Fracture Load of CAD/CAM Fabricated Cantilever Implant-Supported Zirconia Framework: An In Vitro Study

Alshiddi, Ibraheem F; Habib, Syed Rashid; Zafar, Muhammad Sohail; Bajunaid, Salwa Omar; Labban, Nawaf; AlSarhan, Mohammed

doi:10.3390/molecules26082259

Cited by 6 publications

(10 citation statements)

References 43 publications

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“…With the application of CAD/CAM, there are several superstructure materials that are suggested for implant-supported, full-arch rehabilitations, such as a cobalt–chrome alloy [ 2 ], a titanium alloy [ 7 ], zirconia [ 15 , 16 ], carbon-fiber polymers [ 17 , 18 ] and the polyaryletherketone family [ 14 , 19 ]. Despite the extensive literature on the effects of superstructure materials for conventional implants [ 6 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], the data regarding biomechanical behavior of zygomatic implants are limited [ 2 , 6 , 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials

et al. 2022

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The aim of this study was to assess and compare the stress–strain pattern of zygomatic dental implants supporting different superstructures using 3D finite element analysis (FEA). A model of a tridimensional edentulous maxilla with four dental implants was designed using the computer-aided design (CAD) software. Two standard and two zygomatic implants were positioned to support the U-shaped bar superstructure. In the computer-aided engineering (CAE) software, different materials have been simulated for the superstructure: cobalt–chrome (CoCr) alloy, titanium alloy (Ti), zirconia (Zr), carbon-fiber polymers (CF) and polyetheretherketone (PEEK). An axial load of 500 N was applied in the posterior regions near the zygomatic implants. Considering the mechanical response of the bone tissue, all superstructure materials resulted in homogeneous strain and thus could reconstruct the edentulous maxilla. However, with the aim to reduce the stress in the zygomatic implants and prosthetic screws, stiffer materials, such Zr, CoCr and Ti, appeared to be a preferable option.

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Section: Introductionmentioning

confidence: 99%

Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials

et al. 2022

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“…Similarly, Alshiddi et al [ 47 ] studied the effect of size/dimension and the micro-cracks produced from diamond burs during the milling process on the fracture resistance of CAD/CAM fabricated implant-supported cantilever zirconia frameworks. They found significant variations in the fracture load between the implant-supported cantilever zirconia frameworks with different cantilever lengths and thicknesses of the distal abutments were found.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Fracture Load of the Four Translucent Zirconia Crowns

et al. 2021

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Recently, translucent zirconia has become the most prevalent material used as a restorative material. This study aimed to compare the crown fracture load of the four most common different translucent zirconia brands available in the market at 1.5 mm thickness. Standardized tooth preparations for a full ceramic crown were designed digitally with software (AutoCAD) by placing a 1.0 mm chamfer margin and 1.5 mm occluso-cervical curvature for the crown sample manufacturing. Stylized crowns were chosen to control the thickness of the crown. The axial and occlusal thickness were standardized to 1.5 mm thickness except at the central pit, which was 1.3 mm thick. The STL file for the tooth dies was prepared using software (3Shape TRIOS® Patient Monitoring, Copenhagen, Denmark). The tooth dies were printed with a resin material (NextDent Model 2.0, Vertex-Dental B.V., Soesterberg, The Netherlands) using a 3D printing software (3D Sprint® Client Version 3.0.0.2494) from a 3D printer (NextDent™ 5100, Vertex-Dental B.V., Soesterberg, The Netherlands). The printing layer thickness was 50 µm. Then, a total of twenty-eight (N = 28) stylized crowns were milled out of AmannGirrbach (Amann Girrbach GmbH, Pforzheim, Germany) (n = 7), Cercon HT (Dentsply Sirona, Bensheim, Germany) (n = 7), Cercon XT (Dentsply Sirona, Bensheim, Germany) (n = 7), and Vita YZ XT (Zahnfabrik, Bäd Sackingen, Germany) (n = 7). Following sintering the crowns, sandblasting was performed and they were bonded to the tooth dies with the resin cement (RelyX U-200, 3M ESPE, Seefeld, Germany) and permitted to self-cure under finger pressure for 6 min. The crowns were loaded on the occlusal surface in a universal testing machine (MTS Centurion) with a stainless-steel ball indenter (7 mm radius) with a loading rate of 1 mm/min to contact the stylized crowns on each of the four cusps until failure. A rubber sheet (1.5 mm thickness) was positioned between the crown and indenter, which helped with the load distribution. Statistical analysis was done using SPSS version 20 (IBM Company, Chicago, USA). The fracture loads were analyzed using Dunnett’s T3 test, and the number of cracks was analyzed using the Mann–Whitney U test among the groups. The significant level was set at p value = 0.05. The mean fracture loads were 3086.54 ± 441.74 N, 4804.94 ± 70.12 N, 3317.76 ± 199.80 N, and 2921.87 ± 349.67 N for AmannGirrbac, Cercon HT, Cercon XT, and Vita YZ XT, respectively. The mean fracture loads for the surfaces with the greatest number of cracks (excluding the occlusal surfaces) were on the lingual surface for AmannGirrbach and Cercon HT, on the distal and mesial for Cercon XT, and on the buccal for Vita YZ XT. We found that the AmannGirrbach had the most overall cracks. Cercon XT had the greatest number of occlusal cracks and appeared to be the most shattered. Cercon HT had the least number of cracks. In conclusion, Cercon HT presented the best strength properties, the highest fracture load, and no visible cracks. AmannGirrbach presented the lowest strength properties.

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“…Therefore, implant-supported fixed complete dentures, commonly known as hybrid prostheses, are mostly composed of cantilevers [ 7 ], that is, a multiple retainer with one or more unsupported free ends [ 8 ], thus allowing the prosthesis to extend to at least the first molar [ 2 ]. The use of cantilevers in fixed prostheses on dental implants is beneficial in places with unfavorable anatomical characteristics, namely, reduced alveolar ridges [ 9 ]; however, the placement of implants can be compromised due to their proximity to certain structures, such as the maxillary sinuses, the roots of adjacent teeth, and the inferior alveolar nerve [ 8 ]. However, long cantilevers should be avoided due to their biomechanical properties, which can lead to prosthesis fracture [ 5 , 7 ] as well as loss of bone around the implants [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Due to their aesthetic properties, there has been a substantial increase in the use of zirconia and ceramics in prosthetic rehabilitation [ 9 , 11 , 12 ]. This increase is due not only to the aesthetic component, but also due to these materials’ high fracture resistance and other mechanical properties [ 11 ], their excellent biocompatibility, and their physical properties [ 9 , 11 , 15 ]. These materials can be used in the elaboration of crowns, posts, fixed partial dentures, abutments, and structures on implants [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…This increase is due not only to the aesthetic component, but also due to these materials’ high fracture resistance and other mechanical properties [ 11 ], their excellent biocompatibility, and their physical properties [ 9 , 11 , 15 ]. These materials can be used in the elaboration of crowns, posts, fixed partial dentures, abutments, and structures on implants [ 9 ]. Currently, yttrium-stabilized tetragonal zirconia (Y-TZP) is the ceramic material that has the highest fracture resistance [ 16 ], and it is the ceramic material most used as a rehabilitation material in high stress areas due to its high strength [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Fracture Resistance of CAD/CAM Implant-Supported 3Y-TZP-Zirconia Cantilevers: An In Vitro Study

et al. 2022

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(1) Introduction: Implant-supported fixed complete dentures are mostly composed of cantilevers. The purpose of this work was to evaluate the fracture resistance of zirconia (Prettau®, second generation, or Ice Zirkon Translucent, first generation) with cantilever lengths of 6 and 10 mm, and zirconia’s fracture resistance in relation to an average bite force of 250 N. (2) Materials and methods: Forty structures were created in CAD/CAM and divided into four groups: group A (6 mm cantilever in IZT), group B (10 mm cantilever in IZT), group C (6 mm cantilever in Pz), and group D (10 mm cantilever in pz). The study consisted of a traditional “load-to-failure” test. (3) Results: A statistically significant result was found for the effect of cantilever length, t(38) = 16.23 (p < 0.001), with this having a large effect size, d = 4.68. The 6 mm cantilever length (M = 442.30, sd = 47.49) was associated with a higher mean force at break than the 10 mm length (M = 215.18, sd = 40.74). No significant effect was found for the type of zirconia: t(38) = 0.31 (p = 0.757), and d = 0.10. (4) Conclusions: All the components with cantilever lengths of 6 mm broke under forces higher than 250 N. Cantilevers larger than 10 mm should be avoided.

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Fracture Load of CAD/CAM Fabricated Cantilever Implant-Supported Zirconia Framework: An In Vitro Study

Cited by 6 publications

References 43 publications

Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials

Stress Distribution Pattern in Zygomatic Implants Supporting Different Superstructure Materials

Comparison of Fracture Load of the Four Translucent Zirconia Crowns

Fracture Resistance of CAD/CAM Implant-Supported 3Y-TZP-Zirconia Cantilevers: An In Vitro Study

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