restored with CAD/CAM FRC post-cores.

METHODS

Root canals of bovine incisors were treated, leaving post preparations of ∼10 mm. Teeth were allocated into three groups: (i) cast metal post-core, (ii) FRC prefabricated post with a direct resin core build-up, and (iii) CAD/CAM FRC post-core. Posts and zirconia crowns were cemented using resin cement. Specimens were subjected to step-stress accelerated-life fatigue testing in water. Use level probability Weibull curves, probability of survival for a mission of 100,000 cycles at 25, 50, and 100 N, Weibull modulus, and characteristic strength were calculated and plotted. Failure mode was examined under a stereomicroscope.

RESULTS

Restored incisors demonstrated high probability of survival (93-100%) for missions estimated at 25 and 50 N, irrespective of post-core foundation. At 100 N, incisors restored with metal posts presented significantly higher probability of survival (99%) relative to CAD/CAM posts (79%), whereas FRC groups demonstrated no significant difference. Weibull analysis indicated no significant difference on the Weibull modulus (m = 3.38-5.92). Incisors reconstructed with metal post-cores (431 N) presented significantly higher characteristic strength relative to prefabricated (200 N) and CAD/CAM (202 N) FRC post-cores. While post fracture was the chief failure mode for prefabricated and CAD/CAM FRC post-cores, post and/or root fracture were the main event for metal post-cores.

CONCLUSION

Endodontically treated incisors without ferrule restored with CAD/CAM FRC post-cores presented promising probability of survival for loads compatible with anterior masticatory forces and favorable failure modes.

Molar form, enamel growth, and durophagy in Cercocebus and Lophocebus

Objectives

To test the hypothesis that differences in crown structure, enamel growth, and crown geometry in Cercocebus and Lophocebus molars covary with differences in the feeding strategies (habitual vs. fallback durophagy, respectively) of these two genera. Relative to Lophocebus molars, Cercocebus molars are predicted to possess features associated with greater fracture resistance and to differ in enamel growth parameters related to these features.

Materials and Methods

Sample proveniences are as follows: Cercocebus atys molars are from the Taï Forest, Ivory Coast; Lophocebus albigena molars are from a site north of Makoua, Republic of Congo; and a Lophocebus atterimus molar is from the Lomako Forest, Democratic Republic of Congo. For μCT scans on which aspects of molar form were measured, sample sizes ranged from 5 to 35 for Cercocebus and 3 to 12 for Lophocebus. A subsample of upper molars was physically sectioned to measure enamel growth variables.

Results

Partly as a function of their larger size, Cercocebus molars had significantly greater absolute crown strength (ACS) than Lophocebus molars, supporting the hypothesis. Greater crown heights in Cercocebus are achieved through faster enamel extension rates. Also supporting the hypothesis, molar flare and proportional occlusal basin enamel thickness were significantly greater in Cercocebus. Relative enamel thickness (RET), however, was significantly greater in Lophocebus.

Discussion

If ACS is a better predictor of fracture resistance than RET, then Cercocebus molars may be more fracture resistant than those of Lophocebus. Greater molar flare and proportional occlusal basin thickness might also afford Cercocebus molars greater fracture resistance.

Special architecture and anti-wear strategies for giant panda tooth enamel: Based on wear simulation findings

Giant pandas are the flagship species in world conservation. Due to bamboo being the primary food source for giant pandas, dental wear is common owing to the extreme toughness of the bamboo fiber. Even though research on tooth enamel wear in humans and domestic animals is well-established, research on tooth enamel wear in giant pandas is scarce. The purpose of this study is to evaluate tooth enamel wear resistance in giant pandas to provide a basis for a better understanding of their evolutionary process. From microscopic and macroscopic perspectives, the abrasion resistance of dental enamel in giant pandas is compared with that of herbivorous cattle and carnivorous dogs in this study. This involves the use of micro-scratch and frictional wear tests. The results show that the boundary between the enamel prism and the enamel prism stroma is well-defined in panda and canine teeth, while bovine tooth enamel appears denser. Under constant load, the tribological properties of giant panda enamel are similar to those of canines and significantly different from those of bovines. Test results show that the depth of micro scratches in giant panda and canine enamel was greater than in cattle, with greater elastic recovery occurring in dogs. Scratch morphology indicates that the enamel substantive damage critical value is greater in pandas than in both dogs and cattle. The analysis suggests that giant panda enamel consists of a neatly arranged special structure that may disperse extrusion stress and absorb impact energy through a series of inelastic deformation mechanisms to cope with the wear caused by eating bamboo. In this study, the excellent wear resistance of giant panda's tooth enamel is verified by wear tests. A possible theoretical explanation of how the special structure of giant panda tooth enamel may improve its wear resistance is provided. This provides a direction for subsequent theoretical and experimental studies on giant panda tooth enamel and its biomaterials.

Fractographic analysis of 35 clinically fractured bi-layered and monolithic zirconia crowns

OBJECTIVES

The aim of this retrieval study was to analyze the fracture features and identify the fracture origin of zirconia-based single crowns that failed during clinical use.

METHODS

Thirty-five fractured single crowns were retrieved from dental practices (bi-layered, n=15; monolithic, n=20). These were analyzed according to fractographic procedures by optical and scanning electron microscopy to identify fracture patterns and fracture origins. The fracture origins were closely examined. The crown margin thickness and axial wall height were measured.

RESULTS

Three types of failure modes were observed: total fractures, marginal semilunar fractures, and incisal chippings. Most of the crowns (23) had fracture origins at the crown margin and seven of them had defects in the fracture origin area. The exact fracture origin was not possible to identify due to missing parts in four crowns. The crown wall thickness was 20% thinner and wall height 30% shorter in the fracture origin area compared to the opposite side.

CONCLUSIONS

The findings in this study show that fractography can reveal fracture origins and fracture modes of both monolithic and bi-layered dental zirconia. The findings indicate that the crown margin on the shortest axial wall is the most common fracture origin site.

CLINICAL SIGNIFICANCE

Crown design factors such as material thickness at the margin, axial wall height and preparation type affects the risk of fracture. It is important to ensure that the crown margins are even and flawless.

Hunter-Schreger Band configuration in human molars reveals more decussation in the lateral enamel of 'functional' cusps than 'guiding' cusps

OBJECTIVES

Enamel prism decussation, which manifests as Hunter-Schreger Bands (HSB), is considered a mechanism to mitigate crack propagation. During the chewing cycle, the 'functional' cusps that are involved in Phase II crushing and grinding experience more complex patterns of stress than do those that 'guide' the molars into occlusion (Phase I). This study examines HSB configuration in the lateral enamel of human molars to identify potential differences between these cusps as predicted from their functional distinctions.

DESIGN

Measurements were recorded from scanning electron micrographs of sections through the mesial cusps of unworn permanent molars. For each section, HSB packing density and the relative thickness of decussated enamel were quantified in the cuspal and middle segments of lateral enamel over the guiding and functional cusps.

RESULTS

No clear trend from first to third molars in HSB configuration was found in either jaw. In maxillary molars, the functional cusp displays higher HSB packing density in the cuspal and middle segments, and relatively thicker decussated enamel in the cuspal segment than does the guiding cusp. In mandibular molars, the functional cusp displays higher HSB packing density in the middle segment than does the guiding cusp, but no difference in relative thickness was found between them. Enamel of mandibular molars shows weaker decussation than maxillary molars.

CONCLUSIONS

The results suggest that guiding cusps are intrinsically more susceptible to crack propagation than functional cusps in human permanent molars. Structural factors such as enamel decussation should be considered when interpreting enamel chipping patterns in dietary contexts.

On the Mechanical Properties of Hybrid Dental Materials for CAD/CAM Restorations

Two hybrid dental materials available for computer-aided design and manufacturing (CAD/CAM) dental restorations have been selected to explore their potential. On the one hand, the scarcely investigated polymer-based material Vita Enamic^® (VE) and, on the other hand, the leucite-based material IPS Empress^® CAD (EC). Their micro-structure and mechanical performance were analyzed in two environments: directly as received by the manufacturer (AR), and after immersion and storage in artificial saliva (AS) for 30 days to determine the influence of the saliva effect. To avoid an inappropriate selection of materials for clinical use, a full understanding of their mechanical behavior is essential. Therefore, this investigation aims to determine the micro-structural and chemical composition by field emission scanning electron microscopy (FE-SEM) and X-ray fluorescence analysis, establishing the density, micro- and nano-hardness, the nano-elastic modulus, and the flexural strength and fracture toughness (by introducing a femto-laser notch to replicate a real crack). In addition, fracture surfaces of the broken samples were analyzed to correlate the failure micro-mechanisms with their mechanical properties. Results indicate that while the crystalline phase of the materials is very similar (composed of SiO₂ and Al₂O₃), the micro-structure and mechanical behavior is not. The material EC, with finer micro-structure, exhibits a higher mechanical performance but with greater variability of results. Furthermore, the material VE, with a 25 vol.% polymer phase, shows a mechanical performance similar to enamel and dentin and therefore more similar to human behavior.

Characterisation of mechanical and surface properties of novel biomimetic interpenetrating alumina-polycarbonate composite materials

OBJECTIVE

To determine the mechanical and surface characteristics of two novel biomimetic interpenetrating phase alumina-polycarbonate (Al₂O₃-PC) composite materials, comprising aligned honeycomb-like porous ceramic preforms infiltrated with polycarbonate polymer.

METHOD

Two composite materials were produced and characterised. Each comprised a porous structure with a ceramic-rich (polymer-poor) top layer, graduated through to a more porous ceramic-poor (polymer-rich) bottom layer. In addition, pure polycarbonate and dense alumina specimens were subjected to the same characterisation namely: density, compression, three-point bend, hardness, surface loss and surface roughness testing. Scanning electron microscopy and micro computerised tomography were employed for structural examination.

RESULTS

Three-dimensional aligned honeycomb-like ceramic structures were produced and full interpenetration of the polymer phase was observed using MicroCT. Depending on the ceramic volume in the initial aqueous ceramic suspension, the density of the final interpenetrating composites ranged from 2.64 to 3.01g/cm³, compressive strength ranged from 192.43 to 274.91MPa, flexural strength from 105.54 to 148.47MPa, fracture toughness from 2.17 to 3.11MPa.m^½, hardness from 0.82 to 1.52GPa, surface loss from 0.71 to 1.40μm and surface roughness, following tooth brushing, from 0.70 to 0.99μm. Composite specimens showed characteristic properties part way between enamel and polycarbonate.

SIGNIFICANCE

There was a correlation between the initial solid ceramic loading in the aqueous suspension, used to produce the porous ceramic scaffolds, and the subsequent characteristic properties of the composite materials. These novel composites show potential as aesthetic orthodontic bracket materials, as their properties fit part way between those of ceramic, enamel and polycarbonate.

Beyond Description: The Many Facets of Dental Biomechanics

Teeth lie at the interface between an animal and its environment and, with some exceptions, act as a major component of resource procurement through food acquisition and processing. Therefore, the shape of a tooth is closely tied to the type of food being eaten. This tight relationship is of use to biologists describing the natural history of species and given the high instance of tooth preservation in the fossil record, is especially useful for paleontologists. However, correlating gross tooth morphology to diet is only part of the story, and much more can be learned through the study of dental biomechanics. We can explore the mechanics of how teeth work, how different shapes evolved, and the underlying forces that constrain tooth shape. This review aims to provide an overview of the research on dental biomechanics, in both mammalian and non-mammalian teeth, and to synthesize two main approaches to dental biomechanics to develop an integrative framework for classifying and evaluating dental functional morphology. This framework relates food material properties to the dynamics of food processing, in particular how teeth transfer energy to food items, and how these mechanical considerations may have shaped the evolution of tooth morphology. We also review advances in technology and new techniques that have allowed more in-depth studies of tooth form and function.

The influence of storage temperature on fracture behavior of cryopreserved teeth-An in vitro study

Objectives

Cryopreservation is discussed as a viable method of preserving teeth for determined autogenous tooth transplantation. Unchanged physical properties of hard tooth tissues are crucial for functional healing. Due to different thermal expansion coefficients of enamel and dentin or the crystallization process, the freezing process may lead to crack formation, which could adversely impact the long‐term prognosis of the teeth.

Material and methods

Twenty third molars (n = 20) were frozen slowly using a conservative cryopreservation protocol and stored at −80°C (group 1) and −196°C (group 2). After a storage time of 2 weeks, the samples were thawed to a temperature of +36°C and embedded in polymethyl methacrylate blocks. Cyclic loading was carried out using a spherical steel test specimen with 50,000 mechanical load cycles, followed by load to failure testing for determination of critical load.

Results

No significant difference in the first load drop could be detected during the load to failure test under different storage conditions. The values until fracture correlated very closely in contralateral tooth pairs, which emphasizes the importance of crown geometry in load to failure tests.

Conclusions

Conclusions: Cryopreservation, specifically the storage temperature, does not appear to have a significant effect on the physical properties of tooth transplants.

Breaking crown dentine in whole teeth: 3D observations of prevalent fracture patterns following overload

Teeth with intact crowns rarely split or fracture, despite decades of cyclic loading and occasional unexpected overload. This is largely attributed to the presence of dentine, since cracking and fracture of enamel have been frequently reported. Dentine is similar to bone, comprising mineralised collagen fibres as a main constituent. Unlike cortical bone, however, where microcracking and damage arrest are essential for re/modelling and healing, dentine can neither remodel nor regenerate. This raises questions regarding the evolutionary benefits of toughening, leading to uncertainty whether cracks actually appear in dentine in situ. Here we study the notion that circumpulpal dentine is usually protected against, rather than damaged by severe overloads, even though it is not much more massive or stronger than it needs to be. To address this, we examined hydrated teeth still within whole jawbones of freshly-slaughtered skeletally mature pigs, mechanically loaded until fracture. Force displacement curves, optical and electron microscopy combined with 3D microstructural analysis by conventional micro-computed tomography (μCT) revealed mostly brittle fracture paths in circumpulpal crown dentine. Once overload cracks reach this mass of dentine they propagate rapidly along straight paths often parallel to the enamel flanks of the oblong shovel shaped premolars. We find infrequent signs of active toughening mechanisms with minimal crack diversion, ligament bridging and microcracking. When such toughening is seen, it mainly appears in softer dentine in the root, or near the dentine-enamel-junction (DEJ) in mantle dentine. We observed shear bands in overloaded circumpulpal dentine, due to mutual gliding of upper and lower segments. These shear bands are formed as periodic arrays of rotated dentine fragments. The 3D data consistently demonstrate the importance of the layered tooth structure, containing a stiff outer enamel shell, a soft sub-DEJ interlayer and a stiff circumpulpal dentine bulk, for deflecting cracks from splitting the tooth.

Enamel thickness and growth rates in modern human permanent first molars over a 2000 year period in Britain

OBJECTIVES

This study explores variation and trends in first molar enamel thickness and daily enamel secretion rates over a 2000 year period in Britain.

METHODS

Permanent first molars (n = 89) from the Roman, Anglo-Saxon, and Medieval periods, as well as modern-day Britain, were analyzed using standard histological methods. Relative enamel thickness (RET) and linear measurements of cuspal and lateral thickness were calculated for mesial cusps. Daily secretion rates (DSRs) were calculated for inner, mid, and outer enamel regions in both cuspal and lateral enamel. Significant differences and trends were identified between samples using nonparametric statistical tests.

RESULTS

Enamel thickness differed between some populations, but no temporal trends were identified. Early Anglo-Saxon molars had significantly thinner RET than both Late Anglo-Saxon (p < .00) and Medieval (p < .00) molars. Lateral enamel from the Roman molars was significantly thinner than the modern-day sample (p = .04). In contrast, a significant slowing trend in DSRs was observed across the more ancient to modern-day samples in every measured region except the mid-lateral enamel region.

DISCUSSION

This study presents the first evidence for a gradual slowing in the daily rate that enamel is secreted in molars over the past 2000 years in Britain. However, this trend was not matched by consistent or significant positive or negative shifts in enamel thickness. These findings suggest that modern human molars of similar enamel thickness, from different modern and ancient populations, formed at different rates.

Fracture mechanics, enamel thickness and the evolution of molar form in hominins

As the tissue most directly responsible for breaking down food in the oral cavity, the form and function of enamel is obviously of evolutionary significance in humans, non-human primates and other vertebrates. Accordingly, a standard metric, relative enamel thickness (RET), has been used for many decades to provide insights into vertebrate and human palaeobiology. Relatively thick enamel has evolved many times in vertebrates including hominoids (the group to which living humans and fossil hominins belong), and this pattern is thought to provide information about taxonomy, phylogeny, functional anatomy and diet. In particular, relatively thick enamel is thought to make tooth crowns strong so that they resist fractures associated with eating mechanically resistant foods. Here, we use current models of tooth biomechanics to show that RET is at best only moderately informative of function and diet in living hominoids and fossil hominins, and at worst provides misleading information. We propose a new metric, absolute crown strength, to assess the resistance of teeth to fracture, and identify what may be a novel characteristic of tooth strength in fossil hominins.

The dental microwear of hard-object feeding in laboratory Sapajus apella and its implications for dental microwear formation

OBJECTIVES

This study seeks to determine if (a) consumption of hard food items or a mixture of food items leads to the formation of premolar or molar microwear in laboratory capuchin monkeys (Sapajus apella) in one feeding session and (b) rates of microwear formation are associated with the number of food items consumed.

MATERIALS AND METHODS

Five adult male capuchins were used in two experiments, one where they were fed unshelled Brazil nuts, and the other where they were fed a mixture of food items. Dental impressions were taken before and after each feeding session. Epoxy casts made from those impressions then were used in SEM analyses of rates of microwear formation. Upper and lower premolars and molars were analyzed. Qualitative comparisons were made and Spearman's rank-order correlations used to examine the relationship between rates of microwear formation and number of Brazil nuts consumed.

RESULTS

Premolars and molars generally showed new microwear in the form of pits and scratches. However, the incidence of those features was low (0-6%). Rates of microwear formation were highest during the consumption of Brazil nuts.

DISCUSSION

Variations in the rate of microwear formation on the premolars likely reflected patterns of ingestion whereas consistency in the rate of microwear on the molars likely reflected patterns of chewing. While dental microwear formation seemed to be correlated with the number of hard objects consumed, rates did differ between individuals. Differences in results between the two experiments demonstrate some of the limitations in our knowledge of dental microwear formation.

Downregulation of FGF Signaling by Spry4 Overexpression Leads to Shape Impairment, Enamel Irregularities, and Delayed Signaling Center Formation in the Mouse Molar

FGF signaling plays a critical role in tooth development, and mutations in modulators of this pathway produce a number of striking phenotypes. However, many aspects of the role of the FGF pathway in regulating the morphological features and the mineral quality of the dentition remain unknown. Here, we used transgenic mice overexpressing the FGF negative feedback regulator Sprouty4 under the epithelial keratin 14 promoter (K14‐Spry4) to achieve downregulation of signaling in the epithelium. This led to highly penetrant defects affecting both cusp morphology and the enamel layer. We characterized the phenotype of erupted molars, identified a developmental delay in K14‐Spry4 transgenic embryos, and linked this with changes in the tooth developmental sequence. These data further delineate the role of FGF signaling in the development of the dentition and implicate the pathway in the regulation of tooth mineralization. © 2019 The Authors. JBMR Plus is published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

The Materials of Mastication: Material Science of the Humble Tooth

Dental functional morphology, as a field, represents a confluence of materials science and biology. Modern methods in materials testing have been influential in driving the understanding of dental tissues and tooth functionality. Here we present a review of dental enamel, the outermost tissue of teeth. Enamel is the hardest biological tissue and exhibits remarkable resilience even when faced with a variety of mechanical threats. In the light of recent work, we progress the argument that the risk of mechanical degradation across multiple scales exhibits a strong and continued selection pressure on structural organization of enamel. The hierarchical nature of enamel structure presents a range of scale-dependent toughening mechanisms and provides a means by which natural selection can drive the specialization of this tissue from nanoscale reorganization to whole tooth morphology. There has been much learnt about the biomechanics of enamel recently, yet our understanding of the taxonomic diversity of this tissue is still lacking and may form an interesting avenue for future research.

Wear of ceramic-based dental materials

An investigation is made of wear mechanisms in a suite of dental materials with a ceramic component and tooth enamel using a laboratory test that simulates clinically observable wear facets. A ball-on-3-specimen wear tester in a tetrahedral configuration with a rotating hard antagonist zirconia sphere is used to produce circular wear scars on polished surfaces of dental materials in artificial saliva. Images of the wear scars enable interpretation of wear mechanisms, and measurements of scar dimensions quantify wear rates. Rates are lowest for zirconia ceramics, highest for lithium disilicate, with feldspathic ceramic and ceramic-polymer composite intermediate. Examination of wear scars reveals surface debris, indicative of a mechanism of material removal at the microstructural level. Microplasticity and microcracking models account for mild and severe wear regions. Wear models are used to evaluate potential longevity for each dental material. It is demonstrated that controlled laboratory testing can identify and quantify wear susceptibility under conditions that reflect the essence of basic occlusal contact. In addition to causing severe material loss, wear damage can lead to premature tooth or prosthetic failure.

Hydration-induced nano- to micro-scale self-recovery of the tooth enamel of the giant panda

The tooth enamel of vertebrates comprises a hyper-mineralized bioceramic, but is distinguished by an exceptional durability to resist impact and wear throughout the lifetime of organisms; however, enamels exhibit a low resistance to the initiation of large-scale cracks comparable to that of geological minerals based on fracture mechanics. Here we reveal that the tooth enamel, specifically from the giant panda, is capable of developing durability through counteracting the early stage of damage by partially recovering its innate geometry and structure at nano- to micro- length-scales autonomously. Such an attribute results essentially from the unique architecture of tooth enamel, specifically the vertical alignment of nano-scale mineral fibers and micro-scale prisms within a water-responsive organic-rich matrix, and can lead to a decrease in the dimension of indent damage in enamel introduced by indentation. Hydration plays an effective role in promoting the recovery process and improving the indentation fracture toughness of enamel (by ∼73%), at a minor cost of micro-hardness (by ∼5%), as compared to the dehydrated state. The nano-scale mechanisms that are responsible for the recovery deformation, specifically the reorientation and rearrangement of mineral fragments and the inter- and intra-prismatic sliding between constituents that are closely related to the viscoelasticity of organic matrix, are examined and analyzed with respect to the structure of tooth enamel. Our study sheds new light on the strategies underlying Nature's design of durable ceramics which could be translated into man-made systems in developing high-performance ceramic materials. STATEMENT OF SIGNIFICANCE: Tooth enamel plays a critical role in the function of teeth by providing a hard surface layer to resist wear/impact throughout the lifetime of organisms; however, such enamel exhibits a remarkably low resistance to the initiation of large-scale cracks, of hundreds of micrometers or more, comparable to that of geological minerals. Here we reveal that tooth enamel, specifically that of the giant panda, is capable of partially recovering its geometry and structure to counteract the early stages of damage at nano- to micro-scale dimensions autonomously. Such an attribute results essentially from the architecture of enamel but is markedly enhanced by hydration. Our work discerns a series of mechanisms that lead to the deformation and recovery of enamel and identifies a unique source of durability in the enamel to accomplish this function. The ingenious design of tooth enamel may inspire the development of new durable ceramic materials in man-made systems.

Recent advances in understanding the fatigue and wear behavior of dental composites and ceramics

Dental composite and ceramic restorative materials are designed to closely mimic the aesthetics and function of natural tooth tissue, and their longevity in the oral environment depends to a large degree on their fatigue and wear properties. The purpose of this review is to highlight some recent advances in our understanding of fatigue and wear mechanisms, and how they contribute to restoration failures in the complex oral environment. Overall, fatigue and wear processes are found to be closely related, with wear of dental ceramic occlusal surfaces providing initiation sites for fatigue failures, and subsurface fatigue crack propagation driving key wear mechanisms for composites, ceramics, and enamel. Furthermore, both fatigue and wear of composite restorations may be important in enabling secondary caries formation, which is the leading cause of composite restoration failures. Overall, developing a mechanistic description of fatigue, wear, and secondary caries formation, along with understanding the interconnectivity of all three processes, are together seen as essential keys to successfully using in vitro studies to predict in vivo outcomes and develop improved dental restorative materials.

On the Materials Science of Nature's Arms Race

Biological material systems have evolved unique combinations of mechanical properties to fulfill their specific function through a series of ingenious designs. Seeking lessons from Nature by replicating the underlying principles of such biological materials offers new promise for creating unique combinations of properties in man-made systems. One case in point is Nature's means of attack and defense. During the long-term evolutionary "arms race," naturally evolved weapons have achieved exceptional mechanical efficiency with a synergy of effective offense and persistence-two characteristics that often tend to be mutually exclusive in many synthetic systems-which may present a notable source of new materials science knowledge and inspiration. This review categorizes Nature's weapons into ten distinct groups, and discusses the unique structural and mechanical designs of each group by taking representative systems as examples. The approach described is to extract the common principles underlying such designs that could be translated into man-made materials. Further, recent advances in replicating the design principles of natural weapons at differing lengthscales in artificial materials, devices and tools to tackle practical problems are revisited, and the challenges associated with biological and bioinspired materials research in terms of both processing and properties are discussed.

Enamel Microcracks Induced by Simulated Occlusal Wear in Mature, Immature, and Deciduous Teeth

Enamel wear, which is inevitable due to the process of mastication, is a process in which the microcracking of enamel occurs due to the surface contacting very small hard particles. When these particles slide on enamel, a combined process of microcutting and microcracking in the surface and subsurface of the enamel takes place. The aim of this study was to detect microscopic differences in the microcrack behavior by subjecting enamel specimens derived from different age groups (immature open-apex premolars, mature closed-apex premolars, and deciduous molars) to cycles of simulated impact and sliding wear testing under controlled conditions. Our findings indicated that the characteristics of the microcracks, including the length, depth, count, orientation, and relation to microstructures differed among the study groups. The differences between the surface and subsurface microcrack characteristics were most notable in the enamel of deciduous molars followed by immature premolars and mature premolars whereby deciduous enamel suffered numerous, extensive, and branched microcracks. Within the limitations of this study, it was concluded that enamel surface and subsurface microcracks characteristics are dependent on the posteruptive age with deciduous enamel being the least resistant to wear based on the microcrack behavior as compared to permanent enamel.

Effects of Ceramic Density and Sintering Temperature on the Mechanical Properties of a Novel Polymer-Infiltrated Ceramic-Network Zirconia Dental Restorative (Filling) Material

BACKGROUND Polymer-infiltrated ceramic-network (PICN) dental material is a new and practical development in orthodontics. Sintering is the process of forming a stable solid mass from a powder by heating without melting. The aim of this study was to evaluate the effects of sintering temperature on the mechanical properties of a PICN zirconia dental material. MATERIAL AND METHODS A dense zirconia ceramic and four PICN zirconia dental materials, with varying porosities, were sintered at three different temperatures; 12 PICN zirconia dental materials based on these porous ceramics were prepared, as well as a pure polymer. After the specimen preparation, flexural strength and elastic modulus values were measured using the three-point bending test, and fracture toughness were determined by the single-edge notched beam (SENB) method. The Vickers hardness test method was used with an indentation strength (IS) test. Scanning electron microscopy (SEM) was used to examine the microstructure of the ceramic surface and the fracture surface. RESULTS Mechanical properties of the PICN dental materials, including flexural strength, elastic modulus, fracture toughness, and hardness, were more similar to the properties of natural teeth when compared with traditional dental ceramic materials, and were affected by the density and sintering temperature. SEM showed that the porous ceramic network became cohesive and that the length of cracks in the PICN dental material was reduced. CONCLUSIONS PICN zirconia dental materials were characterized by similar mechanical properties to natural dental tissues, but further studies are required continue to improve the similarities with natural human enamel and dentin.

Fabrication and characterisation of a novel biomimetic anisotropic ceramic/polymer-infiltrated composite material

OBJECTIVE

To fabricate and characterise a novel biomimetic composite material consisting of aligned porous ceramic preforms infiltrated with polymer.

METHOD

Freeze-casting was used to fabricate and control the microstructure and porosity of ceramic preforms, which were subsequently infiltrated with 40-50% by volume UDMA-TEGDMA polymer. The composite materials were then subjected to characterisation, namely density, compression, three-point bend, hardness and fracture toughness testing. Samples were also subjected to scanning electron microscopy and computerised tomography (Micro-CT).

RESULTS

Three-dimensional aligned honeycomb-like ceramic structures were produced and full interpenetration of the polymer phase was observed using micro-CT. Depending on the volume fraction of the ceramic preform, the density of the final composite ranged from 2.92 to 3.36g/cm³, compressive strength ranged from 206.26 to 253.97MPa, flexural strength from 97.73 to 145.65MPa, hardness ranged from 1.46 to 1.62GPa, and fracture toughness from 3.91 to 4.86MPam^1/2.

SIGNIFICANCE

Freeze-casting provides a novel method to engineer composite materials with a unique aligned honeycomb-like interpenetrating structure, consisting of two continuous phases, inorganic and organic. There was a correlation between the ceramic fraction and the subsequent, density, strength, hardness and fracture toughness of the composite material.

Mechanical performance of polymer-infiltrated zirconia ceramics

OBJECTIVE

The aim of this study was to evaluate the microstructure and mechanical behavior of polymer-infiltrated zirconia ceramics as a function of pre-sintering temperature (1000-1150°C).

METHODS

Polymer-infiltrated zirconia ceramics were prepared by combining the porous zirconia networks and polymer through infiltration and polymerization. XRD was employed to determine phase structure. The microstructure and fracture mechanism were observed by SEM. Flexural strength and fracture toughness were measured by three-point bending method and single-edge-notched beam method, respectively. A nanoindentation system was employed to determine elastic modulus and hardness.

RESULTS

Different porosities and polymer contents can be obtained by tuning the pre-sintered temperature of zirconia ceramic precursors. Zirconia network porosity varies from 46.3% to 34.7% and the relevant polymer content ranges from 18.4wt.% to 12.3wt.% when the pre-sintered temperature is set from 1000°C to 1150°C. The flexural strength, fracture toughness, hardness, and elastic modulus values of the specimen pre-sintered at 1150°C are 240.9MPa, 3.69MPam^1/2, 3.1GPa, and 58.8GPa, respectively.

CONCLUSION

The pre-sintering temperature has a significant effect on the microstructure and mechanical properties of polymer-infiltrated zirconia ceramics and the optimal pre-sintering temperature is 1150°C.

CLINICAL SIGNIFICANCE

Specimen pre-sintered at 1150°C shows tooth-like mechanical properties, suggesting a promising restorative material in dental clinic. Moreover, the synthesis process is simple and can be easily performed in a prosthesis laboratory.

On the Relationship Between Tooth Shape and Masticatory Efficiency: A Finite Element Study

Dental topography has successfully linked disparate tooth shapes to distinct dietary categories, but not to masticatory efficiency. Here, the relationship between four dental topographic metrics and brittle food item breakdown efficiency during compressive biting was investigated using a parametric finite element model of a bunodont molar. Food item breakdown efficiency was chosen to represent masticatory efficiency as it isolated tooth-food item interactions, where most other categories of masticatory efficiency include several aspects of the masticatory process. As relative food item size may affect the presence/absence of any relationship, four isometrically scaled, hemispherical, proxy food items were considered. Topographic metrics were uncorrelated to food item breakdown efficiency irrespective of relative food item size, and dental topographic metrics were largely uncorrelated to one another. The lack of a correlation between topographic metrics and food item breakdown efficiency is not unexpected as not all food items break down in the same manner (e.g., nuts are crushed, leaves are sheared), and only one food item shape was considered. In addition, food item breakdown efficiency describes tooth-food item interactions and requires location and shape specific information, which are absent from dental topographic metrics. This makes it unlikely any one efficiency metric will be correlated to all topographic metrics. These results emphasize the need to take into account how food items break down during biting, ingestion, and mastication when investigating the mechanical relationship between food item shape, size, mechanical properties, and breakdown, and tooth shape.

On the importance of aging to the crack growth resistance of human enamel

With improvements in oral health and an overall increase in quality of life, the percentage of fully or largely dentate seniors is increasing. Understanding the effects of aging on the mechanical properties of teeth is essential to the maintenance of lifelong oral health. In this investigation the effects of aging on the fracture toughness of human enamel were evaluated from incremental crack growth experiments performed on tissue of donor teeth representing "young" (17 ⩽ age ⩽ 25) and "old" (age ⩾ 55) age groups. Results showed that the old enamel exhibited significantly lower resistance to fracture than that of the young tissue in two orthogonal directions of crack growth. For crack growth transverse to the enamel rods, the fracture toughness of the old enamel (0.37 ± 0.15 MPa m(0.5)) was nearly 70% lower than that of tissue from the young teeth (1.23 ± 0.20 MPa m(0.5)). Based on results from a mechanistic analysis of crack growth, the reduction in fracture resistance is attributed to a decrease in the degree of extrinsic toughening. The practice of restorative dentistry should account for these changes in tooth tissues in the treatment of senior patients.

STATEMENT OF SIGNIFICANCE

The mechanical behavior of enamel has been studied for over 3 decades. Due to the limited volume of tissue available for evaluation, past work has been largely based on indentation methods. In this investigation we have evaluated the resistance to fracture of human enamel using a conventional fracture mechanics approach and incremental crack growth. We compared the fracture resistance of cuspal enamel obtained from the teeth of representative "young" and "old" donor groups. Our results show that there is a substantial reduction in the resistance to fracture with age, that it is anisotropic, and that the degradation is more severe than that which occurs to dentin. As such, we feel this work is a significant contribution to the field.

Evaluation of shear bond strength of veneering ceramics and zirconia fabricated by the digital veneering method

PURPOSE

The purpose of this study was to evaluate the shear bond strength (SBS) of veneering ceramic and zirconia fabricated by the digital veneering method.

METHODS

A total of 50 specimens were fabricated, i.e., 10 specimens each for the metal-ceramic (control) group and the four zirconia groups. The zirconia groups comprised specimens fabricated by the digital veneering method, the heat pressing method, and hand layering method for two groups, respectively. Furthermore, the shear bond strength was measured with a universal testing machine (Model 3345, Instron, Canton, MA, USA) and statistically analyzed using one-way ANOVA set at a significance level of P<0.05. The corresponding mode of failure was determined from Scanning Electron Microscope (FESEM JSM 6701F, Jeol Ltd., Japan) observations.

RESULTS

One-way analysis of variance (ANOVA) revealed that the metal-ceramic group had the highest SBS (43.62MPa), followed by the digital veneering method (28.29MPa), the heat pressing method (18.89MPa), and the layering method (18.65, 17.21MPa). The samples fabricated by digital veneering had a significantly higher SBS than the other zirconia samples (P<0.05). All of the samples exhibited mixed failure.

CONCLUSIONS

Veneering ceramic with a zirconia core that was fabricated via the digital veneering method is believed to be effective in clinical use since, its shear bond strength is significantly higher than that resulting from the conventional method.

The effects of relative food item size on optimal tooth cusp sharpness during brittle food item processing

Teeth are often assumed to be optimal for their function, which allows researchers to derive dietary signatures from tooth shape. Most tooth shape analyses normalize for tooth size, potentially masking the relationship between relative food item size and tooth shape. Here, we model how relative food item size may affect optimal tooth cusp radius of curvature (RoC) during the fracture of brittle food items using a parametric finite-element (FE) model of a four-cusped molar. Morphospaces were created for four different food item sizes by altering cusp RoCs to determine whether optimal tooth shape changed as food item size changed. The morphospaces were also used to investigate whether variation in efficiency metrics (i.e. stresses, energy and optimality) changed as food item size changed. We found that optimal tooth shape changed as food item size changed, but that all optimal morphologies were similar, with one dull cusp that promoted high stresses in the food item and three cusps that acted to stabilize the food item. There were also positive relationships between food item size and the coefficients of variation for stresses in food item and optimality, and negative relationships between food item size and the coefficients of variation for stresses in the enamel and strain energy absorbed by the food item. These results suggest that relative food item size may play a role in selecting for optimal tooth shape, and the magnitude of these selective forces may change depending on food item size and which efficiency metric is being selected.

The role of organic proteins on the crack growth resistance of human enamel

With only 1% protein by weight, tooth enamel is the most highly mineralized tissue in mammals. The focus of this study was to evaluate contributions of the proteins on the fracture resistance of this unique structural material. Sections of enamel were obtained from the cusps of human molars and the crack growth resistance was quantified using a conventional fracture mechanics approach with complementary finite element analysis. In selected specimens the proteins were extracted using a potassium hydroxide treatment. Removal of the proteins resulted in approximately 40% decrease in the fracture toughness with respect to the fully proteinized control. The loss of organic content was most detrimental to the extrinsic toughening mechanisms, causing over 80% reduction in their contribution to the total energy to fracture. This degradation occurred by embrittlement of the unbroken bridging ligaments and consequent reduction in the crack closure stress. Although the organic content of tooth enamel is very small, it is essential to crack growth toughening by facilitating the formation of unbroken ligaments and in fortifying their potency. Replicating functions of the organic content will be critical to the successful development of bio-inspired materials that are designed for fracture resistance.

Enamel ultrastructure in fossil cetaceans (Cetacea: Archaeoceti and Odontoceti)

The transition from terrestrial ancestry to a fully pelagic life profoundly altered the body systems of cetaceans, with extreme morphological changes in the skull and feeding apparatus. The Oligocene Epoch was a crucial time in the evolution of cetaceans when the ancestors of modern whales and dolphins (Neoceti) underwent major diversification, but details of dental structure and evolution are poorly known for the archaeocete-neocete transition. We report the morphology of teeth and ultrastructure of enamel in archaeocetes, and fossil platanistoids and delphinoids, ranging from late Oligocene (Waitaki Valley, New Zealand) to Pliocene (Caldera, Chile). Teeth were embedded in epoxy resin, sectioned in cross and longitudinal planes, polished, etched, and coated with gold palladium for scanning electron microscopy (SEM) observation. SEM images showed that in archaeocetes, squalodontids and Prosqualodon (taxa with heterodont and nonpolydont/limited polydont teeth), the inner enamel was organized in Hunter-Schreger bands (HSB) with an outer layer of radial enamel. This is a common pattern in most large-bodied mammals and it is regarded as a biomechanical adaptation related to food processing and crack resistance. Fossil Otekaikea sp. and delphinoids, which were polydont and homodont, showed a simpler structure, with inner radial and outer prismless enamel. Radial enamel is regarded as more wear-resistant and has been retained in several mammalian taxa in which opposing tooth surfaces slide over each other. These observations suggest that the transition from a heterodont and nonpolydont/limited polydont dentition in archaeocetes and early odontocetes, to homodont and polydont teeth in crownward odontocetes, was also linked to a marked simplification in the enamel Schmelzmuster. These patterns probably reflect functional shifts in food processing from shear-and-mastication in archaeocetes and early odontocetes, to pierce-and-grasp occlusion in crownward odontocetes, with the implication of less demanding feeding biomechanics as seen in most extant odontocetes.

Finite element modeling of occlusal variation in durophagous tooth systems

In addition to breaking hard prey items, the teeth of durophagous predators must also resist failure under high loads. To understand the effects of morphology on tooth resistance to failure, finite element models were used to examine differences in total strain energy (J), first principal strain, and the distribution of strains in a diversity of canonical durophagous tooth morphologies. By changing the way loads were applied to the models, I was also able to model the effects of large and small prey items. Tooth models with overall convex morphologies have higher in-model strains than those with flat or concave occlusal surface. When a cusp is added to the tooth model, taller or thinner cusps increase in-model strain. While there is little difference in the relationships between tooth morphology and strain measurements for most models, there is a marked difference between effects of the large and small prey loads on the concave and flat tooth morphologies. Comparing these data with measurements of force required by these same morphologies to break prey items illustrates functional tradeoffs between the need to prevent tooth failure under high loads by minimizing in-tooth strain versus the drive to reduce the total applied force.

Precision and Reliability of the T-Scan III System

Precise analysis of occlusal contacts and occlusal force is a problem in functional diagnostics that has not yet been satisfactorily resolved, despite the fact that the deleterious consequences of an unbalanced occlusion are widespread and can be severe. In clinical practice, the present-day analysis of the occlusion is reduced to depicting force with color-marking foils that leave ink marks upon the teeth. However, these foils only indicate the localization of contacts, but do not describe reliably the occlusal force relationships. Precise analysis that incorporates time resolution and plots the distribution of forces within the occlusion is not possible when employing the traditional occlusal indicator methods. A detailed occlusal force and timing analysis can only be provided by performing a computer-assisted analysis, using the T-Scan III system (Tekscan, Inc. S. Boston, MA, USA), which records changing relative occlusal force levels and real-time occlusal contact sequence data with High Definition (HD) recording sensors. This chapter demonstrates the accuracy and reliability of this computer-based occlusal measurement method that reliably describes the time-dependent distribution of occlusal force evolution.

Type VII collagen is enriched in the enamel organic matrix associated with the dentin-enamel junction of mature human teeth

The inner enamel region of erupted teeth is known to exhibit higher fracture toughness and crack growth resistance than bulk phase enamel. However, an explanation for this behavior has been hampered by the lack of compositional information for the residual enamel organic matrix. Since enamel-forming ameloblasts are known to express type VII collagen and type VII collagen null mice display abnormal amelogenesis, the aim of this study was to determine whether type VII collagen is a component of the enamel organic matrix at the dentin-enamel junction (DEJ) of mature human teeth. Immunofluorescent confocal microscopy of demineralized tooth sections localized type VII collagen to the organic matrix surrounding individual enamel rods near the DEJ. Morphologically, immunoreactive type VII collagen helical-bundles resembled the gnarled-pattern of enamel rods detected by Coomassie Blue staining. Western blotting of whole crown or enamel matrix extracts also identified characteristic Mr=280 and 230 kDa type VII dimeric forms, which resolved into 75 and 25 kDa bands upon reduction. As expected, the collagenous domain of type VII collagen was resistant to pepsin digestion, but was susceptible to purified bacterial collagenase. These results demonstrate the inner enamel organic matrix in mature teeth contains macromolecular type VII collagen. Based on its physical association with the DEJ and its well-appreciated capacity to complex with other collagens, we hypothesize that enamel embedded type VII collagen fibrils may contribute not only to the structural resilience of enamel, but may also play a role in bonding enamel to dentin.

On the Mechanics of Fatigue and Fracture in Teeth

Tooth fracture is a major concern in the field of restorative dentistry. However, knowledge of the causes for tooth fracture has developed from contributions that are largely based within the field of mechanics. The present manuscript presents a technical review of advances in understanding the fracture of teeth and the fatigue and fracture behavior of their hard tissues (i.e., dentin and enamel). The importance of evaluating the fracture resistance of these materials, and the role of applied mechanics in developing this knowledge will be reviewed. In addition, the complex microstructures of tooth tissues, their roles in resisting tooth fracture, and the importance of hydration and aging on the fracture resistance of tooth tissues will be discussed. Studies in this area are essential for increasing the success of current treatments in dentistry, as well as in facilitating the development of novel bio-inspired restorative materials for the future.

Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function

Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all-ceramic single-tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass-ceramic, and alumina single-tooth restorations. Design features seem to be of great importance for fracture initiation.

Role of multiple cusps in tooth fracture

The role of multiple cusps in the biomechanics of human molar tooth fracture is analysed. A model with four cusps at the bite surface replaces the single dome structure used in previous simulations. Extended finite element modelling, with provision to embed longitudinal cracks into the enamel walls, enables full analysis of crack propagation from initial extension to final failure. The cracks propagate longitudinally around the enamel side walls from starter cracks placed either at the top surface (radial cracks) or from the tooth base (margin cracks). A feature of the crack evolution is its stability, meaning that extension occurs steadily with increasing applied force. Predictions from the model are validated by comparison with experimental data from earlier publications, in which crack development was followed in situ during occlusal loading of extracted human molars. The results show substantial increase in critical forces to produce longitudinal fractures with number of cuspal contacts, indicating a capacity for an individual tooth to spread the load during mastication. It is argued that explicit critical force equations derived in previous studies remain valid, at the least as a means for comparing the capacity for teeth of different dimensions to sustain high bite forces.