Influence of Implant Angulation on the Fracture Resistance of Zirconia Abutments

Thulasidas, Shreedevi; Givan, Daniel A.; Lemons, Jack E.; O'Neal, Sandra J.; Ramp, Lance C.; Liu, Perng‐Ru

doi:10.1111/jopr.12182

Cited by 30 publications

(36 citation statements)

References 17 publications

(46 reference statements)

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“…Another consideration is the loading angles used in the study. Although 45° loading angulation between incisal edge of veneer and plunger orientation best simulates intraoral interincisal angle based on well‐established cephalometric measurements, 54,55 on pretesting attempts to do a 45° loading angulation excessive bending force was placed on the typodont teeth. This excessive bending resulted in breakage of the typodont tooth abutment before any veneer failures.…”

Section: Discussionmentioning

confidence: 99%

Effect of incisal preparation design on load‐to‐failure of ceramic veneers

Bennani

Aarts

Lyons

et al. 2020

J Esthet Restor Dent

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Objective: This in vitro study aims to evaluate load-to-failure of ceramic veneers with butt joint (BJ) and feathered edge (FE) incisal preparation designs, and to correlate these results to the failure mode of the restorations. Materials and methods:One hundred and forty-eight typodont teeth (customized Nissin A25A-UL19B) were divided into two different preparation configurations BJ and FE and two different loading angulations, 0 and 20 . Lithium disilicate ceramic veneers (IPS e.max CAD, Ivoclar Vivadent) were milled using computer-aided-designand-computer-aided-manufacturing (CAD/CAM) techniques. Veneers were bonded to typodont teeth with resin cement (IPS Variolink Esthetic, Ivoclar Vivadent). Each group was loaded at the incisal edge using an Instron Universal Testing Machine at a crosshead speed of 0.01 mm/s till failure.Results: Pairwise comparison showed veneers from the BJ groups had a significantly higher load-to-failure value compared to the FE groups. Veneers with a FE preparation design loaded at 20 angulation had the lowest load-to-failure value.Conclusions: Within the limitations of the present study, both incisal preparation designs and loading angulations have significant effects on the load-to-failure values of ceramic veneers. BJ group exhibits a significantly higher load-to-failure value compared to the FE group.Clinical significance: BJ incisal preparation is preferred over FE preparation design. K E Y W O R D S butt joint, feathered edge, load-to-failure, preparation design, veneer preparation 1 | INTRODUCTION Ceramic veneers have become a popular treatment modality due to their conservative and esthetic nature and clinical performance. 1-3Compared to resin composite veneers, ceramic veneers are stronger and more durable, as they are less susceptible to wear, marginal fracture, discoloration, staining, and plaque accumulation. 4-6 A recent systematic review and meta-analysis of the clinical outcome of ceramic veneers showed that both feldspathic porcelain and glass-ceramic laminate veneers have high survival rates. 7 Glass-ceramic laminate veneers show a slightly higher survival rate than feldspathic porcelain veneers, 94% vs 87%, respectively. The complications reported were fracture/chipping (4%), debonding (2%), severe marginal discoloration (2%), endodontic problems (2%), and secondary caries (1%). 7 A recent retrospective clinical study conducted in a university setting by two academic staff with a follow-up of 20 years indicated that ceramic fracture was the main reason for failure of ceramic veneers. 1 This finding is also supported by numerous earlier clinical studies. 3,8-16

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Section: Discussionmentioning

confidence: 99%

Effect of incisal preparation design on load‐to‐failure of ceramic veneers

Bennani

Aarts

Lyons

et al. 2020

J Esthet Restor Dent

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“…The inherent properties of ceramic materials, with lower resistance to fracture and lesser flexural strength when compared to metal abutments, may explain these findings (Miyazaki, Nakamura, Matsumura, Ban, & Kobayashi, 2013). The risk of abutment fracture, however, is also related to the thickness of the material (Park, Phark & Chee, 2017;Zandparsa & Albosefi, 2016) and ultimately to the position and angulation of the implant with respect to the final restoration (Albosefi, Finkelman, & Zandparsa, 2014;Thulasidas et al, 2015). Metal interfaces within the ceramic abutments have been proposed as a means to reduce these complications (Mieda et al, 2017;Truninger et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Biological effect of the abutment material on the stability of peri‐implant marginal bone levels: A systematic review and meta‐analysis

Sanz‐Sánchez

Sanz‐Martín

Albornoz

et al. 2018

Clinical Oral Implants Res

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“…15 The fracture resistance of zirconia is influenced by many factors. Abutment selection is 1 of the controllable factors.…”

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confidence: 99%

“…14 Implant angulation is another factor that has affected the fracture resistance of zirconia in vitro. 15 For this study, abutments were custom milled from monolithic zirconia to restore implants placed at different apical positions or angles to the direction of occlusal force.…”

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confidence: 99%