Fracture toughness improvements of dental ceramic through use of yttria-stabilized zirconia (YSZ) thin-film coatings

An application of finite element method in material selection for dental implant crowns

Materials used for dental crowns show a wide range of variety, and a dentist's choice can depend on several factors such as patient desires, esthetics, tooth factors, etc. One of the most important issues for implant surgery is the primary stability and it should be provided to minimize the risks of screw loosening, failed osseointegration, or nonunion. The current study aims to present the Finite Element Analysis (FEA)-based material selection strategy for a dental crown in terms of reducing the aforementioned risks of dental implants. A virtual surgery mandible model obtained using MIMICS software was transferred to the ANSYS and material candidates determined using CES software were compared using FEA. The results indicated that Zr0₂+Y₂O₃ (zirconia) has shown a 12.79% worse performance compared to Au83-88/Pt4-12/Pd4.5-6 alloy in terms of abutment loosening. On the other hand, zirconia is the most promising material for dental crowns in terms of the stability of the bone-implant complex. Therefore, it may show the best overall performance for clinical use. Moreover, as suggested in this study, a better outcome and more accurate predictions can be achieved using a patient-specific FEA approach for the material selection process.

Oxide thin films as bioactive coatings

Growth and survival of biological cells (eukaryotes and prokaryotes) on artificial environments often depend on their interactions with the specific surface. Various organic materials can be coated on substrates to assist cells' adhesion and other subsequent cellular processes. However, these coatings are expensive, degrade over short time period, and may even interfere with the cells' signaling processes. Therefore, the use of inorganic surfaces in order to control cellular interactions is of scientific importance from fundamental and application perspectives. Among inorganic materials, oxide thin films have received considerable attention. Thin films of oxides have the advantage of tailoring the surfaces for cellular interactions while using a negligible amount of the oxide material. Here, we review the lesser known application of inorganic oxide coatings as biocompatible and implantable platforms for different purposes, such as biofilm inhibition, cell culture and implant enhancements.

Zirconia-Based Screw-Retained Prostheses Supported by Implants: A Retrospective Study on Technical Complications and Failures

BACKGROUND

Little information is yet available on zirconia-based prostheses supported by implants.

PURPOSE

To evaluate technical problems and failures of implant-supported zirconia-based prostheses with exclusive screw-retention.

MATERIAL AND METHODS

Consecutive patients received screw-retained zirconia-based prostheses supported by implants and were followed over a time period of 5 years. The implant placement and prosthetic rehabilitation were performed in one clinical setting, and all patients participated in the maintenance program. The treatment comprised single crowns (SCs) and fixed dental prostheses (FDPs) of three to 12 units. Screw-retention of the CAD/CAM-fabricated SCs and FDPs was performed with direct connection at the implant level. The primary outcome was the complete failure of zirconia-based prostheses; outcome measures were fracture of the framework or extensive chipping resulting in the need for refabrication. A life table analysis was performed, the cumulative survival rate (CSR) calculated, and a Kaplan-Meier curve drawn.

RESULTS

Two hundred and ninety-four implants supported 156 zirconia-based prostheses in 95 patients (52 men, 43 women, average age 59.1 ± 11.7 years). Sixty-five SCs and 91 FDPs were identified, comprising a total of 441 units. Fractures of the zirconia framework and extensive chipping resulted in refabrication of nine prostheses. Nearly all the prostheses (94.2%) remained in situ during the observation period. The 5-year CSR was 90.5%, and 41 prostheses (14 SCs, 27 FDPs) comprising 113 units survived for an observation time of more than 5 years. Six SCs exhibited screw loosening, and polishing of minor chipping was required for five prostheses.

CONCLUSIONS

This study shows that zirconia-based implant-supported fixed prostheses exhibit satisfactory treatment outcomes and that screw-retention directly at the implant level is feasible.