Ultimate force and stiffness of 2-piece zirconium dioxide implants with screw-retained monolithic lithium-disilicate reconstructions

Joda, Tim; Voumard, Benjamin; Zysset, Philippe; Brägger, Urs; Ferrari, Marco

doi:10.1016/j.jpor.2017.11.002

Cited by 8 publications

(15 citation statements)

References 23 publications

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“…Significance (linear mixed models, level of significance p < 0.05) calculated for differences regarding the implant design, different covariables and treatments can be found in Table 4. [16,19,21,24,26,30]. The remaining investigations evaluated a mixture of both 1-and 2-piece implants [13,27,28].…”

Section: Discussionmentioning

confidence: 99%

“…Material selection of the included studies is listed in Table 1. Of the included implants, 577 were made from Y-TZP, whereas 154 were manufactured from ATZ [13,18,19,22,24,26]. When pooling the outcome for 1-and 2-piece zirconia implants, the bending moment at the time point of implant fracture was significantly affected by the material (p = 0.002; Table 4).…”

Section: Methodsmentioning

confidence: 99%

“…When only the fracture load [N] during static loading was reported, three options allowed for the calculation of the bending moment: (1) embedding was described to fully respect ISO 14801 (prescribing a lever arm of 5.5 mm allowing for the calculation of the bending moment), (2) all details regarding the embedding were provided in the manuscript (e.g., by providing a scheme) or (3) the bending moment and/or lever arm were provided by the authors upon request. As an example, six of the included studies adopted ISO 14801 for embedding [15,17,21,[24][25][26], whereas three provided all necessary information [19,27,28] allowing us to calculate the bending moment (embedding level, angulation, total sample length, point of loading). In the remaining cases the bending moment was reported [13,20,22] or sent by the authors [12,18,29,30].…”

Section: Screening Process/included Datamentioning

confidence: 99%

“…This did not change when stratifying the outcome for 1-(p = 0.273) and 2-piece (p = 0.191) implants. However, the included studies evaluated only very few implants in the range of 3 mm (range: 3.0-3.3 mm; n = 15, 207.2 ± 14.3 Ncm) [24,27] and 5 mm (range: 4.5-5.0 mm; n = 41, 349.4 ± 125.4 Ncm) [15,19,27,28], whereas the majority of implants had a diameter in the range of 4 mm (range: 3.8-4.4 mm; n = 675, 394.9 ± 170.4 Ncm). Boxplots can be seen in Figure 5.…”

Section: Implant Diametermentioning

confidence: 99%

“…Of the two-piece implants included in the present review (n = 236), 159 abutments were assembled by screw retention [13,16,19,21,24,26]. Most screws were made from titanium, but also gold and polyetheretherketone (PEEK; in one study, carbon-fiber-reinforced [26]) were used.…”

Section: Abutment Preparation and Implant-abutment-connection (Iac)mentioning

confidence: 99%

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Fracture Resistance of Zirconia Oral Implants In Vitro: A Systematic Review and Meta-Analysis

et al. 2020

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Various protocols are available to preclinically assess the fracture resistance of zirconia oral implants. The objective of the present review was to determine the impact of different treatments (dynamic loading, hydrothermal aging) and implant features (e.g., material, design or manufacturing) on the fracture resistance of zirconia implants. An electronic screening of two databases (MEDLINE/Pubmed, Embase) was performed. Investigations including > 5 screw-shaped implants providing information to calculate the bending moment at the time point of static loading to fracture were considered. Data was extracted and meta-analyses were conducted using multilevel mixed-effects generalized linear models (GLMs). The Šidák method was used to correct for multiple testing. The initial search resulted in 1864 articles, and finally 19 investigations loading 731 zirconia implants to fracture were analyzed. In general, fracture resistance was affected by the implant design (1-piece > 2-piece, p = 0.004), material (alumina-toughened zirconia/ATZ > yttria-stabilized tetragonal zirconia polycrystal/Y-TZP, p = 0.002) and abutment preparation (untouched > modified/grinded, p < 0.001). In case of 2-piece implants, the amount of dynamic loading cycles prior to static loading (p < 0.001) or anatomical crown supply (p < 0.001) negatively affected the outcome. No impact was found for hydrothermal aging. Heterogeneous findings of the present review highlight the importance of thoroughly and individually evaluating the fracture resistance of every zirconia implant system prior to market release.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Screening Process/included Datamentioning

confidence: 99%

Section: Implant Diametermentioning

confidence: 99%

Section: Abutment Preparation and Implant-abutment-connection (Iac)mentioning

confidence: 99%

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Fracture Resistance of Zirconia Oral Implants In Vitro: A Systematic Review and Meta-Analysis

et al. 2020

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Clinical Longevity of Zirconia Implants with the Focus on Biomechanical and Biological Outcome

Kohal

Dennison

2020

Curr Oral Health Rep

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Purpose of Review The goal of the present review is to update the reader on the scientific background of zirconia ceramic implants. Clinical investigations using zirconia ceramic implants over the last couple of years have brought up some new developments and questions. Can we be confident in placing zirconia ceramic implants given the recently published data? Is there a difference in the application of one- and two-piece implants? Recent Findings Systematic reviews on preclinical investigations of zirconia implants revealed that one-piece zirconia implants (> 4 mm) are sufficiently stable for clinical use. The same is true for some clinically available two-piece implant systems. Osseointegration and soft tissue integration are, according to the reviews, similar between titanium and zirconia implants with similar surface topographies. Regarding the clinical outcome, a meta-review exists evaluating systematic reviews. The findings of the systematic reviews and the meta-review are that there are good short-term clinical results for one-piece zirconia implants. However, the data for two-piece implants is not robust. Summary In certain applications (single tooth restorations and small bridges), the results of zirconia implants are comparable with titanium implants in short-term studies. Some mid-term investigations support the short-term results. However, according to the current scientific data available, zirconia implants cannot yet be considered an alternative to titanium implants because there are many areas where there is a lack of clinical studies on zirconia implants. Currently, they are an addendum to the titanium implant armamentarium for situations where they are useful (patient request, known hypersensitivity to titanium, or questions of esthetics when titanium might appear inappropriate for a certain situation/condition), but long-term studies are needed. Without a doubt, there is a need for two-piece zirconia implants, but limited research exists to support their clinical use at the moment.

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Stability and aging resistance of a zirconia oral implant using a carbon fiber-reinforced screw for implant-abutment connection

et al. 2018

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Ultimate force and stiffness of 2-piece zirconium dioxide implants with screw-retained monolithic lithium-disilicate reconstructions

Cited by 8 publications

References 23 publications

Fracture Resistance of Zirconia Oral Implants In Vitro: A Systematic Review and Meta-Analysis

Fracture Resistance of Zirconia Oral Implants In Vitro: A Systematic Review and Meta-Analysis

Clinical Longevity of Zirconia Implants with the Focus on Biomechanical and Biological Outcome

Stability and aging resistance of a zirconia oral implant using a carbon fiber-reinforced screw for implant-abutment connection

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