Fracture strength of zirconia implant abutments on narrow diameter implants with internal and external implant abutment connections: A study on the titanium resin base concept

Sailer, Irena; Asgeirsson, Asgeir G; Thoma, Daniel S.; Fehmer, Vincent; Aspelund, Thor; Özcan, Mutlu; Pjetursson, Bjarni E.

doi:10.1111/clr.13139

Cited by 54 publications

(69 citation statements)

References 19 publications

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“…No screw loosening, or veneer complication was found. On the other hand, the use of rigid frameworks fabricated by metal or zirconia could lead to plastic deformation of the implant shoulder [73,74]. These results are in consistency with the in vitro study of Kaleli et al reporting higher stress values of zirconia customized abutments on implant components, crown and cortical bone, compared to PEEK customized abutments [9].…”

Section: Implant-supported Fixed Dental Prostheses (Ifdps)supporting

confidence: 84%

The use of PEEK in digital prosthodontics: A narrative review

et al. 2020

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Background: Advanced computer-aided design and computer-aided manufacturing (CAD-CAM) technology led to the introduction of an increasing number of machinable materials suitable for dental prostheses. One of these materials is polyetheretherketone (PEEK), a high performance polymer recently used in dentistry with favorable physical, mechanical and chemical properties. The purpose of this study was to review the current published literature on the use of PEEK for the fabrication of dental prostheses with CAD-CAM techniques. Methods: Electronic database searches were performed using the terms "PEEK", "CAD-CAM", "dental", "dentistry" to identify studies related to the use of PEEK for the fabrication of CAD-CAM prostheses. The search period spanned from January 1990 through February 2020. Both in vivo and in vitro studies in English were eligible. Review articles and the references of the included publications were searched to identify relevant articles. Results: A great number of in vitro studies are available in the current literature pointing out the noticeable properties of PEEK. The use of PEEK has been recommended for a wide range of CAD-CAM fabricated fixed and removable dental prostheses. PEEK was additionally recommended for occlusal splints, intra-radicular posts, implant abutments, customized healing abutments and provisional restorations. However, only a few clinical studies were identified. Conclusions: PEEK could be considered as a viable alternative for CAD-CAM fixed and removable dental prostheses to well-established dental materials. Due to the scarcity of clinical data, clinical trials are needed to assess the longterm performance of PEEK prostheses.

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Section: Implant-supported Fixed Dental Prostheses (Ifdps)supporting

confidence: 84%

The use of PEEK in digital prosthodontics: A narrative review

et al. 2020

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“…The use of mesostructure to build the hybrid abutment to replace the conventional titanium abutments has already been reported [21,26,45]. Up to date, in vitro [26,47,48] and in vivo [49] studies and case reports [50,51] reported the use of lithium disilicate or polycrystalline ceramics to manufacture the mesostructure. Meanwhile, one case report [15] and in silico investigations [22][23][24][25] showed the possibility to manufacture the hybrid abutment using PIC material cemented on a Tibase, as performed in this study.…”

Section: Discussionmentioning

confidence: 99%

Survival Probability, Weibull Characteristics, Stress Distribution, and Fractographic Analysis of Polymer-Infiltrated Ceramic Network Restorations Cemented on a Chairside Titanium Base: An In Vitro and In Silico Study

et al. 2020

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Different techniques are available to manufacture polymer-infiltrated ceramic restorations cemented on a chairside titanium base. To compare the influence of these techniques in the mechanical response, 75 implant-supported crowns were divided in three groups: CME (crown cemented on a mesostructure), a two-piece prosthetic solution consisting of a crown and hybrid abutment; MC (monolithic crown), a one-piece prosthetic solution consisting of a crown; and MP (monolithic crown with perforation), a one-piece prosthetic solution consisting of a crown with a screw access hole. All specimens were stepwise fatigued (50 N in each 20,000 cycles until 1200 N and 350,000 cycles). The failed crowns were inspected under scanning electron microscopy. The finite element method was applied to analyze mechanical behavior under 300 N axial load. Log-Rank (p = 0.17) and Wilcoxon (p = 0.11) tests revealed similar survival probability at 300 and 900 N. Higher stress concentration was observed in the crowns’ emergence profiles. The MP and CME techniques showed similar survival and can be applied to manufacture an implant-supported crown. In all groups, the stress concentration associated with fractographic analysis suggests that the region of the emergence profile should always be evaluated due to the high prevalence of failures in this area.

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“…More recent types of ceramic abutments include metal hybrid secondary components to increase the stability at the level of the connection might be the preferred option in future. Internally connected zirconia abutments supported by titanium base abutments exhibited significantly higher strength in vitro studies than one‐piece zirconia abutments, in addition, the bending moments of these titanium base‐supported zirconia abutments were similar to the ones of metal abutments (Sailer et al., ). Other studies also demonstrated more favorable fracture strength values of ceramic abutment supported by hybrid abutments, as compared to one‐piece ceramic abutments (Alsahhafa, Spies, Vachc & Kohal, ; Butz, Heydecke, Okutan & Strub, ; Chun et al., ; Elsayed, Wille, Al‐Akhali & Kern, ; Sailer, Sailer et al., ; Stimmelmayr et al., ; Yilmaz, Salaita, Seidt, McGlumphy & Clelland, ).…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the influence of the implant‐abutment connection on the clinical outcomes of ceramic and metal implant abutments supporting fixed implant reconstructions

Pjetursson

Zarauz

Strasding

et al. 2018

Clinical Oral Implants Res

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106

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Objectives:The objective of this systematic review was to assess the influence of implant-abutment connection and abutment material on the outcome of implantsupported single crowns (SCs) and fixed dental prostheses (FDPs). Methods: An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective and retrospective studies with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using robust Poisson regression, and comparisons were made with multivariable Poisson regression models. Results: The search provided 1511 titles and 177 abstracts. Full-text analysis was performed for 147 articles resulting in 60 studies meeting the inclusion criteria. Meta-analysis of these studies indicated an estimated 5-year survival rate of 97.6%for SCs and 97.0% for FDPs supported by implants with internal implant-abutment connection and 95.7% for SCs and 95.8% for FDPs supported by implants with external connection. The 5-year abutment failure rate ranged from 0.7% to 2.8% for different connections with no differences between the types of connections. The total number of complications was similar between the two connections, yet, at external connections, abutment or occlusal screw loosening was more predominant. Ceramic abutments, both internally and externally connected, demonstrated a significantly higher incidence of abutment fractures compared with metal abutments. Conclusion:For implant-supported SCs, both metal and ceramic abutments with internal and external connections exhibited high survival rates. Moreover, implantsupported FDPs with metal abutments with internal and external connections for also showed high survival rates. K E Y W O R D Sbiological, ceramic, complications, implant abutments, implant crowns, implant fixed dental prostheses, meta-analysis, metal, survival, systematic review, technical, titanium, zirconia | 161 PJETURSSON ET al.

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Fracture strength of zirconia implant abutments on narrow diameter implants with internal and external implant abutment connections: A study on the titanium resin base concept

Cited by 54 publications

References 19 publications

The use of PEEK in digital prosthodontics: A narrative review

The use of PEEK in digital prosthodontics: A narrative review

Survival Probability, Weibull Characteristics, Stress Distribution, and Fractographic Analysis of Polymer-Infiltrated Ceramic Network Restorations Cemented on a Chairside Titanium Base: An In Vitro and In Silico Study

A systematic review of the influence of the implant‐abutment connection on the clinical outcomes of ceramic and metal implant abutments supporting fixed implant reconstructions

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