Abstract
This laboratory study aimed to evaluate the thermo-mechanical fatigue behavior and failure modes of monolithic and rapid-layer posterior single-crowns (SCs) supported by zirconia implants. Methods: 120 all-ceramic crowns supported by one-piece zirconia implants (ceramic.implant; vitaclinical) were divided into five groups (n = 24 each): Group Z-HT: 3Y-TZP monolithic-zirconia (Vita-YZ-HT); Group Z-ST: 4Y-TZP monolithic-zirconia (Vita-YZ-ST); Z-XT: 5Y-TZP monolithic-zirconia (Vita-YZ-XT); Group E: monolithic-polymer-infiltrated ceramic network (PICN,Vita-Enamic); Group RL (rapid layer): PICN-“table-top” (Vita-Enamic), 3Y-TZP-framework (Vita-YZ-HT). Half of the specimens of each group (n = 12) were exposed to fatigue with cyclic mechanical loading (F = 198N, 1.2-million cycles) and simultaneous thermocycling (5–55 °C). Single-load-to-failure testing (Z010, Zwick) was performed for all specimens without/with fatigue application. Data analysis was performed using ANOVA, Tukey’s post-hoc test, two-sample t-test and Bonferroni correction (p < 0.05). Results: All specimens survived fatigue exposure. Significant differences in failure loads were detected among groups (p ≤ 0.004). Materials Z-HT and Z-ST showed the highest failure loads followed by Z-XT, RL and E. The influence of fatigue was only significant for material RL. Conclusions: All types of tested materials exceeded clinically acceptable failure load values higher than 900N and can be recommended for clinical use. Z-HT and Z-ST appear to be highly reliable towards fatigue. Rapid-layer design of PICN and YZ-HT might be an interesting treatment concept for posterior implant SCs.
Highlights
Today, ceramic implants can be considered a valid treatment addendum in the portfolio of dental implantology with osseointegration capacities and survival rates similar to titanium implants [1,2,3]
Superficial wear was observed for the investigated investigated materials materials Z-HT, Z-HT, Z-ST and Z-XT
= 1)without of failure loads application, between 3Yshowed mean failure loads above 1750 N after single load to failure and exceeded reported physiological occlusal forces of 200–900 N in the posterior dentition [33]. These findings suggest that all tested monolithic and rapid-layer implant crown designs are suitable for clinical application on one-piece zirconia implants in the molar area from a mechanical point of view
Summary
Ceramic implants can be considered a valid treatment addendum in the portfolio of dental implantology with osseointegration capacities and survival rates similar to titanium implants [1,2,3]. As most of the studies solely focus on soft- and hard-tissue integration of zirconia implants, little evidence is published on the long-term behavior of their prosthetic counterparts [10,11]. Both the implant and the restorative crown-abutment complex have to be considered as one unit when evaluating a successful dental implant treatment
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