Strain gauge analysis and fracture resistance of implant-supported PEKK hybrid abutments restored with two crown materials: An in vitro study.

Abstract

Polyetherketoneketone (PEKK) was recently introduced as an alternative to titanium and ceramic implant abutments due to its apparent ability to dissipate excessive strain around dental implants. However, the biomechanical behaviors of implant abutment crown systems may change depending on the crown and abutment material combinations used. This study aimed to assess how the crown material affects strain generation and fracture resistance of PEKK hybrid abutment crowns. Sixteen dummy implants (Ø 3.7 x 11 mm), simulating maxillary first premolars, were restored with 16 milled PEKK hybrid abutments and randomly categorized into two groups according to the crown material (n = 8): Group C, milled composite crowns cemented on PEKK hybrid abutments; and Group Z, ultra-translucent zirconia crowns cemented on PEKK hybrid abutments. Before thermocycling, a cyanoacrylate-base adhesive was used to position two strain gauges on buccal and lingual crestal bone surfaces, and a vertical load (100 N) was applied to the central fossa to record the strain generated. Then, all samples were thermocycled between 5°C and 55°C before being loaded to fracture on a universal testing machine. Modes of failure were observed under an optical microscope, and representative samples were examined using a scanning electron microscope. Independent t-tests were used for intergroup comparisons. The significance level was set at (p < 0.05) for all tests.. The results showed a significant difference between both groups. The zirconia group recorded significantly higher strain and fracture resistance values than the composite group (p < 0.001). There was a positive correlation between the strain developed in peri-implant crestal bone and fracture resistance of the abutment crown complex. Strains developed in both groups were within the acceptable clinical range. The crown material substantially impacted the strain and fracture of the PEKK hybrid abutment crown system.