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Diken Türksayar AA, Petersmann S, Spintzyk S. The effect of thermomechanical aging on the fracture resistance of additively and subtractively manufactured polyetheretherketone abutments. J Dent 2024; 149:105225. [PMID: 38969266 DOI: 10.1016/j.jdent.2024.105225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/07/2024] Open
Abstract
OBJECTIVES To evaluate the fracture resistance (FR) of polyetheretherketone (PEEK) abutments produced by additive and subtractive methods compared to milled zirconia abutments. METHODS Custom abutments were designed on Ti-base abutments and produced from three different materials, namely additively manufactured PEEK (PEEK-AM), subtractively manufactured PEEK (PEEK-SM), and zirconia (N = 60). PEEK-AM abutments were printed using PEEK filaments (VESTAKEEP®i4 3DF-T, Evonik Industries AG) on a M150 Medical 3D Printer (ORION AM) by fused filament fabrication (FFF). All surface treatments were carried out according to the manufacturer's instructions. All abutments were cemented on Ti-bases with hybrid abutment cement and then restored with milled zirconia crowns. Each subgroup was divided into non-aged and aged subgroups (n = 10). The aged groups were subjected to thermomechanical aging (49 N, 5-55 °C, 1.2 million cycles). FR tests were performed by using an universal testing machine. Data were statistically analyzed with one-way and two-way ANOVA and t-test. RESULTS The survival rate of the specimens after aging was determined as 100%. It was found that both the material and aging had a significant effect on the FR (p<.001). There was a statistical difference among the fracture values of the groups (p<.001). In both the aged and non-aged groups, PEEK-AM showed the statistically lowest FR, while the highest FR was seen in the zirconia group, which was significantly higher than the PEEK-SM (p<.001). CONCLUSION Hybrid abutments were successfully manufactured, and extrusion-based processed PEEK seems to be a good alternative to subtractive processed PEEK. However, since subtractive manufacturing still appears to be superior, further developments in additive manufacturing are needed to further improve the quality of 3D-printed PEEK parts, especially in terms of accuracy and bonding between adjacent layers. CLINICAL SIGNIFICANCE Additively manufactured PEEK abutments have the potential to be an alternative for implant-supported restorations in the posterior region.
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Affiliation(s)
- Almira Ada Diken Türksayar
- Department of Prosthodontics, Faculty of Dentistry, Biruni University, İstanbul, Turkey; ADMiRE Research Center, Carinthia University of Applied Sciences, Europastrasse 3a, Villach 9524, Austria.
| | - Sandra Petersmann
- ADMiRE Research Center, Carinthia University of Applied Sciences, Europastrasse 3a, Villach 9524, Austria
| | - Sebastian Spintzyk
- ADMiRE Research Center, Carinthia University of Applied Sciences, Europastrasse 3a, Villach 9524, Austria
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Manfredini M, Poli PP, Giboli L, Beretta M, Maiorana C, Pellegrini M. Clinical Factors on Dental Implant Fractures: A Systematic Review. Dent J (Basel) 2024; 12:200. [PMID: 39056987 PMCID: PMC11276356 DOI: 10.3390/dj12070200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/06/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
Dental implant fractures pose a significant challenge to long-term treatment success. This systematic review aims to comprehensively examine the clinical factors influencing dental implant fractures (IFs). Furthermore, strategies to choose the right type of implant and prevent this complication are addressed. A systematic search was conducted across PubMed, Scopus, and Web of Science databases. Eligible studies included retrospective case-control, prospective cohort studies, and clinical trials. The initial search yielded 361 articles, of which 312 were excluded being these reviews, case reports, irrelevant, or written in languages other than English. This left 49 articles, with only 6 meeting the eligibility criteria for an in-depth review. These studies, all retrospective case-control, examine implant characteristics, patient demographics, surgical and prosthetic variables, biomechanical and functional factors, clinical and procedural variables, complications and maintenance issues. The risk of bias was assessed as low using the ROBINS-I tool. Key findings suggest a correlation between implant diameter and structural resistance, with wider implants demonstrating reduced fracture risk. Additionally, posterior regions, especially molars and premolars, exhibit higher susceptibility to IFs due to increased masticatory forces. Implant design and material may considerably influence fracture risk, with conical implants and screw-retained prostheses showing higher vulnerability. Biomechanical overload, particularly in patients with bruxism, emerges as a primary contributing factor to IFs. Prosthesis type significantly influences fracture incidence, with cantilever prostheses posing a higher risk due to increased stress. Peri-implant bone loss is strongly associated with IFs, emphasizing the need for meticulous preoperative assessments and individualized management strategies. Future research should prioritize larger and heterogeneous populations with long-term follow-up and standardized methodologies to enhance the generalizability and comparability of findings. Randomized controlled trials and biomechanical studies under controlled conditions are also essential to elucidate the complex interactions contributing to IFs and developing effective prevention strategies. Additionally, integrating patient-reported outcomes may offer a comprehensive understanding of the impact of IFs on quality of life.
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Affiliation(s)
- Mattia Manfredini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Pier Paolo Poli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Luca Giboli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Matteo Pellegrini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Kaenploy J, Li R, Makowka S, Sadid-Zadeh R. Fracture resistance of cement-retained lithium disilicate implant-supported crowns: Effect of material used for two-piece abutments. J Prosthodont 2024. [PMID: 38807201 DOI: 10.1111/jopr.13871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 03/14/2024] [Accepted: 05/13/2024] [Indexed: 05/30/2024] Open
Abstract
PURPOSE This study compared the fracture strength of single lithium disilicate implant-supported crowns fabricated on two-piece abutments with various materials: ceramic-reinforced PEEK, zirconia, and lithium disilicate. MATERIALS AND METHODS Thirty-six implants were embedded in acrylic cylinders. A two-piece abutment and a crown were designed following a pre-operation scan for a maxillary left central incisor. The designed crown was used to fabricate 36 lithium disilicate crowns. The designed abutment was used to manufacture 36 abutments from 3 materials, 12 each: (A) zirconia; (B) lithium disilicate; and (C) ceramic-reinforced PEEK. Abutments were surface treated and bonded on the titanium base abutments with resin cement. Then, lithium disilicate crowns were bonded on the assigned abutments. Specimens were then subjected to dynamic loading for 1,200,000 cycles. The fracture strength (N) of the assembly was assessed using a universal testing machine. One-way ANOVA followed by multiple comparison tests was used to evaluate the effect of abutment material on the fracture strength of single implant-supported restorations at a significance of .05. RESULTS The average fracture strength for the groups with zirconia, PEEK, and lithium disilicate two-piece abutments were 1362N ± 218N, 1235N ± 115N, and 1472N ± 171N, respectively. There was a significant (p < 0.05) difference in fracture strength among the groups. The lithium disilicate group had significantly higher fracture strength (p = 0.0058) than the group with PEEK; however, there was no significant (p > 0.05) difference between the other groups. CONCLUSIONS Two-piece abutments restored with lithium disilicate crowns investigated in the study have the potential to withstand the average physiological occlusal forces in the anterior region.
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Affiliation(s)
- Jekita Kaenploy
- Department of Restorative Sciences, College of Dentistry, University of Oklahoma, Oklahoma City, Oklahoma, USA
| | - Rui Li
- Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, Buffalo, New York, USA
| | - Steven Makowka
- School of Dental Medicine, University at Buffalo, Buffalo, New York, USA
| | - Ramtin Sadid-Zadeh
- Department of Restorative Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Ožiūnas R, Sakalauskienė J, Staišiūnas L, Žekonis G, Žilinskas J, Janužis G. Physical and mechanical changes on titanium base of three different types of hybrid abutment after cyclic loading. J Adv Prosthodont 2023; 15:33-43. [PMID: 36908752 PMCID: PMC9992696 DOI: 10.4047/jap.2023.15.1.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 03/06/2023] Open
Abstract
PURPOSE This study investigated the physical and mechanical changes in the titanium base of three different hybrid abutment materials after cyclic loading by estimating the post-load reverse torque value (RTV), compressive side fulcrum wear pattern of titanium base, and surface roughness. MATERIALS AND METHODS A total of 24 dental implants were divided into three groups (n = 8 each): Group Z, LD, and P used zirconia, lithium disilicate, and polyetheretherketone, respectively, for hybrid abutment fabrication. RTV was evaluated after cyclic loading with 50 N for 1.2 × 106 chewing cycles. The compressive sides of the titanium bases were analyzed using a scanning electron microscope, and the roughness of the affected areas was measured using an optical profilometer after loading. Datasets were analyzed using Kruskal-Wallis test followed by Mann-Whitney tests with the Bonferroni correction (α = .05). RESULTS Twenty-three samples passed the test; one LD sample fractured after 770,474 cycles. Post-load RTV varied significantly depending on the hybrid-abutment material (P = .020). Group P had a significantly higher median of post-load RTVs than group Z (16.5 and 14.3 Ncm, respectively). Groups LD and P showed minor signs of wear, and group Z showed a more pronounced wear pattern. While evaluating compressive side affected area roughness of titanium bases, lower medians were shown in group LD (Ra 0.16 and Rq 0.22 µm) and group P (Ra 0.16 and Rq 0.23 µm) than in group Z (Ra 0.26 and Rq 0.34 µm); significant differences were found only among the unaffected surface and group Z. CONCLUSION The hybrid abutment material influences the post-load RTV. Group Z had a more pronounced wear pattern on the compressive side of titanium base; however, the surface roughness was not statistically different among the hybrid-abutment groups.
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Affiliation(s)
- Rimantas Ožiūnas
- Department of Prosthodontics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Jurgina Sakalauskienė
- Department of Prosthodontics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Gediminas Žekonis
- Department of Prosthodontics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Juozas Žilinskas
- Department of Prosthodontics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintaras Janužis
- Department of Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Nakonieczny DS, Antonowicz M, SimhaMartynkova G, Kern F, Pazourková L, Erfurt K, Hüpsch M. PA-12-Zirconia-Alumina-Cenospheres 3D Printed Composites: Accelerated Ageing and Role of the Sterilisation Process for Physicochemical Properties. Polymers (Basel) 2022; 14:polym14153152. [PMID: 35956670 PMCID: PMC9370858 DOI: 10.3390/polym14153152] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 12/04/2022] Open
Abstract
The aim of this study was to conduct artificial ageing tests on polymer-ceramic composites prepared from polyamide PA-12 polymer matrix for medical applications and three different variants of ceramic fillers: zirconia, alumina and cenospheres. Before ageing, the samples were subjected to ethyl oxide sterilization. The composite variants were prepared for 3D printing using the fused deposition modeling method. The control group consisted of unsterilized samples. Samples were subjected to artificial ageing in a high-pressure autoclave. Ageing conditions were calculated from the modified Hammerlich Arrhenius kinetic equation. Ageing was carried out in artificial saliva. After ageing the composites were subjected to mechanical (tensile strength, hardness, surface roughness) testing, chemical and structural (MS, FTIR) analysis, electron microscopy observations (SEM/EDS) and absorbability measurements.
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Affiliation(s)
- Damian S. Nakonieczny
- Institute for Manufacturing Technologies of Ceramic Components and Composites, University of Stuttgart, 70569 Stuttgart, Germany;
- Nanotechnology Centre, CEET, VŠB—Technical University of Ostrava, 17. Listopadu 15, 708733 Ostrava-Poruba, Czech Republic;
- Department of Biomedical Engineering, Silesian University of Technology, Akademicka 2A, 44-100 Gliwice, Poland; (M.A.); (M.H.)
- Correspondence: ; Tel.: +48-791-515-766
| | - Magdalena Antonowicz
- Department of Biomedical Engineering, Silesian University of Technology, Akademicka 2A, 44-100 Gliwice, Poland; (M.A.); (M.H.)
| | - Gražyna SimhaMartynkova
- Nanotechnology Centre, CEET, VŠB—Technical University of Ostrava, 17. Listopadu 15, 708733 Ostrava-Poruba, Czech Republic;
| | - Frank Kern
- Institute for Manufacturing Technologies of Ceramic Components and Composites, University of Stuttgart, 70569 Stuttgart, Germany;
| | - Lenka Pazourková
- IT4 Innovations, VŠB—Technical University of Ostrava, 17. Listopadu 15, 708733 Ostrava-Poruba, Czech Republic;
| | - Karol Erfurt
- Faculty of Chemistry, Department of Chemical Organic Technology and Petrochemistry, Silesian University of Technology, Krzywoustego 4, 44-100 Gliwice, Poland;
| | - Michał Hüpsch
- Department of Biomedical Engineering, Silesian University of Technology, Akademicka 2A, 44-100 Gliwice, Poland; (M.A.); (M.H.)
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Diken Turksayar AA, Hisarbeyli D, Seçkin Kelten Ö, Bulucu NB. Wear behavior of current computer-aided design and computer-aided manufacturing composites and reinforced high performance polymers: An in vitro study. J ESTHET RESTOR DENT 2021; 34:527-533. [PMID: 34655152 DOI: 10.1111/jerd.12828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To analyze the wear rate of computer-aided design and computer-aided manufacturing (CAD/CAM) composites, polyetheretherketones and glass ceramics. MATERIAL AND METHODS Our study groups were prepared from two different resin-based composites (Brillant Crios, Cerasmart), a glass ceramic (IPS Emax CAD) and reinforced polyetheretherketone (BioHPP) material (n = 10). Premolar teeth were used as antagonists. The specimens, which were subjected to two body wear tests (240,000 cycles, 1.2 Hz, 50N) in the chewing simulator, were scanned with a 3D laser scanner both before and after the wear test. Volume loss and wear depth were determined by means of the obtained images software program. The wear pattern was examined by scanning electron microscopy. Kruskal Wallis test served for analyzing. RESULTS The least volume loss and wear depth were seen in the polyetheretherketone material (0.06 ± 0.04 mm3 , 0.02 ± 0.01 mm), while the maximum volume loss was seen in the groups containing resin-based composite. (p = 0.05). The volume loss value in glass ceramics is between CAD/CAM composites and polyetheretherketone. CONCLUSION The behavior of polyetheretherketone against enamel was different from glass ceramics and composite materials in terms of the amount of wear. CLINICAL SIGNIFICANCE Polyetheretheketone can be considered as an alternative to other chairside materials in terms of wear resistance.
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Affiliation(s)
| | - Duygu Hisarbeyli
- Department of Restorative Dentistry, Oral and Dental Health Center, İstanbul, Turkey
| | - Özlem Seçkin Kelten
- Department of Restorative Dentistry, Oral and Health Center, Kırıkkale, Turkey
| | - Naime Bilinç Bulucu
- Faculty of Dentistry, Department of Restorative Dentistry, Biruni University, İstanbul, Turkey
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