Fracture loads of screw-retained implant-supported zirconia prostheses after thermal and mechanical stress

Influence of attaching mechanical retentive devices onto frameworks on fracture resistance of implant-supported zirconia crowns

This study investigated the fracture load of implant-supported zirconia crowns (IZCs), in which indirect composite resin or feldspathic porcelain was layered onto zirconia frameworks with mechanical retentive devices. Three different zirconia frameworks were assessed: attaching mechanical retentive devices on glaze and opaque porcelain materials (GL and OP groups, respectively), and no attaching mechanical retentive devices (ND group). The frameworks were layered using feldspathic porcelain (FP veneer) and indirect composite resin (IC veneer). Fracture load of the specimens was measured. In FP veneer, the GL group recorded the highest fracture load. In the IC veneer, the GL and OP groups had significantly higher fracture load than the ND group. The fracture resistance of IZCs can be enhanced by applying glaze material before attaching mechanical retentive devices for porcelain layering. The mechanical retentive devices effectively yielded mechanical interlocking between the zirconia frameworks and the IC veneer in GL and OP groups.

Fracture Resistance of CAD/CAM Implant-Supported 3Y-TZP-Zirconia Cantilevers: An In Vitro Study

(1) Introduction: Implant-supported fixed complete dentures are mostly composed of cantilevers. The purpose of this work was to evaluate the fracture resistance of zirconia (Prettau®, second generation, or Ice Zirkon Translucent, first generation) with cantilever lengths of 6 and 10 mm, and zirconia’s fracture resistance in relation to an average bite force of 250 N. (2) Materials and methods: Forty structures were created in CAD/CAM and divided into four groups: group A (6 mm cantilever in IZT), group B (10 mm cantilever in IZT), group C (6 mm cantilever in Pz), and group D (10 mm cantilever in pz). The study consisted of a traditional “load-to-failure” test. (3) Results: A statistically significant result was found for the effect of cantilever length, t(38) = 16.23 (p < 0.001), with this having a large effect size, d = 4.68. The 6 mm cantilever length (M = 442.30, sd = 47.49) was associated with a higher mean force at break than the 10 mm length (M = 215.18, sd = 40.74). No significant effect was found for the type of zirconia: t(38) = 0.31 (p = 0.757), and d = 0.10. (4) Conclusions: All the components with cantilever lengths of 6 mm broke under forces higher than 250 N. Cantilevers larger than 10 mm should be avoided.

The effect of aging on the fracture resistance of different types of screw-cement-retained implant-supported zirconia-based restorations

Structural durability of screw-cement-retained implant-supported zirconia-based restorations is an important factor in choosing the best type of restoration for clinical use. This study aimed to evaluate the effects of thermocycling on the fracture resistance of different types of screw-cement-retained implant-supported zirconia-based restoration. Two experimental groups (monolithic zirconia and porcelain-veneered zirconia) and a control group of porcelain-fused-to-metal restorations were fabricated via CAD-CAM (n = 14 per group). Half of the specimens of each group (n = 7) were subjected to 10000 thermal cycles. The compressive force was applied and the force leading to fracture was measured by using a Universal Testing Machine. The fractured modes were classified under a scanning electron microscope. The data were analyzed through two-way ANOVA, one-way ANOVA, and independent samples t-test (α = 0.05). Among the non-thermocycled subgroups, the monolithic zirconia specimens were significantly more fracture-resistant than the porcelain-veneered zirconia and porcelain-fused-to-metal groups (P<0.05); but it was not the same with aging (P>0.05). Thermocycling decreased the fracture resistance of all groups; however, the difference was not statistically significant (P<0.05). The monolithic zirconia presented higher fracture resistance than the bilayered restorations for screw-cement retained implant-supported restorations. Thermocycling decreased the fracture resistance of all types of restorations insignificantly which can be clinically important.

Analysis of fractured dental implant body from five different implant systems: a long-term retrospective study

The aim of this study was to perform an analysis of the incidence of implant body fracture and to identify possible risk factors. A long-term follow-up retrospective evaluation of 3477 patients who received 8588 implants from five implant systems was performed. Overall, 2810 patients who received 7502 implants, with an average follow-up of 6.9 years, were included in the analysis. The overall body fracture rate was 0.49% (37/7502), among which 32.4% (12/37) were implants with a reduced diameter. The estimated cumulative fracture rate was 1.24%. Fractures were observed in two patients with three Brånemark implants, 13 patients with 15 Nobel Replace implants, eight patients with eight Camlog implants, eight patients with 11 Ankylos implants, and none of the patients with Thommen implants. Most fractures occurred in the molar region (29/37) and in single implant-supported restorations (30/37). The results showed significant differences between splinted and unsplinted restorations (P = 0.005) and between regular and narrow diameter implants (P = 0.009). Within the limitations of this retrospective analysis, a narrow implant diameter is a potential risk factor for implant body fracture in the posterior region. Furthermore, unsplinted restorations appear to be associated with a higher rate of implant fracture.

Mechanical Stability of Screw-Retained Monolithic and Bi-layer Posterior Hybrid Abutment Crowns after Thermomechanical Loading: An In Vitro Study

To evaluate the failure-load and survival-rate of screw-retained monolithic and bi-layered crowns bonded to titanium-bases before and after mouth-motion fatigue, 72 titanium-implants (SICvantage-max, SIC-invent-AG) were restored with three groups (n = 24) of screw-retained CAD/CAM implant-supported-single-crowns (ISSC) bonded to titanium-bases: porcelain-fused-to-metal (PFM-control), porcelain-fused-to-zirconia (PFZ-test) and monolithic LDS (LDS-test). Half of the specimens (n = 12/group) were subjected to fatigue in a chewing-simulator (1.2 million cycles, 198 N, 1.67 Hz, thermocycling 5–55 °C). All samples were exposed to single-load-to-failure without (PFM0, PFZ0, LDS0) or with fatigue (PFM1, PFZ1, LDS1). Comparisons were statistically analyzed with t-tests and regression-models and corrected for multiple-testing using the Student–Neuman–Keuls method. All PFM and LDS crowns survived fatigue exposure, whereas 16.7% of PFZ showed chipping failures. The mean failure-loads (±SD) were: PFM0: 2633 ± 389 N, PFM1: 2349 ± 578 N, PFZ0: 2152 ± 572 N, PFZ1: 1686 ± 691 N, LDS0: 2981 ± 798 N, LDS1: 2722 ± 497 N. Fatigue did not influence load to failure of any group. PFZ ISSC showed significantly lower failure-loads than monolithic-LDS regardless of artificial aging (p < 0.05). PFM ISSC showed significantly higher failure loads after fatigue than PFZ (p = 0.032). All ISSC failed in a range above physiological chewing forces. Premature chipping fractures might occur in PFZ ISSC. Monolithic-LDS ISSC showed high reliability as an all-ceramic material for screw-retained posterior hybrid-abutment-crowns.

Bond strength between a veneering composite resin and zirconia frameworks with attached mechanical retentive devices

The effects of mechanical retentive devices and various surface treatments on the shear bond strength between a veneering composite resin and zirconia was investigated. Zirconia disks were classified into three surface-treatment groups: airborne-particle abrasion, overglazing, and overglazing with white alumina particles of three different grain sizes (50, 70, and 105 μm) attached onto zirconia disks (ZR-50, ZR-70, and ZR-105, respectively). They were further divided into four groups (n=44): unprimed, Clearfil Porcelain Bond Activator (CA), Clearfil Photo Bond (CB), and CA+CB. An indirect composite resin was bonded to zirconia specimens. Shear bond strengths were measured. For the ZR-70 and ZR-105 groups, the CB and CA+CB specimens exhibited higher bond strengths than the other two specimens after thermocycling. The ZR-70 and ZR-105 groups achieved micromechanical interlocking, and priming with a phosphate monomer (MDP) yielded stable bond strengths between the composite resin and zirconia with alumina particles attached as retentive devices.

Towards Clinical Translation: Optimized Fabrication of Controlled Nanostructures on Implant-Relevant Curved Zirconium Surfaces

Anodization enables fabrication of controlled nanotopographies on Ti implants to offer tailorable bioactivity and local therapy. However, anodization of Zr implants to fabricate ZrO₂ nanostructures remains underexplored and are limited to the modification of easy-to-manage flat Zr foils, which do not represent the shape of clinically used implants. In this pioneering study, we report extensive optimization of various nanostructures on implant-relevant micro-rough Zr curved surfaces, bringing this technology closer to clinical translation. Further, we explore the use of sonication to remove the top nanoporous layer to reveal the underlying nanotubes. Nano-engineered Zr surfaces can be applied towards enhancing the bioactivity and therapeutic potential of conventional Zr-based implants.