Fracture Resistance of Implant Supported All Ceramic Zirconia-lithium Disilicate crowns

Main Article Content

Trinuch Eiampongpaiboon
Somsak Chitmongkolsuk
Nattanich Bunyasresth
Widchaya Kanchanavasita

Abstract

Objectives: The objectives of this study were to evaluate the effects of different veneering methods and the effects of different sizes of abutment on the fracture resistance of the crowns, and to assess the mode of failure of these crowns.


Materials and methods: A hundred and eight implant abutments (Straight 3.5/4.0 TiDesignTM, AstraTech Dental) were fabricated into 3 groups with different sizes of abutments [Ø4.5 (s), Ø5.5 (m), and Ø6.5 (l)]. Each group of implant abutments contained 3 subgroups of 12 specimens each (n=12). Zirconia frameworks were fabricated on all implant abutments. Various veneering materials were then applied and processed on the zirconia frameworks. Fluorapatite veneering ceramics were used as the control group (ZAC). Lithium disilicate crowns were fabricated as the veneering layer on the zirconia frameworks with different procedures: group A bonded via fired Crystal/Connect glass ceramic (FCC) and group B bonded via resin cement (BRC). Resin cement was used for cementation. All specimens were placed in a thermocycling unit and tested with a universal testing machine. Statistical analysis was performed using two-way ANOVA and Tukey B test.


Results: The mean of fracture resistance in the ZAC group was at the highest value (1787-3295N) of cohesive failure. The mean fracture resistance of the FCC group (1714-2809N) was higher than that of the BRC group (1565-1809N). The mean fracture resistance of the abutment diameter 5.5 mm (m) was at the highest value. The largest size of abutment (l) had a mean fracture resistance higher than the smallest size of abutment (s). The two main factors, veneering method and abutment size, had individual effects on fracture resistance. There were significant differences of fracture resistance in all groups with different veneering methods and different sizes of abutment. Adhesive failure was found in the BRC group. Meanwhile the FRC group was found to have both adhesive and combination failure.


Conclusion: The mean fracture resistance of crowns fused with Crystal/Connect was significantly higher than that of crowns bonded with resin cement, but all the crowns had adequate fracture resistance to be used as implant supported restorations in the posterior region.

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1.
Eiampongpaiboon T, Chitmongkolsuk S, Bunyasresth N, Kanchanavasita W. Fracture Resistance of Implant Supported All Ceramic Zirconia-lithium Disilicate crowns. M Dent J [Internet]. 2017 Feb. 15 [cited 2024 Dec. 21];37(1):7-14. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/179969
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Original articles

References

1. Buser D, Janner SF, Wittneben JG, Bragger U, Ramseier CA, Salvi GE. 10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: a retrospective study in 303 partially edentulous patients. Clinical implant dentistry and related research. 2012 Dec;14(6):839-51.
2. Pjetursson BE, Bragger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clinical oral implants research. 2007 Jun;18 Suppl 3:97-113.
3. Wittneben JG, Buser D, Salvi GE, Burgin W, Hicklin S, Bragger U. Complication and failure rates with implant-supported fixed dental prostheses and single crowns: a 10-year retrospective study. Clinical implant dentistry and related research. 2014 Jun;16(3):356-64.
4. Al-Amleh B, Lyons K, Swain M. Clinical trials in zirconia: a systematic review. J Oral Rehabil. 2010 Aug;37(8):641-52.
5. Denry I, Kelly JR. State of the art of zirconia for dental applications. Dental materials : official publication of the Academy of Dental Materials. 2008 Mar;24(3):299-307.
6. Gomes AL, Montero J. Zirconia implant abutments: a review. Medicina oral, patologia oral y cirugia bucal. 2011 Jan;16(1):e50-5.
7. Sailer I, Philipp A, Zembic A, Pjetursson BE, Hammerle CH, Zwahlen M. A systematic review of the performance of ceramic and metal implant abutments supporting fixed implant reconstructions. Clinical oral implants research. 2009 Sep;20 Suppl 4:4-31.
8. Mitov G, Heintze SD, Walz S, Woll K, Muecklich F, Pospiech P. Wear behavior of dental Y-TZP ceramic against natural enamel after different finishing procedures. Dental materials : official publication of the Academy of Dental Materials. 2012 Aug;28(8):909-18.
9. Miyazaki T, Nakamura T, Matsumura H, Ban S, Kobayashi T. Current status of zirconia restoration. Journal of prosthodontic research. 2013 Oct;57(4):236-61.
10. Stimmelmayr M, Sagerer S, Erdelt K, Beuer F. In vitro fatigue and fracture strength testing of one-piece zirconia implant abutments and zirconia implant abutments connected to titanium cores. The International journal of oral & maxillofacial implants. 2013 Mar-Apr;28(2):488-93.
11. Deany IL. Recent advances in ceramics for dentistry. Critical reviews in oral biology and medicine : an official publication of the American Association of Oral Biologists. 1996;7(2):134-43.
12. Tsalouchou E, Cattell MJ, Knowles JC, Pittayachawan P, McDonald A. Fatigue and fracture properties of yttria partially stabilized zirconia crown systems. Dental materials : official publication of the Academy of Dental Materials. 2008 Mar;24(3):308-18.
13. Kelly JR. Dental ceramics: what is this stuff anyway? Journal of the American Dental Association (1939). 2008 Sep;139 Suppl:4S-7S.
14. Heintze SD, Rousson V. Fracture rates of IPS Empress all-ceramic crowns--a systematic review. The International journal of prosthodontics. 2010 Mar-Apr;23(2):129-33.
15. Sobrinho LC, Cattell MJ, Knowles JC. Fracture strength of all-ceramic crowns. Journal of materials science Materials in medicine. 1998 Oct;9(10):555-9.
16. Triwatana P, Nagaviroj N, Tulapornchai C. Clinical performance and failures of zirconia-based fixed partial dentures: a review literature. The journal of advanced prosthodontics. 2012 May;4(2):76-83.
17. Baltzer A. All-ceramic single-tooth restorations: choosing the material to match the preparation--preparing the tooth to match the material. International journal of computerized dentistry. 2008;11(3-4):241-56.
18. Kern M, Sasse M, Wolfart S. Ten-year outcome of three-unit fixed dental prostheses made from monolithic lithium disilicate ceramic. Journal of the American Dental Association (1939). 2012 Mar;143(3):234-40.
19. Stawarczyk B, Ozcan M, Schmutz F, Trottmann A, Roos M, Hammerle CH. Two-body wear of monolithic, veneered and glazed zirconia and their corresponding enamel antagonists. Acta odontologica Scandinavica. 2013 Jan;71(1):102-12.
20. Esquivel-Upshaw J, Rose W, Oliveira E, Yang M, Clark AE, Anusavice K. Randomized, controlled clinical trial of bilayer ceramic and metal-ceramic crown performance. Journal of prosthodontics : official journal of the American College of Prosthodontists. 2013 Apr;22(3):166-73.
21. Hmaidouch R, Weigl P. Tooth wear against ceramic crowns in posterior region: a systematic literature review. International journal of oral science. 2013 Dec;5(4):183-90. PubMed PMID: 24136675.
22. Beuer F, Schweiger J, Eichberger M, Kappert HF, Gernet W, Edelhoff D. High-strength CAD/CAM-fabricated veneering material sintered to zirconia copings--a new fabrication mode for all-ceramic restorations. Dental materials : official publication of the Academy of Dental Materials. 2009 Jan;25(1):121-8.
23. Schmitter M, Mueller D, Rues S. Chipping behaviour of all-ceramic crowns with zirconia framework and CAD/CAM manufactured veneer. Journal of dentistry. 2012 Feb;40(2):154-62.
24. Iwai T, Komine F, Kobayashi K, Saito A, Matsumura H. Influence of convergence angle and cement space on adaptation of zirconium dioxide ceramic copings. Acta odontologica Scandinavica. 2008 Aug;66(4):214-8.
25. Rosentritt M, Steiger D, Behr M, Handel G, Kolbeck C. Influence of substructure design and spacer settings on the in vitro performance of molar zirconia crowns. Journal of dentistry. 2009 Dec;37(12):978-83.
26. Nesse H, Ulstein DM, Vaage MM, Oilo M. Internal and marginal fit of cobalt-chromium fixed dental prostheses fabricated with 3 different techniques. The Journal of prosthetic dentistry. 2015 Nov;114(5):686-92.
27. Waltimo A, Kononen M. Maximal bite force and its association with signs and symptoms of craniomandibular disorders in young Finnish non-patients. Acta odontologica Scandinavica. 1995 Aug;53(4):254-8.
28. Waltimo A, Nystrom M, Kononen M. Bite force and dentofacial morphology in men with severe dental attrition. Scandinavian journal of dental research. 1994 Apr;102(2):92-6.
29. Ferrario VF, Sforza C, Zanotti G, Tartaglia GM. Maximal bite forces in healthy young adults as predicted by surface electromyography. Journal of dentistry. 2004 Aug;32(6):451-7.
30. Schmitter M, Schweiger M, Mueller D, Rues S. Effect on in vitro fracture resistance of the technique used to attach lithium disilicate ceramic veneer to zirconia frameworks. Dental materials : official publication of the Academy of Dental Materials. 2014 Feb;30(2):122-30.
31. Kim JH, Lee SJ, Park JS, Ryu JJ. Fracture load of monolithic CAD/CAM lithium disilicate ceramic crowns and veneered zirconia crowns as a posterior implant restoration. Implant dentistry. 2013 Feb;22(1):66-70.
32. Zahran M, El-Mowafy O, Tam L, Watson PA, Finer Y. Fracture strength and fatigue resistance of all-ceramic molar crowns manufactured with CAD/CAM technology. Journal of prosthodontics : official journal of the American College of Prosthodontists. 2008 Jul;17(5):370-7.
33. Zhao K, Wei YR, Pan Y, Zhang XP, Swain MV, Guess PC. Influence of veneer and cyclic loading on failure behavior of lithium disilicate glass-ceramic molar crowns. Dental materials : official publication of the Academy of Dental Materials. 2014 Feb;30(2):164-71.