Violeta Malpartida-Carrillo1, Pedro Luis Tinedo-López2, Fernando Ortiz-Culca3, Maria E Guerrero4, Silvia P Amaya-Pajares5, Mutlu Özcan6. 1. Department of Periodontology, School of Dentistry, Universidad Cientifica del Sur, Lima, Peru; School of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru, Phone: +511 6106400 extn.: 324, e-mail: viletayu_30@hotmail.com. 2. Department of Periodontology, School of Dentistry, Universidad Cientifica del Sur, Lima, Peru; School of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru. 3. Department of Rehabilitation Stomatology, Faculty of Dentistry, Universidad Nacional Mayor de Sa Marcos, Lima, Peru. 4. Department of Medico Surgical Stomatology, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru. 5. Department of Restorative Dentistry, School of Dentistry, Oregon Health and Science University, Portland, Oregon, USA. 6. Center of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.
Abstract
AIM: To compare fracture resistance between the cement-retained (CR), screw-retained (SR), and combined cement- and screw-retained (CCSR) metal-ceramic (MC) implant-supported molar restorations and the fracture mode after vertical loading simulation. MATERIALS AND METHODS: Thirty MC molar restorations were fabricated on thirty tilted dental implants that were repositioned using prefabricated or universal castable long abutments (UCLA) with 15° of angulation divided into three groups of ten specimens each. Group C: CR, group S: SR, and group CS: cement- and screw-retained. The crowns in group CS were adhesively bonded extraorally, and composite resin was used to fill the screw access holes (SAHs) in groups S and CS. Subsequently, all the specimens were tested for fracture resistance. A scanning electron microscope (SEM) evaluation of the fracture mode was also performed. Mean values of fracture loads were calculated and compared in Newtons (N) using one-way ANOVA and Tukey post hoc test (p < 0.05) for each group. RESULTS: Mean fracture load values were 2718.00 ± 266.25 N for group C, 2125.10 ± 293.82 N for group S, and 2508.00 ± 153.59 N for group CS. Significant differences were found between group S and the other groups on fracture load values. However, no significant differences were found between groups C and CS (p = 0.154). The failures were at MC framework interfaces on mesiolingual cusps. CONCLUSIONS: Cement and CCSR MC molar restorations showed comparable fracture resistance using abutments with 15° of angulation. However, SR design showed significantly the lowest values of resistance. Screw access hole did not significantly affect the fracture resistance of cemented MC molar restorations. All the specimens exhibited mixed adhesive fractures at the mesiolingual cusps. CLINICAL SIGNIFICANCE: Combined cement- and screw-retained restorations (CCSRRs) incorporate the simplicity of the cement method and the retrievability of the screw method, offering good resistance, allowing the removal of the excess of cement before clinical placement of the restoration, and providing another alternative for dental implant rehabilitation.
AIM: To compare fracture resistance between the cement-retained (CR), screw-retained (SR), and combined cement- and screw-retained (CCSR) metal-ceramic (MC) implant-supported molar restorations and the fracture mode after vertical loading simulation. MATERIALS AND METHODS: Thirty MC molar restorations were fabricated on thirty tilted dental implants that were repositioned using prefabricated or universal castable long abutments (UCLA) with 15° of angulation divided into three groups of ten specimens each. Group C: CR, group S: SR, and group CS: cement- and screw-retained. The crowns in group CS were adhesively bonded extraorally, and composite resin was used to fill the screw access holes (SAHs) in groups S and CS. Subsequently, all the specimens were tested for fracture resistance. A scanning electron microscope (SEM) evaluation of the fracture mode was also performed. Mean values of fracture loads were calculated and compared in Newtons (N) using one-way ANOVA and Tukey post hoc test (p < 0.05) for each group. RESULTS: Mean fracture load values were 2718.00 ± 266.25 N for group C, 2125.10 ± 293.82 N for group S, and 2508.00 ± 153.59 N for group CS. Significant differences were found between group S and the other groups on fracture load values. However, no significant differences were found between groups C and CS (p = 0.154). The failures were at MC framework interfaces on mesiolingual cusps. CONCLUSIONS: Cement and CCSR MC molar restorations showed comparable fracture resistance using abutments with 15° of angulation. However, SR design showed significantly the lowest values of resistance. Screw access hole did not significantly affect the fracture resistance of cemented MC molar restorations. All the specimens exhibited mixed adhesive fractures at the mesiolingual cusps. CLINICAL SIGNIFICANCE: Combined cement- and screw-retained restorations (CCSRRs) incorporate the simplicity of the cement method and the retrievability of the screw method, offering good resistance, allowing the removal of the excess of cement before clinical placement of the restoration, and providing another alternative for dental implant rehabilitation.