Implant angulation and fracture resistance of one-piece screw-retained hybrid monolithic zirconia ceramic restorations

PLoS One. 2023 Jan 23;18(1):e0280816. doi: 10.1371/journal.pone.0280816. eCollection 2023.

Abstract

Objective: This study aimed to investigate the fracture resistance of one-piece screw-retained hybrid monolithic zirconia ceramic restorations in different implant angulations.

Materials and methods: Three implant fixtures were embedded in acrylic resin blocks with 0°, 15°, and 25° angulations. For each group of implant angulations, 11 screw-retained one-piece monolithic zirconia restorations were made and bonded to the titanium inserts with a dual-cure self-adhesive resin. The complexes were screwed to the implant fixtures with titanium screws. The samples were thermocycled, subjected to compressive load, and fracture modes were recorded. One-way ANOVA and post hoc Tukey's test were used for statistical analyses (α = 0.05).

Results: One-way ANOVA showed the fracture resistance to be significanltly different among the study groups (P = 0.036). The 15° group was significantly more resistant than 0° (P = 0.031). However, the 25° group was not significantly different from the 15° (P = 0.203) and 0° groups (P = 0.624). Fractures occurred only on the restorations, not at the screw levels.

Conclusions: Tilting the implant up to 15° improves the fracture resistance of one-piece screw-retained hybrid monolithic zirconia restorations; however, increasing the tilt to 25° would not yield restorations with significantly better fracture strength than the straight implants. Accordingly, when angulated implants are indicated in the esthetic zones, one-piece screw-retained hybrid monolithic zirconia ceramic restorations can be used with acceptable fracture strength.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bone Screws
  • Ceramics
  • Dental Abutments
  • Dental Restoration Failure
  • Dental Stress Analysis
  • Materials Testing
  • Titanium*
  • Zirconium*

Substances

  • zirconium oxide
  • Titanium
  • Zirconium

Grants and funding

The study was financially supported by the Vice-Chancellry of Research of Shiraz University of Medical Sciences (grant #00-01-03-24333, granted to RG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.