The aim of this randomized controlled clinical trial was to compare the early clinical outcome of slip-cast glass-infiltrated Alumina/Zirconia and CAD/CAM Zirconia all-ceramic crowns. A total of 30 InCeram® Zirconia and Cercon® Zirconia crowns were fabricated and cemented with a glass ionomer cement in 20 patients. At baseline, 6-month, 1-year, and 2-year recall appointments, Californian Dental Association (CDA) quality evaluation system was used to evaluate the prosthetic replacements, and plaque and gingival index scores were used to explore the periodontal outcome of the treatments. No clinical sign of marginal discoloration, persistent pain and secondary caries was detected in any of the restorations. All InCeram® Zirconia crowns survived during the 2-year period, although one nonvital tooth experienced root fracture coupled with the fracture of the veneering porcelain of the restoration. One Cercon® Zirconia restoration fractured and was replaced. According to the CDA criteria, marginal integrity was rated excellent for InCeram® Zirconia (73%) and Cercon® Zirconia (80%) restorations, respectively. Slight color mismatch rate was higher for InCeram® Zirconia restorations (66%) than Cercon® Zirconia (26%) restorations. Plaque and gingival index scores were mostly zero and almost constant over time. Time-dependent changes in plaque and gingival index scores within and between groups were statistically similar (p>0.05). This clinical study demonstrates that single-tooth InCeram® Zirconia and Cercon® Zirconia crowns have comparable early clinical outcome, both seem as acceptable treatment modalities, and most importantly, all-ceramic alumina crowns strengthened by 25% zirconia can sufficiently withstand functional load in the posterior zone.
Bone micro-morphology has a prevailing effect over implant design on intraosseus initial implant stability, and ITV is more sensitive in terms of revealing biomechanical properties at the bone-implant interface in comparison with ISQ.
The purpose of this study was to evaluate the mechanical characteristics of the implant-abutment connection of a reduced-diameter ITI dental implant. A finite element model of a slashed circle 3.3 mm x 10 mm ITI solid-screw implant and a 6 degrees solid abutment 4 mm in height was constructed, and the implant-abutment complex was embedded vertically in the center of a slashed circle 1.5 cm x 1.5 cm acrylic cylinder. Static vertical and oblique loads of 300 N were applied in separate load cases. The contact area was defined between the implant-abutment connection and nonlinear finite element stress analysis was performed. The magnitude and distribution of Von Mises stresses and displacement characteristics were evaluated. In vertical loading, Von Mises stresses concentrated around the implant-abutment connection at the stem of the screw and around the implant collar. Oblique loading resulted in a 2-fold increase in stresses at the implant collar, which was close to the yield strength of titanium. Displacement values under both loading conditions were negligible. We conclude that, in a reduced-diameter ITI dental implant, vertical and oblique loads are resisted mainly by the implant-abutment joint at the screw level and by the implant collar. The neck of this implant is a potential zone for fracture when subjected to high bending forces. The reduced-diameter ITI dental implant might benefit from reinforcement of this region.
Predictable long-term clinical results can be achieved with solid abutments and synOcta abutments for cement-retained restorations. Solid abutments possess higher removal torque resistance than synOcta abutments when connected to synOcta ITI implants.
Because occlusal forces in humans tend to decrease because of age-related factors, maximum strains around immediately loaded implants supporting maxillary overdentures fall within physiologic levels.
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