João Pitta1, Jenni Hjerppe2,3, Felix Burkhardt1, Vincent Fehmer1, Philipe Mojon1, Irena Sailer1. 1. Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland. 2. Departments of Oral and Maxillofacial Diseases, Helsinki University Hospital (HUH), Helsinki, Finland. 3. Department of Prosthodontics and Stomatognathic physiology, University of Turku, Turku, Finland.
Abstract
OBJECTIVES: To evaluate mechanical stability (survival and complication rates) and bending moments of different all-ceramic monolithic restorations bonded to titanium bases (hybrid abutment-crowns) or to customized titanium abutments compared to porcelain-fused-to-metal crowns (PFM) after thermo-mechanical aging. MATERIALS AND METHODS: 60 conical connection implants (4.3 mm-diameter) were divided in five groups (n=12): PFM using gold abutment (GAbut-PFM), lithium disilicate crown bonded to customized titanium abutment (TAbut+LDS), lithium disilicate abutment-crown bonded to titanium base (TiBase+LDS), zirconia abutment-crown bonded to titanium base (TiBase+ZR), polymer-infiltrated ceramic-network (PICN) abutment-crown bonded to titanium base (TiBase+PICN). Simultaneous thermocycling (5°-55°C) and chewing simulation (1,200,000-cycles, 49N, 1.67Hz) were applied. Catastrophic and non-catastrophic events were evaluated under light microscope, and survival and complication rates were calculated. Specimens that survived aging were loaded until failure and bending moments were calculated. RESULTS: Survival rates after aging were 100% (TAbut+LDS, TiBase+LDS), 91.7% (GA-PFM), 66.7% (TiBase+ZR) and 58.3% (TiBase+PICN) and differed among the groups (p = 0.006). Non-catastrophic events as screw-loosening (GA-PFM) and loss of retention or micro/macro movement (TiBase-groups) were observed. Complication rates varied among the groups (p < 0.001). TiBase+PICN had lower bending moment than all the other groups (p < 0.001). CONCLUSIONS: Hybrid abutment-crowns made of lithium disilicate can be an alternative to PFM-based restorations, although concerns regarding the bonded interface between the titanium base and abutment-crown can be raised. PICN and zirconia may not be recomemmend due to its inferior mechanical and bonding outcomes, respectively. Titanium customized abutment with bonded lithium disilicate crown appears to be the most stable combination. This article is protected by copyright. All rights reserved.
OBJECTIVES: To evaluate mechanical stability (survival and complication rates) and bending moments of different all-ceramic monolithic restorations bonded to titanium bases (hybrid abutment-crowns) or to customized titanium abutments compared to porcelain-fused-to-metal crowns (PFM) after thermo-mechanical aging. MATERIALS AND METHODS: 60 conical connection implants (4.3 mm-diameter) were divided in five groups (n=12): PFM using gold abutment (GAbut-PFM), lithium disilicate crown bonded to customized titanium abutment (TAbut+LDS), lithium disilicate abutment-crown bonded to titanium base (TiBase+LDS), zirconia abutment-crown bonded to titanium base (TiBase+ZR), polymer-infiltrated ceramic-network (PICN) abutment-crown bonded to titanium base (TiBase+PICN). Simultaneous thermocycling (5°-55°C) and chewing simulation (1,200,000-cycles, 49N, 1.67Hz) were applied. Catastrophic and non-catastrophic events were evaluated under light microscope, and survival and complication rates were calculated. Specimens that survived aging were loaded until failure and bending moments were calculated. RESULTS: Survival rates after aging were 100% (TAbut+LDS, TiBase+LDS), 91.7% (GA-PFM), 66.7% (TiBase+ZR) and 58.3% (TiBase+PICN) and differed among the groups (p = 0.006). Non-catastrophic events as screw-loosening (GA-PFM) and loss of retention or micro/macro movement (TiBase-groups) were observed. Complication rates varied among the groups (p < 0.001). TiBase+PICN had lower bending moment than all the other groups (p < 0.001). CONCLUSIONS: Hybrid abutment-crowns made of lithium disilicate can be an alternative to PFM-based restorations, although concerns regarding the bonded interface between the titanium base and abutment-crown can be raised. PICN and zirconia may not be recomemmend due to its inferior mechanical and bonding outcomes, respectively. Titanium customized abutment with bonded lithium disilicate crown appears to be the most stable combination. This article is protected by copyright. All rights reserved.