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Zhang F, Monzavi M, Li M, Čokić S, Manesh A, Nowzari H, Vleugels J, Van Meerbeek B. Fracture analysis of one/two-piece clinically failed zirconia dental implants. Dent Mater 2022; 38:1633-1647. [PMID: 36064469 DOI: 10.1016/j.dental.2022.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/13/2022] [Accepted: 08/18/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Analyzing factors that may have led to fracture of zirconia implants by macro/micro-fractography. METHODS Six one-piece and ten two-piece full-ceramic zirconia implants from two manufacturers, Z-Systems and CeraRoot, were retrieved after clinical failure. The time-to-failure ranged from 3 to 49 months. Optical and scanning electron microscopy (SEM) were used to analyze the fracture planes at the macro- and microscopic level. Treatment planning, surgical protocol, fracture-origin location and characteristic fracture features were assessed. RESULTS The fracture of all implants seemed to have been primarily due to overload in bending mode, while the fracture-initiation sites varied for the one- and two-piece implants. The fracture of all one-piece implants originated in the constriction region between two threads in the endosseous implant part. For two-piece implants, the abutment neck, internal abutment-implant connections and inner threads were found to be the main fracture-initiation sites. Surface defects at the root area for one-piece implants and damages at the abutment surface for two-piece implants were connected to the fracture origins. Importantly, the clinical failures of implants were often found to result from combined effects related to patient aspects, treatment planning/protocols, a high bending moment at the weakest link, implant-surface conditions and specific implant designs. SIGNIFICANCE This study provided information to be considered for future optimization of treatment planning and the surgical protocol for zirconia implants. Optimization of the surface conditions and the zirconia-starting powder were also suggested.
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Affiliation(s)
- Fei Zhang
- KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, B-3001 Leuven, Belgium`; KU Leuven, Department of Oral Health Sciences, BIOMAT - Biomaterials Research Group & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 block a, B-3000 Leuven, Belgium.
| | - Mona Monzavi
- Periodontics and Ceramic Implantology (private Practice), 1401N Tustin Ave Suite #345, Santa Ana, CA 92705, USA
| | - Maoyin Li
- KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, B-3001 Leuven, Belgium`
| | - Stevan Čokić
- KU Leuven, Department of Oral Health Sciences, BIOMAT - Biomaterials Research Group & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 block a, B-3000 Leuven, Belgium
| | - Al Manesh
- Mission Dental Implant Center (private Practice), 26800 Crown Valley Pkwy Ste 425, Mission Viejo, CA 92691, USA
| | - Hessam Nowzari
- Periodontics and Implant Dentistry (private practice), 120 S Spalding Dr #201, Beverlyhills, CA 90210, USA
| | - Jef Vleugels
- KU Leuven, Department of Materials Engineering, Kasteelpark Arenberg 44, B-3001 Leuven, Belgium`
| | - Bart Van Meerbeek
- KU Leuven, Department of Oral Health Sciences, BIOMAT - Biomaterials Research Group & UZ Leuven (University Hospitals Leuven), Dentistry, Kapucijnenvoer 7 block a, B-3000 Leuven, Belgium
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Rathee G, Bartwal G, Rathee J, Mishra YK, Kaushik A, Solanki PR. Emerging Multimodel Zirconia Nanosystems for High‐Performance Biomedical Applications. ADVANCED NANOBIOMED RESEARCH 2021. [DOI: 10.1002/anbr.202100039] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Garima Rathee
- Special Centre for Nano science Jawaharlal Nehru University New Delhi India
| | - Gaurav Bartwal
- Hemwati Nandan Bahuguna Garhwal University Birla Campus, Pauri Garhwal Srinagar Uttarakhand 246174 India
| | - Jyotsna Rathee
- CSE Department Deenbandhu Chhoturam University of Science and Technology Murthal Haryana 131039 India
| | - Yogendra Kumar Mishra
- Mads Clausen Institute NanoSYD University of Southern Denmark Alison 2 6400 Sønderborg Denmark
| | - Ajeet Kaushik
- NanoBioTech Laboratory Department of Natural Sciences, Division of Sciences, Art, and Mathematics Florida Polytechnic University Lakeland FL 33805 USA
| | - Pratima R. Solanki
- Special Centre for Nano science Jawaharlal Nehru University New Delhi India
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Siddiqui DA, Guida L, Sridhar S, Valderrama P, Wilson TG, Rodrigues DC. Evaluation of oral microbial corrosion on the surface degradation of dental implant materials. J Periodontol 2018; 90:72-81. [DOI: 10.1002/jper.18-0110] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/17/2018] [Accepted: 05/27/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Danyal A. Siddiqui
- Department of Bioengineering; The University of Texas at Dallas; Richardson TX
| | - Lidia Guida
- Department of Bioengineering; The University of Texas at Dallas; Richardson TX
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Houshmand A, Donkiewicz P, Smeets R, Jung O, Barbeck M. Incidental finding of a degrading zirconia dental implant 29 months after implantation: Histological and histomorphometrical analysis. J Biomed Mater Res B Appl Biomater 2018; 106:2919-2923. [PMID: 29732681 DOI: 10.1002/jbm.b.34152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 02/27/2018] [Accepted: 04/17/2018] [Indexed: 11/09/2022]
Abstract
With the emerging development and improvement of biomaterials, the application of ceramics in restorative medicine has experienced a renaissance. New production processes have reportedly helped to overcome unfavorable biomechanical characteristics of these materials, which lead to a wide application of zirconia as ground material for dental implants. Zirconia-based implants are biocompatible, demonstrate ability to osseointegrate and have a teeth-like color, rendering them to be an ideal replacement for titanium-based implant systems, which represent the current gold standard in implantology. However, there is a lack of standardized guidelines on production of zirconia-based implants and long-term studies on the stability of this material in vivo are missing. In this study we demonstrate for the first time the accumulation of degradation products of a commercially available one-piece zirconia-based dental implant 29 months after implantation, which was recovered following a traumatic accident. Biopsy specimens from the implant and the surrounding tissue attached to it were processed for histological and histomorphometrical analysis. Although the implant was well integrated into the anchoring bone, degradation particles were observed in tissues adjacent to lower aspects of the implant. The observed implant degradation might seriously compromise implant stability several years after implantation. This incidental finding highlights the requirement of further research on zirconia-based ceramics before they can be advertised as safe alternative to titanium-based implant systems. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2919-2923, 2018.
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Affiliation(s)
| | - Phil Donkiewicz
- Biomedical Materials Group, Institute of Pharmacy, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, Laboratory for Regenerative Orofacial Medicine (LRM), University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Ole Jung
- Department of Oral and Maxillofacial Surgery, Laboratory for Regenerative Orofacial Medicine (LRM), University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Mike Barbeck
- Department of Oral and Maxillofacial Surgery, Laboratory for Regenerative Orofacial Medicine (LRM), University Hospital Hamburg-Eppendorf, Hamburg, Germany
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Liu J, Hong G, Wu YH, Endo K, Han JM, Kumamoto H, Wada T, Kato H, Gao P, Sasaki K. A novel method of surface modification by electrochemical deoxidation: Effect on surface characteristics and initial bioactivity of zirconia. J Biomed Mater Res B Appl Biomater 2016; 105:2641-2652. [PMID: 27783470 DOI: 10.1002/jbm.b.33805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 10/06/2016] [Accepted: 10/12/2016] [Indexed: 11/06/2022]
Abstract
The aim of this study was to investigate and compare the surface characteristics and initial bioactivity of ceria-stabilized zirconia/alumina nanocomposite (NANOZR) with those of yttria-stabilized zirconia (3Y-TZP) and pure titanium (CpTi) following the use of three surface modification methods; polishing, sandblasting/acid-etching (SB-E) and electrochemical deoxidation (ECD). Physical properties including surface morphology, chemical composition, X-ray diffraction, surface wettability, surface roughness, and hardness were measured. Osteoblast-like MC3T3-E1 cells were used to examine cell morphology and attachment to the surfaces of the materials. ECD treated NANOZR (NANOZR-E) showed a well-arranged, self-organized microporous surface structure with significantly low contact angles when compared with the other specimens (p < 0.05). NANOZR-E also demonstrated a slight decrease in monoclinic phase content (-4.4 wt %). The morphology and attachment of MC3T3-E1 cells on NANOZR-E were similar to those on polished and SBE-treated CpTi surfaces. Higher cell affinity was observed on NANOZR-E when compared with ECD treated 3Y-TZP. The findings of this study indicate the effectiveness of the novel technique, ECD, in the formation of a microporous surface on NANOZR when compared with both CpTi and 3Y-TZP. Moreover, this method also appears to improve the biological activity of NANOZR during the initial stage. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2641-2652, 2017.
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Affiliation(s)
- Juan Liu
- Department of Prosthodontics, Tianjin Medical University School of Stomatology, Tianjin, China.,Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Guang Hong
- Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Yu-Han Wu
- Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Kosei Endo
- Division of Aging and Geriatric Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Jian-Min Han
- Dental Materials Laboratory, National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hiroyuki Kumamoto
- Department of Oral Pathology, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Takeshi Wada
- Non-Equilibrium Materials Division, Institute for Materials Research, Tohoku University, Sendai, Japan
| | - Hidemi Kato
- Non-Equilibrium Materials Division, Institute for Materials Research, Tohoku University, Sendai, Japan
| | - Ping Gao
- Department of Prosthodontics, Tianjin Medical University School of Stomatology, Tianjin, China
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
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