Reliability of an injection-moulded two-piece zirconia implant with PEKK abutment after long-term thermo-mechanical loading

Zhang, Fei; Heide, Christoph Meyer zur; Chevalier, Jérôme; Zhang, Fei; Meerbeek, Bart Van; Wesemann, Christian; Santos, Bernardo Camargo dos; Sergo, Valter; Kohal, Ralf‐Joachim; Adolfsson, Erik; Herklotz, Insa; Spies, Benedikt Christopher

doi:10.1016/j.jmbbm.2020.103967

Cited by 10 publications

(18 citation statements)

References 60 publications

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“…This enabled a more realistic representation of the physiological chewing load [ 37 ]. The applied load of 98 N is within the range of mastication forces measured in vivo [ 38 ] and is consistent with comparable preclinical studies [ 36 , 39 ]. The influence of the warm and humid environment was investigated on the implants, given that this is known to cause aging in Y-TZP.…”

Section: Discussionsupporting

confidence: 82%

A Novel Zirconia-Based Composite Presents an Aging Resistant Material for Narrow-Diameter Ceramic Implants

et al. 2021

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A novel ceria-stabilized zirconia-alumina-aluminate composite (Ce-TZP-comp) that is not prone to aging presents a potential alternative to yttrium-stabilized zirconia for ceramic oral implants. The objective of this study was to evaluate the long-term stability of a one-piece narrow-diameter implant made of Ce-TZP-comp. Implant prototypes with a narrow (3.4 mm) and regular (4.0 mm) diameter were embedded according to ISO 14801, and subgroups (n = 8) were subsequently exposed to dynamic loading (107 cycles, 98N) and/or hydrothermal treatment (aging, 85 °C). Loading/aging was only applied as a combined protocol for the 4.0 mm diameter implants. One subgroup of each diameter remained untreated. One sample was cross-sectioned from each subgroup and evaluated with a scanning electron microscope for phase-transformation of the lattice. Finally, the remaining samples were loaded to fracture. A multivariate linear regression model was applied for statistical analyses (significance at p < 0.05). All samples withstood the different loading/aging protocols and no transformation propagation was observed. The narrow diameter implants showed the lowest fracture load after combined loading/aging (628 ± 56 N; p < 0.01), whereas all other subgroups exhibited no significantly reduced fracture resistance (between 762 ± 62 and 806 ± 73 N; p > 0.05). Therefore, fracture load values of Ce-TZP-comp implants suggest a reliable intraoral clinical application in the anterior jaw regions.

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Section: Discussionsupporting

confidence: 82%

A Novel Zirconia-Based Composite Presents an Aging Resistant Material for Narrow-Diameter Ceramic Implants

et al. 2021

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“…It seems probable, that existing defect structures in the implants were sensitive for DL and in particular for DL/HT, which allowed the aging proceed deeper into the implant. These defect structures, however, were not related to the transformation layer of approximately 2 μm at the surface Zhang et al (2020). examined the same zirconia implant (Ceralog)…”

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confidence: 87%

“…The shape and structure of the molds enables the manufacturing of the zirconia implants with their final surface characteristics (Monzavi et al, 2020;Zhang et al, 2020). In addition to reduced manufacturing time, further costs can be reduced, as there is no wear of the grinding machines and ceramic feedstock does not become waste due to the subtractive manufacturing process.…”

Section: Introductionmentioning

confidence: 99%

Influence of loading and aging on the fracture strength of an injection‐molded two‐piece zirconia implant restored with a zirconia abutment

Kohal

Schierholz

Nold

et al. 2022

Clinical Oral Implants Res

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Objective To investigate the fracture strength and potential phase transformation of an injection‐molded two‐piece zirconia implant restored with a zirconia abutment after loading and/or aging. Methods Thirty‐two two‐piece zirconia implants (4.0 mm diameter) restored with zirconia abutments were embedded according to ISO 14801 and divided into four groups (n = 8/group): Three groups were either exclusively hydrothermally treated (group HT; 85°C), dynamically loaded (group DL; 107 cycles; 98 N), or subjected to both treatments simultaneously (group DL/HT). One group remained untreated (group 0). A sample from each group was cross‐sectioned and examined by scanning electron microscopy for possible crystal phase transformation. The remaining samples were then loaded to fracture in a static loading test. A one‐way ANOVA was used for statistical analyses. Results During dynamic loading, three implants of group DL and six implants of group DL/HT fractured at a load of 98 N. The fracture strength of group DL/HT (108 ± 141 Ncm) was significantly reduced compared to the other groups (group 0: 342 ± 36 Ncm; HT: 363 ± 49 Ncm; DL: 264 ± 198 Ncm) (p < .05). Fractures from group 0 and HT occurred at both implant and abutment level, whereas implants from group DL and DL/HT fractured only at implant level. A shallow monoclinic transformation zone of approximately 2 μm was observed following hydrothermal treatment. Conclusions Within the limitations of this study, it can be concluded that dynamic loading and the combination of loading and aging reduced the fracture strength of the implant abutment combination. Hydrothermal treatment caused a shallow transformation zone which had no influence on the fracture strength.

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“…9 The high mechanical properties obtained in these studies than in the present study might be explained by the large implant diameters. 12,23,28 Most fatigue failures were reported as implant body fractures in previous studies; 16,39 an increase in stress at the implant neck has been explained by the decrease in implant diameter, 12,16,40 and angled abutments have been reported to cause higher stresses in the cervical region. 12,25,40 In clinically fractured zirconia implants with a 3.25 mm diameter, the incipient crack was located at the level of the first turn of the thread.…”

Section: Groups Uc-a and Uc-a Or Earlier Failures During Chewing Simu...mentioning

confidence: 98%

“…The clinical conditions can be simulated in vitro by using a chewing simulation device, 33,37,38 and a static loading test can be applied to evaluate mechanical properties and fracture strengths 37,38 . Chewing simulation has been reported to reduce fracture strength, and the implant body is reported to be the weakest link when restored with monolithic zirconia crown restoration, 14,18,39 despite monolithic zirconia being recommended for implant‐supported fixed restorations 3 . In previous studies on zirconia implants, monolithic zirconia or different all‐ceramic materials have been used for crown restorations that were designed mostly in central or molar tooth forms 15 .…”

Section: Introductionmentioning

confidence: 99%

Fatigue resistance and fracture strength of narrow‐diameter one‐piece zirconia implants with angled abutments

Atalay

Öztaş

2022

J Esthet Restor Dent

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Objective: Zirconia implants are assumed to satisfy the esthetic requirements that titanium implants cannot meet, however, there are not enough studies in the literature about narrow-diameter and angled zirconia implants that can be preferred especially in the anterior region. This in vitro study aimed to evaluate the fatigue resistance and fracture strength of narrow-diameter zirconia implants with angled abutments. Materials and Methods: Forty-eight one-piece experimental zirconia implants and monolithic zirconia crowns were produced from 3-YTZP blanks. The implant diameters (3.0 or 3.7 mm) and the restoration types were determined according to three intraoral regions (upper central incisors, lower central incisors, and upper canine), and abutments were designed as straight or 15 angled. The samples were subjected to chewing simulation corresponding to 5 years of clinical performance and then the static loading test. The survival rates of groups were measured by the Kaplan-Meier log-rank test, and the fracture load values were estimated by using Kruskal-Wallis and Mann-Whitney U tests (p < 0.05).Results: All 3.0 mm diameter implants failed the fatigue test. The fatigue resistance of the implants with angled abutments was significantly lower than the straight abutments, and different crown designs were found to affect survival rates significantly. The fracture strengths of the surviving groups were above the maximum physiological chewing forces, and the differences were not significant. Conclusions:The implant diameter, abutment angle, and restoration type have a significant effect on the fatigue behavior of zirconia implants.Clinical Significance: The fracture strengths of the one-piece zirconia implants with a 3.7 mm diameter and a 15 abutment angle are above the chewing forces for the anterior intraoral region.

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Reliability of an injection-moulded two-piece zirconia implant with PEKK abutment after long-term thermo-mechanical loading

Cited by 10 publications

References 60 publications

A Novel Zirconia-Based Composite Presents an Aging Resistant Material for Narrow-Diameter Ceramic Implants

A Novel Zirconia-Based Composite Presents an Aging Resistant Material for Narrow-Diameter Ceramic Implants

Influence of loading and aging on the fracture strength of an injection‐molded two‐piece zirconia implant restored with a zirconia abutment

Fatigue resistance and fracture strength of narrow‐diameter one‐piece zirconia implants with angled abutments

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