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Refaey HS, Abdelkader SH, Aly YM. Fracture resistance and marginal fit of three different overlay designs using advanced zirconia-reinforced lithium disilicate CAD/CAM material. BMC Oral Health 2025; 25:20. [PMID: 39755589 DOI: 10.1186/s12903-024-05315-1] [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: 10/16/2024] [Accepted: 12/09/2024] [Indexed: 01/06/2025] Open
Abstract
BACKGROUND Conservative dentistry introduced modern restoration designs, contributing to the greater use of partial-coverage ceramic restorations. New strong bondable ceramic materials made fabricating partial coverage ceramic restorations easier to restore the badly destructed teeth. AIM OF THE STUDY This study investigated the impact of three distinct overlay preparation designs on the marginal fit (both before and after thermal aging) and the fracture resistance of overlay restorations fabricated using advanced zirconia-reinforced lithium disilicate (ALD) CAD/CAM glass-ceramic blocks. MATERIALS AND METHODS Using a standardized preparation protocol, three typodont molars were prepared to receive three different indirect overlay ceramic restoration designs. The typodont teeth were duplicated to get 27 resin dies that were randomly allocated into three groups (n = 9) based on the preparation design; group (O): a traditional overlay preparation with anatomical occlusal reduction, group (OS): anatomical occlusal reduction with circumferential shoulder finish line, and group (OG): anatomical occlusal reduction with a central groove preparation at the mid-occlusal surface. After standardized restorations fabricated following the manufacturer's guidelines, the restorations were cemented to their corresponding dies and exposed to thermal aging corresponding to 6-month clinical service. Marginal gap was measured before and after thermal aging procedure using an optical microscope. To measure fracture resistance, specimens were loaded till failure using the universal testing machine. The Kruskal Wallis test was utilized to assess data among the groups, followed by Dunn's post hoc test with Bonferroni correction. Differences in the marginal fit before and after thermal aging were evaluated using Wilcoxon Sign Rank test. RESULTS A statistically significant difference in marginal fit was observed between the studied groups, with a p-value of 0.032 where group OS has the lowest micro gap compared to group OG and group O. The fracture resistance group (O) recorded the highest fracture resistance with a statistically significant difference between the studied groups at p value = 0.043. CONCLUSIONS Adjusting the tooth preparation significantly influenced both the fracture resistance load and the marginal fit observed for advanced zirconia-reinforced lithium disilicate glass-ceramic (ALD) overlays.
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Affiliation(s)
- Heidi Saad Refaey
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Sanaa H Abdelkader
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Yasser M Aly
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Batista JNS, Simionato AA, Faria ACL, Rodrigues RCS, Ribeiro RF. Evaluation of Vertical Misfit and Torque Loss of Different Abutments for Tri-Channel Type Internal Connection Dental Implants After Mechanical Cycling. J ORAL IMPLANTOL 2024; 50:31-38. [PMID: 38579114 DOI: 10.1563/aaid-joi-d-23-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
The aim of this study was to evaluate the mechanical behavior of UCLA and Mini-conical abutments for implants with Tri-channel connections regarding torque loss and vertical misfit. Twenty 3-element metal-ceramic fixed partial dentures (FPD) supported by 2 implants were manufactured and divided into 2 groups (n = 10): UCLA (group 1) and Mini-conical Abutments (group 2). The evaluation of torque loss was carried out before and after mechanical cycling, while the vertical fit was evaluated throughout the different stages of manufacturing the prostheses, as well pre- and postcycling (300,000 cycles, 30 N). Statistical analyses of torque loss and vertical misfit were performed using the linear mixed effects model. Both groups showed torque loss after mechanical cycling (P < .05); however, there was no significant percentage differences between them (P = .795). Before cycling, the groups showed a significant difference in terms of vertical misfit values (P < .05); however, this difference was no long observed after cycling (P = .894). Both groups showed torque loss after the cycling test, with no significant difference (P > .05). There was no significant difference in vertical misfit after mechanical cycling; however, in group 1 (UCLA) there was accommodation of the implant-UCLA abutment interface, while group 2 (Mini-conical abutment) did not show changes in the interface with the implant after the test. Both groups behaved similarly regarding the torque loss of the prosthesis retention screws pre- and postmechanical cycling, with greater loss after the test.
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Affiliation(s)
- Julio Neto Souto Batista
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | - Anselmo Agostinho Simionato
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | - Adriana Cláudia Lapria Faria
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
| | | | - Ricardo Faria Ribeiro
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil
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Bhumpattarachai S, Kan JYK, Goodacre CJ, Swamidass RS, Al-Ardah A, Rungcharassaeng K, Lozada J. Effects of cyclic loading on loss of abutment screw torque of angled screw channel single implant crowns on narrow diameter implants. J Prosthet Dent 2023; 130:741.e1-741.e9. [PMID: 37689572 DOI: 10.1016/j.prosdent.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/11/2023]
Abstract
STATEMENT OF PROBLEM Screw access channels that emerge on the facial aspect of anterior screw-retained implant crowns can compromise esthetics. Recently, angled screw channels (ASCs) have been developed that can alter screw access channel angulations to improve esthetics. While ASCs can be used on narrow-diameter implants, information is limited on the loss of abutment screw torque on narrow-diameter implants with ASCs. PURPOSE The purpose of this in vitro study was to compare the loss of abutment screw torque after thermocycling and the cyclic loading of ASCs from 3 different companies connected to narrow-diameter implants. MATERIAL AND METHODS A total of 40 narrow-diameter implants (NobelReplace Conical Connection 3.5×11.5 mm) were mounted individually in acrylic resin blocks and divided equally into 4 groups. The first group, NB-0 (Control), consisted of screw-retained zirconia crowns fabricated on ASCs at 0-degree angulation (n=10). The other 3 groups consisted of a total of 30 screw-retained zirconia crowns fabricated on ASCs at 20-degree angulation: NB-20 (Angulated Screw Channel Solutions), ATL-20 (Atlantis Custom Base Solution with angulated screw access), and DA-20 (Dynamic TiBase). Each crown was secured on the mounted implant with its corresponding titanium base insert and screw and then tightened to the manufacturer's recommended torque with a digital torque gauge. The initial reverse torque value (RTVI) was obtained and recorded at baseline. Subsequently, a new set of screws were tightened to recommended values, and each specimen underwent thermocycling and then cyclic loading at 0 to 100 N at 10 Hz for 1 million cycles to simulate 1year of functional loading. After cyclic loading, the final reverse torque values (RTVF) were recorded and compared with the RTVI to evaluate the percentage torque loss (PTLF). Statistical analysis was performed using the Kruskal-Wallis analysis, Rank base analysis of covariance (ANCOVA), and the Tukey HSD post hoc comparisons (α=.05). RESULTS Significant differences were found for the PTLF among all groups after cyclic loading (P<.001). The PTLF in ATL-20 (51.4%) was significantly higher than in NB-0 (22.2%) (P<.001) and NB-20 (29.2%) (P=.010). No significant difference was found in the PTLF among other groups (P>.05). CONCLUSIONS The abutment screw torque loss after cyclic loading of the ASCs on narrow diameter implants among the 4 groups did not perform comparably. The largest percentage torque loss was recorded for the ATL-20 group. The NB-20 group demonstrated the lowest percentage torque loss. DA-20 showed percentage torque loss less than ATL-20; however, its RTVF was the lowest.
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Affiliation(s)
- Sasiya Bhumpattarachai
- Assistant Professor, Department of General Dentistry, School of Dentistry, Loma Linda University, Loma Linda, Calif; Research Associate, Advanced Dental Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, Calif.
| | - Joseph Y K Kan
- Professor, Advanced Dental Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, Calif
| | - Charles J Goodacre
- Distinguished Professor, Advanced Dental Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, Calif
| | - Rajesh S Swamidass
- Assistant Clinical Professor, Advanced Dental Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, Calif
| | - Aladdin Al-Ardah
- Associate Professor, Advanced Dental Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, Calif
| | | | - Jaime Lozada
- Professor and Program Director, Advanced Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, Calif
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Sutradhar W, Mishra SK, Chowdhary R. Evaluation of customized cobalt-chromium abutments fabricated with different manufacturing process versus titanium stock abutments on the marginal misfit -An in vitro study. J Indian Prosthodont Soc 2022; 22:225-232. [PMID: 36511051 PMCID: PMC9416951 DOI: 10.4103/jips.jips_381_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Aim Accurate fit of the abutment to the implant is required for the uniform load distribution throughout the assembly. The study aims to compare the marginal misfit of titanium stock abutments with the cobalt-chromium (CoCr) customized abutments fabricated with the different manufacturing processes in internal hex implant-abutment connection using an appropriate scanning technique. Setting and Design In vitro comparative study. Materials and Methods A total of 40 abutments were included in the study. Ten titanium stock abutments were used as control (Group CN) and 30 CoCr abutments were fabricated and taken as the test group. Stock abutments were scanned and from obtained images test group abutments were fabricated as follows: Ten cast abutments (Group CA), 10 sintered abutments (Group SA), and 10 milled abutments (Group MA). Endosseous implanst having internal hex connections were matched with 10 stock abutments and 30 customized CoCr abutments. Implants were mounted in a clear epoxy resin block and the abutments were then fitted onto the implants with a torque of 30Ncm. The marginal discrepancy at implant-abutment connections was measured with confocal laser scanning microscope. Statistical Analysis Used One-way ANOVA and Tukey's post hoc test was done for statistical analysis. Results One-way ANOVA revealed a significant difference in marginal misfit of abutments. The mean marginal misfit was lowest for stock abutments (0.35 ± 0.009 μm). Among the customized abutments, the mean marginal misfit was highest for cast abutments (2.44 ± 0.445 μm) followed by sintered abutments (1.67 ± 0.232 μm) and least for milled abutments (0.65 ± 0.041 μm). A significant difference was found in marginal misfit with cast abutments and sintered abutments when compared to stock abutments (P < 0.001). The difference in marginal misfit was insignificant between stock abutments and milled abutments (P = 0.052). Conclusion Difference in marginal misfit exists between the titanium stock abutments and customized CoCr abutments. Among the customized abutments, milled CoCr abutments have the least marginal discrepancy and cast CoCr abutments have a maximum marginal discrepancy. Milled CoCr abutments can be used as an alternative to titanium stock abutments.
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Affiliation(s)
- Writuraj Sutradhar
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Sunil Kumar Mishra
- Department of Prosthodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India,Address for correspondence: Dr. Ramesh Chowdhary, Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru - 560 098, Karnataka, India. E-mail:
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Rizvi N, Alyahya Y, Rizvi A, Narvekar U, Petridis H, Pros C. Accuracy of Original vs. Non-original Abutments Using Various Connection Geometries for Single Unit Restorations: A Systematic Review. J Prosthodont 2021; 31:e21-e52. [PMID: 34866275 DOI: 10.1111/jopr.13464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To ascertain whether the compatibility of non-original abutments (NOAs) with dental implants is influenced by the type of implant connection i.e. internal or external, and whether certain combinations of componentry may be as compatible as the original components. METHODS A structured literature search was conducted using 3 electronic databases (MEDLINE®, The Cochrane Library, and Web of Science Core Collection) for studies reporting on the use of non-original abutments published between 1995 and 2020. This was supplemented with hand searching in relevant journals and references, as well as searching grey literature. Relevant studies were selected according to specific inclusion criteria. Data was collected for the following parameters: precision of fit, microleakage, micromorphological differences, micromotion, rotational misfit, screw loosening, maximum load capacity, fracture resistance, tensile strength, compressive strength and in-vivo implant and prosthesis outcomes. RESULTS The electronic searching and hand search yielded titles and abstracts of 5617 studies following de-duplication; 40 studies were finally selected. Overall, original abutments showed better precision of fit, ability to resist microleakage, prevention of rotational misfit and micromotion, and fatigue strength compared with non-original abutments. Some non-original abutments on external connections were comparable with original abutments in terms of precision of fit and resistance to screw loosening and may be associated with less catastrophic failures than those on internal connections. CONCLUSION Original abutments present more predictable outcomes than non-original abutments with regards to the parameters investigated. However, it seems that external connections can provide some level of compatibility in terms of precision of fit and may also exhibit less catastrophic failures than NOAs on internal connections. This may be due to increased rotational freedom external connections provide. There is a lack of information regarding the influence of connection geometry on many aspects of compatibility and therefore the current clinical recommendation should be to use original abutments. More laboratory studies comparing non-original abutments on different implant connections are required. In addition, there is a need for long-term in vivo studies providing data on the clinical performance of non-original abutments. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Naureen Rizvi
- Unit of Prosthodontics, UCL Eastman Dental Institute, London, United Kingdom
| | - Yasir Alyahya
- Unit of Prosthodontics, UCL Eastman Dental Institute, London, United Kingdom
| | - Ali Rizvi
- Unit of Prosthodontics, UCL Eastman Dental Institute, London, United Kingdom
| | - Unnati Narvekar
- Unit of Prosthodontics, UCL Eastman Dental Institute, London, United Kingdom
| | - Haralampos Petridis
- Unit of Prosthodontics, UCL Eastman Dental Institute, London, United Kingdom
| | - Cert Pros
- Unit of Prosthodontics, UCL Eastman Dental Institute, London, United Kingdom
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The Influence of Laboratory Scanner Versus Intra-Oral Scanner on Determining the Implant Axis by Using Three Different Scan Abutments. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11188543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: The purpose of this in vitro study was to compare the implant axis’ spatial position and orientation by using laboratory scanner versus intra-oral scanner with three different scan abutments. Methods: A 3D model was printed with an internal hex implant analog in the place of teeth 35#. Three standard scan abutments were used: MIS (two-piece titanium), AB (two-piece PEEK and titanium base) and ZZ (one-piece PEEK). Each scan abutment was scanned 30 times by TRIOS E3 (laboratory scanner) and 30 times by Omnicam (intra-oral scanner). For each scan, an STL (stereolithography) file was created, and the spatial characterization of each scan abutment was measured in the X, Y, Z coordinates, and rotational and longitudinal angles. The comparison between all the scans was conducted by superimposition of the STL files, using a 3D software. A t-test and Wilcoxon signed-rank test were used. (p < 0.05) Results: Only the MIS scan abutment showed no statistical difference in the X and Z axes. (p < 0.05). All other scan abutments showed a statistical difference in all axes. The rotational angle of the AB scan abutment was twice the angle of the MIS and ZZ scan abutments. Conclusions: All three scan abutments showed a rotational deviation of the implant axis between the laboratory scanner and the intra-oral scanner. The AB scan abutment showed the greatest deviation (1.04 degrees) while the other two abutments showed deviations of about half a degree in relation to the laboratory scan abutment. There is a need for further studies which will examine the influence of geometry, material, and scan abutment parts on the accuracy of the scan obtained.
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Molinero-Mourelle P, Cascos-Sanchez R, Yilmaz B, Lam WYH, Pow EHN, Del Río Highsmith J, Gómez-Polo M. Effect of Fabrication Technique on the Microgap of CAD/CAM Cobalt-Chrome and Zirconia Abutments on a Conical Connection Implant: An In Vitro Study. MATERIALS 2021; 14:ma14092348. [PMID: 33946477 PMCID: PMC8125438 DOI: 10.3390/ma14092348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 01/03/2023]
Abstract
The aim of this in vitro study was to investigate the microgaps at the implant-abutment interface when zirconia (Zr) and CAD/CAM or cast Co-Cr abutments were used. METHODS Sixty-four conical connection implants and their abutments were divided into four groups (Co-Cr (milled, laser-sintered and castable) and Zirconia (milled)). After chewing simulation (300,000 cycles, under 200 N loads at 2 Hz at a 30° angle) and thermocycling (10,000 cycles, 5 to 50 °C, dwelling time 55 s), the implant-abutment microgap was measured 14 times at each of the four anatomical aspects on each specimen by using a scanning electron microscope (SEM). Kruskal-Wallis and pair-wise comparison were used to analyze the data (α = 0.05). RESULTS The SEM analysis revealed smaller microgaps with Co-Cr milled abutments (0.69-8.39 μm) followed by Zr abutments (0.12-6.57 μm), Co-Cr sintered (7.31-25.7 μm) and cast Co-Cr (1.68-85.97 μm). Statistically significant differences were found between milled and cast Co-Cr, milled and laser-sintered Co-Cr, and between Zr and cast and laser-sintered Co-Cr (p < 0.05). CONCLUSIONS The material and the abutment fabrication technique affected the implant-abutment microgap magnitude. The Zr and the milled Co-Cr presented smaller microgaps. Although the CAD/CAM abutments presented the most favorable values, all tested groups had microgaps within a range of 10 to 150 μm.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Correspondence: ; Tel.: +34-913941922
| | - Rocio Cascos-Sanchez
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland
| | - Walter Yu Hang Lam
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Edmond Ho Nang Pow
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Jaime Del Río Highsmith
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
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Gonzalo E, Vizoso B, Lopez-Suarez C, Diaz P, Pelaez J, Suarez MJ. Evaluation of Milled Titanium versus Laser Sintered Co-Cr Abutments on the Marginal Misfit in Internal Implant-Abutment Connection. MATERIALS 2020; 13:ma13214873. [PMID: 33143092 PMCID: PMC7663543 DOI: 10.3390/ma13214873] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022]
Abstract
The precision of fit at the implant-abutment connection is an important criterion for the clinical success of restorations and implants. Several factors are involved among which are the abutment materials and manufacturing techniques. The aim of this study was to investigate the effect of two materials and methods of manufacturing implant abutments, milled titanium versus laser sintered Co-Cr, on the marginal misfit at the implant-abutment interface. Scanning electron microscopes (SEM) were used to geometrically measure the marginal vertical discrepancy of a total of 80 specimens, classified into eight categories, according to the implant system and abutment. The data were statistically analyzed by Student’s paired t test, one-way and two-way ANOVA with the Bonferroni-Holm correction at the significance level of p = 0.05. Milled titanium abutments demonstrated the lowest misfit values in the implant systems analyzed. The marginal fit of all the groups was within the clinically acceptable range for implant prostheses.
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Falahchai M, Babaee Hemmati Y, Neshandar Asli H, Neshandar Asli M. Marginal adaptation of zirconia‐reinforced lithium silicate overlays with different preparation designs. J ESTHET RESTOR DENT 2020; 32:823-830. [DOI: 10.1111/jerd.12642] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/21/2020] [Accepted: 07/30/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Mehran Falahchai
- Dental Sciences Research Center, Department of Prosthodontics School of Dentistry, Guilan University of Medical Sciences Rasht Iran
| | - Yasamin Babaee Hemmati
- Dental Sciences Research Center, Department of Orthodontics School of Dentistry, Guilan University of Medical Sciences Rasht Iran
| | - Hamid Neshandar Asli
- Dental Sciences Research Center, Department of Prosthodontics School of Dentistry, Guilan University of Medical Sciences Rasht Iran
| | - Marzieh Neshandar Asli
- Undergraduate student, Dental School Anzali Campus, Guilan University of Medical Sciences Rasht Iran
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Influence of Implant Connection, Abutment Design and Screw Insertion Torque on Implant-Abutment Misfit. J Clin Med 2020; 9:jcm9082365. [PMID: 32722131 PMCID: PMC7463581 DOI: 10.3390/jcm9082365] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/18/2020] [Accepted: 07/22/2020] [Indexed: 12/26/2022] Open
Abstract
Background: An accurate fit at the implant-abutment interface is an important factor to avoid biological and mechanical complications. The aim of this study was to evaluate the marginal misfit at the implant-abutment interface on external and Morse taper connection, with straight and angulated abutments under different insertion torque loads. Materials and Methods: A total of 120 implants were used, 60 with external connection (EC) and 60 with Morse taper connection (IC). Straight (SA) (n = 60) and angulated abutments (AA) (n = 60) were randomly screwed to each connection at different torque levels (n = 10 each): 10, 20 and 30 Ncm. All specimens were subjected to thermal and cyclic loading and the misfit was measured by scanning electron microscopy. Data were analyzed with one-way ANOVA, t-test and Kruskal-Wallis test. Results: Significant differences (p < 0.001) were found between connections and abutments regardless of the torque applied. Morse taper connections with straight and angulated abutments showed the lowest misfit values (0.6 µm). Misfit values decreased as torque increased. Conclusions: The misfit was affected by the type of connection. The type of abutment did not influence the fit in the Morse taper connection. The higher the tightening torque applied the increase in the fit of the implant-abutment interface.
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Al-Zordk W, Elmisery A, Ghazy M. Hybrid-abutment-restoration: effect of material type on torque maintenance and fracture resistance after thermal aging. Int J Implant Dent 2020; 6:24. [PMID: 32578068 PMCID: PMC7311558 DOI: 10.1186/s40729-020-00220-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 04/24/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To evaluate the tightening torque maintenance with zirconia, lithium disilicate, and polyetheretherketone (PEEK) hybrid-abutment-crowns after thermal aging, in addition to assess the fracture resistance of hybrid-abutment-crowns fabricated with different materials. Materials and methods Thirty implants were restored with identical hybrid-abutment-crowns, resembling the maxillary first premolar, fabricated from zirconia (Zr), lithium disilicate (L2), or ceramic-reinforced PEEK (PE). The three groups (n = 10) were constructed utilizing a Ti-base. After bonding, each restoration was secured in its respective implant with a torque of 25 Ncm. All restorations were subjected to thermal aging for 7000 cycles. The loosening torque was assessed utilizing the digital torque meter. Each restoration was subjected to fracture testing and the mode of failure was determined. Results Zr group displayed the highest mean torque loss value (2.70 ± 0.59 Ncm) with the mean loosening torque value of 22.38 ± 0.68 Ncm. PE group displayed the lowest mean torque loss (2.55 ± 0.50 Ncm) with mean loosening torque value of 22.61 ± 0.59 Ncm. There was no significant difference between study groups regarding loosening torque (p = 0.68), torque loss (p = 0.80), and percentage of torque loss (p = 0.79). There was significant difference regarding the mean fracture load value between Zr and PE groups. However, there was no significant difference (p = 0.05) regarding mean fracture load value between L2 and PE groups. Conclusion The hybrid-abutment-crown material does not affect the torque maintenance after thermal aging. Based on fracture load, zirconia hybrid-abutment-crown can be used, while lithium disilicate and PEEK hybrid-abutment-crowns may cautiously serve in premolar region.
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Affiliation(s)
- Walid Al-Zordk
- Department of Fixed Prosthodontics, Mansoura University, PO Box 35516, Mansoura, Dakahlia, Egypt.
| | - Ahmed Elmisery
- Department of Fixed Prosthodontics, Mansoura University, PO Box 35516, Mansoura, Dakahlia, Egypt
| | - Mohamed Ghazy
- Department of Fixed Prosthodontics, Mansoura University, PO Box 35516, Mansoura, Dakahlia, Egypt
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Fatigue survival and failure resistance of titanium versus zirconia implant abutments with various connection designs. J Prosthet Dent 2019; 122:315.e1-315.e7. [PMID: 31326150 DOI: 10.1016/j.prosdent.2019.05.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Data regarding the effect of connection design and abutment material on the fatigue survival and failure resistance of implant abutments are scarce. PURPOSE The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the fatigue survival and failure resistance of implant abutment assemblies. MATERIAL AND METHODS Three types of implants (n=18, N=54) and 6 groups of abutments (n=9, N=54) with different connection designs-internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)-and abutment materials-titanium (T) and zirconia (Z)-were investigated. All the abutments were restored with identical central incisor crowns. Fatigue testing, including thermal and mechanical aging, was performed in a mastication simulator (Esetron Smart Robotechnologies) for up to 1.2×106 cycles with a load of 50 N at an angle of 45 degrees. Then, the surviving specimens were subjected to failure resistance testing in a universal testing machine (Shimadzu AG-IS; Shimadzu Corp) at a crosshead speed of 1.0 mm/min. The maximum loads to failure (N) were recorded. Survival performance of the specimens throughout the fatigue testing was examined by the Kaplan-Meier survival analysis. The failure loads were analyzed by using the Kruskal-Wallis test followed by the Mann-Whitney U tests with Bonferroni-Holm correction (α=.05). RESULTS All the specimens of groups ICT, ITT, ITZ, and EHT survived fatigue testing, whereas 2 specimens from group ICZ and 3 specimens from EHZ failed. Statistically significant differences were found among the groups, based on the results of maximum failure loads (P<.05). The highest mean failure load was obtained in the ICT group (1069 ±182 N), followed by the ITT (926 ±197 N), EHT (873 ±126 N), ITZ (568 ±81 N), EHZ (311 ±45 N), and ICZ (287 ±63 N) groups. CONCLUSIONS Abutment material and connection design affected the fatigue survival of implant abutment assemblies. Implant abutment assemblies with a titanium-titanium interface revealed higher failure resistance than the implant abutment assemblies with a titanium-zirconia interface.
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Huang Y, Wang J. Mechanism of and factors associated with the loosening of the implant abutment screw: A review. J ESTHET RESTOR DENT 2019; 31:338-345. [PMID: 31150572 DOI: 10.1111/jerd.12494] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 05/19/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yiqing Huang
- Department of ProsthodonticsHubei‐MOST KLOS & KLOBM, School and Hospital of Stomatology, Wuhan University Wuhan China
- Department of StomatologyThe Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology Wuhan China
| | - Jiawei Wang
- Department of ProsthodonticsHubei‐MOST KLOS & KLOBM, School and Hospital of Stomatology, Wuhan University Wuhan China
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14
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Şen N, Şermet IB, Gürler N. Sealing capability and marginal fit of titanium versus zirconia abutments with different connection designs. J Adv Prosthodont 2019; 11:105-111. [PMID: 31080571 PMCID: PMC6491357 DOI: 10.4047/jap.2019.11.2.105] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/23/2019] [Accepted: 03/14/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Limited data is available regarding the differences for possible microleakage problems and fitting accuracy of zirconia versus titanium abutments with various connection designs. The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the sealing capability and fitting accuracy of abutments. MATERIALS AND METHODS A total of 42 abutments with different connection designs [internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)] and abutment materials [titanium (Ti) and zirconia (Zr)] were evaluated. The inner parts of implants were inoculated with 0.7 µL of polymicrobial culture (P. gingivalis, T. forsythia, T. denticola and F. nucleatum) and connected with their respective abutments under sterile conditions. The penetration of bacteria into the surrounding media was assessed by the visual evaluation of turbidity at each time point and the number of colony forming units (CFUs) was counted. The marginal gap at the implant- abutment interface (IAI) was measured by scanning electron microscope. The data sets were statistically analyzed using Kruskal-Wallis followed by Mann-Whitney U tests with the Bonferroni-Holm correction (α=.05). RESULTS Statistically significant difference was found among the groups based on the results of leaked colonies (P<.05). The EH-Ti group characterized by an external hexagonal connection were less resistant to bacterial leakage than the groups EH-Zr, IT-Zr, IT-Ti, IC-Zr, and IC-Ti (P<.05). The marginal misfit (in µm) of the groups were in the range of 2.7–4.0 (IC-Zr), 1.8–5.3 (IC-Ti), 6.5–17.1 (IT-Zr), 5.4–12.0 (IT-Ti), 16.8–22.7 (EH-Zr), and 10.3–15.4 (EH-Ti). CONCLUSION The sealing capability and marginal fit of abutments were affected by the type of abutment material and connection design.
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Affiliation(s)
- Nazmiye Şen
- Department of Prosthodontics, School of Dentistry, University of Istanbul, Istanbul, Turkey
| | - Ibrahim Bülent Şermet
- Department of Prosthodontics, School of Dentistry, University of Istanbul, Istanbul, Turkey
| | - Nezahat Gürler
- Department of Medical Microbiology, Faculty of Medicine, University of Istanbul, Istanbul, Turkey
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15
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Makowiecki A, Hadzik J, Błaszczyszyn A, Gedrange T, Dominiak M. An evaluation of superhydrophilic surfaces of dental implants - a systematic review and meta-analysis. BMC Oral Health 2019; 19:79. [PMID: 31077190 PMCID: PMC6509828 DOI: 10.1186/s12903-019-0767-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 04/15/2019] [Indexed: 01/07/2023] Open
Abstract
Background The characteristics of a dental implant surface have a decisive influence on the process of osseointegration. According to the current state of knowledge, surface modification can not only affect the morphology of cells, and in this way have a positive impact on osseointegration. Methods The objective of this study was to compare survival rates and marginal bone loss as well as assess the degree of stability of Straumann SLAactive® and Thomenn Incell® implants with a superhydrophilic surface. Authors present review of data published between 01.01.2008 and 12.31.2016 that was found in PubMed/MEDLINE internet database, An Internet search of databases produced a total of 1230 studies, 20 publications were finally selected for the present study based on the established selection and exclusion criteria. Results The statistical analysis was performed. A Cumulative Implant Survival Rate (CSR%) was 98.5%, Marginal bone loss (MBL) after 6 months was M = 0.60 mm and 0.6 5 mm after 12 months and secondary stability in a group Thommen implants M = 71.3 ISQ and M = 75.2 ISQ in group of Straumann. Conclusion Despite certain differences in the values of the studied parameters, both of the systems, i.e. Thommen Inicell and Straumann SLActive, demonstrated a high survival rate, a high level of implant stability and low marginal bone loss.
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Affiliation(s)
| | - Jakub Hadzik
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland. .,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland.
| | - Artur Błaszczyszyn
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland
| | - Tomasz Gedrange
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Orthodontics, Carl Gustav Carus Campus, Technische Universität Dresden, Germany, Fetscherstr. 74, 01307, Dresden, Germany
| | - Marzena Dominiak
- Department of Dental Surgery, Wroclaw Medical University, ul. Krakowska 26, 50-425, Wrocław, Poland.,Department of Oral Implantology, Wroclaw Medical University Wrocław, ul. Krakowska 26, 50-425, Wrocław, Poland
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Kofron MD, Carstens M, Fu C, Wen HB. In vitro assessment of connection strength and stability of internal implant-abutment connections. Clin Biomech (Bristol, Avon) 2019; 65:92-99. [PMID: 31005695 DOI: 10.1016/j.clinbiomech.2019.03.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/01/2019] [Accepted: 03/11/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Various connections have been machined to improve the fit between the dental abutment and implant. In vivo, the instability created by imprecisely fitting components can cause soft tissue irritation and bacterial colonization of the implant system. The aim of this study was to quantify abutment stability under in vitro force applications. METHODS Abutment stability and fit were quantitatively measured after application of rotational, vertical, and horizontal forces. FINDINGS The abutment connection held by friction (Friction-Fit) was the only group to have 0° angular rotation. A significantly greater vertical force was required to pull the abutment from the implant for the Friction-Fit connection as compared to all other experimental groups. The abutment connection held by a mechanically locking friction-fit with four grooves (CrossFit) and Friction-Fit demonstrated significantly lower lateral movement as compared to all other connections. The remaining connections evaluated included two hexagon connections that rely on screw placement for abutment fit (Conical + Hex #1 and Conical + Hex #2), one connection with protruding slots to align with recessed channels inside the implant (Conical + 6 Indexing Slots), and an internal connection that allows for abutment indexing every 120° (Internal Tri-Channel). INTERPRETATION Internal connection geometry influenced the degree of abutment movement. Friction-Fit and CrossFit connections exhibited the lowest rotational and horizontal motions. Significant differences were found between Friction-Fit and CrossFit following the application of a vertical force, with the Friction-Fit requiring a significantly greater pull force to separate the abutment from the implant.
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Affiliation(s)
- Michelle D Kofron
- Biomet 3i, LLC, a Zimmer Biomet company, 4555 Riverside Drive, Palm Beach Gardens, FL, United States.
| | - Matthew Carstens
- Biomet 3i, LLC, a Zimmer Biomet company, 4555 Riverside Drive, Palm Beach Gardens, FL, United States
| | - Cong Fu
- Biomet 3i, LLC, a Zimmer Biomet company, 4555 Riverside Drive, Palm Beach Gardens, FL, United States
| | - Hai Bo Wen
- Biomet 3i, LLC, a Zimmer Biomet company, 4555 Riverside Drive, Palm Beach Gardens, FL, United States
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Kim SJ, Son K, Lee KB. Digital evaluation of axial displacement by implant-abutment connection type: An in vitro study. J Adv Prosthodont 2018; 10:388-394. [PMID: 30370031 PMCID: PMC6202430 DOI: 10.4047/jap.2018.10.5.388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/22/2018] [Accepted: 08/28/2018] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To measure axial displacement of different implant-abutment connection types and materials during screw tightening at the recommended torque by using a contact scanner for two-dimensional (2D) and three-dimensional (3D) analyses. MATERIALS AND METHODS Twenty models of missing mandibular left second premolars were 3D-printed and implant fixtures were placed at the same position by using a surgical guide. External and internal fixtures were used. Three implant-abutment internal connection (INT) types and one implant-abutment external connection (EXT) type were prepared. Two of the INT types used titanium abutment and zirconia abutment; the other INT type was a customized abutment, fabricated by using a computer-controlled milling machine. The EXT type used titanium abutment. Screws were tightened at 10 N·cm, simulating hand tightening, and then at the manufacturers' recommended torque (30 N·cm) 10 min later. Abutments and adjacent teeth were subsequently scanned with a contact scanner for 2D and 3D analyses using a 3D inspection software. RESULTS Significant differences were observed in axial displacement according to the type of implant-abutment connection (P<.001). Vertical displacement of abutments was greater than overall displacement, and significant differences in vertical and overall displacement were observed among the four connection types (P<.05). CONCLUSION Displacement according to connection type and material should be considered in choosing an implant abutment. When adjusting a prosthesis, tightening the screw at the manufacturers' recommended torque is advisable, rather than the level of hand tightening.
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Affiliation(s)
- Sung-Jun Kim
- Department of Dentistry, Graduate School, Kyungpook National University, Daegu, Republic of Korea
| | - KeunBaDa Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute, Kyungpook National University, Daegu, Republic of Korea
| | - Kyu-Bok Lee
- Department of Dentistry, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea.,Advanced Dental Device Development Institute, Kyungpook National University, Daegu, Republic of Korea
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