臺灣博碩士論文加值系統

實驗目的：鑲瓷面的斷裂在臨床上甚為常見，且其所產生的美觀與功能的問題，往往會造成病人以及牙醫師的困擾。本實驗的目的探討不同厚度的鑲瓷面，作用在植體的金屬瓷冠上時，其鑲瓷面的抗斷裂強度是否會受厚度的影響。
材料與方法：40顆寬高長為8×8×8 mm的立方體形狀的金屬瓷冠製作成兩種不同厚度的鑲瓷面，在咬合面、頰側面、近心面、舌側面及遠心面等比例削減1.5mm及2.5mm的厚度，以製作分別為Group 1與Group 3：鑲瓷面為1.5mm；Group 2與Group 4：鑲瓷面為2.5mm，並分成為四組，每組各10顆。並選用Brånemark RP的植體類比體，從平台開始露出約2 mm的高度，並注入硬石膏倒模型，以製作寬高長為30×30×84 mm的實驗模具。植體類比體接上簡易式支台齒後，以暫時黏著劑將金屬瓷冠接上。首先，在Group 3與Group 4的金屬瓷冠上，先以80牛頓、頻率為3Hz，作100,000次垂直的動態力，施壓在近心側邊緣崤咬合面內1mm以作測試，以模擬半年內口腔的咀嚼運動。之後，將所有實驗組的金屬瓷冠固定上拉力測試機（Instron 5566），並以0.5mm/min的速度施壓在金屬瓷冠上近心側邊緣崤咬合面內1mm，直到鑲瓷面發生斷裂，並記錄各組金屬瓷冠的平均抗斷裂數值（kgf）。且利用掃瞄式電子顯微鏡觀察裂紋的型態。以二方分類變異數分析法（two-way ANOVA）與獨立樣本T-檢定（independent t test）來比較不同組之間的差異，同時觀察二項變因，包括不同厚度的鑲瓷面以及動態力是否參與對金屬瓷冠是否有所影響。統計顯著之水準定義：p＜0.05。
實驗結果：（1）Group 3與4的金屬瓷冠經過垂直的動態力測試後，鑲瓷面並沒有發生斷裂，只有凹洞的產生。（2）各實驗組經過單次負載測試後，所得的平均瓷抗斷裂值分別為：Group 1：129.63±12.65 kgf；Group 2：116.08±10.83 kgf；Group 3：84.18±3.98 kgf；Group 4：66.94±11.05 kgf。（3）經過單次負載測試，對於厚度不同的鑲瓷面，只有進行過週期性疲勞測試的實驗組（Group3&4），其瓷抗斷裂的平均值呈現統計上的差異。（4）進行週期性疲勞測試的金屬瓷冠，在電子顯微鏡的觀察下，凹洞處的陶瓷有裂紋形成及裂紋向外擴散的情況。另外，進行單次負載測試的金屬瓷冠，斷裂面較為平整。
結論：根據本實驗的結果，臨床上當補綴物其鑲瓷面的厚度減少至1.5 mm內，能降低鑲瓷面斷裂的機會，而不減少其美觀。

Purpose: Fracture of ceramic veneers is frequently observed in clinical practice and poses an esthetic and functional dilemma both for the patient and the dentist. The purpose of this study was to compare the porcelain fracture resistance between two different thickness of porcelain on the cement-retained implant metal-ceramic crowns. Material and methods: Forty (8×8×8 mm, W×H×L) cubic-shaped single metal-ceramic crowns were fabricated with two different thickness (1.5 mm or 2.5 mm) of porcelain and divided into four groups (10 crowns each): Groups 1 & 3 (1.5 mm), Groups 2 & 4 (2.5 mm). All the samples were cemented on 1mm Easy abutment above a Brånemark RP implant analog embedded in a 30×30×84 mm type IV die stone block. Groups 3 & 4 were first exposed to a vertically dynamic loading of 80N for 100,000 cycles to simulate masticatory function at mesial marginal ridge of the occlusal surface. Afterwards, all the samples were positioned in a custom testing apparatus and vertically loaded on the mesial marginal ridge of the occlusal surface with a universal testing machine (Instron 5566) at a crosshead speed of 0.5 mm/min until fracture. SEM fractographic analysis was utilized to determine the fracture patterns. Mean values of load at fracture (kgf) were recorded in each group and compared with a 2-way ANOVA and independent t-test (p＜0.05)(factors: porcelain thickness, with/without dynamic loading).
Results: 1. No obvious ceramic fracture except digging pits was observed in Groups 3 & 4 after dynamic loading. 2. Mean values of loads required to fracture the crowns were as follow: Group 1: 129.63 ± 12.65 kgf; Group 2: 116.08 ± 10.83 kgf; Group 3: 84.18 ± 3.98 kgf; Group 4: 66.94 ± 11.05 kgf. 3. Dynamic loading prior to fracture test reduced the mean fracture loads significantly in Groups 3 & 4. 4. Cohesive or adhesive fracture of the porcelain can be observed in all four groups in fracture test.
Conclusions: From a clinical viewpoint, to diminish the porcelain thickness of about 1.5mm, can decrease the probability of porcelain fracture of metal-ceramic crowns.

英文摘要………………………………………………………1
中文摘要………………………………………………………3
壹、前言………………………………………………………5
貳、文獻回顧…………………………………………………6
I. 鑲瓷面斷裂的機率……………………………………………6
II. 金屬瓷冠斷裂面的分類………………………………………7
III. 鑲瓷面斷裂病因的探討………………………………………8
IV. 斷裂面特徵的研究……………………………………………11
參、研究目的…………………………………………………13
肆、材料與方法………………………………………………14
I. 實驗模具的製作………………………………………………14
II. 補綴物製作……………………………………………………14
II-1. 支柱的選擇……………………………………………………………14
II-2. 牙冠模型以及薄蓋冠（coping）的製作………………………………14
II-3. 鑄道及包埋……………………………………………………………15
II-4. 去蠟及鑄造……………………………………………………………15
II-5. 金屬瓷冠的製作………………………………………………………16
III. 實驗模模型的取得…………………………………………16
IV. 週期性疲勞測試……………………………………………17
IV-1. 應變計黏貼及位置……………………………………………………17
IV-2. 施力點的選擇及夾具固定……………………………………………17
IV-3. 裝置……………………………………………………………………17
IV-4. 測試機的設定…………………………………………………………17
V. 單次負載斷裂測試……………………………………………18
V-1. 施力點的選擇及夾具固定……………………………………………18
V-2. 測試機的設定…………………………………………………………18
VI. 測試順序………………………………………………………18
VII. 實驗資料分析………………………………………………19
VII-1. 週期性疲勞測試……………………………………………………19
VII-2. 單次負載斷裂測試…………………………………………………19
VIII. 掃描式電子顯微鏡觀察分析………………………………19
VIII-1. 操作過程……………………………………………………………19
VIII-2. 影像攝影與紀錄……………………………………………………19
IX. 統計方法……………………………………………………20
伍、結果………………………………………………………21
I. 週期性疲勞測試分析…………………………………………21
II. 敘述性統計……………………………………………………21
III. 綜合分析……………………………………………………22
IV. 掃描式電子顯微鏡觀察分析………………………………22
陸、討論………………………………………………………24
I. 應變應力分析法………………………………………………24
II. 實驗設計：施力、頻率、撞擊點及牙冠型態的選擇………25
III. 結果分析……………………………………………………26
IV. 掃描式電子顯微鏡觀察分析…………………………………26
V. 相關文獻比較分析……………………………………………28
柒、總結………………………………………………………31
捌、未來研究展望……………………………………………32
附圖…………………………………………………………33
附表…………………………………………………………70
參考文獻……………………………………………………74

附　　圖

圖 1、金屬—陶瓷黏結失敗的分類………………………………………………33
圖 2、寬高長為30×30×84 mm的實驗模具………………………………………33
圖 3、Brånemark RP 1mm高的簡易式支台齒……………………………………34
圖 4、牙冠模型……………………………………………………………………34
圖 5、金屬薄蓋冠側面觀…………………………………………………………35
圖 6、薄蓋冠跟支台齒的密合情況………………………………………………35
圖 7、在析量碾磨機上將受測牙冠的高度碾磨至8 mm高……………………36
圖 8、實驗模型正面觀……………………………………………………………36
圖 9、剪裁過的應變計……………………………………………………………37
圖10、訂製的施力棒………………………………………………………………37
圖11、週期性疲勞測試正面觀……………………………………………………38
圖12、週期性疲勞測試裝置………………………………………………………38
圖13、單次負載斷裂測試裝置圖…………………………………………………39
圖14、單次負載斷裂測試近照觀…………………………………………………39
圖15、鑲瓷面厚度為1.5 mm，進行週期性疲勞測驗，測試開始0s-3s
的情況………………………………………………………………………40
圖16、鑲瓷面厚度為1.5 mm，進行週期性疲勞測驗，測試中段16750s
的情況………………………………………………………………………41
圖17、鑲瓷面厚度為1.5 mm，進行週期性疲勞測驗，測試結束33500s
的情況………………………………………………………………………41
圖18、鑲瓷面厚度為2.5 mm，進行週期性疲勞測驗，測試開始0s-3s
的情況……………………………………………………………………42
圖19、鑲瓷面厚度為2.5 mm，進行週期性疲勞測驗，測試中段16750s
的情況………………………………………………………………………42
圖20、鑲瓷面厚度為2.5 mm，進行週期性疲勞測驗，測試結束33500s
的情況………………………………………………………………………43
圖21、經過週期性疲勞測試，鑲瓷面表面所形成的凹洞………………………43
圖22、Group 1–樣品 1在單次負載測試下之原始資料折線圖…………………44
圖23、Group 1–樣品 2在單次負載測試下之原始資料折線圖…………………44
圖24、Group 1–樣品 3在單次負載測試下之原始資料折線圖…………………45
圖25、Group 1–樣品 4在單次負載測試下之原始資料折線圖…………………45
圖26、Group 1–樣品 5在單次負載測試下之原始資料折線圖…………………46
圖27、Group 1–樣品 6在單次負載測試下之原始資料折線圖…………………46
圖28、Group 1–樣品 7在單次負載測試下之原始資料折線圖…………………47
圖29、Group 1–樣品 8在單次負載測試下之原始資料折線圖…………………47
圖30、Group 1–樣品 9在單次負載測試下之原始資料折線圖…………………48
圖31、Group 1–樣品10在單次負載測試下之原始資料折線圖…………………48
圖32、Group 2–樣品 1在單次負載測試下之原始資料折線圖…………………49
圖33、Group 2–樣品 2在單次負載測試下之原始資料折線圖…………………49
圖34、Group 2–樣品 3在單次負載測試下之原始資料折線圖…………………50
圖35、Group 2–樣品 4在單次負載測試下之原始資料折線圖…………………50
圖36、Group 2–樣品 5在單次負載測試下之原始資料折線圖…………………51
圖37、Group 2–樣品 6在單次負載測試下之原始資料折線圖…………………51
圖38、Group 2–樣品 7在單次負載測試下之原始資料折線圖…………………52
圖39、Group 2–樣品 8在單次負載測試下之原始資料折線圖…………………52
圖40、Group 2–樣品 9在單次負載測試下之原始資料折線圖…………………53
圖41、Group 2–樣品10在單次負載測試下之原始資料折線圖…………………53
圖42、Group 3–樣品 1在單次負載測試下之原始資料折線圖…………………54
圖43、Group 3–樣品 2在單次負載測試下之原始資料折線圖…………………54
圖44、Group 3–樣品 3在單次負載測試下之原始資料折線圖…………………55
圖45、Group 3–樣品 4在單次負載測試下之原始資料折線圖…………………55
圖46、Group 3–樣品 5在單次負載測試下之原始資料折線圖…………………56
圖47、Group 3–樣品 6在單次負載測試下之原始資料折線圖…………………56
圖48、Group 3–樣品 7在單次負載測試下之原始資料折線圖…………………57
圖49、Group 3–樣品 8在單次負載測試下之原始資料折線圖…………………57
圖50、Group 3–樣品 9在單次負載測試下之原始資料折線圖…………………58
圖51、Group 3–樣品10在單次負載測試下之原始資料折線圖…………………58
圖52、Group 4–樣品 1在單次負載測試下之原始資料折線圖…………………59
圖53、Group 4–樣品 2在單次負載測試下之原始資料折線圖…………………59
圖54、Group 4–樣品 3在單次負載測試下之原始資料折線圖…………………60
圖55、Group 4–樣品 4在單次負載測試下之原始資料折線圖…………………60
圖56、Group 4–樣品 5在單次負載測試下之原始資料折線圖…………………61
圖57、Group 4–樣品 6在單次負載測試下之原始資料折線圖…………………61
圖58、Group 4–樣品 7在單次負載測試下之原始資料折線圖…………………62
圖59、Group 4–樣品 8在單次負載測試下之原始資料折線圖…………………62
圖60、Group 4–樣品 9在單次負載測試下之原始資料折線圖…………………63
圖61、Group 4–樣品10在單次負載測試下之原始資料折線圖…………………63
圖62、Groups 1、2、3、4各實驗組所得之箱型圖………………………………64
圖63、斷裂位置：只有陶瓷的斷裂………………………………………………65
圖64、斷裂位置：除了陶瓷斷裂外，也有小部份金屬的外露…………………65
圖65、全新的施力棒撞擊頭表面…………………………………………………66
圖66、經過疲勞測試後的施力棒撞擊頭表面……………………………………66
圖67、全新金屬瓷冠鑲瓷表的表面（500X）……………………………………67
圖68、經過疲勞測試後，金屬瓷冠鑲瓷面的表面（50X）………………………67
圖69、撞擊點中心位置（500X）…………………………………………………68
圖70、撞擊點邊緣位置（500X）…………………………………………………68
圖71、經過單次負載測試後，金屬瓷冠鑲瓷面的緃切面觀（20X）……………69
圖72、大量的河流圖案……………………………………………………………69

附　　表

表 1、Groups 1、2、3、4各實驗組所有受測樣品之瓷抗斷裂值（kgf）……………70
表 2、Groups 1、2、3、4各實驗組所得之標準差統計表…………………………70
表 3、Groups 1、2、3、4各實驗組所有受測樣品在斷裂時撞擊頭之垂直
位置量（mm）………………………………………………………………70
表 4、Groups 1、2、3、4各實驗組標準差在相互比較之獨立樣本T檢定表……71
表 5、Thickness以及Dynload的標準差之獨立樣本T檢定表……………………71
表 6、迴歸分析結果之變異係數分析表……………………………………………72
表 7、瓷抗斷裂值（PFR）與二個參數（Thickness，DynLoad）間之
Pearson相關係數分析表……………………………………………………72
表 8、相關文獻對金屬瓷冠其瓷抗斷裂的實驗方法及結果的總整理……………73

1.Abu-Hassan MI, Abu-Hammad OA, Harrison A. Strains and tensile stress distribution in loaded disc-shaped ceramics specimens. an FEA study. J Oral Rehabil 1998;25:490-495.
2.Akeel R, Nilner M, Nilner K. Masticatory efficiency in individuals with natural dentition. Swed Dent J 1992;16:191-198.
3.Antolovich SD, Saxena A. Fatigue failure. In”Metals handbook”9th ed, Taylor L ed, American Society for Metals, Ohio, pp.102-135, 1986
4.Anusavice KJ, Zhang NZ. Chemical durability of Dicor and fluorocanasite-base glass-ceramics. J Dent Res 1998;77:1553-1559.
5.Ban S, Anusavice KJ. Influence of test method on failure stress of brittle dental materials. J Dent Res 1990;69:1791-1799.
6.Bates JF, Stafford GD, Harrison A. Masticatory function – a review of the literature. II. Speed of movement of the mandible, rate of chewing and forces developed in chewing. J Oral Rehabil 1975;2:281-301.
7.Bates JF, Stafford GD, Harrison A. Masticatory function – a review of the literature. III. Masticatory performance and efficiency. J Oral Rehabil 1976;3:57-67.
8.Bragger U, Aeschlimann S, Burgin W, Hammerle CH, Land NP. Biological and technical complications and failures with fixed partial denture (FPD) on implants and teeth after four to five years of function. Clin Oral Implants Res 2001;12:26-34.
9.Burke FJ. Fracture resistance of teeth restored with dentin-bonded crowns: the effect of increased tooth preparation. Quintessence Int 1996;27:115-121.
10.Burke FJ, Grey NJ. Repair of fracture porcelain units: alternative approaches. Br Dent J 1994;176:251-256.
11.Castellani D, Baccetti T, Giovannoni A, Bernardini UD. Resistance to fracture of metal ceramic and all-ceramic crowns. Int. J Prosthodont 1994;7:149-154.
12.Cheung GS. A preliminary investigation into the longevity and causes of failure of single unit extracoronal restorations. J Dent 1991;19:160-163.
13.Chung KH, Hwang YC. Bonding strengths of porcelain repair systems with various surface treatments. J Prosthet Dent 1997;78:267-274.
14.Clayton JA, Green E. Roughness of pontic materials and dental plaque. J Prosthet Dent 1970;23:407-411.
15.Coornaert J, Adrians P, Boever J. Long-term clinical study of porcelain-fused-to-gold restorations. J Prosthet Dent 1984;51:338-342.
16.Craig RG. ”Restorative Dental Materials.”Ninth Edition, Mosby-Year Book, Int. pp. 477, 1993
17.Dauskardt RH, Marshall DB, Ritchie RO. Cyclic fatigue-crack propagation in magnesia-partially-stabilized zirconia ceramics. J Am Ceram Soc 1990;73:893-903.
18.Denry IL, Hollowey JA, Rosentiel SF. Effect of ion exchange on the microstructure, strength and thermal expansion behavior of a leucite-reinforced porcelain. J Dent Res 1998;77:583-588.
19.Dong XD, Darvell BW. Stress distribution and failure mode of dental ceramic structures under Hertzian indentation. Dent Mater 2003;19:542-551.
20.Ekfeldt A, Carlsson GE, Borjesson G. Clinical evaluation of single-tooth restorations supported by osseointegrated implants: a retrospective study. Int J Oral Maxillofac Implants 1994;9:179-183.
21.Farah JW, Craig RG. Distribution of stresses in porcelain fused to metal and porcelain jacket crowns. J Dent Res 1975;54:255-261.
22.Harrington Z, McDonald A, Knowles J. An in vitro study to investigate the load at fracture of Procera allceram crowns with various thickness of occlusal veneer porcelain. Int J Prosthodont 2003;16:54-58.
23.Hasselman DPH, Fulrath RM. Proposed fracture theory of a dispersion-strengthened glass matrix. J Am Ceram Soc 1966;49:68-72.
24.Helkimo E, Ingervall B. Bite force and functional state of the masticatory system in young men. Swed Dent J 1978;2:167-75.
25.Julien KC, Buschang PH, Throckmorton GS, Dechow PC. Normal masticatory performance in young adults and children. Arch Oral Bio 1996;41:69-75.
26.Kang MS, Ercoli C, Galindo DF, Graser GN, Moss ME, Tallents RH. Comparison of the load at failure of soldered and non-soldered porcelain fused-to-metal crowns. J Prosthet Dent 2003;90:235-240.
27.Kim Y, Oh TJ, Misch CE, Wang HL. Occlusal considerations in implant therapy: clinical guidelines with biomechanical rationale. Clin Oral Implants Res 2005;16:26-35.
28.Ku CW, Park SW, Yang HS. Comparison of the fracture strengths of metal-ceramic crowns and three ceromer crowns. J Prosthet Dent 2002;88:170-175.
29.Lamon J, Evans AG. Statistical analysis of bending strength for brittle solids: A multiaxial fracture problem. J Am Ceram Soc 1983;66:177-182.
30.Levine RA, Clem D, Beagle J, Ganeles J, Johnson P, Solnit G, Keller GW. Multicenter retrospective analysis of the solid-screw ITI implant for posterior single-tooth replacements. Int J Oral Maxillofac Implants 2002;17:550-556.
31.Llobell A, Nicholls JI, Kois JC, Daly CH. Fatiaue life of porcelain repair systems. Int J Prosthodontics 1992;5:205-213.
32.Mackert JR. Effects of thermally induced changes on porcelain-metal compatibility. In: Perspectives in Dental Ceramics. Proceedings of the Forth International Symposium on Ceramics. Preston JD ed, Quintessence Publishing Co., Chicago, IL. pp. 53, 1988
33.McLean JW, Hughes TH. The reinforcement of dental porcelain with ceramic oxides. Br Dent J 1965;119:251-267.
34.McLean JW. A clinical evaluation of recent methods of strengthening dental porcelain. Trans J Br Ceram Soc 1971;70:124-132.
35.Michalske TA, Freiman SW. A molecular interpretation of stress corrosion in silica. Nature 1982;295:511-512.
36.Miller A, Long J, Miller B, Cole J. Comparison of the fracture strengths of ceraminetal crowns versus several all-cermaic crowns. J Prosthet Dent 1992;68:38-41.
37.Monasky GE, Taylor DF. Studies on the wear of porcelain, enamel and gold. J Prosthet Dent 1971;25:299-306.
38.Morneberg TR, Proschel PA. Measurement of masticatory forces and implant loads: a methodologic clinical study. Int J Prosthodonts 2002;15:20-27.
39.Morneberg TR, Proschel PA. In vivo forces on implants influences by occlusal scheme and food consistency. Int J Prosthodont 2003;16:343-347.
40.O''Brien WJ. Ceramics. Dent Clin North Am 1985;29:851-863.
41.Oilo G. Flexural strength and internal defect of some dental porcelain. Acta Odontol Scand 1988;46:313-322.
42.Oram DA, Davies EH, Cruickshanks-Boyd DW. Fracture of ceramic and metalloceramic cylinders. J Prosthet Dent 1984;52:221-230.
43.Ozcan M. Fracture Strength of Ceramic-Fused-to-Metal Crowns Repaired with Two Intraoral Air-Abrasion-Techniques and Some Aspects of Silane Treatment-A Laboratory and Clinical Study (In English). Med Diss, Cologne, Germany. 1999.
44.Ozcan M. Fracture reasons in ceramic-fused-to-metal-restorations. J Oral Rehabil 2003;30:265-269.
45.Ozcan M, Niedermeier W. Clinical study on the reasons and location of the failure of metal-ceramic restorations and survival of repairs. Int J Prosthodont 2002;15:299-302.
46.Phillips RW, Swartz ML. Effect of certain restorative materials on solubility of enamel J Am Dent Assoc 1957;54:623-636.
47.Podshadley AG, Harrison JD. Rat connective tissue response to pontic materials. J Prosthet Dent 1966;16:110-118.
48.Powell GW. Ductile and brittle fractures. In”Metals handbook”9th ed, Taylor L ed, American Society for Metals, Ohio, pp.82-101, 1986
49.Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed Prosthodontics, 1st ed, St Louis: Mosby, pp.115-155, 1988
50.Sherrill CA, O’Brein WJ. Transverse strength of aluminous and feldspathic porcelain. J Dent Res 1974;53:683-690.
51.Shillingburg HT, Hobo S, Whitsett LD, Jacobi R, Brackett SE. Fundamentals of Fixed Prosthodontics, 3rd ed. Chicago: Quintessence, pp. 457-458, 1997
52.Singer A, Serfaty V. Cement-retained implant-supported fixed partial dentures: a 6-month to 3-year follow-up. Int J Oral Maxillofac Implants 1996;11:645-649.
53.Strub JR, Stiffler S, Scharer P. Causes of failure following oral rehabilitation: biological versus technical factors. Quintessence Int 1988;19:215-222.
54.Szivek JA, Gharpuray VM. Strain gauge measurements from bone surfaces. In "Mechanical Testing of Bone and the Bone-Implant Interface" An YH, Draughn RA ed, CRC Press LLC, Washington, D.C., pp.305-320, 2000
55.Torrado E, Ercoli C, Al Mardini M, Graser GN, Tallents RH, Cordaro L. A comparison of the porcelain fracture resistance of screw-retained and cement-retained implant-supported metal-ceramic crowns. J Prosthet Dent 2004;91:532-537.
56.Ulusoy M, Toksavul S. Fracture resistance of five different metal framework designs for metal-ceramic restorartions. Int. J Prosthodont 2002;15:571-574.
57.Walton JN, Gardner FM, Agar JR. A survey of crown and fixed partial denture failures: length of service and reasons for replacement. J Prosthet Dent 1986;56:416-421.
58.Wataha JC. Alloys for prosthodontic restorations. J Prosthet Dent 2002;87:351-363.
59.Widerhorn SM. Moisture assisted crack growth in ceramics. Int J of Fract 1968;4:171-177.
60.Widerhorn SM. Subcritical crack growth in ceramics. In: Fracture Mechanics of Ceramics, Vol. 2, Bradt DC, Hasselman DPH, Lange FF ed, pp.613, 1974
61.William D, Callister Jr. Materials Science and Engineering, An Introduction. 3rd ed, John Wiley ed, pp. 429, 1994
62.Zarone F, Sorrentino R, Traini T, Di lorio D, Caputi S. Fracture resistance of implant-supported screw- versus cement-retained porcelain fused to metal single crowns: SEM fractographic analysis. Dent Mater 2007;23:296–301.
63.陳兆勛. 破壞力學之實際應用. 第一版, 國立編譯館, 台北, pp. 1998;1-45.