Purpose: This study aimed to compare the load to failure and the probability of survival of porcelain fused to zirconia (PFZ) three-unit, implant-supported, fixed dental prostheses (FDPs) to those of indirect composites veneered to either zirconia (CVZ) or milled fiber-reinforced composite (FRC) frameworks under static and fatigue loading. Materials and Methods: One-hundred and twenty posterior three-unit FDP (second premolar pontic) frameworks were fabricated via milling from a single Standard Tessellation Language (STL) file. The FDPs were divided into three groups. Each group (n = 40) was subjected to static (n = 20) and fatigue (n = 20) loading tests, as follows: (1) PFZ: zirconia framework layered with porcelain veneer; (2) CVZ: zirconia framework veneered with indirect composite resin; and (3) FRC: FRC framework veneered with indirect composite resin. After porcelain veneering onto sintered zirconia frameworks, or resin composite veneering onto zirconia or FRC frameworks, FDPs were cemented on their abutments using self-adhesive resin cement. After thermal cycling, half of the FDPs were subjected to an accelerated fatigue test. The other half of the FDPs were subjected to single load-to-failure (SLF) testing at a crosshead speed (1 mm/min). Lifetime analysis was conducted to determine the probability of survival, and fractographic analysis was performed. Results: Significant differences were observed among the studied groups for SLF with the highest characteristic strength values observed for PFZ (2154 N), followed by 1905.47 N for CVZ and 1679.56 N for FRC. The probability of survival for 100,000 cycles at 500 N was the highest for FRC (98%) and CVZ (100%) and was significantly lower for PFZ (88%). Different fracture patterns were observed in the fractography. Conclusions: In fatigue testing, which simulates masticatory function better than static tests, a higher probability of survival was observed for FRC and CVZ than for PFZ. Framework fractures were not observed only for the FRC group, indicating that chairside repair with the addition of indirect composite could be performed for continued function.
Crown/implant (C/I) ratio has been proven to not affect the survival of the implants; however, it is also a fact that no evidence exists with regard to the use of single short implants in the mandibular molar. The aim of this study was to determine whether the crown/implant ratios of single implant-supported fixed restorations on implants of 6-8 mm in the mandibular molar have an impact on the implant survival and marginal bone maintenance. Twelve short dental implants (6-8 mm) were installed and restored with single crowns, loaded after 3 months of healing. The restorations were divided according to crown-to-implant ratio into two groups: Group 1: C/I < 2.0 and Group 2: C/I ≧ 2.0. Alveolar bone loss was measured using CBCT scan, taken at the implant placement and after 12 months follow-up from loading. Reduced implant/crown ratio shown no statistic significant differences on implant survival and the alveolar bone level compared with recommended implant/crown ratio. Within the limitation of this study, it can be concluded that reduced C/I ratio could be used as a substitute for recommended C/I ratio in severely mandibular atrophic residual alveolar ridges.
Background: Zirconia crowns are highly attractive for clinicians, although have poor translucency when used as single restorations, in addition to unknown effect of resin cement shade on final cemented crown shade. This study aimed to assess effect of resin cement opacity on color replication potential of different zirconia frameworks with target tooth color, in addition to different zirconia crowns translucency evaluation. Material and Methods: Twenty-four zirconia crown restorations were fabricated to restore single central maxillary incisor for 8 patients, divided into 3 groups according to color and type of zirconia used (white Zr core, colored Zr core and monolithic HT Zrcowns). Each group was further subdivided into 2 subgroups according to resin cement shade. Using Easyshade spectrophotometer, Delta E color difference was calculated between each crown parameters using 2 different resin luting cement shades and adjacent target tooth. Translucency parameters (TP) were tested for finished crowns. ΔEs obtained were assessed based on ΔEof 1.6 which represented color difference that could not be detected by human eye and considered clinically acceptable. Results: No statistically significant values were found between subgroups related to different resin cement shade. Translucency parameters showed statistically significant different values. Monolithic crowns showed highest translucency parameters followed by Zr crowns on white cores then Zr crowns on colored cores. Conclusions: Resin cement shade didn't affect final color perception. Monolithic high translucency crowns usage gained advantages of high translucency and delamination prevention. Zirconia crowns could be cemented by opaque or transparent cement without affecting final color.
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