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Ranjzad H, Heidari B, Rad FO, Hendi A, Ghorbani Z. Evaluation of Effect of Zirconia Surface Treatment with CO 2 and Nd:YAG Lasers on Shear Bond Strength between Zirconia Frameworks and Porcelain Veneers. J Contemp Dent Pract 2022; 23:1026-1032. [PMID: 37073917 DOI: 10.5005/jp-journals-10024-3412] [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] [Indexed: 03/11/2023]
Abstract
AIM The purpose of this study was to evaluate the effect of zirconia surface treatment with CO2 and Nd:YAG laser on shear bond strength (SBS) between the zirconia framework and porcelain veneering. MATERIALS AND METHODS In this in vitro study, zirconia blocks were converted to 50 cubes and were divided randomly into 5 groups. After sintering (S), porcelain was applied in the control group. The surface treatment of the second to fifth groups included CO2 laser + (S), (S + CO2), Nd:YAG laser + (S), and (S + Nd), respectively. The SBS test was done, and data were analyzed by SPSS16 software. One sample was randomly chosen from each group and the type of failure was examined under scanning electron microscope (SEM). To compare the pairs of means, the least significant difference test was used and the determined significance level was 5% (p < 0.05). RESULTS The SBS of S + Nd group was significantly higher than the other ones, except for S + CO2 group. The least amount of SBS belonged to CO2 + S and the highest to S + Nd group. There were no significant differences between the other groups. CONCLUSION The bond strength of veneering porcelain to zirconia can be altered by surface treatments. It can also be affected by the type and sequence of laser and sintering application. The effect of Nd:YAG laser on the surface of zirconia, in order to create roughness to increase SBS, is better than that of CO2 laser. CLINICAL SIGNIFICANCE Surface treatment of zirconia by certain types of lasers reduces the chipping of the ceramic veneer and increases the success rate of all-ceramic restorations.
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Affiliation(s)
- Hadi Ranjzad
- Department of Prosthodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Farzane Ostovar Rad
- Department of Maxillofacial Radiology, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Amirreza Hendi
- Department of Prosthodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Ghorbani
- Department of Prosthodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran, Phone: +0098 9120248577, +0098 1332119328; e-mail:
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Blanc-Sylvestre N, Bouchard P, Chaussain C, Bardet C. Pre-Clinical Models in Implant Dentistry: Past, Present, Future. Biomedicines 2021; 9:1538. [PMID: 34829765 PMCID: PMC8615291 DOI: 10.3390/biomedicines9111538] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
Biomedical research seeks to generate experimental results for translation to clinical settings. In order to improve the transition from bench to bedside, researchers must draw justifiable conclusions based on data from an appropriate model. Animal testing, as a prerequisite to human clinical exposure, is performed in a range of species, from laboratory mice to larger animals (such as dogs or non-human primates). Minipigs appear to be the animal of choice for studying bone surgery around intraoral dental implants. Dog models, well-known in the field of dental implant research, tend now to be used for studies conducted under compromised oral conditions (biofilm). Regarding small animal models, research studies mostly use rodents, with interest in rabbit models declining. Mouse models remain a reference for genetic studies. On the other hand, over the last decade, scientific advances and government guidelines have led to the replacement, reduction, and refinement of the use of all animal models in dental implant research. In new development strategies, some in vivo experiments are being progressively replaced by in vitro or biomaterial approaches. In this review, we summarize the key information on the animal models currently available for dental implant research and highlight (i) the pros and cons of each type, (ii) new levels of decisional procedures regarding study objectives, and (iii) the outlook for animal research, discussing possible non-animal options.
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Affiliation(s)
- Nicolas Blanc-Sylvestre
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Philippe Bouchard
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Department of Periodontology, Rothschild Hospital, European Postgraduate in Periodontology and Implantology, Université de Paris, 75012 Paris, France
| | - Catherine Chaussain
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
- AP-HP, Reference Center for Rare Disorders of the Calcium and Phosphate Metabolism, Dental Medicine Department, Bretonneau Hospital, GHN-Université de Paris, 75018 Paris, France
| | - Claire Bardet
- Université de Paris, Institut des Maladies Musculo-Squelettiques, Orofacial Pathologies, Imaging and Biotherapies Laboratory URP2496 and FHU-DDS-Net, Dental School, and Plateforme d’Imagerie du Vivant (PIV), 92120 Montrouge, France; (N.B.-S.); (P.B.); (C.C.)
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Ban S. Classification and Properties of Dental Zirconia as Implant Fixtures and Superstructures. MATERIALS 2021; 14:ma14174879. [PMID: 34500970 PMCID: PMC8432657 DOI: 10.3390/ma14174879] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
Various types of zirconia are widely used for the fabrication of dental implant superstructures and fixtures. Zirconia-alumina composites, such as ATZ and NanoZR, are adequate for implant fixtures because they have excellent mechanical strength in spite of insufficient esthetic properties. On the other hand, yttria-stabilized zirconia has been used for implant superstructures because of sufficient esthetic properties. They are classified to 12 types with yttria content, monochromatic/polychromatic, uniform/hybrid composition, and monolayer/multilayer. Zirconia with a higher yttria content has higher translucency and lower mechanical strength. Fracture strength of superstructures strongly depends on the strength on the occlusal contact region. It suggests that adequate zirconia should be selected as the superstructure crown, depending on whether strength or esthetics is prioritized. Low temperature degradation of zirconia decreases with yttria content, but even 3Y zirconia has a sufficient durability in oral condition. Although zirconia is the hardest dental materials, zirconia restorative rarely subjects the antagonist teeth to occlusal wear when it is mirror polished. Furthermore, zirconia has less bacterial adhesion and better soft tissue adhesion when it is mirror polished. This indicates that zirconia has advantageous for implant superstructures. As implant fixtures, zirconia is required for surface modification to obtain osseointegration to bone. Various surface treatments, such as roughening, surface activation, and coating, has been developed and improved. It is concluded that an adequately selected zirconia is a suitable material as implant superstructures and fixtures because of mechanically, esthetically, and biologically excellent properties.
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Affiliation(s)
- Seiji Ban
- Department of Dental Materials Science, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
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Mandelli F, Traini T, Ghensi P. Customized-3D zirconia barriers for guided bone regeneration (GBR): clinical and histological findings from a proof-of-concept case series. J Dent 2021; 114:103780. [PMID: 34400253 DOI: 10.1016/j.jdent.2021.103780] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of this case series was to evaluate, clinically and histologically, customized-3D zirconia barriers manufactured for guided bone regeneration (GBR) procedures. METHODS Seven healthy consecutive patients with severe bone atrophy (two of them with a bilateral atrophy) were selected for a GBR procedure with a zirconia barrier. In a 3D software (DentalCad, Exocad GmbH, Germany), a virtual bone graft was designed and a shell was designed covering the graft; a standard tessellation language (.STL) file was obtained and milled (M1, Zirkonzahn, Italy) using a 1200 MPa zirconia (Prettau, Zirkonzahn, Italy). Nine GBR surgeries (8 upper-posterior jaw, 1 lower-posterior jaw) were performed using autogenous bone chips mixed with xenograft (SmartBone, IBI-SA, Switzerland / BioOss, Geistlich, Switzerland) covered with a zirconia barrier, fixed by means of screws. After healing, implant sites were prepared with a trephine bur, collecting a bone biopsy, and dental implants were inserted (Neodent, Straumann Group, Switzerland). Specimens were histologically analyzed. RESULTS Eight successful surgeries were recorded; one zirconia barrier got exposed after one month of healing but no signs of infection were present till the barrier was removed. In all cases it was possible to insert implants with no additional bone augmentation procedures. Histological evaluations showed the presence of intense deposition of new bone. CONCLUSIONS Within the limitations of the present case series, the tested customized-3D zirconia barriers confirmed good clinical and histological performances, and, even in case of premature exposure, did not show signs of infection. Preliminary results suggest they are effective for GBR procedures. Further research is necessary with a larger sample size. CLINICAL SIGNIFICANCE The presented barriers could be a viable alternative to titanium-reinforced polytetrafluoroethylene membranes and customized meshes.
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Affiliation(s)
- Federico Mandelli
- DDS, Oral Surgery Spec. - Private practice, Via Padana Superiore 15, Milan, Italy.
| | - Tonino Traini
- CDT-MDT, DDS, Oral Surgery Spec., PhD - Department Innovative Technologies in Medicine & Dentistry, University "G. d'Annunzio" of Chieti-Pescara, Chieti, Italy.
| | - Paolo Ghensi
- DDS, Oral Surgery Spec., Clin MSc, PhD - Department CIBIO, University of Trento, Trento, Italy.
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Ruiz Henao PA, Caneiro Queija L, Mareque S, Tasende Pereira A, Liñares González A, Blanco Carrión J. Titanium vs ceramic single dental implants in the anterior maxilla: A 12-month randomized clinical trial. Clin Oral Implants Res 2021; 32:951-961. [PMID: 34061402 DOI: 10.1111/clr.13788] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/13/2021] [Accepted: 05/13/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of this randomized clinical trial was to compare ceramic and titanium implants with respect to the esthetic and clinical parameters, and patient-reported outcome measures (PROMs). MATERIAL AND METHODS Thirty patients received thirty implants (8-12 mm in length, 3.3 mm diameter, and a tissue level design) to replace single teeth in the anterior maxilla. Patients were randomly allocated to receive a ceramic or a titanium implant. Esthetic, clinical parameters, and PROMs were evaluated 18 months after surgery. RESULTS At 12 months post-final loading, there were no significant differences between groups with respect to esthetics. Mean Index Crown Aesthetic score was 6.31 (95% C.I. 4.59-8.04) and 6.07 (95% C.I. 4.21-7.93) for ceramic and titanium implants, respectively. The pink esthetic score (PES) was 7.81 (95% C.I. 6.90-8.73) for ceramic implants and 7.86 (95% C.I. 7.11-8.60) for titanium implants, with no significant differences between groups. No statistically significant differences were found for any of the other clinical parameters and PROMs. CONCLUSIONS Monotype ceramic implants have proven to be a good treatment option in the upper anterior sector, showing favorable esthetic results, being comparable to titanium implants. This clinical trial has been registered in clinical trials with the identifier CI_RCT_US16 and registration number NCT04707677. A retrospective registration of the clinical trial was carried out since registration was not mandatory on the date the study began.
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Affiliation(s)
- Paula Andrea Ruiz Henao
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Leticia Caneiro Queija
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Santiago Mareque
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Almudena Tasende Pereira
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonio Liñares González
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.,Odontología Médico-Quirúrgica (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
| | - Juan Blanco Carrión
- Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.,Odontología Médico-Quirúrgica (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain
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Graf T, Güth JF, Edelhoff D, Krennmair G, Stimmelmayr M. Influence of butt joint connections with long guiding areas on the stability of single crowns and 3-unit bridges - an in-vitro-study. J Prosthodont Res 2021; 65:455-460. [PMID: 34176848 DOI: 10.2186/jpr.jpr_d_20_00036] [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] [Indexed: 11/06/2022]
Abstract
PURPOSE The aim of this study was to evaluate the stability of single crowns and 3-unit bridges in relation to the implant-abutment complex with and without tube in tube connection. METHODS 60 specimens with a total of 90 implants (diameter 3.8 mm) were fabricated and distributed into 4 groups: CST (Crown with short tube), CLT (crown with long tube), BNT (Bridge without tube) and BLT (bridge with long tube). All superstructures consisted of one-piece hybrid abutment restorations out of monolithic zirconia, bonded on prefabricated titanium bases and were directly screwed into the implants. Specimen underwent artificial aging (2.000.000 cycles, 120 N, 30° off axis) and were subsequently loaded in an universal testing machine at an angle of 30° until failure. The specimens were examined for damage during and after artificial aging. RESULTS During artificial aging, one test specimen of group CLT and two test specimens of group BNT failed. The average failure load was 498.8 (± 34.4) N for CLT, 418.8 (± 41.5) N for CST, 933.1 (± 26.2) N for BLT and 634.4 (± 29.0) N for BNT, with a statistical differences (p ˂ 0.001) between the crown and bridge groups. All tested samples exhibited macroscopic deformations at the implant shoulder, which were more pronounced in the specimens without a tube in tube connection. CONCLUSIONS Single crowns and 3-unit bridges with a long tube in tube connection showed significantly higher fatigue fracture strength compared to restorations with short or without tube in tube connection.
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Affiliation(s)
- Tobias Graf
- Department of Prosthodontics, University of Munich, Munich
| | | | | | | | - Michael Stimmelmayr
- Department of Prosthodontics, University of Munich, Munich.,Private Practice for Oral Surgery, Cham
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Vilor-Fernández M, García-De-La-Fuente AM, Marichalar-Mendia X, Estefanía-Fresco R, Aguirre-Zorzano LA. Single tooth restoration in the maxillary esthetic zone using a one-piece ceramic implant with 1 year of follow-up: case series. Int J Implant Dent 2021; 7:26. [PMID: 33821399 PMCID: PMC8021669 DOI: 10.1186/s40729-021-00308-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 02/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background Oral implants have helped clinicians to improve the quality of life for many patients. The material of choice for dental implants currently remains titanium type IV, whose mechanical and biological properties have been proven throughout the history of implantology. Yet, this material is not exempt from complications. For these reasons, ceramic alternatives to titanium have emerged. Thus, the purpose of this study is to evaluate peri-implant hard and soft tissue stability with the use of a one-piece ceramic implant (Straumann® PURE Ceramic Implant) during 1 year of follow-up. Study design One-piece all-ceramic zirconia (ZrO2) implants were placed to replace single missing teeth in the esthetic zone. Six to 8 weeks after the procedure, the definitive prosthesis was fabricated. At the time of prosthesis, placement (T0) photographs and periapical radiographs were taken, and the following clinical parameters were recorded: probing depth (PD), plaque index (PI), bleeding on probing (BOP), suppuration on probing (SOP), distance from gingival margin to incisal edge (GM-IE), and Jemt papilla index (JPI). Follow-up appointments were scheduled at 4 (T4), 8 (T8), and 12 (T12) months, when the same parameters were recorded. In addition, plaque control was reinforced and prophylaxis was carried out. In this last appointment, a final periapical radiograph was taken to assess marginal bone loss. Results A total of 32 zirconia implants were placed in 28 patients (16 women and 12 men, aged between 34 and 67 years). The survival and success rate were 93.75%. The increase in probing depth from baseline to 12 months was 0.78 mm. Assessments of plaque index and bleeding on probing showed a slight increase throughout the study. Conclusions The results obtained with the Straumann® PURE Ceramic implants show them to exhibit very good clinical behavior. The survival rate of the implants of our pilot study was 93.75%. For these reasons, we can say that zirconia implants could be an alternative to titanium implants in the esthetic zone.
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Affiliation(s)
- Miren Vilor-Fernández
- Department of Stomatology II, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain
| | - Ana-María García-De-La-Fuente
- Department of Stomatology II, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain.
| | - Xabier Marichalar-Mendia
- Department of Nursing I, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain
| | - Ruth Estefanía-Fresco
- Department of Stomatology II, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain
| | - Luis-Antonio Aguirre-Zorzano
- Department of Stomatology II, University of the Basque Country (UPV/EHU), Barrio Sarriena s/n, 48940, Leioa, Bizkaia, Spain
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Iijima N, Homma S, Nakano R, Hayashi S, Hirano T, Iijima T, Yajima Y. Fatigue properties of hollow zirconia implants. Dent Mater J 2021; 40:885-893. [PMID: 33692224 DOI: 10.4012/dmj.2020-248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective of this study was to clarify the fatigue behavior of hollow yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) specimens assuming its use for two-piece implants. The fatigue properties of a solid specimen (which simulated a one-piece implant) and 3 types of hollow specimens (which simulated two-piece implants) were evaluated. Specimens were either solid with a diameter of 4.0 mm (S) or hollow with an inner diameter of 3.0 mm and outer diameters of 4.0 mm (H0.5), 4.5 mm (H0.75), or 5.0 mm (H1.0). For each group, 25 specimens were prepared followed by blast and acid etch treatment. Static fracture and cyclic fatigue tests were conducted by modifying the methods provided in ISO6872. Fracture modes were determined by observing the surfaces under a scanning electron microscope. As a result, the cyclic fatigue load of S and H1.0 were similar, and hollow specimens with outer diameters greater than 0.75 mm displayed the ability to withstand molar occlusal forces.
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Affiliation(s)
- Noriko Iijima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Shinya Homma
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Ryotaro Nakano
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Shota Hayashi
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Tomoki Hirano
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Toshihiko Iijima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
| | - Yasutomo Yajima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College
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Retention and Clinical Performance of Zirconia Crowns: A Comprehensive Review. Int J Dent 2020; 2020:8846534. [PMID: 33123199 PMCID: PMC7584951 DOI: 10.1155/2020/8846534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/24/2020] [Accepted: 10/04/2020] [Indexed: 11/30/2022] Open
Abstract
Zirconia has been used for rehabilitation of edentulous spaces approximately for a decade, and there have been several reports regarding the clinical performance and retention of zirconia crowns. Outstanding mechanical properties, biocompatibility, and excellent aesthetics make zirconia-based crowns as a popular crown among the current all-ceramic crowns in restorative dentistry. However, restoration with a zirconia crown is a challenging treatment. The goal of this study was to assess the current literature to summarize the studies reporting the effective risk factors on retention of zirconia crowns to provide clinicians with a useful point of view in the decision-making process for use of these restorations. Literature based-search was performed to find related articles until August 2020 using EMBASE, Google Scholar, and MEDLINE. Search terms used were “zirconia restorations properties,” “zirconia crowns clinical performance,” “zirconia crown survival,” “biological complications,” and “zirconia crown retention.” Results were limited to papers available in English. The references of all related literature were also searched for further citations. Overall, although clinical long-term and follow-up studies are a vital requirement to conclude that zirconia has great reliability, it seems that zirconia crown restorations are both well tolerated and sufficiently resistant.
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Komasa S, Takao S, Yang Y, Zeng Y, Li M, Yan S, Zhang H, Komasa C, Kobayashi Y, Nishizaki H, Nishida H, Kusumoto T, Okazaki J. Effects of UV Treatment on Ceria-Stabilized Zirconia/Alumina Nanocomposite (NANOZR). MATERIALS 2020; 13:ma13122772. [PMID: 32570895 PMCID: PMC7345710 DOI: 10.3390/ma13122772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/08/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022]
Abstract
Nanostructured zirconia/alumina composite (NANOZR) has been explored as a suitable material for fabricating implants for patients with metal allergy. In this study, we examined the effect of UV treatment on the NANOZR surface. The experimental group was UV-treated NANOZR and the control group was untreated NANOZR. Observation of the surface of the UV-treated materials revealed no mechanical or structural change; however, the carbon content on the material surface was reduced, and the material surface displayed superhydrophilicity. Further, the effects of the UV-induced superhydrophilic properties of NANOZR plates on the adhesion behavior of various cells were investigated. Treatment of the NANOZR surface was found to facilitate protein adsorption onto it. An in vitro evaluation using rat bone marrow cells, human vascular endothelial cells, and rat periodontal ligament cells revealed high levels of adhesion in the experimental group. In addition, it was clarified that the NANOZR surface forms active oxygen and suppresses the generation of oxidative stress. Overall, the study results suggested that UV-treated NANOZR is useful as a new ceramic implant material.
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Affiliation(s)
- Satoshi Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Seiji Takao
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Yuanyuan Yang
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Yuhao Zeng
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Min Li
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Sifan Yan
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Honghao Zhang
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Chisato Komasa
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
| | - Yasuyuki Kobayashi
- Osaka Research Institute of Industrial Science and Technology, Morinomiya Center, 1-6-50, Morinomiya, Joto-ku, Osaka 536-8553, Japan;
| | - Hiroshi Nishizaki
- Department of Japan, Faculty of Health Sciences, Osaka Dental University, 1-4-4, Makino-honmachi, Hirakata-shi, Osaka 573-1121, Japan; (H.N.); (T.K.)
| | - Hisataka Nishida
- Department of Advanced Hard Materials, The Institute of Scientific and Industrial Research (ISIR), Osaka University, Osaka 567-0047, Japan;
| | - Tetsuji Kusumoto
- Department of Japan, Faculty of Health Sciences, Osaka Dental University, 1-4-4, Makino-honmachi, Hirakata-shi, Osaka 573-1121, Japan; (H.N.); (T.K.)
| | - Joji Okazaki
- Department of Removable Prosthodontics and Occlusion, Osaka Dental University, 8-1 Kuzuha-hanazono-cho, Hirakata, Osaka 573-1121, Japan; (S.K.); (S.T.); (Y.Y.); (Y.Z.); (M.L.); (S.Y.); (H.Z.); (C.K.)
- Correspondence: ; Tel.: +81-72-864-3084; Fax: +81-72-864-3184
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Elkharashi A, Grzech-Leśniak K, Deeb JG, Abdulmajeed AA, Bencharit S. Exploring the use of pulsed erbium lasers to retrieve a zirconia crown from a zirconia implant abutment. PLoS One 2020; 15:e0233536. [PMID: 32479553 PMCID: PMC7263620 DOI: 10.1371/journal.pone.0233536] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/07/2020] [Indexed: 11/18/2022] Open
Abstract
Background Removal of cement-retained implant fixed restorations when needed, can be challenging. Conventional methods of crown removal are time consuming and costly for patients and practitioners. This research explored the use of two different types of pulsed erbium lasers as a non-invasive tool to retrieve cemented zirconia crowns from zirconia implant abutments. Materials and methods Twenty identical zirconia crowns were cemented onto 20 identical zirconia prefabricated abutments using self-adhesive resin cement. The specimens were divided into two groups for laser assisted crown removal; G1 for erbium-doped yttrium aluminum garnet laser (Er:YAG), and G2 for erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG). For the G1, after the first crown removal, the specimens were re-cemented and removed again using the Er:YAG laser. Times needed to remove the crowns were recorded and analyzed using ANOVA (α = 0.05). The surfaces of the crown and the abutment were further examined using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) analyses. Results The average times of zirconia crown removal from zirconia abutments were 5 min 20 sec and 5 min 15 sec for the Er:YAG laser of first and second experiments (G1), and 5 min 55 sec for the Er,Cr:YSGG laser experiment (G2). No statistical differences were observed among the groups. SEM and EDS examinations of the materials showed no visual surface damaging or material alteration from the two pulsed erbium lasers. Conclusions Both types of pulsed erbium lasers can be viable alternatives for retrieving a zirconia crown from a zirconia implant abutment. Despite operating at different wavelengths, the Er:YAG and Er,Cr:YSGG lasers, perform similarly in removing a zirconia crown from a zirconia implant abutment with similar parameters. There are no visual and elemental composition damages as a result of irradiation with pulsed erbium lasers.
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Affiliation(s)
- Ahmed Elkharashi
- Department of Biochemistry and Molecular Biology, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | | | - Janina Golob Deeb
- Department of Periodontology, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Aous A. Abdulmajeed
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Sompop Bencharit
- Department of General Practice, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, Richmond, Virginia, United States of America
- * E-mail:
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Bethke A, Pieralli S, Kohal RJ, Burkhardt F, von Stein-Lausnitz M, Vach K, Spies BC. Fracture Resistance of Zirconia Oral Implants In Vitro: A Systematic Review and Meta-Analysis. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E562. [PMID: 31991565 PMCID: PMC7040771 DOI: 10.3390/ma13030562] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/15/2020] [Accepted: 01/21/2020] [Indexed: 12/27/2022]
Abstract
Various protocols are available to preclinically assess the fracture resistance of zirconia oral implants. The objective of the present review was to determine the impact of different treatments (dynamic loading, hydrothermal aging) and implant features (e.g., material, design or manufacturing) on the fracture resistance of zirconia implants. An electronic screening of two databases (MEDLINE/Pubmed, Embase) was performed. Investigations including > 5 screw-shaped implants providing information to calculate the bending moment at the time point of static loading to fracture were considered. Data was extracted and meta-analyses were conducted using multilevel mixed-effects generalized linear models (GLMs). The Šidák method was used to correct for multiple testing. The initial search resulted in 1864 articles, and finally 19 investigations loading 731 zirconia implants to fracture were analyzed. In general, fracture resistance was affected by the implant design (1-piece > 2-piece, p = 0.004), material (alumina-toughened zirconia/ATZ > yttria-stabilized tetragonal zirconia polycrystal/Y-TZP, p = 0.002) and abutment preparation (untouched > modified/grinded, p < 0.001). In case of 2-piece implants, the amount of dynamic loading cycles prior to static loading (p < 0.001) or anatomical crown supply (p < 0.001) negatively affected the outcome. No impact was found for hydrothermal aging. Heterogeneous findings of the present review highlight the importance of thoroughly and individually evaluating the fracture resistance of every zirconia implant system prior to market release.
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Affiliation(s)
- Annalena Bethke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Felix Burkhardt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
| | - Manja von Stein-Lausnitz
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany;
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (A.B.); (S.P.); (F.B.); (M.v.S.-L.)
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center—University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany;
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Effects of pontic span and fiber reinforcement on fracture strength of multi-unit provisional fixed partial dentures. J Dent Sci 2019; 14:309-317. [PMID: 31528260 PMCID: PMC6739267 DOI: 10.1016/j.jds.2018.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 09/28/2018] [Indexed: 12/03/2022] Open
Abstract
Background/purpose Clinically, PMMA resin is extensively used for fabricating provisional FPDs. However, fracture often occurs due to the unsatisfactory mechanical strength, especially within connectors of long-span provisional FPDs. The purpose of this study is to evaluate the fracture load of fiber-reinforced provisional FPDs with various pontic span lengths, and to identify the most suitable span length for fiber-reinforced long-span provisional FPDs. Materials and methods Fifty-six provisional FPDs with various pontic span lengths were fabricated. Seven samples from each group were reinforced with glass fibers. Unreinforced counterparts served as control. The samples were fixed on the abutments after thermocycling and then received a fatigue test. Subsequently, they were mechanically loaded until fracture, and the initial fracture load and fracture patterns were recorded. Statistical analysis, including two-sample t-test, one-way, two-way ANOVA, Tukey-Kramer HSD post hoc analysis and χ2 test were used to evaluate mechanical performance. Results The mean fracture load of FPDs with 14 mm pontic span length is significantly higher than the other lengths. The fracture load of each reinforced group is significantly higher than each counterpart control. There is no interaction between two variables, pontic span and fiber reinforcement. With fiber reinforcement, the fracture patterns were altered from catastrophic fracture to bent or partial fracture. But, the fracture patterns were not affected by pontic span. Conclusion The fracture load of acrylic FPDs decreases significantly when pontic span length is greater than 17 mm. Adding glass fibers into long-span provisional FPDs can significantly improve the fracture resistance and fracture patterns.
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Nueesch R, Conejo J, Mante F, Fischer J, Märtin S, Rohr N, Blatz MB. Loading capacity of CAD/CAM-fabricated anterior feldspathic ceramic crowns bonded to one-piece zirconia implants with different cements. Clin Oral Implants Res 2019; 30:178-186. [PMID: 30629769 DOI: 10.1111/clr.13404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 11/22/2018] [Accepted: 12/23/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study evaluated the loading capacity of CAD/CAM-fabricated anterior feldspathic ceramic crowns bonded to one-piece zirconia implants with different cements. MATERIAL AND METHODS Fifty one-piece zirconia implants were embedded in epoxy resin. The abutment aspect of one implant was optically scanned and a standardized upper canine was designed with CAD-software. Fifty feldspathic ceramic crowns were milled, polished, and mounted on the implants either without any cement, with a temporary cement or with three different composite resin cements after surface pretreatment as recommended by the manufacturers (n = 10). After storage in distilled water at 37°C for 24 hr, specimens were loaded until fracture on the palatal surface of the crown at an angle of 45° to the long axis of the implant and loads until fracture were detected and compared. Compressive strength of the investigated cement materials was determined. Statistical analyses were done with One-way ANOVA followed by post hoc Fisher LSD test (α = 0.05). RESULTS The cements revealed significantly different compressive strength values (temporary cement: 37.1 ± 7.0 MPa; composite resin cements: 185.8 ± 21.3, 277.9 ± 22.1, and 389.0 ± 13.6 MPa, respectively). Load-at-fracture values had an overall mean value of 237.1 ± 58.2 N with no significant difference among the composite resin cements (p > 0.05). Fracture load values with the temporary cement or without cement were significantly lower (p < 0.002). CONCLUSIONS CAD/CAM-fabricated anterior feldspathic ceramic crowns bonded to one-piece zirconia implants provide sufficient resistance to intraoral forces.
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Affiliation(s)
- Reto Nueesch
- Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Julian Conejo
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Francis Mante
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Jens Fischer
- Division of Dental Materials and Engineering, Department of Reconstructive Dentistry, University Center for Dental Medicine, Basel, Switzerland.,VITA Zahnfabrik, Bad Säckingen, Germany
| | | | - Nadja Rohr
- Division of Dental Materials and Engineering, Department of Reconstructive Dentistry, University Center for Dental Medicine, Basel, Switzerland
| | - Markus B Blatz
- Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
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Haro Adánez M, Nishihara H, Att W. A systematic review and meta-analysis on the clinical outcome of zirconia implant–restoration complex. J Prosthodont Res 2018; 62:397-406. [DOI: 10.1016/j.jpor.2018.04.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/20/2018] [Accepted: 04/26/2018] [Indexed: 11/26/2022]
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Current status of zirconia implants in dentistry: preclinical tests. J Prosthodont Res 2018; 63:1-14. [PMID: 30205949 DOI: 10.1016/j.jpor.2018.07.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 07/18/2018] [Accepted: 07/26/2018] [Indexed: 11/23/2022]
Abstract
PURPOSE This systematic review aimed to provide an overview of zirconia implants as well as regarding the outcome of the implant-restorative complex in preclinical studies. STUDY SELECTION An electronic search of the literature prior to July 2017 was performed to identify all articles related to preclinical research on zirconia implants. The search was conducted using MEDLINE (National Library of Medicine) and PubMed without restrictions concerning the date of publication. The search terminology included: zirconia implant, osseointegration, bone-to-implant contact, soft tissue, histology, histomorphometry, surface modification, surface roughness, surface characteristics, and restoration (connecting multiple keywords with AND, OR). RESULTS Fifty-seven studies were finally selected from an initial yield of 654 titles, and the data were extracted. The identified preclinical studies focused on several aspects related to zirconia implants, namely biocompatibility, mechanical properties, implant design, osseointegration capacity, soft tissue response, and restorative options. Due to heterogeneity of the studies, a meta-analysis was not possible. The most frequently used zirconia material for the fabrication of implants is yttria-stabilized tetragonal zirconia polycrystal. The resistance-to-fracture for zirconia implants ranged between 516-2044N. The mostly investigated parameter was osseointegration, which is compared to that of titanium. A lack of evidence was found with other parameters. CONCLUSIONS Due to its good biocompatibility as well as favorable physical and mechanical properties, zirconia implants are a potential alternative to titanium implants. However, knowledge regarding the implant-restorative complex and related aspects is still immature to recommend its application for daily practice.
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18
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Figueiredo VMGD, Pereira SMB, Bressiani E, Valera MC, Bottino MA, Zhang Y, Melo RMD. Effects of porcelain thickness on the flexural strength and crack propagation in a bilayered zirconia system. J Appl Oral Sci 2017; 25:566-574. [PMID: 29069155 PMCID: PMC5806690 DOI: 10.1590/1678-7757-2015-0479] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 03/10/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study evaluated the influence of porcelain (VM9, VITA Zahnfabrik, Germany) thickness on the flexural strength and crack propagation in bilayered zirconia systems (YZ, VITA Zahnfabrik, Germany). MATERIAL AND METHODS Thirty zirconia bars (20.0x4.0x1.0 mm) and six zirconia blocks (12.0x7.5x1.2 mm) were prepared and veneered with porcelain with different thickness: 1 mm, 2 mm, or 3 mm. The bars of each experimental group (n=10) were subjected to four-point flexural strength testing. In each ceramic block, a Vickers indentation was created under a load of 10 kgf for 10 seconds, for the propagation of cracks. RESULTS The results of flexural strength were evaluated by One-way ANOVA and Tukey's test, with a significance level of 5%. The factor "thickness of the porcelain" was statistically significant (p=0.001) and the l-mm group presented the highest values of flexural strength. The cracks were predominant among the bending specimens with 1 and 2 mm of porcelain, and catastrophic failures were found in 50% of 3-mm-thick porcelain. After the indentation of blocks, the most severe defects were observed in blocks with 3-mm-thick porcelain. CONCLUSION The smallest (1 mm) thickness of porcelain on the zirconia infrastructure presented higher values of flexural strength. Better resistance to defect propagation was observed near the porcelain/ zirconia interface for all groups. Higher flexural strength was found for a thinner porcelain layer in a bilayered zirconia system. The damage caused by a Vickers indentation near and far the interface with the zirconia shows that the stress profiles are different.
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Affiliation(s)
- Viviane Maria Gonçalves de Figueiredo
- Univ. Estadual Paulista, Instituto de Ciência e Tecnologia de São José dos Campos, Departamento de Materiais Odontológicos e Prótese, São Jose dos Campos, SP, Brasil
| | - Sarina Maciel Braga Pereira
- Univ. Estadual Paulista, Instituto de Ciência e Tecnologia de São José dos Campos, Departamento de Materiais Odontológicos e Prótese, São Jose dos Campos, SP, Brasil
| | - Eduardo Bressiani
- Univ. Estadual Paulista, Instituto de Ciência e Tecnologia de São José dos Campos, Departamento de Odontologia Restauradora, São Jose dos Campos, SP, Brasil
| | - Márcia Carneiro Valera
- Univ. Estadual Paulista, Instituto de Ciência e Tecnologia de São José dos Campos, Departamento de Odontologia Restauradora, São Jose dos Campos, SP, Brasil
| | - Marco Antônio Bottino
- Univ. Estadual Paulista, Instituto de Ciência e Tecnologia de São José dos Campos, Departamento de Materiais Odontológicos e Prótese, São Jose dos Campos, SP, Brasil
| | - Yu Zhang
- New York University, College of Dentistry, Biomaterials and Biomimetics, New York, USA
| | - Renata Marques de Melo
- Univ. Estadual Paulista, Instituto de Ciência e Tecnologia de São José dos Campos, Departamento de Materiais Odontológicos e Prótese, São Jose dos Campos, SP, Brasil
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Zaugg LK, Zehnder I, Rohr N, Fischer J, Zitzmann NU. The effects of crown venting or pre-cementing of CAD/CAM-constructed all-ceramic crowns luted on YTZ implants on marginal cement excess. Clin Oral Implants Res 2017; 29:82-90. [DOI: 10.1111/clr.13071] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Lucia K. Zaugg
- Department of Periodontology, Endodontology and Cariology; University Center for Dental Medicine Basel, University of Basel; Basel Switzerland
- Centre for Craniofacial and Regenerative Biology, Dental Institute; King's College London; London UK
| | - Isabella Zehnder
- Department of Periodontology, Endodontology and Cariology; University Center for Dental Medicine Basel, University of Basel; Basel Switzerland
| | - Nadja Rohr
- Department of Reconstructive Dentistry and Temporomandibular Disorders; University Center for Dental Medicine Basel, University of Basel; Basel Switzerland
| | - Jens Fischer
- Department of Reconstructive Dentistry and Temporomandibular Disorders; University Center for Dental Medicine Basel, University of Basel; Basel Switzerland
| | - Nicola U. Zitzmann
- Department of Periodontology, Endodontology and Cariology; University Center for Dental Medicine Basel, University of Basel; Basel Switzerland
- Department of Reconstructive Dentistry and Temporomandibular Disorders; University Center for Dental Medicine Basel, University of Basel; Basel Switzerland
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Abstract
OBJECTIVES During the last decades, several changes of paradigm have modified our view on how biomaterials' surface characteristics influence the bioresponse. After becoming aware of the role of a certain microroughness for improved cellular contact and osseointegration of dental titanium implants, the likewise important role of surface energy and wettability was increasingly strengthened. Very recently, synergistic effects of nanoscaled topographical features and hydrophilicity at the implant/bone interface have been reported. METHODS Questions arise about which surface roughness and wetting data are capable to predict the bioresponse and, ultimately, the clinical performance. Current methods and approaches applied for topographical, wetting and surface energetic analyses are highlighted. Current knowledge of possible mechanisms explaining the influence of roughness and hydrophilicity at the biological interface is presented. RESULTS Most marketed and experimental surfaces are based on commonly available additive or subtractive surface modifying methods such as blasting, etching or anodizing. Different height, spatial, hybrid and functional roughness parameters have been identified as possible candidates able to predict the outcome at hard and soft tissue interfaces. Likewise, hydrophilic implants have been proven to improve the initial blood contact, to support the wound healing and thereby accelerating the osseointegration. SIGNIFICANCE There is clear relevance for the influence of topographical and wetting characteristics on a macromolecular and cellular level at endosseous implant/biosystem interfaces. However, we are still far away from designing sophisticated implant surfaces with the best possible, selective functionality for each specific tissue or cavity interface. Firstly, because our knowledge of the respective surface related reactions is at best fragmentary. Secondly, because manufacturing of multi-scaled complex surfaces including distinct nanotopographies, wetting properties, and stable cleanliness is still a technical challenge and far away from being reproducibly transferred to implant surfaces.
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Sivaraman K, Chopra A, Narayan AI, Balakrishnan D. Is zirconia a viable alternative to titanium for oral implant? A critical review. J Prosthodont Res 2017; 62:121-133. [PMID: 28827030 DOI: 10.1016/j.jpor.2017.07.003] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/22/2017] [Accepted: 07/11/2017] [Indexed: 02/04/2023]
Abstract
PURPOSE Titanium based implant systems, though considered as the gold standard for rehabilitation of edentulous spaces, have been criticized for many inherent flaws. The onset of hypersensitivity reactions, biocompatibility issues, and an unaesthetic gray hue have raised demands for more aesthetic and tissue compatible material for implant fabrication. Zirconia is emerging as a promising alternative to conventional Titanium based implant systems for oral rehabilitation with superior biological, aesthetics, mechanical and optical properties. This review aims to critically analyze and review the credibility of Zirconia implants as an alternative to Titanium for prosthetic rehabilitation. STUDY SELECTION The literature search for articles written in the English language in PubMed and Cochrane Library database from 1990 till December 2016. The following search terms were utilized for data search: "zirconia implants" NOT "abutment", "zirconia implants" AND "titanium implants" AND "osseointegration", "zirconia implants" AND compatibility. RESULTS The number of potential relevant articles selected were 47. All the human in vivo clinical, in vitro, animals' studies were included and discussed under the following subheadings: Chemical composition, structure and phases; Physical and mechanical properties; Aesthetic and optical properties; Osseointegration and biocompatibility; Surface modifications; Peri-implant tissue compatibility, inflammation and soft tissue healing, and long-term prognosis. CONCLUSIONS Zirconia implants are a promising alternative to titanium with a superior soft-tissue response, biocompatibility, and aesthetics with comparable osseointegration. However, further long-term longitudinal and comparative clinical trials are required to validate zirconia as a viable alternative to the titanium implant.
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Affiliation(s)
- Karthik Sivaraman
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Manipal, 576104, India.
| | - Aditi Chopra
- Department of Periodontology, Manipal College of Dental Sciences, Manipal University, Manipal, India
| | - Aparna I Narayan
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Manipal, 576104, India
| | - Dhanasekar Balakrishnan
- Department of Prosthodontics, Manipal College of Dental Sciences, Manipal University, Manipal, 576104, India
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Abstract
STATEMENT OF PROBLEM Dental implants are typically made of titanium. However, with the current systems on the market, the implant neck often shows through the gingival tissues as a black or dark gray line and/or as a grayish discoloration of the peri-implant soft tissue. PURPOSE The purpose of this in vitro study was to test a new implant design. The key component of this design is the ceramic shell that covers the polished collar of the tissue-level titanium implant and masks its dark color to mimic natural dentition. The main purpose was to determine the maximum torque for fracturing the ceramic shell and compare it with clinical implant insertion torque value. MATERIAL AND METHODS Type 4 commercially pure titanium endosseous implants of 3 different diameters (3.3, 4.1, and 4.8 mm) were used. Porcelain was applied in 0.5-mm thickness to the polished collar of each implant. An axial-torsional universal testing machine was used to twist the implants until failure. The data (n=10) were statistically analyzed by ANOVA and the Tukey honest significant difference test (α=.05). The maximum torque for each diameter group was also compared with the optimum clinical implant insertion torque value of 35 Ncm (control) using a 1-sample t test. RESULTS None of the tested groups had a fractured ceramic shell. Instead, the implant carriers fractured at the maximum torque levels. Therefore, the fracture of the implant carriers was selected as the maximum (failure) torque value. A statistical difference was found for the failure torque between the 3.3-mm diameter and the other 2 diameters (P<.001) although no statistical differences were found between the 4.1-mm and 4.8-mm diameters (P=.106). A statistically significant difference was found between the failure torque of any one of the tested groups and the clinical insertion torque (P<.001). CONCLUSIONS The ceramic shells did not fracture. Instead, the implant carriers fractured at certain torque levels. These levels were sufficiently higher than the clinical torque values.
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Affiliation(s)
- Waleed Elshahawy
- Lecturer, Department of Fixed Prosthodontics, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Raed Ajlouni
- Professor, Department of Restorative Science, Baylor College of Dentistry, Texas A&M Health Science Center, Dallas, Texas
| | - Khaldoun Ajlouni
- Professor, Department of Restorative Science, Baylor College of Dentistry, Texas A&M Health Science Center, Dallas, Texas.
| | - Abdelfattah Sadakah
- Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tanta University, Tanta, Egypt
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Kim HK, Woo KM, Shon WJ, Ahn JS, Cha S, Park YS. Comparison of peri-implant bone formation around injection-molded and machined surface zirconia implants in rabbit tibiae. Dent Mater J 2017; 34:508-15. [PMID: 26235717 DOI: 10.4012/dmj.2015-024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this study was to compare osseointegration and surface characteristics of zirconia implants made by the powder injection molding (PIM) technique against those made by the conventional milling procedure in rabbit tibiae. Surface characteristics of 2 types of implants were evaluated. Sixteen rabbits received 2 types of external hex implants with similar geometry, either machined zirconia implants or PIM zirconia implants, in the tibiae. Removal torque tests and histomorphometric analyses were performed. The roughness of the PIM zirconia implants was higher than that of machined zirconia implants. The PIM zirconia implants exhibited significantly higher bone-implant contact and removal torque values than the machined zirconia implants (p<0.001). The osseointegration of the PIM zirconia implant is promising, and PIM, using the roughened mold etching technique, can produce substantially rougher surfaces on zirconia implants.
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Affiliation(s)
- Hong-Kyun Kim
- Department of Oral Anatomy, Dental Research Institute and School of Dentistry, Seoul National University
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Cionca N, Hashim D, Mombelli A. Zirconia dental implants: where are we now, and where are we heading? Periodontol 2000 2016; 73:241-258. [DOI: 10.1111/prd.12180] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Kammermeier A, Rosentritt M, Behr M, Schneider-Feyrer S, Preis V. In vitro performance of one- and two-piece zirconia implant systems for anterior application. J Dent 2016; 53:94-101. [PMID: 27528418 DOI: 10.1016/j.jdent.2016.08.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To investigate the long-term in vitro performance and fracture resistance of one-piece and bonded two-piece zirconia implant systems for anterior application. METHODS Two groups of bonded two-piece zirconia (ZZB), four groups of one-piece zirconia (Z), and two groups of two-piece titanium (TTS, reference) implant systems were restored with identical monolithic zirconia crowns (n=10/group). Eight specimens per group were mounted at an angle of 135° in the chewing simulator and subjected to thermal cycling (TC:18,000 cycles; 5°/55°) and mechanical loading (ML:3.6×10(6) cycles; 100N) simulating an anterior situation. Fracture resistance and maximum bending stress were determined for specimens that survived aging and for two references per group after 24h water storage. SEM pictures were used for failure analysis. Data were statistically analysed (one-way-ANOVA, post-hoc Bonferroni, Kaplan-Meier-Log-Rank, α=0.05). RESULTS A one-piece zirconia and a two-piece titanium implant system survived TCML without failures. Both bonded two-piece zirconia implant systems and a one-piece zirconia implant system totally failed (fractures of abutment or implant). Failure numbers of the other systems varied between 1× (1 group) and 5× (2 groups). Significantly different survival rates were found (Log-Rank-test: p=0.000). Maximum fracture forces/bending stresses varied significantly ( ANOVA p=0.000) between 188.00±44.80N/381.02±80.15N/mm(2) and 508.67±107.00N/751.45±36.73N/mm(2). Mean fracture values after 24h water storage and TCML were not significantly different. CONCLUSION Zirconia implant systems partly showed material defects or connection insufficiencies. Bonded two-piece systems had higher failure rates and lower fracture resistance than one-piece implants. CLINICAL SIGNIFICANCE Individual zirconia implant systems may be applied in anterior regions with limitations.
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Affiliation(s)
- Armin Kammermeier
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany
| | - Michael Behr
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany
| | - Sibylle Schneider-Feyrer
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany
| | - Verena Preis
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany.
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Comparison of surface modified zirconia implants with commercially available zirconium and titanium implants: a histological study in pigs. IMPLANT DENT 2016; 23:502-7. [PMID: 25025856 DOI: 10.1097/id.0000000000000110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION New biomaterials and their various surface modifications should undergo in vitro and in vivo evaluation before clinical trials. The objective of our in vivo study was to evaluate the biocompatibility of newly created zirconium implant surfaces after implantation in the lower jaw of pigs and compare the osseointegration of these dental implants with commercially available zirconium and titanium implants. MATERIALS AND METHODS After a healing period of 12 weeks, a histological analysis of the soft and hard tissues and a histomorphometric analysis of the bone-implant contact (BIC) were performed. RESULTS The implant surfaces showed an intimate connection to the adjacent bone for all tested implants. The 3 newly created zirconium implant surfaces achieved a BIC of 45% on average in comparison with a BIC of 56% from the reference zirconium implants and 35% from titanium implants. Furthermore, the new zirconium implants had a better attachment to gingival and bone tissues in the range of implant necks as compared with the reference implants. CONCLUSION The results suggest that the new implants comparably osseointegrate within the healing period, and they have a good in vivo biocompatibility.
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In Vitro Behavior of Osteoblasts on Zirconia After Different Intensities of Erbium, Chromium-Doped. J Craniofac Surg 2016; 27:784-8. [DOI: 10.1097/scs.0000000000002429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Preis V, Kammermeier A, Handel G, Rosentritt M. In vitro performance of two-piece zirconia implant systems for anterior application. Dent Mater 2016; 32:765-74. [PMID: 27068740 DOI: 10.1016/j.dental.2016.03.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 02/03/2016] [Accepted: 03/22/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the influence of the implant-abutment connection on the long-term in vitro performance and fracture resistance of two-piece zirconia implant systems for anterior application. METHODS Six groups of two-piece zirconia implant systems (n=10/group) with screw-retained (5×) or bonded (1×) connections were restored with full-contour zirconia crowns. A two-piece screw-retained titanium system served as reference. For simulating anterior loading the specimens (n=8/group) were mounted at an angle of 135° in the chewing simulator, and subjected to thermal cycling (TC: 2×9000×5°/55°C) and mechanical loading (ML: 3.6×10(6)×100N). Failed restorations were examined (scanning electron microscopy). Fracture resistance and maximum bending stress of surviving restorations were determined. 2 specimens per group were loaded to fracture after 24h water storage without TCML. Data were statistically analyzed (ANOVA; Bonferroni; Kaplan-Meier-Log-Rank; α=0.05). RESULTS The bonded zirconia system and the titanium reference survived TCML without any failures. Screw-retained zirconia systems showed fractures of abutments and/or implants, partly combined with screw fracture/loosening. Failure frequency (F) varied between the groups (F=8×: 3 groups, F=3×: 1 group, F=1×: 1 group). The Log-Rank-test showed significant (p=0.000) differences. Fracture forces and maximum bending stresses (mean±standard deviation) differed significantly ( ANOVA p=0.000) between 233.4±31.4N/317.1±42.6N/mm(2) and 404.3±15.1N/549.2±20.5N/mm(2). Fracture forces after TCML were similar to 24h fracture forces. SIGNIFICANCE Screw-retained two-piece zirconia implant systems showed higher failure rates and lower fracture resistance than a screw-retained titanium system, and may be appropriate for clinical anterior requirements with limitations. Failures involved the abutment/implant region around the screw, indicating that the connecting design is crucial for clinical success.
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Affiliation(s)
- Verena Preis
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany.
| | - Armin Kammermeier
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany
| | - Gerhard Handel
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, Regensburg University Medical Center, 93042 Regensburg, Germany
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Gautam C, Joyner J, Gautam A, Rao J, Vajtai R. Zirconia based dental ceramics: structure, mechanical properties, biocompatibility and applications. Dalton Trans 2016; 45:19194-19215. [DOI: 10.1039/c6dt03484e] [Citation(s) in RCA: 159] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Zirconia (ZrO2) based dental ceramics have been considered to be advantageous materials with adequate mechanical properties for the manufacturing of medical devices.
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Affiliation(s)
- Chandkiram Gautam
- Department of Material Science and Nano Engineering
- 6100 Main MS-325
- Rice University
- Houston
- USA
| | - Jarin Joyner
- Department of Material Science and Nano Engineering
- 6100 Main MS-325
- Rice University
- Houston
- USA
| | | | - Jitendra Rao
- Department of Prosthodontics
- Faculty of Dental Sciences
- King George Medical University
- Lucknow - 226003
- India
| | - Robert Vajtai
- Department of Material Science and Nano Engineering
- 6100 Main MS-325
- Rice University
- Houston
- USA
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Schienle S, Al-Ahmad A, Kohal RJ, Bernsmann F, Adolfsson E, Montanaro L, Palmero P, Fürderer T, Chevalier J, Hellwig E, Karygianni L. Microbial adhesion on novel yttria-stabilized tetragonal zirconia (Y-TZP) implant surfaces with nitrogen-doped hydrogenated amorphous carbon (a-C:H:N) coatings. Clin Oral Investig 2015; 20:1719-32. [DOI: 10.1007/s00784-015-1655-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/09/2015] [Indexed: 12/14/2022]
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Fathy SM, El-Fallal AA, El-Negoly SA, El Bedawy AB. Translucency of monolithic and core zirconia after hydrothermal aging. ACTA BIOMATERIALIA ODONTOLOGICA SCANDINAVICA 2015; 1:86-92. [PMID: 27335897 PMCID: PMC4894082 DOI: 10.3109/23337931.2015.1102639] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 08/02/2015] [Accepted: 09/28/2015] [Indexed: 02/04/2023]
Abstract
Objective: To evaluate the hydrothermal aging effect on the translucency of partially stabilized tetragonal zirconia with yttria (Y-TZP) used as monolithic or fully milled zirconia and of core type. Methods: Twenty disc-shaped specimens (1 and 10 mm) for each type of monolithic and core Y-TZP materials were milled and sintered according to the manufacturer’s instruction. The final specimens were divided into two groups according to the type of Y-TZP used. Translucency parameter (TP) was measured over white and black backgrounds with the diffuse reflectance method; X-ray diffraction (XRD) and scanning electron microscope (SEM) were used to analyze the microstructure of both Y-TZP types before and after aging. Data for TP values was statistically analyzed using Student’s t-test. Results: Monolithic Y-TZP showed the highest TP mean value (16.4 ± 0.316) before aging while core Y-TZP showed the lowest TP mean value (7.05 ± 0.261) after aging. There was a significant difference between the two Y-TZP types before and after hydrothermal aging. XRD analysis showed increases in monoclinic content in both Y-TZP surfaces after aging. Conclusion: Monolithic Y-TZP has a higher chance to low-temperature degradation than core type, which may significantly affect the esthetic appearance and translucency hence durability of translucent Y-TZP.
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Affiliation(s)
- Salma M Fathy
- Department of Dental Biomaterial, Faculty of Dentistry, Mansura University , Mansoura , Egypt
| | - Abeer A El-Fallal
- Department of Dental Biomaterial, Faculty of Dentistry, Mansura University , Mansoura , Egypt
| | - Salwa A El-Negoly
- Department of Dental Biomaterial, Faculty of Dentistry, Mansura University , Mansoura , Egypt
| | - Abu Baker El Bedawy
- Department of Physics, Faculty of Science, Mansura University , Mansoura , Egypt
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Lan TH, Liu PH, Chou MMC, Lee HE. Fracture resistance of monolithic zirconia crowns with different occlusal thicknesses in implant prostheses. J Prosthet Dent 2015; 115:76-83. [PMID: 26412004 DOI: 10.1016/j.prosdent.2015.06.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 06/17/2015] [Accepted: 06/24/2015] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM The use of monolithic zirconia crowns in implant prostheses is increasing, especially when the interdental space is insufficient. However, fractures have been reported in clinical practice. PURPOSE The purpose of this study was to determine the minimal thickness of a complete zirconia crown used for an implant prosthesis in the posterior dental region. MATERIAL AND METHODS Fifty complete zirconia crowns were produced using a computer-aided design/computer-aided manufacturing technique. In each group, 5 crowns of varying thicknesses (0.4, 0.5, 0.6, 0.7, and 0.8 mm) were subjected to cycles of vertical and 10-degree oblique compressive loading at 5 Hz and 300 N in a servohydraulic testing machine. Five finite element models comprising 5 different occlusal thicknesses (0.4, 0.5, 0.6, 0.7, and 0.8 mm) were simulated at 2 loading angles (0 and 10 degrees) and 3 loading forces (300, 500, and 800 N). Data were statistically analyzed, and fracture patterns were observed with a scanning electron microscope. RESULTS Cyclic loading tests revealed that the fracture resistance of the specimens was positively associated with prosthesis thickness (P<.01). Low von Mises stress values were obtained for prostheses with a minimal thickness of 0.7 mm under varying loading directions and forces. CONCLUSIONS Zirconia prostheses with a minimal thickness of 0.7 mm had a high fracture resistance and the lowest stress values. Therefore, dentists and laboratory technicians should carefully choose the optimum thickness of zirconia prostheses.
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Affiliation(s)
- Ting-Hsun Lan
- Attending Dentist, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung Taiwan; Assistant Professor, School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Pao-Hsin Liu
- Assistant Professor, Department of Biomedical Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Mitch M C Chou
- Professor, Department of Materials & Opto-electronic Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Huey-Er Lee
- Professor, School of Dentistry, College of Dental Medicine, Kaohsiung, Taiwan
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Apratim A, Eachempati P, Krishnappa Salian KK, Singh V, Chhabra S, Shah S. Zirconia in dental implantology: A review. J Int Soc Prev Community Dent 2015; 5:147-56. [PMID: 26236672 PMCID: PMC4515795 DOI: 10.4103/2231-0762.158014] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Titanium has been the most popular material of choice for dental implantology over the past few decades. Its properties have been found to be most suitable for the success of implant treatment. But recently, zirconia is slowly emerging as one of the materials which might replace the gold standard of dental implant, i.e., titanium. Materials and Methods: Literature was searched to retrieve information about zirconia dental implant and studies were critically analyzed. PubMed database was searched for information about zirconia dental implant regarding mechanical properties, osseointegration, surface roughness, biocompatibility, and soft tissue health around it. The literature search was limited to English language articles published from 1975 to 2015. Results: A total of 45 papers met the inclusion criteria for this review, among the relevant search in the database. Conclusion: Literature search showed that some of the properties of zirconia seem to be suitable for making it an ideal dental implant, such as biocompatibility, osseointegration, favourable soft tissue response and aesthetics due to light transmission and its color. At the same time, some studies also point out its drawbacks. It was also found that most of the studies on zirconia dental implants are short-term studies and there is a need for more long-term clinical trials to prove that zirconia is worth enough to replace titanium as a biomaterial in dental implantology.
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Affiliation(s)
- Abhishek Apratim
- Department of Prosthodontics, Melaka Manipal Medical College, Melaka, Malaysia
| | | | | | - Vijendra Singh
- Department of Periodontics, Melaka Manipal Medical College, Melaka, Malaysia
| | - Saurabh Chhabra
- Department of Dentistry, New Delhi Municipal Council (NDMC), New Delhi, India
| | - Sanket Shah
- Department of Prosthodontics, Vaidik Dental College, Daman, Gujarat, India, India
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Bayramoğlu E, Kulak Özkan Y, Yildiz C. Comparison of marginal and internal fit of press-on-metal and conventional ceramic systems for three- and four-unit implant-supported partial fixed dental prostheses: An in vitro study. J Prosthet Dent 2015; 114:52-8. [DOI: 10.1016/j.prosdent.2015.01.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 01/12/2015] [Accepted: 01/14/2015] [Indexed: 11/29/2022]
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Kohal RJ, Kilian JB, Stampf S, Spies BC. All-Ceramic Single Crown Restauration of Zirconia Oral Implants and Its Influence on Fracture Resistance: An Investigation in the Artificial Mouth. MATERIALS 2015; 8:1577-1589. [PMID: 28788018 PMCID: PMC5507023 DOI: 10.3390/ma8041577] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 03/20/2015] [Accepted: 03/27/2015] [Indexed: 11/30/2022]
Abstract
The aim of the current investigation was to evaluate the fracture resistance of one-piece zirconia oral implants with and without all-ceramic incisor crowns after long-term thermomechanical cycling. A total of 48 implants were evaluated. The groups with crowns (C, 24 samples) and without crowns (N, 24 samples) were subdivided according to the loading protocol, resulting in three groups of 8 samples each: Group “0” was not exposed to cyclic loading, whereas groups “5” and “10” were loaded with 5 and 10 million chewing cycles, respectively. This resulted in 6 different groups: C0/N0, C5/N5 and C10/N10. Subsequently, all 48 implants were statically loaded to fracture and bending moments were calculated. All implants survived the artificial aging. For the static loading the following average bending moments were calculated: C0: 326 Ncm; C5: 339 Ncm; C10: 369 Ncm; N0: 339 Ncm; N5: 398 Ncm and N10: 355 Ncm. To a certain extent, thermomechanical cycling resulted in an increase of fracture resistance which did not prove to be statistically significant. Regarding its fracture resistance, the evaluated ceramic implant system made of Y-TZP seems to be able to resist physiological chewing forces long-term. Restauration with all-ceramic single crowns showed no negative influence on fracture resistance.
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Affiliation(s)
- Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Center for Dental Medicine, University Hospital Freiburg, Albert-Ludwigs-University, Freiburg 79106, Germany.
| | | | - Susanne Stampf
- Department for Medical Biometry and Medical Informatics, Institute for Medical Biometry and Statistics, Albert-Ludwigs-University, Freiburg 79104, Germany.
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry, Center for Dental Medicine, University Hospital Freiburg, Albert-Ludwigs-University, Freiburg 79106, Germany.
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Osman RB, Swain MV. A Critical Review of Dental Implant Materials with an Emphasis on Titanium versus Zirconia. MATERIALS 2015; 8:932-958. [PMID: 28787980 PMCID: PMC5455450 DOI: 10.3390/ma8030932] [Citation(s) in RCA: 202] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 01/20/2015] [Accepted: 02/12/2015] [Indexed: 01/21/2023]
Abstract
The goal of the current publication is to provide a comprehensive literature review on the topic of dental implant materials. The following paper focuses on conventional titanium implants and more recently introduced and increasingly popular zirconia implants. Major subtopics include the material science and the clinical considerations involving both implant materials and the influence of their physical properties on the treatment outcome. Titanium remains the gold standard for the fabrication of oral implants, even though sensitivity does occur, though its clinical relevance is not yet clear. Zirconia implants may prove to be promising in the future; however, further in vitro and well-designed in vivo clinical studies are needed before such a recommendation can be made. Special considerations and technical experience are needed when dealing with zirconia implants to minimize the incidence of mechanical failure.
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Affiliation(s)
- Reham B Osman
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centrum of Dentistry Amsterdam (ACTA), 1081 LA Amsterdam, The Netherlands.
- Department of Removable Prosthodontics, Cairo University, Giza 11553, Egypt.
| | - Michael V Swain
- Biomaterials Laboratory, Sydney Dental Hospital, the University of Sydney, Surry Hills, NSW 2010, Australia.
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Spies BC, Sauter C, Wolkewitz M, Kohal RJ. Alumina reinforced zirconia implants: Effects of cyclic loading and abutment modification on fracture resistance. Dent Mater 2015; 31:262-72. [DOI: 10.1016/j.dental.2014.12.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/12/2014] [Accepted: 12/16/2014] [Indexed: 11/28/2022]
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Cattani-Lorente M, Scherrer S, Durual S, Sanon C, Douillard T, Gremillard L, Chevalier J, Wiskott A. Effect of different surface treatments on the hydrothermal degradation of a 3Y-TZP ceramic for dental implants. Dent Mater 2014; 30:1136-46. [DOI: 10.1016/j.dental.2014.07.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/20/2014] [Accepted: 07/09/2014] [Indexed: 02/04/2023]
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Li RWK, Chow TW, Matinlinna JP. Ceramic dental biomaterials and CAD/CAM technology: state of the art. J Prosthodont Res 2014; 58:208-16. [PMID: 25172234 DOI: 10.1016/j.jpor.2014.07.003] [Citation(s) in RCA: 209] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 07/25/2014] [Accepted: 07/28/2014] [Indexed: 11/15/2022]
Abstract
PURPOSE Ceramics are widely used as indirect restorative materials in dentistry because of their high biocompatibility and pleasing aesthetics. The objective is to review the state of the arts of CAD/CAM all-ceramic biomaterials. STUDY SELECTION CAD/CAM all-ceramic biomaterials are highlighted and a subsequent literature search was conducted for the relevant subjects using PubMed followed by manual search. RESULTS Developments in CAD/CAM technology have catalyzed researches in all-ceramic biomaterials and their applications. Feldspathic glass ceramic and glass infiltrated ceramic can be fabricated by traditional laboratory methods or CAD/CAM. The advent of polycrystalline ceramics is a direct result of CAD/CAM technology without which the fabrication would not have been possible. CONCLUSIONS The clinical uses of these ceramics have met with variable clinical success. Multiple options are now available to the clinicians for the fabrication of aesthetic all ceramic restorations.
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Affiliation(s)
- Raymond Wai Kim Li
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong Special Administrative Region.
| | - Tak Wah Chow
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong Special Administrative Region
| | - Jukka Pekka Matinlinna
- Faculty of Dentistry, The University of Hong Kong, The Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong Special Administrative Region
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Bankoğlu Güngör M, Aydın C, Yılmaz H, Gül EB. An Overview of Zirconia Dental Implants: Basic Properties and Clinical Application of Three Cases. J ORAL IMPLANTOL 2014; 40:485-94. [DOI: 10.1563/aaid-joi-d-12-00109] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Due to the possible aesthetic problems of titanium implants, the developments in ceramic implant materials are increasing. Natural tooth colored ceramic implants may be an alternative to overcome aesthetic problems. The purpose of this article is to give information about the basic properties of dental zirconia implants and present 3 cases treated with two-piece zirconia implants. Two-piece zirconia dental implants, 4.0 mm diameter and 11.5 mm in length, were inserted into maxillary incisor region. They were left for 6 months to osseointegrate. Panoramic and periapical radiographs were obtained and examined for bone-implant osseointegration. During the follow-up period the patients were satisfied with their prosthesis and no complication was observed.
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Affiliation(s)
| | - Cemal Aydın
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Handan Yılmaz
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Esma Başak Gül
- Department of Prosthodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
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Rosentritt M, Hagemann A, Hahnel S, Behr M, Preis V. In vitro performance of zirconia and titanium implant/abutment systems for anterior application. J Dent 2014; 42:1019-26. [PMID: 24699071 DOI: 10.1016/j.jdent.2014.03.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 03/05/2014] [Accepted: 03/23/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To investigate the type of failure and fracture resistance behaviour of different zirconia and titanium implant/abutment systems for anterior application. METHODS Eight groups of implant-abutment combinations (n=8/system) were restored with identical full-contour zirconia crowns. The systems represented one-piece and multi-piece zirconia (Z) or titanium (T) implants/abutments with different types of connection (screwed=S, bonded=B). The following combinations (implant-abutment-connection) were investigated: ZZS, ZZB, ZZZB (three-piece), ZTS, TTS, TTS reference, and Z (one-piece, 2×). To simulate clinical anterior loading situations the specimens were mounted into the chewing simulator at an angle of 135° and subjected to thermal cycling (2×3000×5°/55°C) and mechanical loading (1.2×10(6)×50N; 1.6Hz). Fracture resistance and maximum bending stress were determined for all specimens that survived ageing. Data were statistically analyzed with the Kolmogorov-Smirnov-test and one-way ANOVA (α=0.05). Survival performance was calculated with the Kaplan-Meier Log-Rank test. RESULTS Independent of the material combinations screwed systems showed partly failures of the screws during simulation (ZZS: 3×, ZTS: 8×, TTS: 3×). Screw failures were combined with implant/abutment fractures of zirconia systems. Zirconia one-piece implants and the reference system did not show any failures, and only one specimen of the systems with a bonded connection (ZZZB) fractured. Mean (±standard deviation) fracture forces and maximum bending stresses differed significantly (p=0.000) between 187.4±42.0N/250.0±56.0N/mm(2) (ZZZB) and 524.3±43.1N/753.0±61.0N/mm(2) (Z). CONCLUSIONS Both material (zirconia or titanium) and the type of connection influenced failure resistance during fatigue testing, fracture force, and maximum bending stress. CLINICAL SIGNIFICANCE Different material combinations for implants and abutments as well as different types of connection achieved acceptable or even good failure and fracture resistance that may be satisfactory for anterior clinical application.
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Affiliation(s)
- Martin Rosentritt
- Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042 Regensburg, Germany
| | - Anna Hagemann
- Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042 Regensburg, Germany
| | - Sebastian Hahnel
- Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042 Regensburg, Germany
| | - Michael Behr
- Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042 Regensburg, Germany
| | - Verena Preis
- Department of Prosthetic Dentistry, University Medical Center Regensburg, 93042 Regensburg, Germany.
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Dede DÖ, Armaganci A, Ceylan G, Cankaya S, Celik E. Influence of abutment material and luting cements color on the final color of all ceramics. Acta Odontol Scand 2013; 71:1570-8. [PMID: 23627846 DOI: 10.3109/00016357.2013.777114] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE The purpose of this study is to evaluate the effects of different abutment materials and luting cements color on the final color of implant-supported all-ceramic restorations. MATERIALS AND METHODS Ten A2 shade IPS e.max Press disc shape all-ceramic specimens were prepared (11 × 1.5 mm). Three different shades (translucent, universal and white opaque) of disc shape luting cement specimens were prepared (11 × 0.2 mm). Three different (zirconium, gold-palladium and titanium) implant abutments and one composite resin disc shape background specimen were prepared at 11 mm diameter and appropriate thicknesses. All ceramic specimens colors were measured with each background and luting cement samples on a teflon mold. A digital spectrophotometer used for measurements and data recorded as CIE L*a*b* color co-ordinates. An optical fluid applied on to the samples to provide a good optical connection and measurements on the composite resin background was saved as the control group. ΔE values were calculated from the ΔL, Δa and Δb values between control and test groups and data were analyzed with one-way variance analysis (ANOVA) and mean values were compared by the Tukey HSD test (α = 0.05). RESULTS One-way ANOVA of ΔL, Δa, Δb and ΔE values of control and test groups revealed significant differences for backgrounds and seldom for cement color groups (p the 0.05). Only zirconium implant abutment groups and gold palladium abutment with universal shade cement group were found to be clinically acceptable (ΔE ≤ 3.0). CONCLUSION Using titanium or gold-palladium abutments for implant supported all ceramics will be esthetically questionable and white opaque cement will be helpful to mask the dark color of titanium abutment.
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Affiliation(s)
- Dogu Ömür Dede
- Department of Prosthodontics, Faculty of Dentistry, Bülent Ecevit University , Zonguldak , Turkey
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Sghaireen MG. Fracture Resistance and Mode of Failure of Ceramic versus Titanium Implant Abutments and Single Implant-Supported Restorations. Clin Implant Dent Relat Res 2013; 17:554-61. [DOI: 10.1111/cid.12160] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Mohd G. Sghaireen
- Department of Prosthodontics; Faculty of Dentistry; Al-Jouf University; Sakaka Saudi Arabia
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Siddiqi A, Kieser JA, De Silva RK, Thomson WM, Duncan WJ. Soft and Hard Tissue Response to Zirconia versus Titanium One-Piece Implants Placed in Alveolar and Palatal Sites: A Randomized Control Trial. Clin Implant Dent Relat Res 2013; 17:483-96. [DOI: 10.1111/cid.12159] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Allauddin Siddiqi
- Department of Oral Sciences; Oral Implantology Research Group; Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Jules August Kieser
- Sir John Walsh Research Institute; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Rohana Kumara De Silva
- Sir John Walsh Research Institute; Department of Oral Diagnostic and Surgical Sciences; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - William Murray Thomson
- Sir John Walsh Research Institute; Department of Oral Sciences; Discipline of Dental Public Health; Faculty of Dentistry; University of Otago; Dunedin New Zealand
| | - Warwick John Duncan
- Sir John Walsh Research Institute; Department of Oral Sciences; Faculty of Dentistry; University of Otago; Dunedin New Zealand
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Aydın C, Yılmaz H, Bankoğlu M. A single-tooth, two-piece zirconia implant located in the anterior maxilla: a clinical report. J Prosthet Dent 2013; 109:70-4. [PMID: 23395330 DOI: 10.1016/s0022-3913(13)00027-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
It can be difficult to achieve a natural appearance in the anterior region with implant-supported restorations because metal components may show through the soft tissue. Zirconia implants, therefore, should be considered as an alternative treatment for improved esthetics. The goal of this clinical report was to evaluate a new 2-piece zirconia implant system for the maxillary anterior region. A 2-piece zirconia dental implant was placed in the maxillary left lateral incisor position and left in place for 6 months to osseointegrate. Panoramic and periapical radiographs were examined for bone-implant osseointegration. The plaque control record (PCR), bleeding on probing (BOP), and probing depth (PD) were measured after the cementation of the definitive restoration and a 6-month follow-up period. The PCR, BOP, and PD values were compared and the marginal bone level was also evaluated by making standardized periapical radiographs. The results showed that over the 6-month follow-up period, the marginal area was healthy and presented no bleeding on probing, no plaque accumulation, and no change in periimplant marginal bone level.
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Affiliation(s)
- Cemal Aydın
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey.
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Osteoblast and bone tissue response to surface modified zirconia and titanium implant materials. Dent Mater 2013; 29:763-76. [DOI: 10.1016/j.dental.2013.04.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 02/24/2013] [Accepted: 04/11/2013] [Indexed: 12/31/2022]
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Wang CF, Huang HL, Lin DJ, Shen YW, Fuh LJ, Hsu JT. Comparisons of maximum deformation and failure forces at the implant-abutment interface of titanium implants between titanium-alloy and zirconia abutments with two levels of marginal bone loss. Biomed Eng Online 2013; 12:45. [PMID: 23688204 PMCID: PMC3667051 DOI: 10.1186/1475-925x-12-45] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 05/15/2013] [Indexed: 11/10/2022] Open
Abstract
Background Zirconia materials are known for their optimal aesthetics, but they are brittle, and concerns remain about whether their mechanical properties are sufficient for withstanding the forces exerted in the oral cavity. Therefore, this study compared the maximum deformation and failure forces of titanium implants between titanium-alloy and zirconia abutments under oblique compressive forces in the presence of two levels of marginal bone loss. Methods Twenty implants were divided into Groups A and B, with simulated bone losses of 3.0 and 1.5 mm, respectively. Groups A and B were also each divided into two subgroups with five implants each: (1) titanium implants connected to titanium-alloy abutments and (2) titanium implants connected to zirconia abutments. The maximum deformation and failure forces of each sample was determined using a universal testing machine. The data were analyzed using the nonparametric Mann–Whitney test. Results The mean maximum deformation and failure forces obtained the subgroups were as follows: A1 (simulated bone loss of 3.0 mm, titanium-alloy abutment) = 540.6 N and 656.9 N, respectively; A2 (simulated bone loss of 3.0 mm, zirconia abutment) = 531.8 N and 852.7 N; B1 (simulated bone loss of 1.5 mm, titanium-alloy abutment) = 1070.9 N and 1260.2 N; and B2 (simulated bone loss of 1.5 mm, zirconia abutment) = 907.3 N and 1182.8 N. The maximum deformation force differed significantly between Groups B1 and B2 but not between Groups A1 and A2. The failure force did not differ between Groups A1 and A2 or between Groups B1 and B2. The maximum deformation and failure forces differed significantly between Groups A1 and B1 and between Groups A2 and B2. Conclusions Based on this experimental study, the maximum deformation and failure forces are lower for implants with a marginal bone loss of 3.0 mm than of 1.5 mm. Zirconia abutments can withstand physiological occlusal forces applied in the anterior region.
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Mai R, Kunert-Keil C, Grafe A, Gedrange T, Lauer G, Dominiak M, Gredes T. Histological behaviour of zirconia implants: An experiment in rats. Ann Anat 2012; 194:561-6. [DOI: 10.1016/j.aanat.2012.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 09/13/2012] [Accepted: 09/24/2012] [Indexed: 11/24/2022]
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Mitsias M, Koutayas SO, Wolfart S, Kern M. Influence of zirconia abutment preparation on the fracture strength of single implant lithium disilicate crowns after chewing simulation. Clin Oral Implants Res 2012; 25:675-82. [PMID: 23106096 DOI: 10.1111/clr.12058] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The use of all-ceramic crowns over zirconia abutments is a well-established esthetic treatment option in implant dentistry; however, the effect of the mechanical processing due to abutment preparation has not been investigated under functional loading. The purpose of the study was to evaluate the influence of the zirconia abutment preparation depth and preparation mode on the fracture strength and fracture mode of lithium disilicate crowns after chewing simulation. MATERIAL AND METHODS Seventy single implant-supported lithium disilicate glass-ceramic crowns (IPS e.max Press, Ivoclar Vivadent) were adhesively cemented (Multilink Automix, Ivoclar Vivadent) onto zirconia abutments (ZirDesign, Astra Tech) using implants with a diameter of 4.5 mm and a length of 15.0 mm (Osseospeed, Astra Tech). Study design concerned the replacement of a maxillary central incisor (11.0 mm in height and 8.0 mm in width). Subgroups (n = 7) were subjected to dynamic loading (C) up to 1.2 × 10(6) loading cycles at 135° with 98N in a thermomechanical chewing simulator (Kausimulator, Willytech); followed by quasi-static loading at a cross-head speed of 0.5 mm/min until fracture in a universal testing machine (Z010/TN2S, Zwick). Additional subgroups were also subjected to quasi-static loading (S) at 135°. Lithium disilicate implant crowns were divided into five study groups (n = 14) according to the abutment preparation depth [A (control): 0.5 mm, B: 0.7 mm, C: 0.9 mm, and preparation mode [(No label): milling by the manufacturer, (P): copy-milling by the Celay System (Mikrona)]. RESULTS All specimens survived dynamic loading and mean fracture strengths (N) after quasi-static loading were as follows: Group SA: 384 ± 84; Group CA: 403 ± 67; Group SB: 294 ± 95; Group CB: 374 ± 75; Group SC: 332 ± 52; Group CC: 373 ± 105; Group SPB: 332 ± 80; Group CPB: 499 ± 91; Group SPC: 380 ± 101; and Group CPC: 358 ± 54. CONCLUSIONS Statistical analysis using multiple linear regression showed that both the preparation depth and mode had no influence on the fracture strength of the implant crowns (P > 0.05); however, fracture strength increased statistically significantly after 5 years chewing simulation (P = 0.01).
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Affiliation(s)
- Miltiadis Mitsias
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry Christian-Albrechts University at Kiel, Kiel, Germany; Private Practice, Athens, Greece
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Lee WT, Koak JY, Lim YJ, Kim SK, Kwon HB, Kim MJ. Stress shielding and fatigue limits of poly-ether-ether-ketone dental implants. J Biomed Mater Res B Appl Biomater 2012; 100:1044-52. [PMID: 22331553 DOI: 10.1002/jbm.b.32669] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 09/16/2011] [Accepted: 12/10/2011] [Indexed: 11/08/2022]
Abstract
The poly-ether-ether-ketone (PEEK) polymer is of great interest as an alternative to titanium in orthopedics because of its biocompatibility and low elastic modulus. This study evaluated the fatigue limits of PEEK and the effects of the low elastic modulus PEEK in relation to existing dental implants. Compressive loading tests were performed with glass fiber-reinforced PEEK (GFR-PEEK), carbon fiber-reinforced PEEK (CFR-PEEK), and titanium rods. Among these tests, GFR-PEEK fatigue tests were performed according to ISO 14801. For the finite element analysis, three-dimensional models of dental implants and bone were constructed. The implants in the test groups were coated with a 0.5-mm thick and 5-mm long PEEK layer on the upper intrabony area. The strain energy densities (SED) were calculated, and the bone resorption was predicted. The fatigue limits of GFR-PEEK were 310 N and were higher than the static compressive strength of GFR-PEEK. The bone around PEEK-coated implants showed higher levels of SED than the bone in direct contact with the implants, and the wider diameter and stiffer implants showed lower levels of SED. The compressive strength of the GFR-PEEK and CFR-PEEK implants ranged within the bite force of the anterior and posterior dentitions, respectively, and the PEEK implants showed adequate fatigue limits for replacing the anterior teeth. Dental implants with PEEK coatings and PEEK implants may reduce stress shielding effects. Dental implant application of PEEK polymer-fatigue limit and stress shielding.
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Affiliation(s)
- Woo-Taek Lee
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
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