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Abstract
BackgroundZirconia materials are known for their optimal aesthetics, but they are brittle, and concerns remain about whether their mechanical properties are sufficient for withstanding the forces exerted in the oral cavity. Therefore, this study compared the maximum deformation and failure forces of titanium implants between titanium-alloy and zirconia abutments under oblique compressive forces in the presence of two levels of marginal bone loss.MethodsTwenty implants were divided into Groups A and B, with simulated bone losses of 3.0 and 1.5 mm, respectively. Groups A and B were also each divided into two subgroups with five implants each: (1) titanium implants connected to titanium-alloy abutments and (2) titanium implants connected to zirconia abutments. The maximum deformation and failure forces of each sample was determined using a universal testing machine. The data were analyzed using the nonparametric Mann–Whitney test.ResultsThe mean maximum deformation and failure forces obtained the subgroups were as follows: A1 (simulated bone loss of 3.0 mm, titanium-alloy abutment) = 540.6 N and 656.9 N, respectively; A2 (simulated bone loss of 3.0 mm, zirconia abutment) = 531.8 N and 852.7 N; B1 (simulated bone loss of 1.5 mm, titanium-alloy abutment) = 1070.9 N and 1260.2 N; and B2 (simulated bone loss of 1.5 mm, zirconia abutment) = 907.3 N and 1182.8 N. The maximum deformation force differed significantly between Groups B1 and B2 but not between Groups A1 and A2. The failure force did not differ between Groups A1 and A2 or between Groups B1 and B2. The maximum deformation and failure forces differed significantly between Groups A1 and B1 and between Groups A2 and B2.ConclusionsBased on this experimental study, the maximum deformation and failure forces are lower for implants with a marginal bone loss of 3.0 mm than of 1.5 mm. Zirconia abutments can withstand physiological occlusal forces applied in the anterior region.
Highlights
Zirconia materials are known for their optimal aesthetics, but they are brittle, and concerns remain about whether their mechanical properties are sufficient for withstanding the forces exerted in the oral cavity
Groups A and B were each divided into two subgroups with five implants each: (1) titanium implants connected to titanium-alloy abutments (Groups A1 and B1 with simulated bone losses of 3.0 and 1.5 mm, respectively) and (2) titanium implants connected to zirconia abutments (Groups A2 and B2 with simulated bone losses of 3.0 and 1.5 mm, respectively)
The failure force did not differ significantly between Groups B1 and B2 (P = 0.41), whereas the maximum deformation force was higher in Group B1 than in Group B2 (P = 0.04), being larger for titanium-alloy abutments than for zirconia abutments
Summary
Zirconia materials are known for their optimal aesthetics, but they are brittle, and concerns remain about whether their mechanical properties are sufficient for withstanding the forces exerted in the oral cavity. The survival rates of dental implants are generally high. Goodacre et al divided the causes of implant failure into the following six categories: surgery, implant loss, bone loss, peri-implant soft tissue, mechanical difficulties, and esthetic/ phonetic problems [8]. The unesthetic bluish color of titanium remains visible through the soft tissues [9,10,11], which is of great concern when the maxillary incisors are treated, especially in patients with a high smile line or a thin mucosal biotype. The increasing demand for more favorable esthetic outcomes makes ceramic a potentially attractive alternative material because of its toothlike color
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