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Research Paper
Jiawen Guoa, Beimin Tiana, Ran Weib, Weiguo Wanga, Hongyun Zhangc,
Xiaohong Wua, Lin Heb,nn, Shaofeng Zhanga,n
a
State Key Laboratory of Military Stomatology, Department of Prosthodontics, School of Stomatology,
Fourth Military Medical University, Changle Xi Road 145, Xi’an 710032, China
b
State Key Laboratory for Mechanical Behavior of Materials, Xi’an Jiaotong University, Xi’an 710049, China
c
State Key Laboratory of Military Stomatology, Department of Oral Anatomy and Physiology, School of Stomatology,
Fourth Military Medical University, Changle Xi Road 145, Xi’an 710032, China
Article history: The excessive abrasion of occlusal surfaces in ceramic crowns limits the service life of
Received 14 April 2014 restorations and their clinical results. However, little is known about the time-dependent wear
Received in revised form behavior of ceramic restorations during the chewing process. The aim of this in vitro study
28 July 2014 was to investigate the dynamic evolution of the wear behavior of veneering porcelain in PFM
Accepted 10 August 2014 crowns as wear progressed, as tested in a chewing simulator. Twenty anatomical metal–
Available online 19 August 2014 ceramic crowns were prepared using Ceramco III as the veneering porcelain. Stainless steel
Keywords: balls served as antagonists. The specimens were dynamically loaded in a chewing simulator
Wear with 350 N up to 2.4 106 loading cycles, with additional thermal cycling between 5 and 55 1C.
Porcelain During the testing, several checkpoints were applied to measure the substance loss of the
Metal ceramic crowns crowns’ occlusal surfaces and to evaluate the microstructure of the worn areas. After 2.4 106
Dynamic process cycles, the entire wear process of the veneering porcelain in the PFM crowns revealed three
Chewing simulator wear stages (running-in, steady and severe wear stages). The occlusal surfaces showed traces
of intensive wear on the worn areas during the running-in wear stage, and they exhibited the
propagation of cracks in the subsurface during steady wear stage. When the severe wear stage
was reached, the cracks penetrated the ceramic layer, causing the separation of porcelain
pieces. It also exhibited a good correlation among the microstructure, the wear loss and the
wear rate of worn ceramic restorations. The results suggest that under the conditions of
simulated masticatory movement, the wear performance of the veneering porcelain in PFM
crowns indicates the apparent similarity of the tribological characteristics of the traditional
mechanical system. Additionally, the evaluation of the wear behavior of ceramic restorations
should be based on these three wear stages.
& 2014 Elsevier Ltd. All rights reserved.
n
Corresponding author. Tel.: þ86 29 82665165/þ86 29 84776468.
nn
Corresponding author.
E-mail addresses: helin@mail.xjtu.edu.cn (L. He), sfzhang1963.fmmu@gmail.com (S. Zhang).
http://dx.doi.org/10.1016/j.jmbbm.2014.08.006
1751-6161/& 2014 Elsevier Ltd. All rights reserved.
24 journal of the mechanical behavior of biomedical materials 40 (2014) 23 –32
hypothesis of this study was that the entire wear process of (nickel–chromium, Co 60%, Cr 24%, Heraeus Kulzer Dental,
veneering porcelain would consist of three wear stages. Shanghai, China) were conventionally fabricated and cast,
respectively, according to the manufacturer’s directions (lost
wax technique) (Fig. 1b). All 20 castings were placed in an
ultrasonic cleaner and were inspected under 10x magnifica-
2. Materials and methods tion (Olympus BH2; Olympus Corp, Tokyo, Japan) for surface
irregularities. After the removal of all of the positive internal
2.1. Preparation of PFM crown specimens
irregularities with a round bur (Dura-Green Stones TC4
HP0042, Shofu, Tokyo, Japan), these frameworks were
An artificial mandibular first molar positioned in a mannequin
veneered with porcelain (hand-layered technique) (Ceramco
was prepared for a complete crown. The preparation consisted
III; Dentsply, Burlington, NJ, USA) by the same experienced
of 2.0 mm of occlusal reduction, 1.5 mm of axial reduction and a
technician, following the manufacturer’s guidelines. An
1.0 mm shoulder finish line with rounded internal angles that
impression of the desired anatomy of a waxed mandibular
extended 360 degrees around the tooth, following the outlined
first molar was used to guide the porcelain veneering
cementoenamel junction. The axial walls had an approximate
contour. The approximate porcelain thickness was 1.0 mm
taper of 6 degrees. Then, the prepared molar received an
on the axial walls and 1.5 mm on the occlusal surface
impression with polyvinylsiloxane material (Express, 3M ESPE,
(Fig. 1c). All of the crowns were tried in, and no internal
St. Paul, MN, USA), which was filled with layers of resin-based
adjustments were necessary for an appropriate fit. The
composite (Z100, 3M ESPE, St Paul, MN, USA) and was cured
crowns were glazed and cemented on the respective com-
according to the manufacturer’s recommendations and multi-
posite resin replicas, using a resin cement (PANAVIA F,
plied, resulting in 20 identically prepared tooth replicas (Fig. 1a).
Kuraray Medical Inc, Tokyo, Japan) according to the manu-
These replicas were incubated in water for a minimum of 30
facturer’s instructions. The crowns were fully seated with
days to assure water hydration and to eliminate any dimen-
finger pressure. The crown/die assembly was placed under a
sional alterations after crown cementation (Huang et al., 2008).
50 N static load. After 60 s, excess cement was removed. Ten
Following incubation, the replicas were embedded in epoxy
minutes later, the PFM crown specimens were rinsed thor-
resin that was poured into PVC tubes 25 mm-diameter, with
oughly with an air–water spray. Finally, any residual excess
their long axis aligned with the tube’s long axis. The finish line
cement was removed, and all of the crowns were stored in
preparations were located 2 mm above the resin surface. An
37 1C distilled water for at least 24 h for future use (Fig. 1d).
impression of each replica was obtained using polyether
material (Impregum F, 3M ESPE, St. Paul, MN, USA), and working
dies of each replica impression were made of class IV dental 2.2. Wear testing in the chewing simulator
stone (Die-Stone, Heraeus Kulzer Dental, Shanghai, China).
Based on these stone dies, standard design frameworks To simulate the wear that occurs in occlusal contact, each
with an even thickness of 0.5 mm and 20 metal cores specimen was mechanically tested with a custom-designed
Fig. 1 – Pictures of specimen: (a) tooth replica; (b) metal core of crown; (c) PFM anatomical single crown; (d) assembled PFM
crown specimen.
26 journal of the mechanical behavior of biomedical materials 40 (2014) 23 –32
chewing simulator. A schematic diagram of the testing wear test, the loading force was 350 N, which was in an
machine used in this research appears in Fig. 2. In principle, appropriate load range measured during mastication and
the load was produced by the compressed spring (7), which swallowing (Kelly, 1999). According to the literature, the wear
was confined in a cylindrical container (8). Each container produced by 240,000–250,000 masticatory cycles in a chewing
was mounted on a separate vertical bar (6), and each test simulator corresponded to the wear measured after 1 year of
chamber (4) had a vertical bar and a cylindrical container. The clinical service (Sakaguchi et al., 1986). Therefore, to simulate
chewing simulator contained 12 test chambers. Every 6 10 years of clinical service, a total of 2.4 106 loading cycles
vertical bars were linked by a transverse bar (5), driven by a were performed. During wear simulation, the specimens
step motor (1). All 12 test chambers were divided into two were subjected to thermal cycles in distilled water at alter-
columns (2) arranged parallel to each other on a flat plane (3). nating temperatures of 5 and 55 1C, with a duration of 2 min
The rotation of the transverse bar induced axial movement of for each cycle.
the vertical bar and its cylindrical container. When the
indenter (9), which had a rigid connection with the lower
surface of the cylindrical container, came into contact with
the specimen (11), the spring became pressed and the desired 2.3. Wear measurements and date analysis
loading force was released. In this manner, the apparatus
provided reciprocating movement and cyclic loading of the To observe the dynamic evolution process of the wear
testing sample. Some similarity to the masticatory pattern behavior of veneering porcelain in PFM crowns, seven check-
had been achieved. In addition, the simulator included a points were employed over 2.4 106 cycles. After 1.25 105,
thermocycling system, using magnetic valves in conjunction 2.5 105, 5 105, 1 106, 1.5 106, 2 106 and 2.4 106 loading
with a heating and cooling system controlled by computer cycles each, impressions of the specimens’ occlusal surfaces
programs. Through a metal pipe (10), hot or cool water was (n ¼12) were obtained using a polyvinylsiloxane impression
sprayed on the specimen at regular intervals. material. Replicas were made with epoxy resin, and the
For wear loading, metal sphere indenters were used as substance loss of the replicas’ surfaces was measured with
antagonists to substitute for cusps of teeth. These metallic a non-contact 3D white light profilometer (PS50, Nanovea,
balls with a diameter of 10 mm were made of stainless steel Irvine, CA, USA) and its dedicated software (Nanovea 3D
(ASTM 403), and had a Vickers hardness value of about 350 Software, Nanovea, Irvine, CA, USA).
HV after a quenching and tempering treatment. The hardness The profilometer consisted of a three-dimensional digiti-
is close to that of natural enamel. The full crown specimens zer and a PC with a color monitor. The digitizer had a motor-
were set up in brass sample holders (12) immediately beneath driven XY measurement table and a vertically adjustable
the indenters. With the antagonist declined, it first contacted optical sensor with an auto-focus system. The sensor had a
the lingual inclined surface of the disto-buccal cusp 1 mm measurement range of 12 mm in the vertical direction. It also
from its cuspal tip and then passively slid into the central had vertical resolution of 200 nm and lateral resolution of
fossa, accompanied by approximately 1 mm of lateral move- 500 nm. When the wear test reached a checkpoint, each
ment. When it reached the final cusp-fossa relationship, replica of twelve crown specimens was embedded in PMMA
three occlusal point contacts (distobuccal, mesiolingual and resin with its occlusal surfaces facing vertically upward,
distolingual) were created. Both the beginning and the final using the same split mold (stainless steel, hollow cylinder
contact positions between the antagonists and crowns were shaped: 20 mm inner diameter 14.5 mm height). Three
assessed with black articulating paper (thickness of 20 μm) reference marks were made on the top surface of the resin
and were adjusted if necessary. Then, the specimens were stub around the replicate crown, by pressing a wax tool tip
fastened by pouring PMMA resin (GC Unifast Trad, GC- against the uncured resin. After curing, the entire resin
Corporation, Tokyo, Japan) into brass holders. In the current replica was removed from the mold and placed under the
optical sensor. The scanned area was 7 mm 7 mm and
contained the entire replicate crown and three reference
marks. All of the scans were obtained at a 30 Hz frequency
using 50 μm step sizes in both the x and y directions. In the
resultant digitized images, three reference marks, which
acted as reference points, could determine a plane, making
all of the specimens comparable. In the present study, the
surface area of the wear facets was chosen as the parameter
representing the substance loss of the veneering porcelain.
Defining the wear area on each crown, the surface area of the
wear facets was calculated using the dedicated software. As
the wear test proceeded, the ceramic loss at all seven
checkpoints was evaluated in sequence. After collecting all
Fig. 2 – Schematic drawing of the chewing simulator: (1) step of the separate data at different checkpoints, a fitted wear
motor; (2) two columns of the test chamber; (3) flat plane; curve was generated, which reflected the dynamic evolution
(4) test chamber; (5) transverse bar; (6) vertical bar; process of the wear behavior of the crown’s occlusal surface.
(7) compression spring; (8) cylindrical container; (9) indenter; The wear rate was calculated from the derivative of the wear
(10) metal pipe; (11) specimen; (12) sample holder. loss data relative to time, using numerical differentiation.
journal of the mechanical behavior of biomedical materials 40 (2014) 23 –32 27
2.4. Morphological observations of the wear surfaces and the crowns after different chewing cycles are summarized in
subsurfaces Table 1. Setting the chewing cycles as the x-axis, a wear curve
is presented below (Fig. 3), showing the tendency of three
To reveal the different statuses of the microstructure over the distinct wear stages over the whole test. Overall, the bound-
entire wear test, four observation points were selected, which ary between the running-in wear stage and the steady wear
represented the period before the test and the early, middle and stage was situated at approximately 1 106 cycles because
later wear periods respectively. After 0, 2.5 105, 1 106 and the mean wear rate at 1 106 cycles (0.02770.017 mm2/1 104
2.4 106 loading cycles each, two samples were gold sputtered cycles) was significantly lower than that at 5 105 cycles
(MC 1000, Hitachi High-Technologies Corporation, Tokyo, Japan), (0.08770.034 mm2/1 104 cycles) (po0.05), while no signifi-
followed by morphological observation of the worn surface using cant difference in wear rate was observed between 1 106
a scanning electron microscope (SEM) (S-4800, Hitachi High- and 1.5 106 cycles. Thus, under the conditions of the current
Technologies Corporation, Tokyo, Japan). Then, these samples study, the running-in wear stage of the veneering porcelain
were embedded in PMMA resin and were cross-sectioned along ranged from about 0 to 1 106 cycles. During this period, the
the central area of the wear surface, parallel to the sagittal plane mean surface area of the wear facets increased continuously,
of the crown. After being serially polished with increasingly finer while the wear rate decreased from 0.19370.038 mm2/1 104
grit silicon carbide paper and diamond paste, the subsurface of cycles to 0.02770.017 mm2/1 104 cycles. Furthermore, the
the worn area was also gold sputtered and was inspected by boundary between the steady wear stage and the severe wear
means of the SEM. stage was situated at approximately 1.5 106 cycles, because
the wear rate between 1 106 and 1.5 106 cycles was always
2.5. Statistical analysis sustained at a relatively stable low value, while the wear rate
at 2.0 106 cycles (0.05870.017 mm2/1 104 cycles) obviously
All of the wear rate data were analyzed using repeated increased, compared with that at 1.5 106 cycles (0.0067
measures ANOVA to determine whether the differences 0.003 mm2/1 104 cycles) (po0.05). Therefore from about
between the mean wear rate values of veneering porcelain 1 106 to 1.5 106 cycles, the porcelain of the PFM crowns
observed at each checkpoint were statistically significant underwent a steady wear stage such that the mean surface
(α¼0.05). A repeated measures design was used because area of the wear facets increased slowly and slightly. After
repeated measurements of the same sample were obtained approximately 1.5 106 cycles, the severe wear stage was
at different time intervals. Tukey’s post-hoc test was used for reached during which both the mean surface area of the wear
multiple pair-wise comparisons of the means. By comparing facets and the mean wear rate showed upward trends.
the mean wear rate of each pair of neighboring checkpoints, Although the reduction in the wear rate between 2.5 105
three wear stages were distinguished. and 5 105 cycles did not showed a significant difference
(p40.05), the mean wear rate at 1 106 cycles resumed showing
an obvious decrease, compared with that at 5 105 cycles
3. Results (po0.05). Additionally, the period between 0 to 1 106 cycles
demonstrated an overall downward trend. Therefore, the wear
All of the crowns survived 2.4 106 cycles, and none of them process between 2.5 105 and 5 105 cycles belonged to the
exhibited any signs of defects after dynamic loading. Only running-in wear stage and could not be considered a boundary
typical worn surfaces were observed on the veneering porce- that distinguished different wear stages.
lain of the PFM crowns. The mean wear loss and wear rates of Based on the wear curve determined above, morphological
observations at 0, 2.5 105, 1 106 and 2.4 106 cycles demon-
Table 1 – Summary of wear loss and wear rate after strated the veneering porcelain of PFM crowns situated before
various chewing cycles (n ¼12). the test period and during running-in, steady and severe wear
Cycles Mean wear loss Mean wear rate and
(1 104 and standard standard deviations of
times) deviations of tested porcelain(in mm2/
tested 1 104 cycles)
porcelain
(in mm2)
0 0 Tukey
test
12.5 2.4170.47 0.19370.038 A
25 3.7270.57 0.10570.045 B
50 5.8970.65 0.08770.034 B
100 7.2370.84 0.02770.017 CD
150 7.5370.85 0.00670.003 D
200 10.4371.54 0.05870.017 BC
240 12.8571.26 0.06170.017 BC
Fig. 4 – SEM images of the morphology of the wear facets of veneering porcelain on PFM crowns at different stages: (a) before
the test; (b) dotted circle on (a) at greater magnification; (c) running-in wear stage; (d) dotted circle on (c) at greater
magnification; (e) steady wear stage; (f) dotted circle on (e) at greater magnification; (g) severe wear stage; (h) dotted circle on
(g) at greater magnification.
stages, respectively. Regarding these morphological observa- During the running-in wear stage, SEM fractographic anal-
tions of the wear surface, SEM images of the non-dynamic ysis revealed an uneven occlusal surface with many tiny
loading specimens showed intact and smooth surfaces (Fig. 4a defects (Fig. 5c and d), while the inner structure of porcelain
and b), while during the running-in wear stage, roughening of remained intact. During the steady wear stage, the initiation of
the ceramic surfaces was observed over the occlusal contact cracks occurred at the shallow subsurface of the porcelain,
area. The mass of small wear traces was densely distributed closing onto the occlusal surface (Fig. 5e and f). The path of
over these roughening surfaces (Fig. 4c and d). During the propagation of the cracks was oblique. When the severe wear
steady wear stage, these wear traces grew larger and coalesced stage was reached, the bulk of the porcelain was fractured,
with each other, forming several cracks (Fig. 4e), while some leaving hollow defects on the occlusal surface (Fig. 5g and h).
relatively smooth surfaces emerged among the roughening
surfaces (Fig. 4f). When the severe wear stage was reached,
the size of cracks increased, while the area of relatively smooth 4. Discussion
surfaces decreased (Fig. 4g and h).
Regarding morphological observations of the subsurface of In this study, the time-dependent wear behavior of veneering
the worn area, SEM images of the non-dynamic loading porcelain in PFM crowns was investigated in a custom-designed
specimens showed an intact inner structure of porcelain chewing simulator. The research hypothesis that the wear
and a continuously smooth occlusal surface (Fig. 5a and b). process of the veneering porcelain would consist of three
journal of the mechanical behavior of biomedical materials 40 (2014) 23 –32 29
Fig. 5 – The sectional SEM morphology of worn veneering porcelain on PFM crowns at different stages: (a) before the test;
(b) dotted circle on (a) at greater magnification; (c) running-in wear stage; (d) dotted circle on (c) at greater magnification; (e)
steady wear stage; (f) dotted circle on (e) at greater magnification; (g) severe wear stage; (h) dotted circle on (g) at greater
magnification.
distinct wear stages was confirmed. According to the wear been perceived as a valid model for in vitro testing, to provide
curve, the tendency of the three wear stages could be identified. a clinically relevant loading pattern and test environment
From about the beginning to 1 106 cycles, the porcelain of the (Heintze, 2006; Mehl et al., 2007; Mormann et al., 2013; Preis
PFM crowns underwent a running-in wear stage; from about et al., 2012). When the blunt indenter contacted with the occlusal
1 106 to 1.5 106 cycles, the samples were sustained in a surface of the ceramic crown, several different types of stress
steady wear stage; and after approximately 1.5 106 cycles, they zones generated in the bi-layer structures. Apart from the
reached a severe wear stage. Although the wear loss of the PFM inevitable phenomenon of oral wear, these stress fields were
crowns’ occlusal surfaces showed an obvious increasing trend also responsible for the generation of cone cracking, plastic
during the running-in and severe wear stages, it increased only deformation and radial cracking respectively (Lawn et al., 2004).
slightly during the steady wear stage. The wear rate first And these failure (cracking) modes were closely related to the
decreased from the running-in to the steady wear stage and clinical failed ceramic restorations (Zhang et al., 2013). In addi-
then increased from the steady to the severe wear stage. These tion, there were two main reasons for choosing the veneering
changing features in wear behavior were similar to the typical porcelain of PFM crowns as the representatives: metal–ceramic
tribological characteristics of wear components, which usually crowns remain widely used clinically (Reitemeier et al., 2006;
showed the changing trend of the three wear stages during the Walton, 1999), and compared with lithium disilicate ceramic and
entire wear process (Wen and Huang, 2012). zirconia ceramic, veneering porcelain, which is a feldspathic
Among different wear assays, the simulation of masticatory ceramic, usually has moderate wear resistance (Kim et al., 2012;
movement by chewing simulators has been widely used and has Preis et al., 2011; Wang et al., 2012), which would render the
30 journal of the mechanical behavior of biomedical materials 40 (2014) 23 –32
entire test more efficient. All of the specimens were made into (Fig. 5f), due to the dynamic loading (Kim et al., 2008; White
anatomical full PFM crowns, aiming to bridge the gap between et al., 1997). Compared with the intact inner structure of
laboratory tests and clinical cases. Sornsuwan et al. (2011) porcelain in the non-dynamically loaded specimens, the
indicated that occlusal surface geometry should also be consid- presence of cracks indicated that the mechanical properties
ered with regard to the generation of stress during occlusal of the veneering porcelain began to degenerate (Chen et al.,
contact. Therefore, the choice of a standard anatomical crown 1999; Kelly, 1999). With the propagation of cracks and the
not only standardized the experimental conditions, but it also penetration of the ceramic layer, the balance that was
provided a clinically relevant stress state. Permanent thermal created during the steady wear stage collapsed. Blocks of
cycling with water kept the specimens wet during the entire test ceramic material separated from the occlusal surface,
and caused additional aging of the ceramics. A wet environment leaving only pit-like defects (Fig. 5h), which increased the
should enhance subcritical crack growth due to structural area of surface wear. Such a performance implied that the
changes in the ceramic (Taskonak et al., 2008). wear behavior of the crown reached the severe wear stage.
Throughout the entire wear process, the changing Even the contact stress consistently decreased, so the
trends in the wear curve and the SEM images suggested subsurface ceramic structure, which was already fragile,
that there existed a significant correlation among the wear might fracture easily under lower stress conditions (Attia
loss, the wear rate and the microstructure of the full crown et al., 2006; Kelly, 1999; Zhang et al., 2013).
specimens. At the beginning of the wear testing, high Ceramco III, which is generally used for the veneering of
contact stress was generated as a result of point contacts metal substructures with the hand-layered technique, is a
between the antagonist and the occlusal surface of the PFM type of low-fusing feldspathic-based glass-ceramic (Cesar
crown. Under such stress conditions, the veneering porce- et al., 2008). With its fine-grained leucite (K2O Al2O3 4SiO2)
lain, which consisted of a brittle glass ceramic with little or crystalline phase (Cattell et al., 2001; Ong et al., 2000), the
no plastic deformation, was subject to brittle breakage mechanical properties of dental porcelain can be promoted to
(Gonzaga et al., 2011; Zhang et al., 2013). Ravikiran and some extent due to the toughening mechanisms of crack
Lim (1999) also indicated that a greater load was more likely deflection and crack-tip shielding action (Cesar et al., 2005;
to cause ceramic particle fracture and easy separation from Morena et al., 1986). However, the inherent brittleness of the
the base material. Therefore, during the running-in wear ceramic remains unchanged because it continues to exhibit
stage, the mass of superficial porcelain of the PFM crown in low tensile strength and low ductility and toughness values
the contact zone, with a smaller contact area and under (Quinn et al., 2003). Both brittle fracturing and fatigue wear
higher contact stress, experienced obvious wear damage are known to be responsible for the wear behavior of
and material loss. Correspondingly, the wear curve showed ceramic materials (D’Incau et al., 2012; Mair et al., 1996;
rapid growth during this period. SEM images of the wear Suputtamongkol et al., 2010). According to Mair et al. (1996),
facets during the running-in wear stage, revealing rough the compression and tension zones were generated in porce-
surfaces with grooves, defects and chipping (Fig. 4c and d), lain when an antagonist contacted and slid over porcelain.
suggested active wear behavior at the occlusal surface. With limited capacity for plastic deformation, microcracks
While from the cross-sectional view, brittle breakage and can nucleate and propagate as a result of repeated stress (Yu
chipping were confined to the superficial ceramic layer, et al., 2006). Eventually, these cracks might connect with one
with the deeper ceramic structure of the subsurface another, resulting in the separation and delamination of
remaining intact. As wear progressed, the contact area material pieces. For the veneering porcelain of the PFM crown
increased gradually, which in turn reduced the contact investigated in this study, the wear behavior during the
stress (Bailey et al., 1981). Consequently, the wear rate running-in wear stage was dominated by brittle fractures of
persistently decreased from the running-in wear stage to the superficial ceramic, which resulted in a large number of
the steady wear stage. When it decreased to less than a wear traces, while with the ongoing wear process, the wear
certain threshold, a balance might be achieved among the behavior was converted to fatigue wear during the severe
stress condition, the wear behavior and the microstructure wear stage. When the propagation of cracks reached the
of the PFM crown. Such a period was called the steady wear occlusal surface, fairly large fragments of material detached.
stage, during which the surface area of the wear facets As for the steady wear stage, it was a transitional period
increased slowly and the wear rate maintained at a rela- before the cracks reached the critical condition.
tively low value. Under these circumstances, the stress Our investigation of the three featured wear stages of PFM
intensity factor caused by the lower stress condition did crowns should be a starting point for exploring their underlying
not reach a critical level (Baran et al., 2001; Cesar et al., wear mechanisms, adding a new dimension to the under-
2008). Therefore, delaminating and chipping of the super- standing of the complex wear behavior of the oral cavity and
ficial ceramic layer of the crown presented slow and stable providing a novel method for estimating the wear resistance of
growth, rather than dramatic fracturing, which predomi- all kinds of ceramic restorations. The previous evaluation
nated during the running-in wear stage. During the steady methods, which mainly focused on the amount of wear loss
wear stage, decreasing the density of wear tracks and but ignored the existence of three wear stages, might not be
having smooth surfaces (Fig. 4e and f) were observed in ideal for analyzing the wear behavior of ceramic restorations.
the contact zone, indicating lower wear activity on the For example, after the same number of wear cycles, the wear
crown’s surface. However, from the cross-sectional view, loss of two different kinds of ceramic crowns are at the same
the generated cracks were located in the shallow subsur- level, but the wear statuses are in different wear stages, and the
face of the porcelain and closed onto the occlusal surface situation is too arbitrary to decide whether the two kinds of
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