DTD 5 ARTICLE IN PRESS Journal of Dentistry (xxxx) xx, 1–9 www.intl.elsevierhealth.com/journals/jden The influence of simulated masticatory loading regimes on the bi-axial flexure strength and reliability of a Y-TZP dental ceramic Andrew R. Curtisa, Adrian J. Wrightb, Garry J.P. Flemingc,* a Biomaterials unit, School of dentistry, University of Birmingham, St Chad’s Queensway, Birmingham B4 6NN, UK b School of Chemistry, University of Birmingham, Edgbason, Birmingham B15 2TT, UK c Department of Restorative Dentistry and Periodontology, Dublin Dental School and Hospital, Lincoln Place, Dublin 2, Ireland Received 27 July 2005; accepted 29 July 2005 KEYWORDS Y-TZP; Zirconia; CAD/CAM; Weibull analysis; Bi-axial flexure strength; Simulated masticatory loading; Vickers hardness Summary Objectives: The purpose of the current study was to examine the influence of simulated masticatory loading regimes, to which all-ceramic crown or bridge restorations will routinely be subjected during their service-life, on the performance of a yttria-stabilised tetragonal zirconia polycrystalline (Y-TZP) dental ceramic. Methods: Ten sets of 30 Y-TZP ceramic discs (13 mm diameter, 1.48–1.54 mm thickness) supplied by the manufacturer were randomly selected. Six groups were loaded for 2000 cycles at 500 N (383–420 MPa), 700N (536–588 MPa) and 800 N (613– 672 MPa) with three groups maintained dry and the remaining three groups loaded while immersed in water at 37G1 8C. A further two groups underwent extended simulated masticatory loading regimes at 80 N (61–67 MPa) for 104 and 105 cycles under dry conditions. The mean bi-axial flexure strengths, standard deviations and associated Weibull moduli (m) were determined. The surface hardness was also determined using the Vickers hardness indentation technique. Results: No significant difference (PO0.05) was identified in the bi-axial flexure strength of the simulated masticatory loading regimes and the control specimens loaded dry or wet. A significant increase in m was identified for the Y-TZP specimens following loading while immersed in water (8.6G1.6, 8.5G1.6 and 10.3G1.9) compared with the control (7.1G1.3). However, the extended loading regime to 105 cycles resulted in a significant reduction in the m of the Y-TZP specimens (5.3G 1.0) compared with the control. Localised areas of increased surface hardness were identified to occur directly beneath the spherical indenter. Conclusions: The occurrence of localised areas of increased surface hardness could be the result of either a transformation toughening mechanism or crushing * Corresponding author. Tel.: C353 1 612 7371; fax: C353 1 612 7279. E-mail address: [email protected] (G.J.P. Fleming). 0300-5712/$ - see front matter Q 2005 Published by Elsevier Ltd. doi:10.1016/j.jdent.2005.07.009 DTD 5 ARTICLE IN PRESS 2 A.R. Curtis et al. and densification of the material beneath the indentor manifested as the formation of a surface layer of compressive stresses that counteracted the tensile field generated at the tip of a propagating crack which increased the Weibull modulus of the Y-TZP specimens. The reduced reliability of the Y-TZP specimens loaded to 80 N for 105 cycles was associated with the accumulation of subcritical damage as a result of the extended nature of loading. Q 2005 Published by Elsevier Ltd. Introduction The use of all-ceramic restorations in aesthetic dentistry has increased in popularity while the use of metal-ceramic restorations have suffered a corresponding decline as they fail to meet the aesthetic demand of the patients and practitioners alike.1,2 The drawback of all-ceramic restorations is their inherently brittle nature and propensity to spontaneous failure under low impact stresses at areas of localised high stress concentrations located at pre-existing surface or bulk defects.3–7 The introduction of partially stabilised zirconia ceramics to the dental restorative armoury has increased the reliability of allceramic crown and bridge restorations due to the occurrence of a transformation toughening mechanism.8–10 The transformation toughening mechanism occurs as a result of the allotropic nature of zirconia, which exists in a monoclinic, tetragonal or cubic phase.11 Transformation toughening is induced by a martensitic phase transformation initiated by a diffusionless shear process at near sonic velocities with an associated volumetric increase of 4% and a shear strain of 7%.8,11–16 The process of transformation induces compressive stresses in the crack wake and shear strains that counteract the tensile field generated at the tip of a propagating crack.8,13–16 The addition of a stabiliser, namely yttria, stabilises the transforming zirconia system in the tetragonal phase and retains the layer of compressive stresses, resulting in the formation of a yttria-stabilised tetragonal zirconia polycrystalline (Y-TZP) ceramic and inducing the high fracture strength (O1000 MPa) and fracture toughness (O10 MPam1/2) characteristic of Y-TZP ceramics.12,17–20 Following placement, all-ceramic crown and bridge restorations are subjected on a daily basis to masticatory loading which places the restoration under repeated loading throughout a service-life of in excess of 107 cycles.21 A dental restoration is routinely subjected to masticatory loads in excess of 200 N, while clenching and bruxism forces in the most severe cases can exert loads of up to 1221 N with biting forces routinely experienced by crown and bridge restorations variously ranging from 150 to 665 N. 21,22 When the stresses induced by repeated loading do not initially exceed the flexure strength, the growth of subcritical flaws may result in delayed catastrophic failure.6,8 The presence of pre-existing surface or bulk defects within the ceramic system act as stress intensifiers and localised areas of stress concentration accelerating the occurrence of failure at lower levels of applied stress as a result of repeated loading.23 The use of Y-TZP restorations, while initially possessing a high resistance to failure and strength degradation associated with repeated loading, are susceptible to severe strength loss due to microcracking once a critical load and number of cycles is exceeded.24 Lavae (3M ESPE, Seefeld, Germany) is a 5-mol% Y-TZP ceramic produced by a CAD/CAM technique. The aim the present study was to investigate the influence of the simulated masticatory loading regimes, which routinely occur in the oral environment during the service-life of a Y-TZP ceramic restoration, on the bi-axial flexure strength, Weibull modulus and surface hardness of discshaped Y-TZP specimens. Materials and method Specimens Ten groups of specimens were selected each consisting of 30 nominally identical disc-shaped Y-TZP ceramic specimens (13 mm diameter, 1.48– 1.54 mm thickness) in the A4 shade, which were supplied by the manufacturer. A contact stylus Profilometer (Taylor Hobson, Form Talysurf Series 2, Leicester, England) was used previously to characterize the surface roughness of the discs.25 The Ra value produced was 0.21G0.03 mm and is universally recognized as the international parameter for roughness, namely, is a measure of the arithmetic mean of the absolute departures of the roughness profile from the mean (horizontal) line.25 DTD 5 ARTICLE IN PRESS The effect of repeated loading on a Y-TZP ceramic Simulated masticatory loading Groups A and E were maintained in the ‘as received’ condition as the control groups, Groups B–D were loaded continuously for 2000 cycles at 500 N (383–420 MPa), 700 N (536–588 MPa) and 800 N (613–672 MPa), respectively, to simulate loads experienced in the oral environment. Groups F–H were also loaded continuously while immersed in water at 37G1 8C for 2000 cycles at 500 N (383– 420 MPa), 700 N (536–588 MPa) and 800 N (613– 672 MPa), respectively. Specimen Groups I and J were maintained dry and loaded to a maximum value of 80 N (61–67 MPa) for 104 and 105 cycles, respectively, to simulate the typical level of masticatory loading that all-ceramic crown and bridge restorations routinely experience during service. The simulated masticatory loading regimes were carried out using a universal tensile-testing instrument (Instron Ltd, Model 5544, Buckinghamshire, England). Specimen Groups B–D and F–H were loaded to a maximum value of 500, 700 and 800 N at a frequency of 1.8–2.7 Hz and Groups I and J to 80 N at a frequency of 2.8 Hz on a stainless steel platen, centrally loaded using a 3 mm spherical indenter with a crosshead speed of 40 mm/min. Groups B–D, I and J were loaded in air and Groups F–H were immersed in water at 37G1 8C while centrally loaded. Immediately following simulated masticatory loading regime each specimen was loaded to failure in bi-axial flexure. Bi-axial flexure strength testing The bi-axial flexure strength was determined by centrally loading the specimens on a 10 mm knifeedge support at a crosshead speed of 1 mm/min with a spherical indenter (3 mm diameter). A thin sheet of rubber was placed between the specimen and the knife-edge support to ensure uniform loading and to accommodate any variation in the peripheral thickness or any distortion in the specimen surfaces. The specimens were loaded to failure using a universal tensile-testing instrument (Instron Ltd, Model 5544, Buckinghamshire, England) in either a dry or wet environment depending on the simulated masticatory regime used. The load (N) and extension (mm) at failure was recorded and the specimen thickness at the point of fracture of each disc-shaped specimen was measured using a screw-gauge micrometer (Moore and Wright, Sheffield, England) accurate to 10 mm. The number of fragments produced was recorded to determine the existence of a correlation between the fracture strength and the number of fragments 3 generated at failure. The bi-axial flexure strength was calculated according to Eq. (1)26 smax Z h a i o P n ð1 C nÞ 0:485 ln C 0:52 C 0:48 h h2 (1) where smax was the maximum tensile stress (MPa), P was the measured load at fracture (N), a was the radius of the knife-edge support (mm), h was the specimen thickness at the fracture point (mm) and n the Poisson’s ratio. A value of 0.23 was substituted for the Poisson’s ratio of the Lavae specimens under investigation (Product Specification, 3M ESPE, Seefeld, Germany). Statistical analysis Multiple comparisons of the group means were made utilising a one-way analysis of variance (ANOVA) and a paired Tukey’s multiple range test comparison at a significance level of P!0.05. The bi-axial flexure strength data was ranked in ascending order and Weibull analysis27 was performed on the flexural strength data by plotting ln ln(1/Ps) against lns where Ps was the probability of survival and s was the fracture stress. The gradient of the strength distribution data (m) was determined by superimposing a regression line along the data points to calculate m which is an inverse measure of the strength variation and was defined by Trustrum28 as characterising the ‘brittleness’ of a material. The confidence limits for the test groups subjected to Weibull analysis were considered to be significant when the confidence intervals did not overlap. Vickers hardness A series of eight fragments of the ‘as received’ specimens stored dry (Groups A) and of the loaded specimens stored and loaded in the dry condition (Groups B–D, I and J) were randomly selected. The diamond pyramid head of a Duramin-1 Vickers hardness tester (Struers, Glasgow, Scotland) was applied to the modified surface under a predetermined load (9.807 N) over 15 s to induce a diamond shaped indent. The size of each diagonal distance as a result of the impression of the indenter was measured using a micrometer screw gauge to obtain an average diagonal distance (D), an increased D identified deeper impressions and was indicative of decreased hardness.5 The Vickers hardness (VH) (kgf/mm2) was obtained by calculating the surface ARTICLE IN PRESS DTD 5 4 A.R. Curtis et al. area of the indent according to Eq. (2) 2P 1:854P 8 VH Z Z sin 68 D2 D2 (2) where P was the predetermined load applied in Newtons (N), D the average diagonal distance (mm), 1.854 was the Vicker’s constant and 688 was the angle of indentation of the diamond pyramid head indenter of the Vickers hardness tester.29 To assess the influence of simulated masticatory loading regimes on the surface hardness of disc-shaped specimens and the potential generation of a localised layer (or zone) of compressive stresses eight loaded specimens were selected. Consequentially, the specimens were divided into three regions and four indentation hardness measurements were obtained from each region and a mean VH was calculated. The three regions were (i) directly beneath the spherical ball indenter where loading occurred, (ii) a third of the way from the centre to the edge of the specimens and (iii) two-thirds of the way from the centre to the edge of the specimens. (Fig. 1). Results Dry storage. Following bi-axial flexure strength testing multiple comparisons were performed using a one-way analysis of variance (ANOVA) and paired Tukey test comparisons at the 95% significance level on the resultant data which identified that there was no significant difference (PO0.05) between the mean bi-axial flexure strengths (Table 1) of the control (Group A) and simulated masticatory loaded specimens (Groups B–D). The bi-axial flexure strength data was ranked in ascending order and the resultant associated 95% confidence intervals of the Weibull moduli of Groups A and B and Groups C and D failed to overlap and were therefore considered to be significantly different (Table 1). Following bi-axial flexure strength testing of the Y-TZP specimens loaded to 700 N (536–588 MPa) Region 2 Region 1 Region 3 Figure 1 A diagrammatic representation of a discshaped specimens divided into three regions where Vickers hardness measurements were obtained by making four indentations within each region where illustrated. and 800 N (613–672 MPa) an increase in the number six-, seven- and eight-fragment fractures was identified with a concomitant decrease in the number of three-, four- and five-fragment fractures compared with the control and the specimens loaded to 500 N (383–420 MPa), (Table 1). The survival probability distribution was plotted against the ranked bi-axial flexure strength in ascending order for Group A and the data appeared to exhibit an increased asymmetry within the lower stress range. However, the progressively increased simulated masticatory loads were identified to increase the symmetry within the lower stress ranges (Fig. 2). Wet storage. The simulated masticatory loading regimes of the Y-TZP specimens immersed in water (Groups F–H) were not identified following statistical analysis to be significantly different (PO0.05) compared with the control (Group E). In addition, the bi-axial flexure strength data of the specimens loaded in dry conditions, or loaded while immersed in water were not significantly different (PO0.05). The failure of the associated confidence intervals of Group E and Groups F–H to overlap highlighted a significant increase in the Weibull moduli of the loaded specimens (Table 1). The examination of the fragment fractures identified an increase in the number of three-, four- and five-fragment fractures with a concomitant decrease in the number of sixand seven-fragment fractures as a result of loading (Groups F–H) compared with the control (Group E) and the loaded specimens maintained dry (Groups B–D) (Table 1). The survival probability distribution for the control (Group E) identified the occurrence of an asymmetry within the lower stress range, in contrast with the loaded specimens maintained dry, the asymmetry identified to Groups F–H was not modified as a result of the loading regimes (Fig. 3). Extended loading. The statistical analysis of the extended simulated masticatory loaded regimes failed to identify a significant difference (PO0.05) between the bi-axial flexure strengths of the control and of Groups I and J (Table 1). The Weibull modulus of the bi-axial flexure strengths of Groups I and J (10.9G2.0 and 5.3G1.0, respectively), were identified to be significantly different as the confidence intervals failed to overlap, similarly the confidence intervals of Group A failed to overlap with Groups I and J (Table 1). The bi-axial flexure strength data identified that increasing the number of loading cycles employed from 104 to 105 (Groups I and J) resulted in an increase in the number of three-, four- and five-fragment fractures with a concomitant decrease in the number of six-, seven- and eight-fragment fractures (Table 1). The survival probability distribution of Group I was identified to possess an increased symmetry within Dry extended 500 N (383–420 MPa) 700 N (536–588 MPa) 800 N (613–672 MPa) Control 500 N (383–420 MPa) 700 N (536–588 MPa) 800 N (613–672 MPa) 10,000 (61–67 MPa) 100,000 (61–67 MPa) Group A Group B Group C Group D Group E Group F Group G Group H Group I Group J 793–1451 827–1364 1039–1430 882–1398 850–1556 784–1392 844–1472 909–1467 872–1427 642–1428 1267 (161) 1216 (136) 1246 (104) 1259 (101) 1308 (188) 1216 (141) 1221 (150) 1191 (127) 1250 (115) 1195 (191) 960 1008 1112 1148 961 1003 972 1033 1072 754 7.5 (1.4) 8.4 (1.5) 13.2 (2.4) 12.0 (2.29) 7.1 (1.3) 8.6 (1.6) 8.5 (1.6) 10.3 (1.9) 10.9 (2.0) 5.3 (1.0) 6.5–8.5 7.1–9.7 12.2–14.2 10.2–13.9 6.6–7.6 7.8–9.5 7.9–9.1 9.4–11.3 9.8–12.1 4.4–6.4 0.90 3, 0 and 8 0.87 1, 6 and 13 0.96 0, 2 and 11 0.87 0, 2 and 5 0.96 0, 1 and 5 0.94 1, 4 and 12 0.97 1, 5 and 13 0.95 0, 8 and 14 0.93 2, 2 and 10 0.83 2, 5 and 12 13, 6 and 0 10, 0 and 0 13, 4 and 0 15, 8 and 0 18, 5 and 0 10, 3 and 0 7, 4 and 0 6, 2 and 0 15, 1 and 0 8, 2 and 1 ARTICLE IN PRESS Fracture strengths (MPa) Mean strength (MPa) 10% Failure probability Weibull modulus 95% Confidence intervals R2-value 3, 4 and 5 fragment fractures 6, 7 and 8 fragment fractures Wet Control DTD 5 Dry The effect of repeated loading on a Y-TZP ceramic Table 1 The bi-axial flexure strengths (s) with associated Weibull moduli (m), confidence intervals, R2-values and fragment fractures of groups of 30 Lavae specimens maintained ‘as received’ from the manufacture or loaded dry or while immersed in water at 37G1 8C at 500, 700 and 800 N for 2000 cycles or at 80 N for 104or 105 cycles (numbers in parenthesis represent the standard deviations). 5 ARTICLE IN PRESS DTD 5 6 A.R. Curtis et al. 1 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 600 500 N π 700 N 800 N Probability of Survival Probability of Survival Control 800 1000 1200 1400 Biaxial Flexure strength (MPa) 1600 Figure 2 The survival probability distribution plots of the ‘as received’ Y-TZP specimens and the specimens following the simulated masticatory loading regimes at 2000 cycles at a maximum load of 500, 700 or 800 N. The distributions of the bi-axial flexure strength data highlighted an increased symmetry within the lower stress range as a result of the loading regimes. the lower stress range while the asymmetry was identified to be increased in Group J as a result of the simulated masticatory loading regimes (Fig. 4). Vickers hardness. The simulated masticatory loading regimes were highlighted to identify the occurrence of an increased reliability of loaded specimens which was associated with the occurrence of an increased surface hardness, directly beneath the loading site at the centre of the Y-TZP ceramic specimens and within two concentric regions (Fig. 1). 500 N (383–420 MPa). The loading of the Y-TZP at 500 N for 2000 cycles was not identified to result in Control 500 N π 700 N 800 N 1 Probability of Survival 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 600 800 1000 1200 1400 Biaxial Flexure Strength (MPa) 1600 Figure 3 The survival probability distribution plots of the ‘as received’ Y-TZP specimens and the specimens following the simulated masticatory loading regimes at 2000 cycles at a maximum load of 500, 700 or 800 N. The distributions of the bi-axial flexure strength data highlighted an increased asymmetry within the lower stress range as a result of the loading regimes. 1 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0 600 800 1000 1200 1400 Biaxial Flexure strength (MPa) 1600 Figure 4 The combined survival probability distribution plots of the ‘as received’ Y-TZP specimens and the specimens following the simulated masticatory loading regimes at a maximum load of 104 or 105 cycles. The distributions of the bi-axial flexure strength data highlighted an increased symmetry within the lower stress range as a result of the simulated masticatory loading regimes for 104 cycles. However, loading for 105 cycles at 80 N was identified to result in an increased asymmetry within the lower stress range. a statistically significant increase (PO0.05) in the mean Vickers hardness, however, the mean surface hardness of the area directly loaded (Region 1) was 1637G148 compared with Region 2 and 3 of 1554G 65 and 1518G77, respectively (Table 2). 700N (536–588 MPa). A statistically significant increase in the surface hardness of specimens loaded to 700 N (536–588 MPa) compared with 500 N (383–420 MPa), was identified to occur in Region 1 (P!0.05), which was identified to possess a mean VH of 1834G77 compared with Regions 2 and 3 which possessed a mean VH of 1545G70 and 1583G122, respectively (Table 2). 800N (613–672 MPa). Similarly, following the loading of specimens to 800 N (613–672 MPa) for 2000 cycles resulted in a significant (P!0.05) increase (compared with the 500 N (383–420 MPa) loaded specimens) in the mean VH of Region 1, which was 1850G112, compared with Regions 2 and 3 which were identified to be 1583G76 and 1531G 74, respectively (Table 2). Extended loading. When the extended simulated masticatory loading regimes were employed utilising a maximum load of 80 N (61–67 MPa) over 104 cycles a significantly higher (P!0.05) mean VH of 1692G99 was identified to occur in Region 1, compared with Regions 2 and 3, which were not directly loaded and possessed a mean VH of 1472G 41 and 1475G55, respectively (Table 2). Further increasing the maximum number of cycles employed to 105 resulted in the occurrence of a mean VH in Region 1 of 1643G66, while Regions 2 ARTICLE IN PRESS DTD 5 The effect of repeated loading on a Y-TZP ceramic 7 Table 2 The Vickers hardness (VH) of groups of 30 Lavae specimens loaded dry at 500, 700 and 800 N for 2000 cycles or at 80 N for 104 or 105 cycles, directly beneath the indenter (Region 1) and in two concentric Regions around the indentation site (numbers in parenthesis represent the standard deviations). Control Region 1 Region 2 Region 3 Group A 500 N (383–420 MPa) Group B 700 N (536–588 MPa) Group C 800 N (613–672 MPa) Group D 10,000 (61–67 MPa) Group I 100,000 (61–67 MPa) Group J 1590 (91) 1590 (91) 1590 (91) 1637 (148) 1554 (65) 1518 (77) 1834 (77) 1545 (70) 1583 (122) 1850 (112) 1583 (76) 1531 (74) 1643 (66) 1487 (36) 1457 (44) 1692 (99) 1472 (41) 1475 (55) and 3 were revealed to posses significantly lower (P!0.05) mean VHNs of 1487G36 and 1457G44, respectively (Table 2). Discussion Dry storage. The simulated masticatory loading regimes employed in the current study failed to significantly alter the mean bi-axial flexure strength of the Y-TZP ceramic specimens. Y-TZP ceramics have previously been identified to be high strength materials, which were not influenced by repeated loading of up to 3000 N.6 However, when the stresses induced by repeated loading do not initially exceed the flexure strength, the growth of subcritical flaws may result in the occurrence delayed catastrophic failure following 5!105 cycles.6,8,11 Therefore, it was suggested that the simulated masticatory loads and stresses and the number of cycles employed in the current study failed to induce the accumulation of a sufficient amount of accumulated damage, nor did the number of cycles exceed the critical number, required to initiate a significant reduction in the biaxial flexure strengths. The reliability of the all-ceramic dental restorations has previously been questioned due to the intrinsically brittle nature of ceramic materials as a result of the occurrence of surface or bulk defects and residual stresses which are inherent to the structure of ceramic materials.3–7 The use of simulated masticatory loading regimes has previously been identified to result in unpredictable rates of failure determined by the material toughness and the resistance to crack extension.1, 30,31 In the current study the Weibull modulus of the Y-TZP ceramic was identified to be significantly increased as a result of the loading regimes (8.4G 1.5, 13.2G2.4 and 12.0G2.2, respectively), compared with the control (7.5G1.4). The Vickers indentation technique identified a localised increase in the surface hardness of the Y-TZP specimens (Table 2) directly beneath the spherical indenter, which was markedly harder than the surrounding regions possibly highlighting the occurrence of a toughening mechanism or crushing and densification of the material beneath the indentor, which was responsible for the increased Weibull moduli of the Y-TZP specimens. In addition, the improved Weibull moduli of the loaded specimens was further highlighted by the survival probability distribution, which identified that the asymmetry occurring in the lower stress range was reduced as a result of the loading regimes at 700 N (536–588 MPa) and 800 N (613–672 MPa), compared with 500 N (383–420 MPa) and the control. Wet Storage. The influence of moisture contamination has previously been identified to be detrimental to the fracture strength of ceramic-based dental restorative materials, routinely resulting in a 20% decrease in the mean fracture strength.32–34 The current study highlighted that the bi-axial flexure strengths of the Y-TZP ceramic were not detrimentally influenced by water immersion during simulated masticatory loading. In contrast, the repeated loading of ceramic restorations in an aqueous environment has previously been observed to result in an increased crack velocity, the occurrence of stress-corrosion and the propagation of pre-existing defects to failure at significantly reduced bi-axial flexure strengths.33,35,36 In addition, the accumulation of damage as a result of loading in an active aqueous environment, such as that encountered within the oral environment, causes surface defects to act as stress intensifiers and areas of local stress concentration, facilitating the initiation of fracture at lower levels of applied stress.24 The simulated masticatory loads employed in the current investigation were within the upper range to which Y-TZP crown and bridge structures were likely to be subjected to during service.22–23 The Weibull modulus of ceramic materials has frequently been identified to be decreased as a result of the presence of water, whether in small quantities such as atmospheric levels or due to complete immersion, resulting in a reduction in the flexural strength and Weibull modulus of ceramic DTD 5 ARTICLE IN PRESS 8 restorations.37–39 When the Y-TZP specimens were loaded while immersed in water during the current study a significant increase in the Weibull moduli were identified (8.6G1.6, 8.5G1.6 and 10.3G1.9, respectively), compared with the unloaded specimens (7.1G1.3). The increased m was attributed to either the formation of a layer of compressive stresses possibly as a result of the occurrence of a transformation toughening mechanism or crushing and densification of the material beneath the indentor, identified by the increased localised surface hardness. Furthermore, there was no significant difference between the bi-axial flexure strength and m following the wet and dry loading conditions. In the dental literature there is some controversy regarding the influence of moisture on Y-TZP ceramics.40–42 Recently Marx et al.43 evaluated the threshold intensity factors as lower boundaries for crack propagation in ceramics including a zirconia and the Y-TZP investigated in the current study. The authors highlighted using critical stress intensity values and the threshold values that the composition of the zirconia ceramic investigated had an influence on the crack propagation in zirconia ceramics43 which may account for the controversy previously highlighted in the dental literature40–42 and in the current study. Extended loading. The extended simulated masticatory loading regimes did not result in a significant decrease in the bi-axial flexure strengths of the specimens, furthermore the Weibull modulus of the Y-TZP specimens loaded at 80 N for 104 cycles were identified to be increased following loading, attributed to the increased VH beneath the loading ball. The occurrence of an increased localised surface hardness in Group I was manifested directly beneath the indenter, in Region 1 compared with Regions 2 and 3. The increased VH was attributed to the occurrence of a localised transformation toughening mechanism or crushing and densification of the material beneath the indentor which generated the formation of a layer of compressive stress and characteristically also gives rise to an increased Weibull modulus.12–16 However, when the Y-TZP specimens were loaded to 105 cycles a significant reduction in the Weibull modulus was identified (5.3G1.0) compared with the control (7.5G1.4). In addition, a reduction in the lower range of the bi-axial flexure strengths (642 MPa) compared with the control (793 MPa) and a decrease in the 10% failure probability was identified (Table 1). In line with the simulated masticatory loading regimes for 104 cycles a localised increase in the VH was also identified to occur directly beneath the loading site following loading for 105 cycles. Therefore, it was A.R. Curtis et al. suggested that the extended nature of loading, even at comparatively low loads, introduced the accumulation of subcritical microcracking, crushing and densification of the material beneath the indentor and high levels of tensile stresses associated with the generation, propagation and coalescence of microcracks.9,40,44–45 In summary, the Y-TZP ceramic investigated has the potential for increasing performance when used clinically by the generation of either a compressive layer or crushing and densification of the material beneath the indentor when masticatory loads in the region commonly produced by bruxism or biting forces are encountered in the oral environment. Conclusions The simulated masticatory loading regimes investigated were identified to result in an increased surface hardness directly below the loaded area which modified the surface defect population and thereby the increased Weibull moduli of the Y-TZP ceramic specimens. The increased Weibull moduli were attributed to the formation of a localised layer of compressive stresses or crushing and densification of the material beneath the indentor that counteracted the tensile field at the propagating crack-tip following loads of 700 (536–588 MPa) and 800 N (613–672 MPa). In contrast, extending the simulated masticatory loading regime to 105 cycles at 80 N (61–67 MPa) reduced the Weibull moduli of the specimens as a result of the combined influence of the accumulation of microcrack damage from crushing and densification of the material beneath the indentor and the possible failure to induce a transformation toughening mechanism to counteract the crack propagation. References 1. Lawn BR. Physics of fracture. J Am Ceram Soc 1983;66: 83–91. 2. Doremus RH. Review: bioceramics. J Mater Sci 1992;27: 285–97. 3. Peterson M, Wuttiphan S, Lawn BR, Chyung K. Role of microstructure on contact damage and strength degradation of micaceous glass-ceramics. 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