Comparing the Fracture Resistance and Modes of Failure in Different Types of CAD/CAM Zirconia Abutments with Internal Hexagonal Implants: An In Vitro Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
- There was a marginally significant difference in fracture resistance between the three groups, with the ASC zirconia abutment tending to have a higher fracture resistance than the full zirconia abutment.
- The presence or absence of a titanium insert affects the modes of failure in zirconia abutments. When there is a titanium reinforcement, the abutment presents a relatively horizontal fracture surface; if not, it exhibits an oblique fracture. Furthermore, the titanium insert keeps the buccal fracture surface of the zirconia abutment away from the implant platform, thereby protecting the implant–abutment connection.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Adell, R.; Lekholm, U.; Rockler, B.; Brånemark, P.I. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int. J. Oral Surg. 1981, 10, 387–416. [Google Scholar] [CrossRef]
- Buser, D.; Mericske-Stern, R.; Bernard, J.P.; Behneke, A.; Behneke, N.; Hirt, H.P.; Belser, U.C.; Lang, N.P. Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants. Clin. Oral Implants Res. 1997, 8, 161–172. [Google Scholar] [CrossRef] [PubMed]
- Jung, R.E.; Holderegger, C.; Sailer, I.; Khraisat, A.; Suter, A.; Hämmerle, C.H. The effect of all-ceramic and porcelain-fused-to-metal restorations on marginal peri-implant soft tissue color: A randomized controlled clinical trial. Int. J. Periodontics Restor. Dent. 2008, 28, 357–365. [Google Scholar]
- Prestipino, V.; Ingber, A. All-ceramic implant abutments: Esthetic indications. J. Esthet. Dent. 1996, 8, 255–262. [Google Scholar] [CrossRef]
- Bressan, E.; Paniz, G.; Lops, D.; Corazza, B.; Romeo, E.; Favero, G. Influence of abutment material on the gingival color of implant supported all-ceramic restorations: A prospective multicenter study. Clin. Oral Implants Res. 2011, 22, 631–637. [Google Scholar] [CrossRef]
- Prestipino, V.; Ingber, A. Esthetic high strength implant abutments. Part I. J. Esthet. Dent. 1993, 5, 29–36. [Google Scholar] [CrossRef]
- Prestipino, V.; Ingber, A. Esthetic high strength implant abutments. Part II. J. Esthet. Dent. 1993, 5, 63–68. [Google Scholar] [CrossRef]
- Yildirim, M.; Fisher, H.; Marx, R.; Edelhoff, D. In vivo fracture resistance of implant-supported all-ceramic restorations. J. Prosthet. Dent. 2003, 4, 325–331. [Google Scholar] [CrossRef]
- Butz, F.; Heydecke, G.; Okutan, M.; Strub, J.R. Survival rate, fracture strength and failure mode of ceramic implant abutments after chewing simulation. J. Oral Rehabil. 2005, 32, 838–843. [Google Scholar] [CrossRef] [Green Version]
- Wohlwend, A.; Studer, S.; Scharer, P. Das zirkonoxidabutment ein neues vollkeramisches konzept zur ästhetischen verbesserung der suprastruktur in der implantologie. Quint. Zahnt. 1996, 22, 364–381. [Google Scholar]
- Gibbs, C.H.; Mahan, P.E.; Mauderli, A.; Lundeen, H.C.; Walsh, E.K. Limits of human bite strength. J. Prosthet. Dent. 1986, 56, 226–229. [Google Scholar] [CrossRef]
- Baldissara, P.; Llukacej, A.; Ciocca, L.; Valandro, F.L.; Scotti, R. Translucency of zirconia copings made with different CAD/CAM systems. J. Prosthet. Dent. 2010, 104, 6–12. [Google Scholar] [CrossRef]
- Paphangkorakit, J.; Osborn, J.W. The effect of pressure on a maximum incisal bite force in man. Arch. Oral Biol. 1997, 42, 11–17. [Google Scholar] [CrossRef]
- Helkimo, E.; Carlsson, G.E.; Helkimo, M. Bite force and state of dentition. Acta Odontol. Scand. 1977, 35, 297–303. [Google Scholar] [CrossRef] [PubMed]
- Haraldson, T.; Carlsson, G.E.; Ingervall, B. Functional state, bite force and postural muscle activity in patients with osseointegrated oral implant bridges. Acta Odontol. Scand. 1979, 37, 195–206. [Google Scholar] [CrossRef]
- Waltimo, A.; Könönen, M. A novel bite force recorder and maximal isometric bite force values for healthy young adults. Scand. J. Dent. Res. 1993, 101, 171–175. [Google Scholar] [CrossRef] [PubMed]
- Mitsias, M.E.; Silva, N.R.; Pines, M.; Stappert, C.; Thompson, V.P. Reliability and fatigue damage modes of zirconia and titanium abutments. Int. J. Prosthodont. 2010, 23, 56–59. [Google Scholar] [PubMed]
- Kim, S.; Kim, H.I.; Brewer, J.D.; Monaco, E.A., Jr. Comparison of fracture resistance of pressable metal ceramic custom implant abutments with CAD/CAM commercially fabricated zirconia implant abutments. J. Prosthet. Dent. 2009, 101, 226–230. [Google Scholar] [CrossRef]
- Luthardt, R.G.; Holzhüter, M.; Sandkuhl, O.; Herold, V.; Schnapp, J.D.; Kuhlisch, E.; Walter, M. Reliability and properties of ground Y-TZP-zirconia ceramics. J. Dent. Res. 2002, 81, 487–491. [Google Scholar] [CrossRef]
- Leutert, C.R.; Stawarczyk, B.; Truninger, T.C.; Hämmerle, C.H.; Sailer, I. Bending moments and types of failure of zirconia and titanium abutments with internal implant-abutment connections: A laboratory study. Int. J. Oral Maxillofac. Implants 2012, 27, 505–512. [Google Scholar]
- Ferrari, M.; Tricarico, M.G.; Cagidiaco, M.C.; Vichi, A.; Gherlone, E.F.; Zarone, F.; Sorrentino, R. 3-Year Randomized Controlled Prospective Clinical Trial on Different CAD-CAM Implant Abutments. Clin. Implant Dent. Relat. Res. 2016, 18, 1134–1141. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Gehrke, P.; Johannson, D.; Fischer, C.; Stawarczyk, B.; Beuer, F. In vitro fatigue and fracture resistance of one- and two-piece CAD/CAM zirconia implant abutments. Int. J. Oral Maxillofac. Implants 2015, 30, 546–554. [Google Scholar] [CrossRef] [PubMed]
- Lin, Y.T.; Shen, Y.F.; Wei, P.C.; Hsu, K.W. Clinical evaluation of two-piece zirconia abutments with bonded titanium inserts for implant-supported restorations. J. Prosthet. Dent. 2020, 123, 449–454. [Google Scholar] [CrossRef] [PubMed]
- Gigandet, M.; Bigolin, G.; Faoro, F.; Bürgin, W.; Brägger, U. Implants with original and non-original abutment connections. Clin. Implant Dent. Relat. Res. 2014, 16, 303–311. [Google Scholar] [CrossRef] [PubMed]
- Jarman, J.M.; Hamalian, T.; Randi, A.P. Comparing the fracture resistance of alternatively engineered zirconia abutments with original equipment manufactured abutments with different implant connection designs. Int. J. Oral Maxillofac. Implants 2017, 32, 992–1000. [Google Scholar] [CrossRef] [Green Version]
- Sailer, I.; Sailer, T.; Stawarczyk, B.; Jung, R.E.; Hämmerle, C.H. In vitro study of the influence of the type of connection on the fracture load of zirconia abutments with internal and external implant-abutment connections. Int. J. Oral Maxillofac. Implants 2009, 24, 850–858. [Google Scholar]
- Adatia, N.D.; Bayne, S.C.; Cooper, L.F.; Thompson, J.Y. Fracture resistance of yttria-stabilized zirconia dental implant abutments. J. Prosthodont. 2009, 18, 17–22. [Google Scholar] [CrossRef] [Green Version]
- Nothdurft, F.P.; Doppler, K.E.; Erdelt, K.J.; Knauber, A.W.; Pospiech, P.R. Fracture behavior of straight or angulated zirconia implant abutments supporting anterior single crowns. Clin. Oral Investig. 2011, 15, 157–163. [Google Scholar] [CrossRef]
- Gehrke, P.; Dhom, G.; Brunner, J.; Wolf, D.; Degidi, M.; Piattelli, A. Zirconium implant abutments: Fracture strength and influence of cyclic loading on retaining-screw loosening. Quintessence Int. 2006, 37, 19–26. [Google Scholar]
- Park, J.I.; Lee, Y.; Lee, J.H.; Kim, Y.L.; Bae, J.M.; Cho, H.W. Comparison of fracture resistance and fit accuracy of customized zirconia abutments with prefabricated zirconia abutments in internal hexagonal implants. Clin. Implant Dent. Relat. Res. 2013, 15, 769–778. [Google Scholar] [CrossRef]
- Xu, H.K.K.; Jahanmir, S.; Ives, L.K. Effect of grinding on strength of tetragonal zirconia and zirconia-toughened alumina. Mach. Sci. Technol. 1997, 1, 49–66. [Google Scholar] [CrossRef]
- Stuebinger, S.; Hodel, Y.; Filippi, A. Trauma to anterior implants. Dent. Traumatol. 2004, 2, 169–171. [Google Scholar] [CrossRef] [PubMed]
- Kim, K.-S.; Lim, Y.-J. Axial Displacements and Removal Torque Changes of Five Different Implant-Abutment Connections under Static Vertical Loading. Materials 2020, 13, 699. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Stimmelmayr, M.; Sagerer, S.; Erdelt, K.; Beuer, F. In vitro fatigue and fracture strength testing of one-piece zirconia implant abutments and zirconia implant abutments connected to titanium cores. Int. J. Oral Maxillofac. Implants 2013, 28, 488–493. [Google Scholar] [CrossRef] [Green Version]
- Stimmelmayr, M.; Edelhoff, D.; Güth, J.F.; Erdelt, K.; Happe, A.; Beuer, F. Wear at the titanium-titanium and the titanium-zirconia implant-abutment interface: A comparative in vitro study. Dent. Mater. 2012, 28, 1215–1220. [Google Scholar] [CrossRef]
- Maeda, Y.; Satoh, T.; Sogo, M. In vitro differences of stress concentrations for internal and external hex implant-abutment connections: A short communication. J. Oral Rehabil. 2006, 33, 75–78. [Google Scholar] [CrossRef]
- Klotz, M.W.; Taylor, T.D.; Goldberg, A.J. Wear at the titanium-zirconia implant-abutment interface: A pilot study. Int. J. Oral Maxillofac. Implants 2011, 26, 970–975. [Google Scholar]
- Park, J.M.; Baek, C.H.; Heo, S.J.; Kim, S.K.; Koak, J.Y.; Kim, S.K.; Belser, U.C. An In Vitro Evaluation of the Loosening of Different Interchangeable Abutments in Internal-Connection-Type Implants. Int. J. Oral Maxillofac. Implants 2017, 32, 350–355. [Google Scholar] [CrossRef] [Green Version]
- Alonso-Pérez, R.; Bartolomé, J.F.; Ferreiroa, A.; Salido, M.P.; Pradíes, G. Original vs. nonoriginal abutments for screw-retained single implant crowns: An in vitro evaluation of internal fit, mechanical behaviour and screw loosening. Clin. Oral Implants Res. 2018, 29, 1230–1238. [Google Scholar]
- Kim, J.S.; Raigrodski, A.J.; Flinn, B.D.; Rubenstein, J.E.; Chung, K.-H.; Mancl, L.A. In vitro assessment of three types of zirconia implant abutments under static load. J. Prosthet. Dent. 2013, 109, 255–263. [Google Scholar] [CrossRef]
- Gou, M.; Chen, H.; Fu, M.; Wang, H. Fracture of Zirconia Abutments in Implant Treatments: A Systematic Review. Implant Dent. 2019, 28, 378–387. [Google Scholar] [CrossRef] [PubMed]
- Joda, T.; Brägger, U. Management of a complication with a fractured zirconia implant abutment in the esthetic zone. Int. J. Oral Maxillofac. Implants 2015, 30, e21–e23. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Yilmaz, B.; Salaita, L.G.; Seidt, J.D.; Clelland, N.L.; McGlumphy, E.A. Load to failure of different titanium abutments for an internal hexagon implant. J. Prosthet. Dent. 2015, 114, 513–516. [Google Scholar] [CrossRef] [PubMed]
Material | Abutment Composition | Abutment/Implant Platform Interface | Manufacturer |
---|---|---|---|
OEM NobelProcera CAD/CAM Zirconia Abutment | Zirconia | Zirconia/Titanium | Nobel Biocare, Yorba Linda, Calif |
OEM NobelProcera CAD/CAM ASC Abutment | Zirconia + Ti insert (friction fit) | Titanium/Titanium | Nobel Biocare, Yorba Linda, Calif |
Aftermarket CAD/CAM zirconia abutment on Ti insert | Zirconia + Ti insert (bonded) | Titanium/Titanium | JingGang, Tainan, Taiwan |
Mean Fracture Resistance (N) | |||
---|---|---|---|
Group | N | Mean | SD |
NobelProcera CAD/CAM zirconia abutment | 5 | 252.37 | 82.79 |
NobelProcera CAD/CAM ASC Abutment | 5 | 384.62 | 45.24 |
Aftermarket CAD/CAM zirconia abutment on Ti insert | 5 | 361.83 | 90.31 |
Mean (SD) Distance from Fracture Surface to Implant Platform | |||||
---|---|---|---|---|---|
Group | n | Height of Ti Inserts | Mid-Buccal | Mid-Palatal | Buccal-Lingual Discrepancy |
OEM NobelProcera CAD/CAM zirconia abutment | 5 | 0 mm | 5.11 ± 1.47 mm | 5.11 ± 1.47 mm | |
OEM NobelProcera CAD/CAM ASC Abutment | 5 | 1 mm | 3.52 ± 0.44 mm | 3.82 ± 0.74 mm | 0.30 ± 0.31 mm |
Aftermarket CAD/CAM zirconia abutment on Ti insert | 5 | 2 mm | 4.12 ± 0.13 mm | 5.18 ± 0.18 mm | 1.06 ± 0.04 mm |
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Chang, Y.-T.; Wu, Y.-L.; Chen, H.-S.; Tsai, M.-H.; Chang, C.-C.; Wu, A.Y.-J. Comparing the Fracture Resistance and Modes of Failure in Different Types of CAD/CAM Zirconia Abutments with Internal Hexagonal Implants: An In Vitro Study. Materials 2022, 15, 2656. https://0-doi-org.brum.beds.ac.uk/10.3390/ma15072656
Chang Y-T, Wu Y-L, Chen H-S, Tsai M-H, Chang C-C, Wu AY-J. Comparing the Fracture Resistance and Modes of Failure in Different Types of CAD/CAM Zirconia Abutments with Internal Hexagonal Implants: An In Vitro Study. Materials. 2022; 15(7):2656. https://0-doi-org.brum.beds.ac.uk/10.3390/ma15072656
Chicago/Turabian StyleChang, Yu-Tsen, Yu-Ling Wu, Hung-Shyong Chen, Ming-Hsu Tsai, Chia-Chen Chang, and Aaron Yu-Jen Wu. 2022. "Comparing the Fracture Resistance and Modes of Failure in Different Types of CAD/CAM Zirconia Abutments with Internal Hexagonal Implants: An In Vitro Study" Materials 15, no. 7: 2656. https://0-doi-org.brum.beds.ac.uk/10.3390/ma15072656