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Margin cracks in loaded brittle dome structures are investigated. Dome structures consisting of glass shells filled with polymer resin, simulating the essential features of brittle crowns on tooth dentin, provide model test specimens. Disk indenters of diminishing elastic modulus are used to apply axisymmetric loading to the apex of the domes. Previous studies using hard indenters have focused on fractures initiating in the near-contact region of such specimens, including radial cracks at the glass undersurface directly below the contact axis. Here, we focus on fractures initiating at the remote support margins. Margin cracks can become dominant when loading forces are distributed over broad contact areas, as in biting on soft matter, here simulated by balsa wood disks. Cracks preinitiated at the dome edges during the specimen preparation propagate under load around the dome side into segmented, semilunar configurations reminiscent of some all-ceramic crown failures. Finite element analysis is used to determine the basic stress states within the dome structures, and to confirm a shift in maximum tensile stress from the near-contact area to the dome sides with more compliant indenters.

Statement of problem. Long-term clinical data on the survival of pressed lithium disilicate glass-ceramic restorations and the effect that different technical and clinical variables have on survival are lacking. Purpose. The purpose of this clinical study was to examine the 10-year survival of pressed lithium disilicate glass-ceramic restorations and the relationship between clinical parameters on outcomes. Material and methods. Five hundred and fifty-six patients, ranging in age from 17 to 97 years, from a private clinical practice were enrolled. All participants required single-tooth replacement or repair in any area of the mouth, including single crowns, 3-unit fixed partial dentures, cantilevered anterior restorations, and foundation restorations. Together, the longevity of 1960 complete-coverage restorations was studied. Participants were offered the options of gold, conventional metal-ceramic, or lithium disilicate restoration. Participants who chose glass-ceramic restorations were included in the study. The overall survival of the glass-ceramic restorations was assessed by using clinical factors determined at recall, and the effect of various clinical parameters was evaluated by using Kaplan-Meier survival curves to account for attrition bias and other reasons for failure. The statistical significance of differences between parameters was determined using the log-rank test (a=.05).