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Fracture resistance of crowns cemented on titanium and zirconia implant abutments: a comparison of monolithic versus manually veneered all-ceramic systems


Martínez-Rus, Francisco; Ferreiroa, Alberto; Özcan, Mutlu; Bartolomé, José F; Pradíes, Guillermo (2012). Fracture resistance of crowns cemented on titanium and zirconia implant abutments: a comparison of monolithic versus manually veneered all-ceramic systems. International Journal of Oral & Maxillofacial Implants, 27(6):1448-1455.

Abstract

PURPOSE: To evaluate the fracture resistance of all-ceramic crowns cemented on titanium and zirconia implant abutments.
MATERIAL AND METHODS: Customized implant abutments for maxillary right central incisors made of titanium (Ti) and zirconia (Zr) (n=60, n=30 per group) were fabricated for an internal connection implant system. All-ceramic crowns were fabricated for their corresponding implant abutments using the following systems (n=10 per group): (1) monolithic computer-aided design/computer-assisted manufacture (CAD/CAM) lithium disilicate (MLD); (2) pressed lithium disilicate (PLD); (3) yttrium stabilized tetragonal zirconia polycrystal (YTZP). The frameworks of both PLD and YTZP systems were manually veneered with a fluorapatite-based ceramic. The crowns were adhesively cemented to their implant abutments and loaded to fracture in a universal testing machine (0.5 mm/minute). Data were analyzed using two-way analysis of variance (ANOVA) and Tukey's test (α=0.05).
RESULTS: Both the abutment material (P=.0001) and the ceramic crown system (P=.028) significantly affected the results. Interaction terms were not significant (P=.598). Ti-MLD (558.5±35 N) showed the highest mean fracture resistance among all abutment-crown combinations (340.3±62-495.9±53 N) (P<.05). Both MLD and veneered ceramic systems in combination with Ti abutments (558.5±35-495.9±53 N) presented significantly higher values than with Zr abutments (392.9±55-340.3±62 N) (P<.05). MLD crown system showed significantly higher mean fracture resistance compared to manually veneered ones on both Ti and Zr abutments (P<.05). While Ti-MLD and Ti-PLD abutment-crown combinations failed only in the crowns without abutment fractures, Zr-YTZP combination failed exclusively in the abutment without crown fracture. Zr-MLD and Zr-PLD failed predominantly in both the abutment and the crown. Ti-YTZP showed only implant neck distortion.
CONCLUSIONS: The highest fracture resistance was obtained with titanium abutments restored with MLD crowns, but the failure type was more favorable with Ti-YTZP combination.

PURPOSE: To evaluate the fracture resistance of all-ceramic crowns cemented on titanium and zirconia implant abutments.
MATERIAL AND METHODS: Customized implant abutments for maxillary right central incisors made of titanium (Ti) and zirconia (Zr) (n=60, n=30 per group) were fabricated for an internal connection implant system. All-ceramic crowns were fabricated for their corresponding implant abutments using the following systems (n=10 per group): (1) monolithic computer-aided design/computer-assisted manufacture (CAD/CAM) lithium disilicate (MLD); (2) pressed lithium disilicate (PLD); (3) yttrium stabilized tetragonal zirconia polycrystal (YTZP). The frameworks of both PLD and YTZP systems were manually veneered with a fluorapatite-based ceramic. The crowns were adhesively cemented to their implant abutments and loaded to fracture in a universal testing machine (0.5 mm/minute). Data were analyzed using two-way analysis of variance (ANOVA) and Tukey's test (α=0.05).
RESULTS: Both the abutment material (P=.0001) and the ceramic crown system (P=.028) significantly affected the results. Interaction terms were not significant (P=.598). Ti-MLD (558.5±35 N) showed the highest mean fracture resistance among all abutment-crown combinations (340.3±62-495.9±53 N) (P<.05). Both MLD and veneered ceramic systems in combination with Ti abutments (558.5±35-495.9±53 N) presented significantly higher values than with Zr abutments (392.9±55-340.3±62 N) (P<.05). MLD crown system showed significantly higher mean fracture resistance compared to manually veneered ones on both Ti and Zr abutments (P<.05). While Ti-MLD and Ti-PLD abutment-crown combinations failed only in the crowns without abutment fractures, Zr-YTZP combination failed exclusively in the abutment without crown fracture. Zr-MLD and Zr-PLD failed predominantly in both the abutment and the crown. Ti-YTZP showed only implant neck distortion.
CONCLUSIONS: The highest fracture resistance was obtained with titanium abutments restored with MLD crowns, but the failure type was more favorable with Ti-YTZP combination.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Fixed and Removable Prosthodontics
Dewey Decimal Classification:610 Medicine & health
Date:2012
Deposited On:07 Mar 2013 12:32
Last Modified:05 Apr 2016 16:37
Publisher:Quintessence Publishing
ISSN:0882-2786
Official URL:http://www.quintpub.com/journals/omi/abstract.php?iss2_id=1085&article_id=12688&article=18&title=Fracture%20Resistance%20of%20Crowns%20Cemented%20on%20Titanium%20and%20Zirconia%20Implant%20Abutments:%20A%20Comparison%20of%20Monolithic%20Versus%20Manually%
PubMed ID:23189296
Permanent URL: https://doi.org/10.5167/uzh-75476

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