Fracture Strength of Implant-Supported Ceramic Crowns with Customized Zirconia Abutments: Screw Retained vs. Cement Retained. 2016

Lorenna Bastos Lima Verde Nogueira, and Carmem Dolores Vilarinho Soares Moura, and Carlos Eduardo Francischone, and Valdimar Silva Valente, and Suyá Moura Mendes Alencar, and Walter Leal Moura, and Gregorio Antonio Soares Martins
Postgraduate Program in Dentistry, Federal University of Piaui, Teresina, Brazil.

OBJECTIVE To compare the fracture resistance before and after cyclic fatigue assays of ceramic crowns with customized zirconia abutments when screw retained and cemented onto implants. METHODS The sample of this study consisted of 40 ceramic crowns with zirconia infrastructure fixed onto external hexagonal implants. The crowns were distributed into two groups (n = 20): Screw-retained and cemented crowns. Half the crowns of each group (n = 10) underwent compression until fracture and the other half (n = 10) underwent cyclic fatigue and subsequent compression until fracture. The cyclic fatigue test was carried out using an electromechanical fatigue device (loads from 0 to 100 N, 2 Hz frequency, in distilled water, at 37 °C for a period of 1 million cycles). The compression test was carried out using a universal testing machine with a 0.5 mm/min speed and 5 KN load cell. After fracture, the crowns were classified according to the type of fracture. Student's t test (p < 0.05) was used for statistical analysis. RESULTS The cyclic fatigue altered neither the mean fracture resistance of the screw-retained crowns (before = 1068.31 N, after = 891.49 N; p > 0.05) nor that of the cemented crowns (before = 2117.78 N; after = 2094.81 N; p > 0.05); however, the mean fracture resistance of the cemented crowns was higher than that of the screw-retained crowns both before (p < 0.001) and after (p < 0.001) the cyclic fatigue. Fractures occurred most frequently in the ceramic veneer, followed by fracture of some of the copings. CONCLUSIONS The ceramic crowns cemented onto the customized zirconia abutments offered greater fracture resistance than ceramic crowns with customized zirconia abutments screw retained onto implants. The cyclic fatigue did not seem to influence the fracture resistance of these crowns, whether cemented or screw retained onto implants. Fracture of the veneering ceramic was the predominant failure in this study.

UI MeSH Term Description Entries
D008422 Materials Testing The testing of materials and devices, especially those used for PROSTHESES AND IMPLANTS; SUTURES; TISSUE ADHESIVES; etc., for hardness, strength, durability, safety, efficacy, and biocompatibility. Biocompatibility Testing,Biocompatible Materials Testing,Hemocompatibility Testing,Testing, Biocompatible Materials,Testing, Hemocompatible Materials,Hemocompatibility Testings,Hemocompatible Materials Testing,Materials Testing, Biocompatible,Materials Testing, Hemocompatible,Testing, Biocompatibility,Testing, Hemocompatibility,Testing, Materials,Testings, Biocompatibility
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D002516 Ceramics Products made by baking or firing nonmetallic minerals (clay and similar materials). In making dental restorations or parts of restorations the material is fused porcelain. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed & Boucher's Clinical Dental Terminology, 4th ed) Ceramic
D003442 Crowns A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. Dental Crowns,Crown, Dental,Crowns, Dental,Dental Crown,Crown
D003776 Dental Porcelain A type of porcelain used in dental restorations, either jacket crowns or inlays, artificial teeth, or metal-ceramic crowns. It is essentially a mixture of particles of feldspar and quartz, the feldspar melting first and providing a glass matrix for the quartz. Dental porcelain is produced by mixing ceramic powder (a mixture of quartz, kaolin, pigments, opacifiers, a suitable flux, and other substances) with distilled water. (From Jablonski's Dictionary of Dentistry, 1992) Porcelain,Porcelain, Dental,Dental Porcelains,Porcelains,Porcelains, Dental
D003799 Dental Stress Analysis The description and measurement of the various factors that produce physical stress upon dental restorations, prostheses, or appliances, materials associated with them, or the natural oral structures. Analyses, Dental Stress,Analysis, Dental Stress,Stress Analyses, Dental,Stress Analysis, Dental,Dental Stress Analyses
D000044 Dental Abutments Natural teeth or teeth roots used as anchorage for a fixed or removable denture or other prosthesis (such as an implant) serving the same purpose. Abutments, Dental,Abutment, Dental,Dental Abutment
D015040 Zirconium A rather rare metallic element with atomic number 40, atomic weight 91.224, and symbol Zr.
D019232 Dental Restoration Failure Inability or inadequacy of a dental restoration or prosthesis to perform as expected. Dental Prosthesis Failure,Dental Prosthesis Failures,Dental Restoration Failures,Failure, Dental Prosthesis,Failure, Dental Restoration,Failures, Dental Prosthesis,Failures, Dental Restoration,Prosthesis Failure, Dental,Prosthesis Failures, Dental,Restoration Failure, Dental,Restoration Failures, Dental

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