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Del Castillo R, Gutiérrez-Garrido L, Padial-Molina M, Galindo-Moreno P. Screw-retained internal connection zirconia CAD-CAM abutments in single implant reconstructions: Results of a 1-year prospective case series study. J Prosthodont 2023; 32:679-688. [PMID: 36882991 DOI: 10.1111/jopr.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE To evaluate the clinical and radiographic outcomes of single-tooth implant restorations using one-piece, internally connected, screw-retained, computer-aided design and computer-aided manufactured monolithic zirconia restorations fabricated on regular diameter implants. MATERIAL AND METHODS Following a 2-stage surgical procedure, 22 implants placed in anterior and posterior areas in 21 partially edentulous patients (mean age of 55 years; 9 males/12 females) were evaluated in terms of plaque index, pocket probing depth, bleeding on probing, level of oral hygiene (OH), signs of mucositis/peri-implantitis, esthetic score (ES), gingival zenith position (GZP), papilla index score, the thickness of peri-implant gingiva, radiographic marginal bone loss, and technical complications. Implants and restorations were prospectively followed from the insertion of the restoration (baseline), up to 12-months post-loading. RESULTS A 100% implant survival rate resulted after loading; one implant was lost before loading. Clinically, patients performed an adequate OH, and tissues were kept healthy. Probing depth showed a slightly lower value at baseline compared to any follow-up examination (2.26 [0.94] at baseline vs. 2.53 [0.66] mm at 12 months). ES, GZP, and the thickness of the peri-implant gingiva improved throughout the course of the study. Radiographically, average marginal bone level (MBL) was 0.40 (0.40) mm after 1-year follow-up with no differences in average MBL at all time points. Technically, after 1 year of clinical function, neither abutment fracture nor any other serious complications occurred. Hence, prosthetic reconstruction survival rate was 100%. CONCLUSIONS Clinical outcomes of single-tooth implant restorations using internally connected, screw-retained, computer-aided design and computer-aided manufacturing monolithic zirconia abutments can be considered a reliable treatment alternative after 1-year clinical observation.
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Affiliation(s)
- Rafael Del Castillo
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | | | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria., IBS, University of Granada., Granada, Spain
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria., IBS, University of Granada., Granada, Spain
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2
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Tang K, Luo ML, Zhou W, Niu LN, Chen JH, Wang F. The integration of peri-implant soft tissues around zirconia abutments: Challenges and strategies. Bioact Mater 2023; 27:348-361. [PMID: 37180640 PMCID: PMC10172871 DOI: 10.1016/j.bioactmat.2023.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/23/2023] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Stable soft tissue integration around the implant abutment attenuates pathogen penetration, protects underlying bone tissue, prevents peri-implantitis and is essential in maintaining long-term implant stability. The desire for "metal free" and "aesthetic restoration" has favored zirconia over titanium abutments, especially for implant restorations in the anterior region and for patients with thin gingival biotype. Soft tissue attachment to the zirconia abutment surface remains a challenge. A comprehensive review of advances in zirconia surface treatment (micro-design) and structural design (macro-design) affecting soft tissue attachment is presented and strategies and research directions are discussed. Soft tissue models for abutment research are described. Guidelines for development of zirconia abutment surfaces that promote soft tissue integration and evidence-based references to inform clinical choice of abutment structure and postoperative maintenance are presented.
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Affiliation(s)
- Kai Tang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Meng-Lin Luo
- Institute of Stomatology & Oral Maxilla Facial Key Laboratory, The First Medical Center, Chinese PLA General Hospital & Department of Stomatology, The First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Wei Zhou
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Li-Na Niu
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
| | - Ji-Hua Chen
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
| | - Fu Wang
- National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology &Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
- Corresponding author.
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Strasding M, Jeong Y, Marchand L, Hicklin SP, Sailer I, Sun M, Lee H. Three-Dimensional Peri-Implant Tissue Changes in Immediately vs. Early Placed Tapered Implants Restored with Two Different Ceramic Materials-1 Year Results. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5636. [PMID: 37629928 PMCID: PMC10456968 DOI: 10.3390/ma16165636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND A prospective multi-center randomized controlled clinical trial was performed to digitally analyze tissue volume changes in immediately and early placed implants with simultaneous bone augmentation restored with two different all-ceramic materials. METHODS A total of 60 patients received 60 bone-level tapered implants (BLT, Straumann AG) immediately (n = 30) or early placed, 8-10 weeks after tooth extraction, (n = 30). Implants were restored with all-ceramic single crowns fabricated out of zirconia (Lava Plus, 3M), or lithium disilicate (E.max CAD, Ivoclar Vivadent AG) bonded to titanium base abutments (Variobase for Cerec, Straumann AG). Impressions were taken at baseline (BL), 6 and 12 months, and STL data were used to define an area of interest (AOI) to analyze peri-implant volume changes and midfacial recessions. RESULTS For immediate placement, a mean volume loss of -5.56 mm3 (±5.83 mm3) was found at 6 months, and of -6.62 mm3 (±6.56 mm3) at 12 months. For early placement, a mean volume loss of -1.99 mm3 (±5.82 mm3) at 6 months, and of -3.7 mm3 (±5.62 mm3) at 12 months was found. The differences in volume loss at 12 months between the two implant placement protocols were significant (p = 0.005). In both groups, mean midfacial recessions of 0.48 mm (±0.52) occurred. CONCLUSIONS A more pronounced peri-implant volume loss can be expected 12 months after immediate implant placement compared with early placement.
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Affiliation(s)
- Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Yuwon Jeong
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Laurent Marchand
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Stefan P. Hicklin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland;
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Minji Sun
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Hyeonjong Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
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Saponaro PC, Karasan D, Donmez MB, Johnston WM, Yilmaz B. Prosthetic complications with monolithic or micro-veneered implant-supported zirconia single-unit, multiple-unit, and complete-arch prostheses on titanium base abutments: A single center retrospective study with mean follow-up period of 72.35 months. Clin Implant Dent Relat Res 2023; 25:99-106. [PMID: 36321480 DOI: 10.1111/cid.13149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/13/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The influence of prosthetic design on prosthetic complications when monolithic or micro-veneered zirconia prostheses are supported with titanium base (ti-base) abutments is not well-known. PURPOSE The purpose of this single center, retrospective study was to assess the prevalence of prosthetic complications with monolithic or micro-veneered single-unit, multi-unit, and complete-arch zirconia prostheses supported with ti-base abutments (implant level or multi-unit abutment level). MATERIAL AND METHODS This study retrospectively evaluated the electronic health record (EHR) of participants who received either monolithic or micro-veneered implant-supported single-unit, multi-unit, and/or complete-arch prostheses supported by ti-base or zirconia-ti-base hybrid abutments delivered between the years 2010 and 2021. Data were analyzed by using logistic regression and Exact Mantel-Haenszel chi-square test (α = 0.05) to assess the clinical performance of prostheses and complications including crown decementation, feldspathic porcelain chipping, prosthesis fracture, zirconia-ti-base hybrid abutment decementation, abutment screw loosening, screw fracture, abutment fracture, implant loss, and prosthesis remake. RESULTS The study included 94 participants (50 female, 44 male) with a mean age of 59.5 years (range: 24-101 years of age). The retrospective EHR evaluation yielded 82 single-unit, 51 multi-unit, and 20 complete-arch prostheses on 325 implants. Among 153 prostheses delivered, 108 were micro-veneered (47 single-unit, 41 multi-unit, and 20 complete-arch prostheses) and 45 were monolithic. The average duration was 72.35 months (6.02 years) with a follow-up period of 5-132 months. From the time of insertion to the time of EHR review, of 153 prostheses, 78.43% did not exhibit any prosthetic complication. However, 33 prostheses (21.57%) from 29 participants (30.85%) had at least one prosthetic complication. Only four patients (4.25%) experienced two or more prosthetic complications. Prosthetic design affected the probability of having a complication (p = 0.005); complete-arch prostheses had higher probability (p ≤ 0.028). Single-unit prostheses had lower probability of complication than multi-unit prostheses (p = 0.005). The most commonly observed complication was fracture of veneering material (5.88%) followed by prosthetic screw loosening (4.57%) and decementation between the zirconia and the ti-base abutment (2.61%). Micro-veneered complete-arch prostheses had higher probability of having chipping than that of not having (p < 0.001), and other micro-veneered prosthetic designs had similar probability of chipping with that of complete-arch prostheses (p ≥ 0.082). Frequency of chipping was affected by veneering (p < 0.001). Monolithic prostheses had lower probability of chipping than micro-veneered prostheses, regardless of the prosthetic design (p < 0.001). CONCLUSIONS The frequency of prosthetic complications varied depending on prosthetic design. Complete-arch prostheses had the highest probability of complications while the single-unit prostheses had the lowest. Micro-veneered prostheses had higher probability for chipping than monolithic prostheses. Probability of chipping was similar for micro-veneered single-unit, multi-unit, and complete-arch zirconia prostheses.
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Affiliation(s)
- Paola C Saponaro
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - William Michael Johnston
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Burak Yilmaz
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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5
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Bonyatpour M, Giti R, Erfanian B. Implant angulation and fracture resistance of one-piece screw-retained hybrid monolithic zirconia ceramic restorations. PLoS One 2023; 18:e0280816. [PMID: 36689439 PMCID: PMC9870147 DOI: 10.1371/journal.pone.0280816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 01/09/2023] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the fracture resistance of one-piece screw-retained hybrid monolithic zirconia ceramic restorations in different implant angulations. MATERIALS AND METHODS Three implant fixtures were embedded in acrylic resin blocks with 0°, 15°, and 25° angulations. For each group of implant angulations, 11 screw-retained one-piece monolithic zirconia restorations were made and bonded to the titanium inserts with a dual-cure self-adhesive resin. The complexes were screwed to the implant fixtures with titanium screws. The samples were thermocycled, subjected to compressive load, and fracture modes were recorded. One-way ANOVA and post hoc Tukey's test were used for statistical analyses (α = 0.05). RESULTS One-way ANOVA showed the fracture resistance to be significanltly different among the study groups (P = 0.036). The 15° group was significantly more resistant than 0° (P = 0.031). However, the 25° group was not significantly different from the 15° (P = 0.203) and 0° groups (P = 0.624). Fractures occurred only on the restorations, not at the screw levels. CONCLUSIONS Tilting the implant up to 15° improves the fracture resistance of one-piece screw-retained hybrid monolithic zirconia restorations; however, increasing the tilt to 25° would not yield restorations with significantly better fracture strength than the straight implants. Accordingly, when angulated implants are indicated in the esthetic zones, one-piece screw-retained hybrid monolithic zirconia ceramic restorations can be used with acceptable fracture strength.
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Affiliation(s)
- Milad Bonyatpour
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Rashin Giti
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
| | - Behrad Erfanian
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Fars, Iran
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6
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Akashi Y, Shimoo Y, Hashiguchi H, Nakajima K, Kokubun K, Matsuzaka K. Effects of Excimer Laser Treatment of Zirconia Disks on the Adhesion of L929 Fibroblasts. MATERIALS (BASEL, SWITZERLAND) 2022; 16:115. [PMID: 36614454 PMCID: PMC9821666 DOI: 10.3390/ma16010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
The adhesion of zirconia and soft tissue is very important for the success of zirconia implants. The aim of this study was to characterize the effects of excimer laser treatment of zirconia on the adhesion of L929 fibroblasts. In this study, polished zirconia disks treated with an excimer laser were the experimental group and untreated zirconia disks were the control group. Surface roughness and contact angles of zirconia disks were measured. mRNA expression levels of integrin β1 and collagen type I α1 in L929 fibroblasts cultured on zirconia disks were measured using qRT-PCR. Cell morphology was evaluated using 3D laser microscopy and the expression of vinculin was characterized using confocal microscopy. There was no significant difference in the surface roughness of zirconia disks, but contact angles were significantly lower. mRNA expression of integrin β1 was significantly higher at 3, 6 and 24 h and of collagen type I α1 was significantly higher at 6 and 24 h. L929 fibroblasts tended to form elongated microspikes and vinculin colocalization in those microspikes. Furthermore, vinculin was strongly expressed in filopodia of L929 fibroblasts at 24 h. These results suggest that excimer laser treatment improves adhesion between zirconia disks and L929 fibroblasts.
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Affiliation(s)
- Yoshihiko Akashi
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Yoshiaki Shimoo
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- MALO DENTAL and MEDICAL TOKYO, FUKUHARA GINZA 8F, 7-8-10 Ginza, Chuo-ku, Tokyo 104-0061, Japan
| | - Hayato Hashiguchi
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Kei Nakajima
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Katsutoshi Kokubun
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Kenichi Matsuzaka
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
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Bompolaki D, Edmondson SA, Katancik JA, Kamposiora P, Papavasiliou G. Clinical and Patient‐Reported Outcomes of Single Posterior Implant‐Supported Restorations Completed by Predoctoral Students: A Retrospective Study with Up to 10 Years of Follow Up. J Prosthodont 2020; 30:111-118. [DOI: 10.1111/jopr.13284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Despoina Bompolaki
- Associate Professor, Department of Restorative Dentistry Oregon Health & Science University Portland OR
| | - Sara A. Edmondson
- Resident, Graduate Orthodontics University of Tennessee Health Science Center Memphis TN
| | - James A. Katancik
- Professor and Chair, Department of Periodontology Oregon Health & Science University Portland OR
| | - Phophi Kamposiora
- Assistant Professor, Department of Prosthodontics National and Kapodistrian University of Athens Greece
| | - George Papavasiliou
- Assistant Professor, Department of Prosthodontics National and Kapodistrian University of Athens Greece
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Wittneben J, Gavric J, Sailer I, Buser D, Wismeijer D. Clinical and esthetic outcomes of two different prosthetic workflows for implant‐supported all‐ceramic single crowns—3 year results of a randomized multicenter clinical trail. Clin Oral Implants Res 2020; 31:495-505. [DOI: 10.1111/clr.13586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/13/2019] [Accepted: 01/04/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Julia‐Gabriela Wittneben
- Department of Reconstructive Dentistry & Gerodontology School of Dental Medicine University of Bern Bern Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine Boston MA USA
| | - Jelena Gavric
- Division of Fixed Prosthodontics and Biomaterials School of Dental Medicine University of Geneva Geneva Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials School of Dental Medicine University of Geneva Geneva Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology School of Dental Medicine University of Bern Bern Switzerland
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry ACTA University of Amsterdam and VU University Amsterdam The Netherlands
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Chen JY, Pan YH. Zirconia implant abutments supporting single all-ceramic crowns in anterior and premolar regions: A six-year retrospective study. Biomed J 2019; 42:358-364. [PMID: 31783997 PMCID: PMC6888705 DOI: 10.1016/j.bj.2019.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 03/27/2019] [Accepted: 05/02/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Clinical studies regarding zirconia implant abutments reported good survival rates in the short-term observation period. The purpose of this study was to assess the six-year clinical performance of zirconia abutments supporting all-ceramic crowns in anterior and premolar regions. METHODS The patients received zirconia implant abutments to support all-ceramic crowns in Chang-Gung Medical Center during the period August 2010 to August 2011 were enrolled. In the following six years of observation period after the implant-crown had finished, the clinical parameters of all of the included patients were registered on a special form. The records regarding the following variables: age, gender, implant location, the condition of edentulous site before implant placement, esthetic performance at baseline, presence or absence of technical complications, and biological outcomes were registered and scrutinized for evaluation. RESULTS Out of the 32 zirconia implant abutments and 32 all-ceramic crowns that were followed for six years. Neither abutments nor crowns were lost, yielding 100% survival rates for both zirconia abutments and crowns. The esthetic outcomes were excellent except that a score of 2 was given to two restorations. With regard to technical complications, there was one instance of abutment screw loosening, two cases of veneering ceramic chipping, one restoration with occlusal roughness, and three instances of crowns loosening. Overall, the success rates were 96.8% and 81.2% for abutments and crowns respectively. In biological performance, only 1 implant was classified in group II (satisfactory survival) in the Misch classification, while all the others were classified in group I (excellent). CONCLUSIONS Zirconia abutments supporting all-ceramic crowns demonstrated high survival rate, good biological and esthetic results. While some technical complications were frequently observed, the complication-free rates were 96.8% for abutments and 81.2% for crowns in the medium-term observation period.
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Affiliation(s)
- Jo-Yu Chen
- Department of General Dentistry, ChangGung Memorial Hospital at Taipei, Taipei, Taiwan
| | - Yu-Hwa Pan
- Department of General Dentistry, ChangGung Memorial Hospital at Taipei, Taipei, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; School of Dentistry, College of Medicine, China Medical University, Taichung, Taiwan.
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10
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Katsavochristou A, Sierraalta M, Saglik B, Koumoulis D, George F, Razzoog M. Implant Angulation Effect on the Fracture Resistance of Monolithic Zirconia Custom Abutments: An In Vitro Study. J Prosthodont 2019; 29:394-400. [PMID: 31746068 DOI: 10.1111/jopr.13127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To investigate the fracture resistance and performance of zirconia when employed for the fabrication of implant abutments with different angulations, simulating anterior maxillary oral rehabilitation. MATERIALS AND METHODS Forty-five monolithic zirconia custom abutments of internal conical implant connection were CAD/CAM designed and fabricated. The specimens were divided into three groups (n = 15/group) according to implant-to-abutment angulation. The angulations used were; 0°, 15°, and 25°. The abutments were loaded until failure at 135° using the Universal Testing Machine (Instron, Canton, MA). Collected data were statistically analyzed using one-way ANOVA and post hoc Tukey test. RESULTS Mean (±standard deviation) load at fracture of the zirconia abutments for the three groups were 962.37 ± 93.81 N (Gr15) > 718.25 ± 93.71 N (Gr25) > 534.05 ±133.77 N (Gr0). Statistically significant difference (p < 0.0001) was found between all groups; Gr0 vs. Gr15, Gr0 vs. Gr25, Gr15 vs. Gr25. CONCLUSIONS Contrary to expectations, the non-angulated monolithic zirconia abutments presented the lowest fracture resistance values. Angulating the abutments 15 or 25 degrees, following the palatal resorption pattern of the premaxilla, significantly increased the in vitro fracture resistance.
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Affiliation(s)
- Anastasia Katsavochristou
- Division of Prosthodontics, University of Kentucky College of Dentistry, Lexington, KY.,Biologic & Materials Science, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Marianella Sierraalta
- Biologic & Materials Science, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Berna Saglik
- Biologic & Materials Science, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI
| | | | - Furat George
- Biologic & Materials Science, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI
| | - Michael Razzoog
- Biologic & Materials Science, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI
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Abstract
After tooth loss, an individual may seek tooth replacement so that his/her function and esthetics could be restored. Clinical prosthodontics, during the past decade, has significantly improved and developed according to the advancements in the science and patient's demands and needs. Conventional options in prosthodontics for substituting a missing single tooth include the removable partial denture, partial and full coverage bridgework, and resin-bonded bridgework. Dental implants have gained increasing popularity over the years as they are capable of restoring the function to near normal in both partial and completely edentulous arches. With substantial evidence available, fixed implant-supported prosthesis are fully acknowledged as a reliable treatment option for the replacement of single or multiple missing teeth nowadays. While dental implants are increasingly becoming the choice of replacement for missing teeth, the impediments associated with them are progressively emerging too.
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Affiliation(s)
- Ayesha Hanif
- Division of Clinical Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Saima Qureshi
- Division of Clinical Periodontology, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
| | - Zeeshan Sheikh
- Matrix Dynamics Group, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Haroon Rashid
- Division of Prosthodontics, Faculty of Dentistry, Ziauddin University, Karachi, Pakistan
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12
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Abstract
PURPOSE The purpose of this systematic review was to identify and summarize clinical studies related to the fracture of zirconia abutments in implant treatments. MATERIAL AND METHODS Medline, Embase, and Cochrane library searches were performed and complemented by manual searches from database inception to February 11, 2018, for title and abstract analysis. RESULTS Initially, 645 articles were obtained through database searches. Fifty-three articles were selected for full-text analysis, and 15 studies met the inclusion criteria. The selected studies were analyzed regarding fracture rate, abutment-implant connection, time point of fracture, location of critical crack, causes, managements, and preventive measures with respect to zirconia abutment fracture. CONCLUSIONS Lower fracture rates were reported for internal connection with metal component (2-piece) zirconia abutments compared with external and internal full-zirconia connection (one-piece) zirconia abutments. Overpreparation and overload should be avoided in case of zirconia abutments.
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13
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Lin YT, Shen YF, Wei PC, Hsu KW. Clinical evaluation of two-piece zirconia abutments with bonded titanium inserts for implant-supported restorations. J Prosthet Dent 2019; 123:449-454. [PMID: 31307812 DOI: 10.1016/j.prosdent.2019.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/14/2018] [Accepted: 01/25/2019] [Indexed: 02/04/2023]
Abstract
STATEMENT OF PROBLEM Information about the long-term evaluation of 2-piece zirconia abutments (TPZAs) with bonded titanium inserts for implant-supported restorations is sparse. PURPOSE The purpose of this clinical study was to evaluate the clinical outcome of TPZAs with bonded titanium inserts for implant-supported restorations. MATERIAL AND METHODS This study retrospectively evaluated the records of patients who received implant restorations supported by TPZAs with bonded titanium inserts. The patients were recalled between January 2017 and December 2017 so that the restorations could be examined clinically and radiographically for technical and biological complications. RESULTS A total of 27 patients with 30 restorations and 42 zirconia abutments (ZAs) were included in the study. The patient records revealed that all implants remained integrated. However, 5 restorations supported by seven ZAs in 4 patients had to be refabricated because of abutment failure before the recall. Six of the failed abutments were in the molar area, with a combination of zirconia and titanium as the connection platform. Additional complications included screw loosening (1 patient), ceramic chipping (1 patient), and peri-implantitis (1 patient). The mean observation period was 6.6 ±1.5 years (range: 3.6 to 9.2 years). CONCLUSIONS After a mean observation period of 6 years after insertion, TPZAs with bonded titanium inserts appear to be a suitable treatment option in the anterior and premolar regions. However, in the molar area, the use of the same type of ZA without a complete metal-to-metal connection platform to support the restoration led to a high incidence of fracture.
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Affiliation(s)
- Yu-Ting Lin
- Attending Doctor, Department of Prosthodontics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan, Republic of China
| | - Yu-Fu Shen
- Assistant Professor, Department of Prosthodontics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan, Republic of China
| | - Pein-Chi Wei
- Assistant Professor, Department of Periodontology, Chang Gung Memorial Hospital, Taoyuan Branch, Taoyuan City, Taiwan, Republic of China
| | - Kuang-Wei Hsu
- Lecturer, Department of Prosthodontics, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan City, Taiwan, Republic of China.
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Asgeirsson AG, Sailer I, Gamper F, Jung RE, Hämmerle CHF, Thoma DS. Veneered zirconia abutments cemented on non‐original titanium bases: 1‐year results of a prospective case series. Clin Oral Implants Res 2019; 30:735-744. [DOI: 10.1111/clr.13457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/29/2019] [Accepted: 03/29/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Asgeir G. Asgeirsson
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials University Clinic of Dental Medicine, University of Geneva Geneva Switzerland
| | - Felix Gamper
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine University of Zurich Zurich Switzerland
| | - Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine University of Zurich Zurich Switzerland
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Pils D, Baeppler RJ, Junker R, Kielbassa AM, Nothdurft FP. Application of a standard autoclaving protocol does not harm structural integrity of two-piece zirconia abutments under detachment force testing. Clin Oral Investig 2019; 23:3133-3137. [PMID: 31076883 DOI: 10.1007/s00784-019-02926-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 04/30/2019] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Aim was to assess the influence of a standard autoclaving protocol on the retention of zirconia abutments glued on titanium bases in two-piece implant abutments. MATERIALS AND METHODS Twenty-four CAD/CAM-generated zirconia abutments were adhesively cemented on prefabricated titanium bases. Before mechanical and thermal aging, the specimens were divided into two groups. Group 1 was subjected to a standard steam autoclaving protocol and Group 2 remained untreated (control). The tensile strength in all specimens was evaluated by a standardized pull-off test limited to a maximum force of 1000 N. RESULTS Eleven samples in both groups could be subjected to pull-off testing. Ten samples in Group 1 and three samples in Group 2 failed, while all others reached the maximum pull-off force. This difference was statistically significant. The mean retention values for the failed samples were 694.53 ± 369.10 N in Group 1 and 890.78 ± 25.90 N in Group 2. This difference was not statistically significant. CONCLUSIONS A standard autoclaving protocol does not reduce detachment force of two-piece zirconia abutments. CLINICAL RELEVANCE Clinical sterilization processes as recommended by regulatory authorities seem to be harmless to the structural integrity of two-piece zirconia implant abutments, at least with regard to the retention of the components.
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Affiliation(s)
- Dieter Pils
- Pils Zahntechnik GmbH, Bruck an der Glocknerstrasse, Austria
- Centre for Prosthodontics and Biomaterials, Danube Private University (DPU), Krems an der Donau, Austria
| | - Ralf J Baeppler
- Centre for Prosthodontics and Biomaterials, Danube Private University (DPU), Krems an der Donau, Austria
| | - Rüdiger Junker
- Centre for Prosthodontics and Biomaterials, Danube Private University (DPU), Krems an der Donau, Austria
| | - Andrej M Kielbassa
- Centre for Operative Dentistry, Periodontology, and Endodontology, Danube Private University (DPU), Krems an der Donau, Austria
| | - Frank P Nothdurft
- Department of Prosthetic Dentistry and Dental Materials Sciences, Saarland University, Homburg Campus, Bldg. 71.2, 66421, Homburg, Saar, Germany.
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Wittneben JG, Wismeijer D, Brägger U, Joda T, Abou-Ayash S. Patient-reported outcome measures focusing on aesthetics of implant- and tooth-supported fixed dental prostheses: A systematic review and meta-analysis. Clin Oral Implants Res 2019; 29 Suppl 16:224-240. [PMID: 30328183 DOI: 10.1111/clr.13295] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/24/2018] [Accepted: 05/15/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to summarize the existing evidence on patient-reported aesthetic outcome measures (PROMs) of implant-supported, relative to tooth-supported fixed dental prostheses. MATERIAL AND METHODS In April 2017, two reviewers independently searched the Medline (PubMed), EMBASE, and Cochrane electronic databases, focusing on studies including patient-reported aesthetic outcomes of implant- and tooth-supported fixed dental prostheses (FDPs). Human studies with a mean follow-up period of at least 1 year, a minimum of ten patients, and English, German, or French publication were included. For the comparison of subgroups, random-effects meta-regression for aggregate-level data was used. RESULTS The systematic search for implant-supported prostheses focusing on patient-reported outcomes identified 2,675 titles, which were screened by two independent authors. Fifty full-text articles were analyzed, and finally, 16 publications (including 19 relevant study cohorts) were included. For tooth-supported prostheses, no studies could be included. A total of 816 implant-supported reconstructions were analyzed by patients. Overall aesthetic evaluation by the patients' visual analogue scale (VAS) rating was high in implant-supported FDPs (median: 90.3; min-max: 80.0-94.0) and the surrounding mucosa (median: 84.7; min-max: 73.0-92.0). Individual restorative materials, implant neck design (i.e., tissue or bone level type implants), and the use of a fixed provisional had no effect on patients' ratings of the definitive implant-supported FDPs. CONCLUSIONS Aesthetics is an important patient-reported measure, which lacks in standardized methods; however, patients' satisfaction was high for implant- supported FDPs and the surrounding mucosa.
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Affiliation(s)
- Julia-Gabriela Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, ACTA, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Weigl P, Trimpou G, Grizas E, Hess P, Nentwig GH, Lauer HC, Lorenz J. All-ceramic versus titanium-based implant supported restorations: Preliminary 12-months results from a randomized controlled trial. J Adv Prosthodont 2019; 11:48-54. [PMID: 30847049 PMCID: PMC6400706 DOI: 10.4047/jap.2019.11.1.48] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/10/2018] [Accepted: 01/21/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The aim of the present randomized controlled study was to compare prefabricated all-ceramic, anatomically shaped healing abutments followed by all-ceramic abutments and all-ceramic crowns and prefabricated standard-shaped (round-diameter) titanium healing abutments followed by final titanium abutments restored with porcelain-fused-to-metal (PFM) implant crowns in the premolar and molar regions. MATERIALS AND METHODS Forty-two patients received single implants restored either by all-ceramic restorations (test group, healing abutment, final abutment, and crown all made of zirconia) or conventional titanium-based restorations. Immediately after prosthetic incorporation and after 12 months of loading, implant survival, technical complications, bone loss, sulcus fluid flow rate (SFFR) as well as plaque index (PI) and implant stability (Periotest) were analyzed clinically and radiologically. RESULTS After 12 months of loading, an implant and prosthetic survival rate of 100% was observed. Minor prosthetic complications such as chipping of ceramic veneering occurred in both groups. No statistical significant differences were observed between both groups with only a minimum of bone loss, SFFR, and PI. CONCLUSION All-ceramic implant prostheses including a prefabricated anatomically shaped healing abutment achieved comparable results to titanium-based restorations in the posterior region. However, observational results indicate a benefit as shaping the peri-implant soft-tissue with successive provisional devices and subsequent compression of the soft tissue can be avoided.
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Affiliation(s)
- Paul Weigl
- Department of Prosthodontics, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Georgia Trimpou
- Department of Oral Surgery and Implantology, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Eleftherios Grizas
- Department of Oral Surgery and Implantology, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Pablo Hess
- Department of Oral Surgery and Implantology, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Georg-Hubertus Nentwig
- Department of Oral Surgery and Implantology, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Hans-Christoph Lauer
- Department of Prosthodontics, School of Dentistry, Goethe-University Frankfurt am Main, Germany
| | - Jonas Lorenz
- Department of Prosthodontics, School of Dentistry, Goethe-University Frankfurt am Main, Germany
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18
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Thoma DS, Wolleb K, Bienz SP, Wiedemeier D, Hämmerle CHF, Sailer I. Early histological, microbiological, radiological, and clinical response to cemented and screw-retained all-ceramic single crowns. Clin Oral Implants Res 2018; 29:996-1006. [DOI: 10.1111/clr.13366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 06/20/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Karin Wolleb
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Stefan P. Bienz
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Daniel Wiedemeier
- Statistical Services, Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic for Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Irena Sailer
- Division for Fixed Prosthodontics and Biomaterials, Center of Dental Medicine; University of Geneva; Geneva Switzerland
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19
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Aivazi M, Fathi M, Nejatidanesh F, Mortazavi V, Hashemi Beni B, Matinlinna JP. Effect of Surface Modification on Viability of L929 Cells on Zirconia Nanocomposite Substrat. J Lasers Med Sci 2018; 9:87-91. [PMID: 30026892 DOI: 10.15171/jlms.2018.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Introduction: Zirconia bioceramic can be considered for metallic replacement in dental implant applications. A proper method of surface modification may promote better osseointegration. Methods: In study evaluated viability of fibroblast cell following surface treatment. Therefore, viability L929 cells were characterized using MTT assay and scanning electron microscopy. Results: The viability assessment determined significant differences A-Y-TZP20 without surface treatment as compared to laser surface treatment (B), laser surface treatment + hydroxyapatiteyttrium stabilized tetragonal zirconia nanocomposite coat (C) and control. This study demonstrated that L929 cells approximately proliferated and spread on A-Y-TZP20 nanocomposite disk in laser surface treatment(B), Laser surface treatment + hydroxiapatite-yttrium stabilized tetragonal zirconia nanocomposite coat (C) groups similar to control group. Conclusion: Laser surface treatment showed positive effect on the viability of L929 cells.
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Affiliation(s)
- Moluk Aivazi
- Biomaterials Research Group, Department of Materials Engineering, Isfahan University of Technology, Isfahan, Iran
| | - Mohammadhossein Fathi
- Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farahnaz Nejatidanesh
- Dental Materials Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vajihesadat Mortazavi
- Torabinejad Dental Research Center, Department of Operative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Batoul Hashemi Beni
- Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jukka Pekka Matinlinna
- Dental Material Science, Head of Unit, Faculty of Dentistry, The University of Hong Kong, 4/FDental Material Science, The Prince Philip Dental Hospital, 34Hospital Road, Sai Ying Pun, Hong Kong
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20
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ElHoussiney AG, Zhang H, Song J, Ji P, Wang L, Yang S. Influence of implant location on the clinical outcomes of implant abutments: a systematic review and meta-analysis. Clin Cosmet Investig Dent 2018. [PMID: 29520162 PMCID: PMC5834166 DOI: 10.2147/ccide.s143910] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To compare the failure events and incidence of complications of different abutment materials in anterior and posterior regions. Failure was defined as complete loss of the abutment requiring replacement by a new abutment. Materials and methods Electronic searches using PubMed/Medline and Google Scholar complemented with manual searches were performed with specific search terms. Searches were restricted to publications in English between January 2006 and March 2016. Results A total of 863 and 1,264 implants were inserted in the anterior and posterior regions, respectively, in a total of 1,529 patients. No titanium abutments failed in anterior or posterior regions. On the other hand, 1.6% of zirconia abutments failed in the anterior region and 1.5% failed in the posterior region. Technical complications occurred mostly in the posterior region and mostly involved zirconia abutment. Meta-analysis was possible only for zirconia-abutment failure, due to considerable heterogeneity of studies and outcome variables. No significant difference in failure rate was found between anterior and posterior zirconia abutments (risk ratio 1.53, 95% CI 0.49–4.77; P=0.47). Conclusion This systematic review and meta-analysis showed similar outcomes of different abutment materials when used in anterior and posterior regions in terms of failure events and biological and aesthetic complications. The only significant finding was the increased incidence of technical complications in the posterior region, mostly involving zirconia abutments. Abutment-screw loosening was the most common technical complication.
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Affiliation(s)
| | - He Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Jinlin Song
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Ping Ji
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Lu Wang
- Department of Prosthodontics
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Sampatanukul T, Serichetaphongse P, Pimkhaokham A. Histological evaluations and inflammatory responses of different dental implant abutment materials: A human histology pilot study. Clin Implant Dent Relat Res 2017; 20:160-169. [PMID: 29181880 DOI: 10.1111/cid.12562] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Improvements of soft tissue to the abutment surface results in more stable peri-implant conditions, however, few human histological studies have compared soft tissue responses around different abutment materials. PURPOSE To describe the peri-implant tissue around 3 abutment materials; titanium, zirconia, and gold alloy, over an 8-week healing period. MATERIALS AND METHODS Fifteen edentulous sites were treated with implants. Eight weeks later, peri-implant tissue was harvested and processed using a nonseparation resin embedded technique. The tissue attachment characteristics were assessed at clinical stages using the gingival index (GI) score, surgical stage (surgical score), and histological stage (histological attachment percentage). Additionally, the inflammatory responses were evaluated using inflammatory extent and inflammatory cellularity grades. Nonparametrical statistics were used to describe the GI and surgical scores, and analytical statistics were used to analyze the histological attachment percentages as well as the inflammatory extent and cellularity grades amongst the 3 groups. RESULTS There were no statistically significant differences among the groups for GI score (P = .071) and surgical score (P = .262). Titanium and zirconia exhibited nearly similar mean histological attachment percentages while gold alloy had a significantly lower percentage (P = .004). For the inflammatory extent and cellularity grades, the odds of being one grade higher for gold alloy abutment was 5.18 and 17.8 times that of titanium abutment, respectively. However, for the zirconia abutment, the odds were 0.87 and 7.5 times higher than the titanium group. CONCLUSIONS The tissue around the gold alloy abutments resulted in worse attachment conditions compared with the titanium and zirconia abutments. Inflammation tended to be higher in the tissue around the gold alloy abutments than the titanium and zirconia abutments.
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Affiliation(s)
| | - Pravej Serichetaphongse
- Department of Prosthodontics, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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22
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Nilsson A, Johansson LÅ, Lindh C, Ekfeldt A. One-piece internal zirconia abutments for single-tooth restorations on narrow and regular diameter implants: A 5-year prospective follow-up study. Clin Implant Dent Relat Res 2017; 19:916-925. [DOI: 10.1111/cid.12515] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/26/2017] [Accepted: 06/10/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Andrée Nilsson
- Division of Prosthetic Dentistry; Maxillofacial Unit, Halmstad Hospital; Halmstad Sweden
| | - Lars-Åke Johansson
- Division of Prosthetic Dentistry; Maxillofacial Unit, Halmstad Hospital; Halmstad Sweden
- Department of Periodontology, Faculty of Odontology; Malmö University; Malmö Sweden
| | - Christina Lindh
- Department of Oral Radiology, Faculty of Odontology; Malmö University; Malmö Sweden
| | - Anders Ekfeldt
- Department of Prosthetic Dentistry and Oral Function, Faculty of Dentistry, Institute of Clinical Dentistry; University of Oslo; Oslo Norway
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Alsahhaf A, Spies BC, Vach K, Kohal RJ. Fracture resistance of zirconia-based implant abutments after artificial long-term aging. J Mech Behav Biomed Mater 2017; 66:224-232. [DOI: 10.1016/j.jmbbm.2016.11.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/17/2016] [Accepted: 11/21/2016] [Indexed: 02/04/2023]
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Brunot-Gohin C, Duval JL, Verbeke S, Belanger K, Pezron I, Kugel G, Laurent-Maquin D, Gangloff S, Egles C. Biocompatibility study of lithium disilicate and zirconium oxide ceramics for esthetic dental abutments. J Periodontal Implant Sci 2016; 46:362-371. [PMID: 28050314 PMCID: PMC5200862 DOI: 10.5051/jpis.2016.46.6.362] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Accepted: 10/21/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose The increasing demand for esthetically pleasing results has contributed to the use of ceramics for dental implant abutments. The aim of this study was to compare the biological response of epithelial tissue cultivated on lithium disilicate (LS2) and zirconium oxide (ZrO2) ceramics. Understanding the relevant physicochemical and mechanical properties of these ceramics will help identify the optimal material for facilitating gingival wound closure. Methods Both biomaterials were prepared with 2 different surface treatments: raw and polished. Their physicochemical characteristics were analyzed by contact angle measurements, scanning white-light interferometry, and scanning electron microscopy. An organotypic culture was then performed using a chicken epithelium model to simulate peri-implant soft tissue. We measured the contact angle, hydrophobicity, and roughness of the materials as well as the tissue behavior at their surfaces (cell migration and cell adhesion). Results The best cell migration was observed on ZrO2 ceramic. Cell adhesion was also drastically lower on the polished ZrO2 ceramic than on both the raw and polished LS2. Evaluating various surface topographies of LS2 showed that increasing surface roughness improved cell adhesion, leading to an increase of up to 13%. Conclusions Our results demonstrate that a biomaterial, here LS2, can be modified using simple surface changes in order to finely modulate soft tissue adhesion. Strong adhesion at the abutment associated with weak migration assists in gingival wound healing. On the same material, polishing can reduce cell adhesion without drastically modifying cell migration. A comparison of LS2 and ZrO2 ceramic showed that LS2 was more conducive to creating varying tissue reactions. Our results can help dental surgeons to choose, especially for esthetic implant abutments, the most appropriate biomaterial as well as the most appropriate surface treatment to use in accordance with specific clinical dental applications.
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Affiliation(s)
- Céline Brunot-Gohin
- Laboratory of Biomaterials and Bone Site Inflammation, University of Reims Champagne-Ardenne, Reims, France.; Laboratory of Biomechanics and Bioengineering, Research Center of Royallieu, University of Technology of Compiègne, Sorbonne Universities, Compiègne, France.; University of Reims Champagne-Ardenne, Faculty of Odontology, Reims, France
| | - Jean-Luc Duval
- Laboratory of Biomechanics and Bioengineering, Research Center of Royallieu, University of Technology of Compiègne, Sorbonne Universities, Compiègne, France
| | - Sandra Verbeke
- University of Reims Champagne-Ardenne, Faculty of Odontology, Reims, France
| | - Kayla Belanger
- Laboratory of Biomechanics and Bioengineering, Research Center of Royallieu, University of Technology of Compiègne, Sorbonne Universities, Compiègne, France
| | - Isabelle Pezron
- Laboratory of Integrated Renewable Matter Transformations, Research Center of Royallieu, University of Technology of Compiègne, Sorbonne Universities, Compiègne, France
| | - Gérard Kugel
- Tufts University School of Dental Medicine, Boston, MA, USA
| | - Dominique Laurent-Maquin
- Laboratory of Biomaterials and Bone Site Inflammation, University of Reims Champagne-Ardenne, Reims, France.; University of Reims Champagne-Ardenne, Faculty of Odontology, Reims, France
| | - Sophie Gangloff
- Laboratory of Biomaterials and Bone Site Inflammation, University of Reims Champagne-Ardenne, Reims, France
| | - Christophe Egles
- Laboratory of Biomechanics and Bioengineering, Research Center of Royallieu, University of Technology of Compiègne, Sorbonne Universities, Compiègne, France.; Tufts University School of Dental Medicine, Boston, MA, USA
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25
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Soft tissue biological response to zirconia and metal implant abutments compared with natural tooth: microcirculation monitoring as a novel bioindicator. IMPLANT DENT 2016; 24:37-41. [PMID: 25290282 DOI: 10.1097/id.0000000000000167] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Zirconia is often used for implant abutments for esthetics. The aim of this clinical study was to compare the effects of zirconia and metal abutments on periimplant soft tissue. MATERIALS AND METHODS Ten maxillary anterior implant patients, 5 with metal abutments and 5 with zirconia abutments, were enrolled in this trial. The soft tissue around the implant abutments was evaluated by 2-dimensional laser speckle imaging and thermography. The blood flow in soft tissue around natural teeth was also measured to correct for differences among the subjects. RESULTS Significantly greater blood flow was detected in the zirconia abutment group (95.64 ± 5.17%) relative to the metal abutment group (82.25 ± 8.92%) in free gingiva (P = 0.0317). Reduced blood flow (by almost 18%) was detected in the tissue surrounding metal abutments compared with the tissue surrounding natural teeth. The surface temperature showed no significant difference for all measurements. CONCLUSIONS These results suggest that blood flow in tissue surrounding zirconia abutments is similar to that in soft tissue around natural teeth. Moreover, zirconia abutments could be advantageous for the maintenance of immune function by improving blood circulation.
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Wittneben J, Gavric J, Belser U, Bornstein M, Joda T, Chappuis V, Sailer I, Brägger U. Esthetic and Clinical Performance of Implant-Supported All-Ceramic Crowns Made with Prefabricated or CAD/CAM Zirconia Abutments: A Randomized, Multicenter Clinical Trial. J Dent Res 2016; 96:163-170. [DOI: 10.1177/0022034516681767] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Patients’ esthetic expectations are increasing, and the options of the prosthetic pathways are currently evolving. The objective of this randomized multicenter clinical trial was to assess and compare the esthetic outcome and clinical performance of anterior maxillary all-ceramic implant crowns (ICs) based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with hand buildup technique. The null hypothesis was that there is no statistically significant difference between the 2 groups. Forty implants were inserted in sites 14 to 24 (FDI) in 40 patients in 2 centers, the Universities of Bern and Geneva, Switzerland. After final impression, 20 patients were randomized into group A, restored with a 1-piece screw-retained single crown made of a prefabricated zirconia abutment with pressed ceramic as the veneering material using the cut-back technique, or group B using an individualized CAD/CAM zirconia abutment (CARES abutment; Institut Straumann AG) with a hand buildup technique. At baseline, 6 mo, and 1 y clinical, esthetic and radiographic parameters were assessed. Group A exhibited 1 dropout patient and 1 failure, resulting in a survival rate of 94.7% after 1 y, in comparison to 100% for group B. No other complications occurred. Clinical parameters presented stable and healthy peri-implant soft tissues. Overall, no or only minimal crestal bone changes were observed with a mean DIB (distance from the implant shoulder to the first bone-to-implant contact) of −0.15 mm (group A) and 0.12 mm (group B) at 1 y. There were no significant differences at baseline, 6 mo, and 1 y for DIB values between the 2 groups. Pink esthetic score (PES) and white esthetic score (WES) values at all 3 examinations indicated stability over time for both groups and pleasing esthetic outcomes. Both implant-supported prosthetic pathways represent a valuable treatment option for the restoration of single ICs in the anterior maxilla ( ClinicalTrials.gov NCT02905838).
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Affiliation(s)
- J.G. Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | - J. Gavric
- Division of Fixed Prosthodontics and Biomaterials, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - U.C. Belser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - M.M. Bornstein
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - T. Joda
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Section for Digital Reconstructive Technology + Implant Dentistry [DiRecT+ID], School of Dental Medicine, University of Bern, Bern, Switzerland
| | - V. Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - I. Sailer
- Division of Fixed Prosthodontics and Biomaterials, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - U. Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Ekfeldt A, Fürst B, Carlsson GE. Zirconia abutments for single-tooth implant restorations: a 10- to 11-year follow-up study. Clin Oral Implants Res 2016; 28:1303-1308. [PMID: 27663724 DOI: 10.1111/clr.12975] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the clinical outcome of custom-made zirconia abutments for implant-supported single-tooth restorations 10-11 years after insertion. MATERIAL AND METHODS The study comprises a clinical examination of 23 patients with 30 restorations placed 10-11 years ago. Oral surgeons placed the implants. The prosthodontic treatment was provided at a prosthodontic specialist clinic. The restoration was either an all-ceramic crown for cementation or a screw-retained one-piece restoration with the veneering porcelain baked directly to the zirconia abutment. Besides the clinical and radiographic examination at the 10- to 11-year follow-up, the patients' records were scrutinized regarding clinical and radiographic data from insertion of the restoration up to the last visit at the clinic. RESULTS The zirconia abutments performed well. Both technical and biological complications were rare; most patients were in general extremely satisfied with the restorations. No all-ceramic crowns fractured during the observation period. One implant was lost after 5½ years in service. There were no significant differences for changes in any of the soft tissue registrations or the peri-implant marginal bone level between the conventional two-piece abutment-crown restoration and the one-piece restoration. The peri-implant bone level changes from placement to the clinical examination 10-11 years later were small (mean 0.26 mm, SD 0.6 mm). CONCLUSIONS Zirconia abutments for single-implant crowns demonstrated excellent technical and biological results over 10-11 years of function, and most patients were extremely satisfied with the aesthetics and the function of their single-implant restorations.
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Affiliation(s)
- Anders Ekfeldt
- Department of Prosthetic Dentistry and Oral Function, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Björn Fürst
- Specialist Clinic of Prosthetic Dentistry, Public Dental Health Service, Västra Götaland, Mölndal Hospital, Mölndal, Sweden
| | - Gunnar E Carlsson
- Department of Prosthetic Dentistry/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Ferrari M, Tricarico MG, Cagidiaco MC, Vichi A, Gherlone EF, Zarone F, Sorrentino R. 3-Year Randomized Controlled Prospective Clinical Trial on Different CAD-CAM Implant Abutments. Clin Implant Dent Relat Res 2016; 18:1134-1141. [PMID: 26988025 DOI: 10.1111/cid.12418] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 02/08/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND Zirconia abutments were introduced to restore esthetic regions and showed sufficient stability to support implant restorations. Nonetheless, to date the observation periods are shorter than those of titanium abutments. PURPOSE To assess the survival of implant crowns supported by computer aided design-computer aided manufacturing (CAD-CAM) abutments after 3 years. MATERIALS AND METHODS Fifty-six patients were selected for this prospective clinical study. Each patient received at least 1 titanium implant for a total of 89 fixtures. A two-stage surgical technique and no additional soft or hard tissue graft were used. The implants were randomly divided into 3 groups receiving different CAD-CAM abutments: titanium, titanium nitride, and zirconia. Zirconia or metal-ceramic crowns were used as final restorations. Cementation was the baseline and the restorations were checked after 6 months, 1, 2, and 3 years, assessing any mechanical complication. Statistical analyses were performed to evaluate the 3-year success rates. RESULTS Five failures were reported in the zirconia group; all the failed restorations showed fractures of the abutment connection. Four failures occurred in posterior regions and one more occurred while screwing the abutment. Titanium and titanium nitride abutments had significantly higher 3-year success rates than zirconia abutments (p < .05). CONCLUSIONS Atlantis titanium and titanium nitride abutments showed optimal clinical performances after 3 years. Conversely, Atlantis zirconia abutments should be avoided to restore posterior regions.
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Affiliation(s)
- Marco Ferrari
- Professor and Chair, Department of Prosthodontics and Dental Materials, University of Siena, Siena, Italy
| | | | - Maria Crysanti Cagidiaco
- Assistant Professor, Department of Prosthodontics and Dental Materials, University of Siena, Siena, Italy
| | - Alessandro Vichi
- Research Professor, Department of Prosthodontics and Dental Materials, University of Siena, Siena, Italy
| | - Enrico Felice Gherlone
- Professor and Chair, Department of Dentistry, University "Vita Salute San Raffaele" of Milan, Milan, Italy
| | - Fernando Zarone
- Professor and Chair, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University "Federico II" of Naples, Naples, Italy
| | - Roberto Sorrentino
- Research Professor, Department of Prosthodontics and Dental Materials, University of Siena, Siena, Italy
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Harada K, Shinya A, Gomi H, Hatano Y, Shinya A, Raigrodski AJ. Effect of accelerated aging on the fracture toughness of zirconias. J Prosthet Dent 2015; 115:215-23. [PMID: 26548887 DOI: 10.1016/j.prosdent.2015.08.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 08/23/2015] [Accepted: 08/26/2015] [Indexed: 10/22/2022]
Abstract
STATEMENT OF PROBLEM Low temperature degradation (LTD) of yttria-stabilized tetragonal zirconia polycrystals (Y-TZP) is of concern. PURPOSE The purpose of this in vitro study was to assess the effect of accelerated aging on the Vickers hardness and fracture toughness of a newly developed Y-TZP and 2 primary Y-TZPs. MATERIAL AND METHODS Two primary 3 mol% Y-TZP, Lava (LA), Everest Zirconium Soft (EV), and a new 3 mol% Y-TZP, ZirTough (NZ) were assessed. Specimens (n=30 each brand) of 10 × 10 × 3 mm were hydrothermally treated for accelerated aging to examine LTD. Five conditions were used (n = 5 per condition) as follows: control group (no aging); 5 hours at 134°C/0.2 MPa (5h-134°C); 100 hours at 134°C/0.2 MPa (100 h-134°C); 5 hours at 180°C/1.0 MPa (5 h-180°C); and 20 hours at 180°C/1.0 MPa (20 h-180°C). Fracture toughness was measured by using the indentation fracture (IF) method under a loading of 294 N and calculated from the obtained measurements. To observe differences in particle composition and fracture patterns, mirror-polished test specimens (n=5 each brand) were re-sintered at 1200°C for 1 hour as a thermal etching process, and a Vickers indenter was pressed into the test specimens according to the IF method. Test piece surfaces and cracks were observed with scanning electron microscopy (SEM). One-way ANOVA and the post- hoc (Scheffé test were used to examine) interlevel significant differences (α=.05). RESULTS The Vickers hardness and fracture toughness were as follows: 1319 HV and 7.36 MPa · m(1/2) for LA, and 1371 HV and 6.76 MPa · m(1/2) for EV in no aging; 1334 HV and 7.02 MPa · m(1/2) for LA, and 1346 HV and 6.07 MPa · m(1/2) for EV in 5h-134°C. No significant differences were found between no aging and 5h-134°C for LA and EV for Vickers hardness and fracture toughness. Measurements could not be made for LA and EV for 100 h-134°C, 5h-180°C, or 20 h-180°C because of fractures in the surface layer. For NZ, Vickers hardness and fracture toughness were as follows: 1261 HV and 15.60 MPa · m(1/2) in no aging; 1217 HV and 14.98 MPa · m(1/2) in 5h-134°C; 1231 HV and 15.13 MPa · m(1/2) in 100 h-134°C; 1252 HV and 15.51 MPa · m(1/2) in 5h-180°C; 1224 HV and 15.01 MPa · m(1/2) in 20 h-180°C. No significant differences were shown in the Vickers hardness and fracture toughness. SEM observations after the thermal etching processing of NZ showed zirconia particles and scattered alumina particles. CONCLUSION Measurements with LA and EV could only be made for no aging and 5h-134°C, and no significant differences were found in Vickers hardness and fracture toughness. Measurements were made with NZ under all conditions and no significant differences were found in Vickers hardness and fracture toughness.
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Affiliation(s)
- Kosuke Harada
- Adjunct Lecturer, Department of Crown and Bridge, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan; and Visiting Lecturer, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.
| | - Akikazu Shinya
- Associate Professor, Department of Crown and Bridge, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Harunori Gomi
- Professor, Department of Crown and Bridge, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Yasuo Hatano
- Associate Professor, Department of Crown and Bridge, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Akiyoshi Shinya
- Professor Emeritus, Department of Crown and Bridge, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Ariel J Raigrodski
- Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
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Kutkut A, Abu-Hammad O, Mitchell R. Esthetic Considerations for Reconstructing Implant Emergence Profile Using Titanium and Zirconia Custom Implant Abutments: Fifty Case Series Report. J ORAL IMPLANTOL 2015; 41:554-61. [DOI: 10.1563/aaid-joi-d-12-00274] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Titanium and zirconia custom implant abutments are now commonly used for esthetic implant dentistry. Custom implant abutments allow the clinician to improve an implant's emergence profile, to customize cervical margins in accordance with the anatomy of the natural root, and to compensate for poor implant angulation. All of these are essential for optimum esthetic outcomes. Computer-aided design/computer-aided machining (CAD/CAM) technology allows the clinician to design custom implant abutment configurations and create natural-looking superstructures that are in harmony with the adjacent dentition and soft tissue. The CAD/CAM technique provides precise fit, reduces the cost of the procedure, and eliminates dimensional inaccuracies inherent in the conventional waxing and casting technique. The aim of this report is to describe a simplified technique for reconstructing emergence profiles during implant restoration using milled titanium and zirconia custom implant abutments. The results of 50 consecutive cases are reported.
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Affiliation(s)
- Ahmad Kutkut
- Department of Oral Health Practice, Division of Restorative Dentistry, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Osama Abu-Hammad
- Faculty of Dentistry, Taibah University, Almadena Almunawaara, Kingdom of Saudia Arabia
| | - Richard Mitchell
- Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Ky
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31
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Kappel S, Eiffler C, Lorenzo-Bermejo J, Stober T, Rammelsberg P. Undetected residual cement on standard or individualized all-ceramic abutments with cemented zirconia single crowns - a prospective randomized pilot trial. Clin Oral Implants Res 2015; 27:1065-71. [DOI: 10.1111/clr.12691] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Stefanie Kappel
- Department of Prosthodontics; University of Heidelberg; Heidelberg Germany
| | - Constantin Eiffler
- Department of Prosthodontics; University of Heidelberg; Heidelberg Germany
| | - Justo Lorenzo-Bermejo
- Institute for Medical Biometry and Informatics; University of Heidelberg; Heidelberg Germany
| | - Thomas Stober
- Department of Prosthodontics; University of Heidelberg; Heidelberg Germany
| | - Peter Rammelsberg
- Department of Prosthodontics; University of Heidelberg; Heidelberg Germany
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Linkevicius T, Vaitelis J. The effect of zirconia or titanium as abutment material on soft peri-implant tissues: a systematic review and meta-analysis. Clin Oral Implants Res 2015; 26 Suppl 11:139-47. [PMID: 26073346 DOI: 10.1111/clr.12631] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/29/2022]
Abstract
AIM The objective of this review was to analyze research with regard to the effect of zirconia or titanium as abutment material on soft peri-implant tissues. METHODS Clinical studies were selected via electronic and hand searches in English language journals until December 1, 2014. Only randomized clinical trials (RCTs) and prospective controlled clinical trials (CCTs) showing direct comparison between zirconia (Zr) and titanium (Ti) abutments in the same patient were considered. The outcome measures were (1) soft tissue color, (2) soft tissue recession, (3) peri-implant probing, (4) bleeding on probing, (5) esthetic indexes, (6) patient-reported outcome, (7) marginal bone level, and (8) biological complications. RESULTS Nine relevant studies (11 papers) were identified: 4 RCTs and 5 CCTs. Due to heterogeneity in the study design, statistical methods, and reported results, a meta-analysis of the data was feasible only for soft tissue color. The outcome was found to be significantly superior for Zr abutments. For the other outcome measures, a qualitative analysis of the selected articles was performed. The studies did not show any statistically significant differences between Zr and Ti abutments on soft tissue recession, probing depths, bleeding on probing, marginal bone level, and patient-reported outcome. One study reported significantly higher pink esthetic score (PES) scores at Zr implants with Zr abutments, compared to metal implants and Ti abutments. CONCLUSION Overall, the research does not support any obvious advantage of Ti or Zr abutments over each other. However, there is a significant tendency in Zr abutments evoking better color response of peri-implant mucosa and superior esthetic outcome measured by PES score.
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Affiliation(s)
- Tomas Linkevicius
- Faculty of Medicine, Institute of Odontology, Vilnius University, Vilnius, Lithuania.,Vilnius Mokslo Grupe, Vilnius, Lithuania.,Vilnius Implantology Center, Vilnius, Lithuania
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Ferrari M, Vichi A, Zarone F. Zirconia abutments and restorations: From laboratory to clinical investigations. Dent Mater 2015; 31:e63-76. [DOI: 10.1016/j.dental.2014.11.015] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 11/19/2014] [Accepted: 11/21/2014] [Indexed: 10/24/2022]
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Effect of hydrothermal degradation on three types of zirconias for dental application. J Prosthet Dent 2014; 112:1377-84. [DOI: 10.1016/j.prosdent.2014.07.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 07/15/2014] [Accepted: 07/15/2014] [Indexed: 02/04/2023]
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35
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Effect of platform connection and abutment material on stress distribution in single anterior implant-supported restorations: A nonlinear 3-dimensional finite element analysis. J Prosthet Dent 2014; 112:1096-102. [PMID: 24831744 DOI: 10.1016/j.prosdent.2014.03.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 03/14/2014] [Accepted: 03/18/2014] [Indexed: 11/23/2022]
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36
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Passos SP, Linke B, Larjava H, French D. Performance of zirconia abutments for implant-supported single-tooth crowns in esthetic areas: a retrospective study up to 12-year follow-up. Clin Oral Implants Res 2014; 27:47-54. [DOI: 10.1111/clr.12504] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2014] [Indexed: 12/01/2022]
Affiliation(s)
| | - Bernie Linke
- School of Dentistry; University of Alberta; Edmonton AB Canada
| | - Hannu Larjava
- Faculty of Dentistry; University of British Columbia; Vancouver BC Canada
- Private Practice Calgary; AB Canada
| | - David French
- Faculty of Dentistry; University of British Columbia; Vancouver BC Canada
- Private Practice Calgary; AB Canada
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Kobune K, Miura T, Sato T, Yotsuya M, Yoshinari M. Influence of plasma and ultraviolet treatment of zirconia on initial attachment of human oral keratinocytes: expressions of laminin γ2 and integrin β4. Dent Mater J 2014; 33:696-704. [PMID: 25273051 DOI: 10.4012/dmj.2014-087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Initial attachment of human oral keratinocytes cultured on yttria-stabilized tetragonal zirconia polycrystal (TZP) surfaces that were subjected to UV or oxygen plasma (O2-plasma) treatment was investigated. The viability of the attached cells, mRNA expression of laminin γ2 and integrin β4, distribution of laminin γ2 and integrin β4, cell area, and cell morphology were assessed. The results showed that no differences in the viability of attached cells were recognized among the conditions. However, expression of laminin γ2 and integrin β4 as well as cell morphology were promoted only in O2-plasma specimens even though superhydrophilicity was obtained in both the UV and O2-plasma specimens compared with the untreated control specimen. The photocatalytic activity was believed to be closely involved in the above-mentioned differences. The results of this study suggest that TZP surface treated with oxygen plasma promotes the initial attachment capability of human oral keratinocytes with enhancing the extracellular matrix such as laminin γ2.
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Affiliation(s)
- Kazuhiro Kobune
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College
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38
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Abstract
Although osseointegrated dental implants have become a predictable and effective modality for the treatment of single or multiple missing teeth, their use is associated with clinical complications. Such complications can be biologic, technical, mechanical, or esthetic and may compromise implant outcomes to various degrees. This article presents prosthetic complications accompanied with implant-supported single and partial fixed dental prostheses.
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Zembic A, Philipp AOH, Hämmerle CHF, Wohlwend A, Sailer I. Eleven-Year Follow-Up of a Prospective Study of Zirconia Implant Abutments Supporting Single All-Ceramic Crowns in Anterior and Premolar Regions. Clin Implant Dent Relat Res 2014; 17 Suppl 2:e417-26. [PMID: 25180473 DOI: 10.1111/cid.12263] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Clinical studies on zirconia abutments report very good survival rates and biological and technical results, but few have an observation period of more than 5 years. PURPOSE The aim of this study was to assess the long-term performance of customized zirconia implant abutments supporting all-ceramic crowns. MATERIALS AND METHODS Twenty-seven patients receiving 54 single implants were included (25 incisors, 14 canines, 15 premolars in both jaws). Yttria-stabilized zirconia abutments were screwed to the implants with a defined torque. All-ceramic crowns were adhesively cemented onto the abutments. The implants, abutments, and crowns were clinically and radiographically examined after 11 years of use. Modified United States Public Health Service (USPHS) criteria were used to assess technical outcomes: fracture of abutment/crown framework/veneering ceramic, loosening of abutment screw/crown, marginal adaptation, anatomical form, occlusal wear, and abutment fit. The biological parameters were pocket probing depth, plaque control record, bleeding on probing, papilla index, and gingival/mucosal recession at implants and neighboring natural teeth. The cumulative success rate of abutments and crowns was calculated by the Kaplan-Meier method. The results of the USPHS criteria were analyzed descriptively. RESULTS Sixteen patients with 31 zirconia abutments were examined at 11.3 (±0.9) years after implantation. No abutment or crown was lost. The cumulative success rate was 96.3% for abutments and 90.7% for crowns. Two abutment screws loosened, and three crowns exhibited minor chipping. There were no biological complications. CONCLUSIONS Customized zirconia single implant abutments exhibited excellent long-term outcomes in anterior and premolar regions.
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Affiliation(s)
- Anja Zembic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Oral Implantology and Prosthetic Dentistry, Academic Center for Dentistry Amsterdam, MOVE Research Institute, Amsterdam, The Netherlands
| | - Alexander Otto Hermann Philipp
- Effretikon, Switzerland.,Clinic for Preventive Dentistry, Periodontology and Cariology, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph Hans Franz Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
| | | | - Irena Sailer
- Clinic of Fixed Prosthodontics and Biomaterials, School of Dental Medicine, University of Geneva, Geneva, Switzerland
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40
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Nothdurft FP, Nonhoff J, Pospiech PR. Pre-fabricated zirconium dioxide implant abutments for single-tooth replacement in the posterior region: success and failure after 3 years of function. Acta Odontol Scand 2014; 72:392-400. [PMID: 24304290 DOI: 10.3109/00016357.2013.863970] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Zirconia implant abutments have gained a much broader clinical use over the past few years. The aim of the present study was to assess the clinical performance of a pre-fabricated zirconium dioxide implant abutment for single-tooth replacement in the posterior region. MATERIALS AND METHODS Forty implants of the XiVE(®) S plus screw type (DENTSPLY Friadent, Mannheim, Germany) were inserted in the posterior region of 24 patients and provided with zirconium dioxide abutments (FRIADENT(®) CERCON(®) Abutment, DENTSPLY Friadent). The following parameters were used to document the state of soft tissue: modified plaque index, modified sulcus bleeding index and pocket depth. Mesial and distal bone levels were determined on radiographs during the prosthetic treatment and at the 36-month recall. RESULTS Thirty-seven implants could be followed up after 36 months in function. One patient wearing two abutments was lost to follow-up. One abutment exhibited a rotational misfit after 2 years in function. A further abutment showed the same failure at the 36-months recall appointment. In the remaining 36 implants the soft and hard tissue parameters were indicative of a low inflammatory status. Compared to the baseline situation, a partly significant bone apposition could be observed. Chipping of parts of the veneering ceramic was registered in 22% of the remaining implant restorations. CONCLUSIONS The use of zirconia abutments in this study lead to mainly healthy peri-implant hard and soft tissue conditions but, considering the observed failures after 3 years in function, clinical long-term results should be awaited before recommending full zirconia implant abutments in a posterior indication.
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Affiliation(s)
- Frank P Nothdurft
- Department of Prosthetic Dentistry and Dental Materials Sciences, Saarland University , Homburg/Saar , Germany
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Delben JA, Barão VA, Ferreira MB, da Silva NR, Thompson VP, Assunção WG. Influence of abutment-to-fixture design on reliability and failure mode of all-ceramic crown systems. Dent Mater 2014; 30:408-16. [DOI: 10.1016/j.dental.2014.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 01/07/2014] [Accepted: 01/14/2014] [Indexed: 11/16/2022]
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Worni A, Kolgeci L, Rentsch-Kollar A, Katsoulis J, Mericske-Stern R. Zirconia-Based Screw-Retained Prostheses Supported by Implants: A Retrospective Study on Technical Complications and Failures. Clin Implant Dent Relat Res 2014; 17:1073-81. [PMID: 24576088 DOI: 10.1111/cid.12214] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little information is yet available on zirconia-based prostheses supported by implants. PURPOSE To evaluate technical problems and failures of implant-supported zirconia-based prostheses with exclusive screw-retention. MATERIAL AND METHODS Consecutive patients received screw-retained zirconia-based prostheses supported by implants and were followed over a time period of 5 years. The implant placement and prosthetic rehabilitation were performed in one clinical setting, and all patients participated in the maintenance program. The treatment comprised single crowns (SCs) and fixed dental prostheses (FDPs) of three to 12 units. Screw-retention of the CAD/CAM-fabricated SCs and FDPs was performed with direct connection at the implant level. The primary outcome was the complete failure of zirconia-based prostheses; outcome measures were fracture of the framework or extensive chipping resulting in the need for refabrication. A life table analysis was performed, the cumulative survival rate (CSR) calculated, and a Kaplan-Meier curve drawn. RESULTS Two hundred and ninety-four implants supported 156 zirconia-based prostheses in 95 patients (52 men, 43 women, average age 59.1 ± 11.7 years). Sixty-five SCs and 91 FDPs were identified, comprising a total of 441 units. Fractures of the zirconia framework and extensive chipping resulted in refabrication of nine prostheses. Nearly all the prostheses (94.2%) remained in situ during the observation period. The 5-year CSR was 90.5%, and 41 prostheses (14 SCs, 27 FDPs) comprising 113 units survived for an observation time of more than 5 years. Six SCs exhibited screw loosening, and polishing of minor chipping was required for five prostheses. CONCLUSIONS This study shows that zirconia-based implant-supported fixed prostheses exhibit satisfactory treatment outcomes and that screw-retention directly at the implant level is feasible.
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Affiliation(s)
- Andreas Worni
- Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Lumni Kolgeci
- Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Rentsch-Kollar
- Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Joannis Katsoulis
- Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Regina Mericske-Stern
- Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland
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Egawa M, Miura T, Kato T, Saito A, Yoshinari M. In vitro adherence of periodontopathic bacteria to zirconia and titanium surfaces. Dent Mater J 2014; 32:101-6. [PMID: 23370877 DOI: 10.4012/dmj.2012-156] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Tetragonal zirconia polycrystals (TZP) has drawn attention as a potential alternative to titanium (Ti) in dental implant treatment, as it minimizes both allergic reactions and esthetic problems. It is also important for dental implants to maintain plaque-free surfaces to prevent peri-implantitis. The purpose of this study was to investigate in vitro adherence of periodontopathic bacteria to TZP comparing with Ti.Periodontopathic bacteria were cultured on polished discs of two kinds of TZP, and Ti as a control. After incubation, the numbers of adherent bacteria were estimated. No significant differences among specimens were observed in the initial attachment, although a decrease was observed in initial attachment to saliva-coated specimens. In the bacterial colonization, no significant differences were recognized among specimens. The adherence of the periodontopathic bacteria on TZP was similar to that on Ti. These results suggest that a strategy is required for inhibition of the bacterial adherence to TZP.
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Affiliation(s)
- Masahiro Egawa
- Division of Oral Implants Research, Oral Health Science Center, Tokyo Dental College, Mihama-ku, Chiba, Japan
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44
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Martínez-Rus F, Rivera B, Özcan M, Pradíes G. Prosthodontic considerations in the implant-supported all-ceramic restoration of congenitally missing maxillary lateral incisor: a clinical report. J Prosthodont 2013; 23:232-5. [PMID: 24118630 DOI: 10.1111/jopr.12096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2013] [Indexed: 11/26/2022] Open
Abstract
The congenitally missing maxillary lateral incisor is the most common agenesis in the anterior region. There are several treatment options for this anomaly, which causes severe deficiencies: orthodontic space closure, tooth-supported restoration, or single-tooth implant. Each of these solutions has a high degree of success if used in the correct situation. An implant-supported restoration with an interdisciplinary approach provides a predictable outcome. This article describes the treatment of a patient with agenesis of the maxillary left lateral incisor. After orthodontic space management, it was decided to restore the tooth with an all-ceramic crown cemented on a zirconia custom abutment, which fractured after only 6 weeks of service. Fractographic analysis revealed that the failure was due to over-reduction of the buccal wall to correct the labial emergence of the implant. Zirconia abutments should be designed with even wall thicknesses of at least 0.8 mm to avoid areas that may compromise functional success.
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Bidra AS, Rungruanganunt P. Clinical Outcomes of Implant Abutments in the Anterior Region: A Systematic Review. J ESTHET RESTOR DENT 2013; 25:159-76. [DOI: 10.1111/jerd.12031] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Avinash S. Bidra
- Post-Graduate Prosthodontics; Department of Reconstructive Sciences; University of Connecticut Health Center; Farmington CT USA
| | - Patchanee Rungruanganunt
- Department of Reconstructive Sciences; University of Connecticut Health Center; Farmington CT USA
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de Medeiros RA, Vechiato-Filho AJ, Pellizzer EP, Mazaro JVQ, dos Santos DM, Goiato MC. Analysis of the peri-implant soft tissues in contact with zirconia abutments: an evidence-based literature review. J Contemp Dent Pract 2013; 14:567-72. [PMID: 24172009 DOI: 10.5005/jp-journals-10024-1364] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study is to evaluate through a literature review, the soft tissue response in contact with zirconia abutments, including case reports comparing prosthetics rehabilitations with zirconia and titanium abutments upto 3 years of follow-up as well as the factors that should be considered on implant's abutment selection. BACKGROUND Metallic abutments can provide grayish color when in contact with thin soft tissues which may lead the implant prosthetic treatment to failure. In this context, the abutments of zirconia stand out because there is an excellent linking between esthetics and the health of peri-implant soft tissues. MATERIALS AND METHODS A consult of the published researches was made on the PubMed database from 2000 to September 2012. The including criteria were: literature reviews, clinical studies and case reports in English that focused on the response of the soft tissue in contact with zirconia implant abutments. The studies that were not in English and did not match the tackled issue were excluded. RESULTS A total of 32 articles were found. According to the search strategy, just 16 articles were selected for this review. Three studies affirmed that zirconia abutments have an excellent soft tissue response; one study showed increased gingival recession with zirconia abutments and nine studies do not stand out any difference on biological behavior between titanium and zirconia abutments. Three studies affirmed that zirconia abutments provide natural gingival appearance, anatomic contour and greater esthetics. CONCLUSION The use of zirconia abutments is recommended for anterior regions because of their greater optical properties and esthetic results and more studies should be performed and analyzed longitudinally regarding their biological response. CLINICAL SIGNIFICANCE The zirconia abutments have been established to be essential in order to achieve great esthetic results in cases of thin peri-implant soft tissues and in regions where the three-dimensional placement of implants is more superficial.
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Affiliation(s)
- Rodrigo Antonio de Medeiros
- Department of Dental Materials and Prosthodontics, Univ Estadual Paulista (UNESP), Aracatuba Dental School, Sao Paulo, Brazil, Phone: 551836363247, e-mail:
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Rationale for the use of CAD/CAM technology in implant prosthodontics. Int J Dent 2013; 2013:768121. [PMID: 23690778 PMCID: PMC3652193 DOI: 10.1155/2013/768121] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 03/28/2013] [Indexed: 11/18/2022] Open
Abstract
Despite the predictable longevity of implant prosthesis, there is an ongoing interest to continue to improve implant prosthodontic treatment and outcomes. One of the developments is the application of computer-aided design and computer-aided manufacturing (CAD/CAM) to produce implant abutments and frameworks from metal or ceramic materials. The aim of this narrative review is to critically evaluate the rationale of CAD/CAM utilization for implant prosthodontics. To date, CAD/CAM allows simplified production of precise and durable implant components. The precision of fit has been proven in several laboratory experiments and has been attributed to the design of implants. Milling also facilitates component fabrication from durable and aesthetic materials. With further development, it is expected that the CAD/CAM protocol will be further simplified. Although compelling clinical evidence supporting the superiority of CAD/CAM implant restorations is still lacking, it is envisioned that CAD/CAM may become the main stream for implant component fabrication.
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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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Gracis S, Michalakis K, Vigolo P, Vult von Steyern P, Zwahlen M, Sailer I. Internal vs. external connections for abutments/reconstructions: a systematic review. Clin Oral Implants Res 2012; 23 Suppl 6:202-16. [DOI: 10.1111/j.1600-0501.2012.02556.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Stefano Gracis
- Division of Postgraduate Prosthodontics; Tufts University; School of Dental Medicine; Boston; MA; USA
| | - Konstantinos Michalakis
- Division of Postgraduate Prosthodontics; Tufts University; School of Dental Medicine; Boston; MA; USA
| | - Paolo Vigolo
- Department of Clinical Odontostomatology; University of Padova; Institute of Clinical Dentistry; Padova; Italy
| | | | - Marcel Zwahlen
- Institute of Social and Preventive Medicine; University of Berne; Bern; Switzerland
| | - Irena Sailer
- Clinic of Fixed and Removable Prosthodontics and Dental Material Sciences; Center for Dental Medicine; University of Zurich; Zurich; Switzerland
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Zembic A, Bösch A, Jung RE, Hämmerle CHF, Sailer I. Five-year results of a randomized controlled clinical trial comparing zirconia and titanium abutments supporting single-implant crowns in canine and posterior regions. Clin Oral Implants Res 2012; 24:384-90. [PMID: 23025514 DOI: 10.1111/clr.12044] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To test the survival rates, and the technical and biological complication rates of customized zirconia and titanium abutments 5 years after crown insertion. MATERIAL AND METHODS Twenty-two patients with 40 single implants in maxillary and mandibular canine and posterior regions were included. The implant sites were randomly assigned to zirconia abutments supporting all-ceramic crowns or titanium abutments supporting metal-ceramic crowns. Clinical examinations were performed at baseline, and at 6, 12, 36 and 60 months of follow-up. The abutments and reconstructions were examined for technical and/or biological complications. Probing pocket depth (PPD), plaque control record (PCR) and Bleeding on Probing (BOP) were assessed at abutments (test) and analogous contralateral teeth (control). Radiographs of the implants revealed the bone level (BL) on mesial (mBL) and distal sides (dBL). Data were statistically analyzed with nonparametric mixed models provided by Brunner and Langer and STATA (P < 0.05). RESULTS Eighteen patients with 18 zirconia and 10 titanium abutments were available at a mean follow-up of 5.6 years (range 4.5-6.3 years). No abutment fracture or loss of a reconstruction occurred. Hence, the survival rate was 100% for both. Survival of implants supporting zirconia abutments was 88.9% and 90% for implants supporting titanium abutments. Chipping of the veneering ceramic occurred at three metal-ceramic crowns supported by titanium abutments. No significant differences were found at the zirconia and titanium abutments for PPD (meanPPDZrO2 3.3 ± 0.6 mm, mPPDTi 3.6 ± 1.1 mm), PCR (mPCRZrO2 0.1 ± 0.3, mPCRTi 0.3 ± 0.2) and BOP (mBOPZrO2 0.5 ± 0.3, mBOPTi 0.6 ± 0.3). Moreover, the BL was similar at implants supporting zirconia and titanium abutments (mBLZrO2 1.8 ± 0.5, dBLZrO2 2.0 ± 0.8; mBLTi 2.0 ± 0.8, dBLTi 1.9 ± 0.8). CONCLUSIONS There were no statistically or clinically relevant differences between the 5-year survival rates, and the technical and biological complication rates of zirconia and titanium abutments in posterior regions.
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Affiliation(s)
- Anja Zembic
- Division of Fixed Prosthodontics, University of Berne, Berne, Switzerland
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