Abutment Material Research Articles

Effect of cement type, luting protocol, and ceramic abutment material on the shade of cemented titanium-based lithium disilicate crowns and surrounding peri-implant soft tissue: a spectrophotometric analysis.

The objective of the study was to analyze the impact of cement, bonding pretreatment, and ceramic abutment material on the overall color results of CAD-CAM ceramic crowns bonded to titanium-based hybrid abutments. For single implant restoration of a maxillary lateral incisor a total of 51 CAD-CAM-fabricated monolithic lithium disilicate crowns were fabricated and subsequently bonded onto 24 lithium disilicate Ti-base abutments, 24 zirconia Ti-base abutments and 3 resin abutment replicas as a control group. The 48 copings were cemented with three definitive and one provisional cement on both grit-blasted and non-blasted Ti-bases. The color of each restoration and surrounding artificial gingiva was measured spectrophotometrically at predefined measuring points and the CIELAB (ΔEab) color scale values were recorded. The color outcome of ceramic crowns bonded to hybrid abutments and soft tissues was affected differently by cements of different brands. Grit-blasting of Ti-bases prior to cementing CAD-CAM copings affected the color results of all-ceramic crowns. There was a significant difference (P = .038) for the median ΔE value between blasted and non-blasted reconstructions at the cervical aspect of the crown. Full-ceramic crowns on zirconia Ti-base abutments exhibited significantly lower ΔE values below the threshold of visibility (ΔE 1.8). In all subcategories tested, the use of a highly opaque temporary cement demonstrated the lowest median ΔE for both the crown and the artificial gingiva. Various cements, core ceramic materials and airborne particle abrasion prior to bonding can adversely affect the color of Ti-base supported ceramic crowns and peri-implant soft tissue. However, zirconia CAD-CAM copings and an opaque cement can effectively mask this darkening.

Investigation of the Fracture Strength Between Dental Implant And Ti-Base Abutment Produced with Different Heights and Grades of Titanium Material

New prosthetic designs were developed to provide a balanced transmission of the stress caused by the chewing function to other mechanical and anatomical structures, and these designs revealed new research areas. An example of this is screw-retained implant-supported prostheses. With screw-retained prostheses, the residual cement problem is eliminated. However, abutment material and abutment design may adversely affect the mechanical and aesthetic properties of prostheses. Ti-base abutments have been developed to solve these problems. However, studies on clinical succes, material content and abutment height of ti-base abutments remain up-to-date. In our study, the effect or abutment heights on the bond strength and stress distribution with monolithic zirconia crowns in ti-base abutments manufactured from different titanium Gr types will be tested. Titanium Gr 4, Gr 5 and Gr 23 ELI materials will be used in our study. A total of 7 groups are planned with ti-base abutments with a abutment length of 3.5 mm, 5.5 mm for Gr 4 and Gr 5, abutment length of 3.5 mm, 5.5 mm and 7 mm for Gr 23. In the in vitro experiment, the fracture strength of the samples will be tested with the universal testing device. total of 77 implants, ti-base abutments and monolithic zirconia crowns will be used by creating 11 samples for each study group. The obtained values will be recorded in Newtons and Megapascals. The data will be analysed using the SPSS 22.0 programme. As a result, while the lowest fracture strength values were observed in Gr 4 Ti material in all ti-base abutment lengths in the samples for which the fracture strength test was performed, similar values were observed in the ti-base abutments produced from Gr 5 and Gr 23 ELİ alloys. When the relationship of bonding strengths with Ti alloys was evaluated, it was seen that there was no significant difference between Ti alloys.

Influence of Zirconia/Glass Veneer Thickness and Implant Abutment Material on the Final Shade of Implant Restorations.

Achieving an optimal shade match for these restorations is crucial for aesthetic outcomes. The thickness of zirconia/glass veneer and the choice of implant abutment material play vital roles in determining the final shade of implant restorations. This study investigated the influence of zirconia/glass veneer thickness (0.5 mm and 1.0 mm) and implant abutment material (zirconia and titanium) on the final shade of implant restorations. A total of 60 identical implant restorations were fabricated and divided into four groups based on the combinations of veneer thickness and abutment material. The shade of each restoration was assessed using a shade guide, and color differences (ΔE) were measured with a spectrophotometer. Data were analyzed using statistical tests (e.g., ANOVA). The results indicated that the veneer thickness significantly influenced the final shade of implant restorations. Restorations with 0.5 mm veneer thickness exhibited a lower ΔE value (indicating a closer shade match) compared to those with 1.0 mm veneer thickness. Additionally, the choice of implant abutment material had a minor but statistically significant effect on shade. Zirconia abutments yielded slightly better shade-matching results compared to titanium abutments. In implant restorations, the thickness of the zirconia/glass veneer plays a critical role in achieving a desirable shade match. A veneer thickness of 0.5 mm is recommended for optimal aesthetic outcomes.

The effects of direct polymethylmethacrylate and zirconia-on-Ti-base abutments on peri-implant soft tissue integration: A study in minipigs.

To assess two types of abutment materials routinely used in daily prac-tice-direct polymethyl methacrylate (PMMA) and a zirconia-on-Ti-base abut-ment-and their effects on peri-implant soft tissues and bone remodeling in a mini-pig model. A total of 40 implants were placed in five mini-pigs in a single-stage surgery. Four different types of abutment materials (n = 10 per group) were used: (1) titanium (control); (2) zirconia (control); (3) PMMA (test 1); and (4) Ti-base (zirconia bonded to a titanium framework; test 2). After 3 months of healing, the samples were collected and subjected to nondecalcified histology. The soft tissue dimensions (sulcus, junctional epithelium, and connective tissue attach-ment) were assessed on each abutment mesially and distally, and the distance from the implant margin to the first bone-to-implant contact (BIC) was measured. No statistically significant differences were found among the four groups regarding soft tissue dimensions (P = .21), and a long junctional epithelium (mean: 4.1 mm) and a short connective tissue attachment (mean: 0.3 mm) were found in the majority of abutments. In some samples, the junctional epithelium extended all the way to the bone level. The measured peri-implant bone remodeling was similar in all four groups (P = .25). The present findings indicate that both di-rect PMMA and zirconia-on-Ti-base abutments seem to allow soft tissue integration similar to that of titanium and zirconia abutments. However, clinical studies are war-ranted to either confirm or refute the observed findings and to further investigate the influence of different materials on mucointegration.

Effect of abutment screw-access hole on the fatigue performance of implant-supported lithium-disilicate luted simplified restorations

The present study aimed to evaluate the impact of the existence of an abutment screw-access hole and the filling effects on the fatigue mechanical behavior of a luted lithium-disilicate glass-ceramic. Seventy-two discs (Ø = 10 mm, 1.0 mm in thickness) of lithium disilicate (IPS e.max CAD, Ivoclar AG) were obtained from prefabricated blocks. Thirty-six abutment specimens of an opaque zirconia (Yz - IPS e.max ZirCAD, Ivoclar AG) and titanium (Ti - Luminesse Ti-Cam discs, Talladium Inc.) were confectioned, and allocated according to 6 groups: Yz and Ti rigid (without screw access hole); Yz unfilled, Yz filled, Ti unfilled and Ti filled (with the screw access (Ø = 2.5 mm) in the center). For the unfilled groups, only a polytetrafluoroethylene tape was used. Resin composite (Tetric N-Ceram, Ivoclar AG) was applied to the screw access hole for the filled groups (Yz and Ti). A cyclic fatigue test was carried out (load of 200 N, 10,000 cycles each; 20 Hz of frequency, step size of 100 N until failure detection (radial/cone crack). The fatigue failure load (FFL) and number of cycles until failure (CFF) were recorded for statistical purposes. The stress distribution (MPa) was evaluated by finite element analysis. A statistically positive effect of the abutment material and the presence of the screw access hole was observed (p ≤ 0.05). The rigid groups (without screw access holes) depicted almost 100% of survival after the fatigue tests. Among the other groups, the Yz-filled group showed the best performance (p ≤ 0.05), followed by the Yz unfilled group. The Ti groups depicted lower values of FFL and CFF, with the Ti unfilled group showing the most unfavorable fatigue behavior (p ≤ 0.05). The lowest tensile stress concentration in the restorative material was observed with the use of rigid abutments, the filled groups depicted intermediate values, while unfilled groups showed the highest stress concentration (Yz rigid = 306.3 MPa; Ti rigid = 310.4 MPa < Yz filled = 490.7 MPa; Ti filled = 498.9 MPa < Yz unfilled = 707.6 MPa; Ti unfilled = 719.7 MPa). Therefore, the presence of a screw-access hole decreases the mechanical performance of a lithium disilicate ceramic regardless of the abutment material. In the presence of a screw-access hole, zirconia abutments depicted a higher fatigue failure load when compared with titanium. The filling of the abutment screw-access hole with resin composite increased the mechanical performance of the simulated restoration.

Abutment Materials. Which Material to choose? Literature Review

The study is a literature review regarding the characteristics of different abutment materials and their indications. Titanium is still the first choice regarding the construction of the abutments. Anyway, with the increase request for aesthetic, new materials with adequate aesthetic are being considered. The most used materials as abutment materials are: titanium, zirconia, cast gold, alumina, PEEK and resin, surgical stainless steel. There is lack of evidence regarding the properties, the survival rate, the biological complications, technical complications, the response of the soft and hard peri implant tissue of the different abutment materials. Based on the literature, titanium should continue to be considered the first choice in constructing abutments. However, other materials, especially zirconia and alumina, have demonstrated to work equally well and should be considered appropriate for clinical use. There is a need for further research, especially on soft tissue integration and the anti-biofilm properties of the abutment materials.

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

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.

In vitro assessment of the effect of luting agents, abutment height, and fatigue on the retention of zirconia crowns luted to titanium base implant abutments

Statement of problemThe bonding of implant-supported prostheses is determined by abutment material, convergence angle, height, surface treatment, and luting agents. However, studies evaluating the bonding of luting agents to titanium base abutments with different heights under fatigue conditions are scarce. PurposeThe purpose of this in vitro study was to evaluate the retention of zirconia crowns bonded with different luting agents to titanium base abutments of different heights before and after fatigue testing. Material and methodsZirconia crowns were designed, milled, and distributed into 4 experimental groups according to the luting agents (G-Multi Primer/G-Cem LinkForce [MP/GC] and Scotchbond Universal/RelyX Ultimate [SU/RU]) and titanium base abutment heights (2.5 mm and 4 mm) (n=10). Pull-out testing was performed in a universal testing machine at a crosshead speed of 1 mm/min until crown displacement. Fatigue testing was performed by an electric precision fatigue simulator (1×106 cycles; 100 N; and 15 Hz), followed by pull-out testing of fatigued specimens. Collected data were statistically evaluated by using a linear mixed model after post hoc comparisons by the least significant difference test (α=.05). ResultsLuting agents, abutment heights, and fatigue influenced the bonding retention of zirconia crowns to titanium base abutments. SU/RU agents promoted higher pull-out compared with MP/GC for both abutment heights before and after fatigue. Higher abutment height increased pull-out regarding lower abutment height for SU/RU materials before and after fatigue testing. Although fatigue had no significant effect on the pull-out of MP/GC, lower bond retention was observed for SU/RU after fatigue, regardless of abutment height. ConclusionsLuting agent composition and the interaction with abutment height and fatigue influenced the retention of zirconia crowns to titanium base abutments.

The effect of different abutment materials on peri-implant tissues-A systematic review and meta-analysis.

In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the surrounding peri-implant tissues after at least 1 year? This systematic review included eligible randomized controlled trials identified through an electronic search (Medline, Embase and Web of Science) comparing alternative abutment materials versus titanium (alloy) abutments with a minimum follow-up of 1 year and including at least 10 patients/group. Primary outcomes were peri-implant marginal bone level (MBL) and probing depth (PD), these were evaluated based on meta-analyses. Abutment survival, biological and technical complications and aesthetic outcomes were the secondary outcomes. The risk of bias was assessed with the RoB2-tool. This review is registered in PROSPERO with the number (CRD42022376487). From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 12 articles could be included. Concerning the primary outcomes (MBL and PD), no differences could be seen between titanium abutment and zirconia or alumina abutments, not after 1 year (MBL: zirconia: MD = -0.24, 95% CI: -0.65 to 0.16, alumina: MD = -0.06, 95% CI: -0.29 to 0.17) (PD: zirconia: MD = -0.06, 95% CI: -0.41 to 0.30, alumina: MD = -0.29, 95% CI: -0.96 to 0.38), nor after 5 years. Additionally, no differences were found concerning the biological complications and aesthetic outcomes. The most important technical finding was abutment fracture in the ceramic group and chipping of the veneering material. Biologically, titanium and zirconia abutments seem to function equally up to 5 years after placement.

Group 3 ITI Consensus Report: Materials and antiresorptive drug-associated outcomes in implant dentistry.

The aim of Working Group 3 was to address the influence of both material- and anti-resorptive drug- related factors on clinical and biological outcomes and complications in implant dentistry. Focused questions were addressed on (a) implant materials other than titanium (alloy)s, (b) transmucosal abutment materials and (c) medications affecting bone metabolism were addressed. Three systematic reviews formed the basis for discussion in Group 3. Consensus statements and clinical recommendations were formulated by group consensus based on the findings of the systematic reviews. Patient perspectives and recommendations for future research were also conveyed. These were then presented and accepted following further discussion and modifications as required by the plenary. Zirconia is a valid alternative to titanium as material for implant and transmucosal components, allowing soft and hard tissue integration with clinical outcomes-identified by implant survival, marginal bone loss and peri-implant probing depths-up to 5-years comparable to titatnium. However, most of the evidence for zirconia implants is based on 1-piece implants limiting the indication range. Furthermore, based on expert opinion, zirconia transmucosal components might be preferred in the esthetic zone. In patients receiving low-dose bisphosphonate therapy, the rate of early implant failure is not increased, while the long-term effects remain poorly studied. Although it has not been sufficiently addressed, similar outcomes can be expected with low-dose denosumab. A drug holiday is not recommended when considering implant placement in patients treated with low-dose ARD. However, the specific therapeutic window, the cumulative dose and the administration time should be considered. Access to peri-implant supportive care is mandatory to prevent peri-implantitis-related medication-related osteonecrosis of the jaw (MRONJ) or implant-related sequestra (IRS). In patients receiving low-dose anti-resorptive drugs (ARD) therapy, the risk of complications related to implant placement is high, and implant procedures in this specific population should be strictly treated in a comprehensive multidisciplinary center. Finally, healthy dental implants should not be removed before low or high-dose ARD. Zirconia implants can be an alternative to titanium implants in selected indications. However, the current state of evidence remains limited, especially for 2-piece implant designs. Administration of low-dose ARD did not show any negative impact on early implant outcomes, but careful follow-up and supportive care is recommended in order to prevent peri-implant MRONJ and IRS. Implant placement in high-dose patients must be strictly considered in a comprehensive multidisciplinary center.

Polyetheretherketone (PEEK) as a Biomaterial: An Overview.

Polyetheretherketone (PEEK) is a very powerful biomaterial that is increasingly used in dentistry. It has superior properties, which make it desirable in implantology. The applications of PEEK includefinger prosthesis, RPD and FPD framework, and dental implants. Changes in the production of polyketone-based materials have been made toensure consistent production of polymers for medical applications.PEEK isa high-performance semicrystalline material that has physical properties such as high resilience and strength. It is a tooth-colored material, making it desirable for its aesthetic appearance. Traditional manufacturingmethods like injection molding, extrusion, and compression molding are usedforPEEK. Despite the high price of the polymer, the additional value that PEEK materials bring by offering the possibility of manufacturing parts include lightweight, strength or toughness and able to survive longer in harsh environments.PEEK has trauma or shock cancelling abilities, fracture resisting abilities, stress distributing ability, osseointegrating abilities, With such great qualities PEEK has an increased demand in the market, and this biomaterial never failes to surprise with its amazing success rate.Even in dentistry PEEK has a wide range of applicationswhich includes, as a dental implants biomaterial, prosthetic material, abutment material, post and core material, crowns, removable partial denture framework. With such a huge range of applications PEEK is said to have been providing an all in one package for dentistry.PEEK biomaterial shows great compatibility with bioactive materials which has proven to be of great help to mankind as not only it is involved in life sciences but also in automotives and aerodynamics as well. The main motto of this review is to know the qualities and the properties of PEEK as a capable implant prosthesis for its application focusing on dental implants.This review tells us about the challenges faced when using this material and benefits and advantages ofthis biomaterial.

Construction of silver-coated high translucent zirconia implanting abutment material and its property of antibacterial

High translucent zirconia (HTZ) has excellent mechanical properties, biocompatibility, and good semi-translucency making it an ideal material for aesthetic anterior dental implant abutments without antibacterial properties. In the oral environment, the surface of the abutment material is susceptible to microbial adhesion and biofilm formation, which can lead to infection or peri-implantitis and even implant failure. This study aims to promote the formation of a biological seal at the implant-soft tissue interface by modifying the HTZ surface, using the load-bearing capacity of the aluminosilicate porous structure and the broad-spectrum antibacterial effect of silver nanoparticles to prevent peri-implant bacterial infection and inflammation and to improve the success rate and prolong the use of the implant. FE-SEM (field emission scanning electron microscopes), EDS (energy dispersive spectroscopy), and XPS (X-ray photoelectron spectroscopy) results showed that aluminosilicate non-vacuum sintering can form open micro- and nanoporous structures on HTZ surfaces, and that porous aluminosilicate coatings obtain a larger number, smaller size, and more uniformly shaped silver nanoparticles than smooth aluminosilicate coatings, and could be deposited deeper in the coating. The ICP-AES (inductively coupled plasma-atomic emission spectroscopy) results showed that the early silver ion release of both the smooth silver coating and the porous silver coating was obvious, the silver ion concentration released by the former was higher than that of the latter. However, the silver ion concentration released by the porous silver coating was higher than that of the smooth coating when the release slowed down. Both smooth and porous silver coatings both inhibited E. coli (Escherichia coli), S. aureus (Staphylococcus aureus), and L. acidophilus (L. acidophilus), and porous silver coatings had stronger antibacterial properties. The silver coating was successfully constructed on the surface of HTZ, through aluminium silicate sintering and silver nitrate solution impregnation. It was found that the high concentration environment of silver nitrate solution was more advantageous for nano-Ag deposition, and the non-vacuum sintered porous surface was able to obtain a larger number of nano-Ag particles with smaller sizes. The porous Ag coating exhibited superior antibacterial properties. It was suggested that the HTZ with silver coating had clinical application, and good antibacterial properties that can improve the survival rate and service life of implants.

Contour Analysis of Three-Dimensional Peri-Implant Mucosal Model as an Endpoint Analysis of Photofunctionalization Effects on Implant Abutment Materials.

The objective of this study was to examine the effect of photofunctionalization on the soft-tissue contour formed at the interface of various abutment materials using end-point analyses obtained from the three-dimensional oral mucosal model (3D-OMMs). Commercially pure titanium (CPTi), alumina-toughened zirconia (ATZ), and yttria-stabilized zirconia (YSZ) made into discs shapes were classified into two groups: UV-treated (PTx) and non-treated (NTx). The materials in PTx groups were exposed to UV light for 12 min. Human gingival fibroblasts and TR146 epithelial cell lines co-cultured on the acellular dermal membrane were used to construct the 3D-OMM. After 4 days of culture, the discs were inserted into the holes prepared within the membrane of 3D-OMMs. The contour formed by the tissue was evaluated after 14 days of culture. The UV treatment of abutment materials resulted in the formation of more non-pocket-tissue types among the PTx group (p = 0.002). Of all materials tested, soft tissue contour around YSZ showed higher scores for the non-pocket type in both non- and UV-treated groups. The non-pocket type of tissue attachment was frequently found in all surfaces modified by photofunctionalization, particularly zirconia. The 3D-OMM can be used to evaluate the biological endpoints of implant surface modifications.

The effect of different abutment and restorative crown materials on stress distribution in single-unit implant-supported restorations: A 3D finite element stress analysis.

To evaluate the effect of restorative materials with or without resin content, modeled on zirconia and titanium abutment materials, on the stress distribution on the alveolar bone, implant, and prosthetic crowns with a 3D finite element stress analysis. Titanium and zirconia abutments were combined with three implant-supported crown materials (polymer infiltrated hybrid ceramic (PICN), lithium disilicate (LD), and zirconia-reinforced lithium silicate (ZLS)) to create six experimental groups. The 40×30×20mm alveolar bone, 3.75× 10mm implant, esthetic abutment, and maxillary first premolar crown bonded over the abutment were the components of the finite element models. On the lingual cusp of the crown, the 150 N occlusal loading was applied in the buccolingual direction at a 30° angle. Equivalent von Mises stress and maximum and minimum principal stresses were used for both the qualitative and quantitative evaluation of the stress distribution of the created models. The von Mises stress in implant and abutment did not differ according to the crown materials. The use of a zirconia abutment resulted in higher von Mises stress values in the abutment but lower stress values in the implant. The highest stress values were obtained in ZLS (196.65MPa) and LD (194.05MPa) crowns. The use of titanium abutments, regardless of crown materials, resulted in higher von Mises stress values in restorative crowns than in zirconia abutments. The principal stress values in alveolar bone showed similar distribution and concentration in all models. Changes in crown material did not affect stress distribution in the implant and peripheral bone. However, the zirconia esthetic abutment resulted in a lower stress concentration on the implant.

Effect of different abutment materials on the expression of genes and proteins related to hemidesmosome adhesion in human gingival epithelial cells

Objective: To investigate the effects of polyetheretherketone, zirconium dioxide, and titanium abutment materials on the expression of genes and proteins related to hemidesmosome adhesion in human gingival epithelial cells, in order to screen out abutment materials that are easier for epithelial adhesion. Methods: Forty-eight specimens were prepared in each of the three materials, polyetheretherketone, zirconium oxide, and pure titanium specimens. The surface morphology of each group of specimens was observed by scanning electron microscopy, the surface roughness was measured by the white light interferometer, and the contact angle was measured by optical contact angle measuring instrument. The early adhesion status of human gingival epithelial cells on the surface of each group of specimens was observed by scanning electron microscopy, and the proliferation ability of human gingival epithelial cells on the surface of each group of specimens was assessed by using a cell counting kit, and the expression levels of genes and proteins related to the adhesion of human gingival epithelial cells on the surface of each group of specimens were detected by real-time fluorescence quantitative PCR and Western blotting, respectively. Results: The surface morphology of the three groups of specimens was flat and smooth. The mean roughness (Ra value) of the polyetheretherketone, zirconia, and pure titanium groups were (95.63±2.06), (37.93±3.56), and (134.2±4.62) nm (F=368.16, P<0.001), respectively, and the mean maximum height (Rz value) was (2.42±0.22), (0.87±0.10) and (3.77±0.28) nm (F=91.95, P<0.001), with statistical significance (P<0.05). The contact angles were 81.23°±0.91°, 82.08°±2.10°, and 80.47°±1.85°, respectively, with no statistically significant overall difference (F=0.45, P=0.658). Human gingival epithelial cells showed irregular shapes such as flattened and extended polygons and polygons on the surface of the three groups of specimens, exhibiting a typical paving stone pattern. The differences in cell proliferation among the three groups at 1 and 3 d of culture were not statistically significant (P>0.05). Cell proliferation in the polyetheretherketone group was significantly greater those those in the zirconia and pure titanium groups at 5 and 7 d of culture (P<0.05). The mRNA expression levels and protein expression levels of laminin α3, integrin β4, and collagen ⅩⅦ in the polyetheretheretherketone group at 3 and 7 d of incubation were significantly greater than those in the zirconium oxide and pure titanium groups at the same time points (P<0.05). Conclusions: Polyetheretherketone is more conducive to the adhesion of hemidesmosome in human gingival epithelial cells than zirconium dioxide and pure titanium abutment materials.

Current Evidence on the Use of PEEK as Implant Abutment Material

Current Evidence on the Use of PEEK as Implant Abutment Material

Static and Fatigue Mechanical Performance of Abutments Materials for Dental Restorations.

The choice of the proper restorative material is essential for the long-term success of implant-supported rehabilitations. This study aimed to analyze and compare the mechanical properties of four different types of commercial abutment materials for implant-supported restorations. These materials included: lithium disilicate (A), translucent zirconia (B), fiber-reinforced polymethyl methacrylate (PMMA) (C), and ceramic-reinforced polyether ether ketone (PEEK) (D). Tests were carried out under combined bending-compression conditions, which involved applying a compressive force tilted with respect to the abutment axis. Static and fatigue tests were performed on two different geometries for each material, and the results were analyzed according to ISO standard 14801:2016. Monotonic loads were applied to measure static strength, whereas alternating loads with a frequency of 10 Hz and a runout of 5 × 106 cycles were applied for fatigue life estimation, corresponding to five years of clinical service. Fatigue tests were carried out with a load ratio of 0.1 and at least four load levels for each material, and the peak value of the load levels was reduced accordingly in subsequent levels. The results showed that the static and fatigue strengths of Type A and Type B materials were better than those of Type C and Type D. Moreover, the fiber-reinforced polymer material, Type C, showed marked material-geometry coupling. The study revealed that the final properties of the restoration depended on manufacturing techniques and the operator's experience. The findings of this study can be used to inform clinicians' choice of restorative materials for implant-supported rehabilitation, considering factors such as esthetics, mechanical properties, and cost.

The effect of abutment material stiffness on the mechanical behavior of dental implant assemblies: A 3D finite element study

PurposeThis study aimed to evaluate the stress distribution and microgap formation in implant assemblies with conical abutments made of different materials under an oblique load. Materials and methodsThe mechanical behavior of an implant assembly with a titanium abutment was analyzed and compared with that of an assembly with a Y-TZP abutment using finite element analysis (FEA). A torque of 20 Ncm was first applied to the abutment screw, followed by oblique loads of 10 N–280 N applied to the prosthesis placed on the implant. The maximum stress in the abutment screw, the microgap formation process, and the critical load for bridging the internal implant space were evaluated. ResultsNo significant difference in stress distribution between the two cases was observed, with the stresses being mainly concentrated at the top half of the screw (the predicted maximum von Mises stress was approximately 1200 MPa at 280 N). The area in contact at the implant-to-abutment interface decreased with increasing load for both abutments, with the critical load for bridging the internal implant space being roughly 140 N. The maximum gap size being was approximately 470 μm with either abutment. ConclusionThere was no significant difference in the stress distribution or microgap formed between implant assemblies with titanium and Y-TZP abutments having an internal conical connection.

The Effect of Zirconia and Titanium as Abutment Materials on Peri-Implant Soft and Hard Tissues in Mandibular Implant Supported Over-denture

Purpose: To evaluate the effect of zirconia and titanium as abutment materials onperi-implant bone height changes and pocket depth in mandibular implant supportedover-denture. Subjects and methods: Ten completely edentulous patients wereselected from the Outpatient Clinic of the Faculty of Dental Medicine for Girls,Al-Azhar University. Two implants were implanted in the inter-foraminal area ofmandibular ridge. Two different abutments were screwed over implants. Right abutmentwas constructed of zirconia and left one was constructed of titanium. Construction ofmaxillary complete denture and mandibular implant supported over-denture for allpatients was performed. Radiographic and clinical evaluation of implants has beenperformed at denture insertion, 6 months, 9 months and 12 months. Results: Theprevious study illustrated that titanium abutments had significantly higher values ofbone height changes and pocket depth measurements than zirconia abutments duringfollow up period. Conclusion: Zirconia abutments had great superiority over titaniumabutments in preservation of peri-implant hard and soft tissues in mandibularimplant-supported over-denture within the follow up period of this study.

The Effect of Zirconia and Titanium as Abutment Materials on Peri-Implant Soft and Hard Tissues in Mandibular Implant Supported Over-denture

Purpose: To evaluate the effect of zirconia and titanium as abutment materials onperi-implant bone height changes and pocket depth in mandibular implant supportedover-denture. Subjects and methods: Ten completely edentulous patients wereselected from the Outpatient Clinic of the Faculty of Dental Medicine for Girls,Al-Azhar University. Two implants were implanted in the inter-foraminal area ofmandibular ridge. Two different abutments were screwed over implants. Right abutmentwas constructed of zirconia and left one was constructed of titanium. Construction ofmaxillary complete denture and mandibular implant supported over-denture for allpatients was performed. Radiographic and clinical evaluation of implants has beenperformed at denture insertion, 6 months, 9 months and 12 months. Results: Theprevious study illustrated that titanium abutments had significantly higher values ofbone height changes and pocket depth measurements than zirconia abutments duringfollow up period. Conclusion: Zirconia abutments had great superiority over titaniumabutments in preservation of peri-implant hard and soft tissues in mandibularimplant-supported over-denture within the follow up period of this study.