Martin Rosentritt1, Andreas Rembs1, Michael Behr1, Sebastian Hahnel1, Verena Preis2. 1. Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany. 2. Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg 93042, Germany. Electronic address: verena.preis@ukr.de.
Abstract
OBJECTIVE: To investigate the influence of the combination of patient-specific abutments and titanium adhesive bases on the long-term in vitro performance of anterior crowns. METHODS: Ten systems of screw-retained implant and adhesive base combinations (n=8/group) were restored with zirconia or polyetherketone (PEEK) abutments and identical full-anatomical zirconia crowns. For simulating clinical anterior loading, implants were fixed at an angle of 135° and submitted to prolonged thermal cycling and mechanical loading (TC: 6×3000 cycles, 5°C/55°C; ML: 100N, 3.6×10(6) cycles) to cause and register fatigue failure. Failed restorations were examined by means of scanning electron microscopy. Surviving restorations were loaded to fracture. Data (mean±standard deviation) were statistically analyzed (ANOVA; Bonferroni; Kaplan-Meier-Log-Rank; α=0.05). RESULTS: Seven systems survived TCML without any failure. The other three systems showed loosening and fracturing of the screw (0.4-1.6×10(6) loadings) or debonding between base and abutment (0.002-3.4×10(6) loadings). None of the systems showed any fracture of the crown or failed bonding between abutment and crown. The Log-Rank test showed significant (p=0.000) differences. Fracture data significantly varied (ANOVA p=0.000) between the individual systems (minimum: 371N; maximum: 763N). Failures were mostly caused by bending or fracturing of the screw and in three cases by fracture of the abutment. CONCLUSIONS: Anterior implant-supported zirconia crowns on titanium adhesive bases and bonded patient-specific zirconia abutments provided good in vitro performance and high fracture resistance. Sufficient high torque moments and early re-screwing may be advised. CLINICAL RELEVANCE: Most adhesive base and abutment combinations may be appropriate for anterior application. Individual improvements may contribute to enduring success.
OBJECTIVE: To investigate the influence of the combination of patient-specific abutments and titanium adhesive bases on the long-term in vitro performance of anterior crowns. METHODS: Ten systems of screw-retained implant and adhesive base combinations (n=8/group) were restored with zirconia or polyetherketone (PEEK) abutments and identical full-anatomical zirconia crowns. For simulating clinical anterior loading, implants were fixed at an angle of 135° and submitted to prolonged thermal cycling and mechanical loading (TC: 6×3000 cycles, 5°C/55°C; ML: 100N, 3.6×10(6) cycles) to cause and register fatigue failure. Failed restorations were examined by means of scanning electron microscopy. Surviving restorations were loaded to fracture. Data (mean±standard deviation) were statistically analyzed (ANOVA; Bonferroni; Kaplan-Meier-Log-Rank; α=0.05). RESULTS: Seven systems survived TCML without any failure. The other three systems showed loosening and fracturing of the screw (0.4-1.6×10(6) loadings) or debonding between base and abutment (0.002-3.4×10(6) loadings). None of the systems showed any fracture of the crown or failed bonding between abutment and crown. The Log-Rank test showed significant (p=0.000) differences. Fracture data significantly varied (ANOVA p=0.000) between the individual systems (minimum: 371N; maximum: 763N). Failures were mostly caused by bending or fracturing of the screw and in three cases by fracture of the abutment. CONCLUSIONS: Anterior implant-supported zirconia crowns on titanium adhesive bases and bonded patient-specific zirconia abutments provided good in vitro performance and high fracture resistance. Sufficient high torque moments and early re-screwing may be advised. CLINICAL RELEVANCE: Most adhesive base and abutment combinations may be appropriate for anterior application. Individual improvements may contribute to enduring success.