Comparison of fracture resistance of pressable metal ceramic custom implant abutment with a commercially fabricated CAD/CAM zirconia implant abutment

J Prosthet Dent. 2013 Nov;110(5):389-96. doi: 10.1016/j.prosdent.2013.06.004. Epub 2013 Sep 5.

Abstract

Statement of problem: The predictable nature of the hot pressing ceramic technique has several applications, but no study was identified that evaluated its application to the fabrication of custom implant abutments.

Purpose: The purpose of this study was to compare the fracture resistance of an experimentally designed pressable metal ceramic custom implant abutment (PR) with that of a duplicate zirconia abutment (ZR).

Materials and methods: Two groups of narrow platform (NP) (Nobel Replace) implant abutment specimens were fabricated (n=10). The experimental abutment (PR) had a metal substructure cast with ceramic alloy (Lodestar) and veneered with leucite pressable glass ceramic (InLine PoM). Each PR abutment was individually scanned and 10 duplicate CAD/CAM ZR abutments were fabricated for the control group. Ceramic crowns (n=20) with the average dimensions of a human lateral incisor were pressed with lithium disilicate glass ceramic (IPS e.max Press) and bonded on the abutments with a resin luting agent (Multilink Automix). The specimens were subjected to thermocycling, cyclic loading, and finally static loading to failure with a computer-controlled Universal Testing Machine. An independent t test (1 sided) determined whether the mean values of the fracture load differed significantly (α=.05) between the 2 groups.

Results: No specimen failed during cyclic loading. Upon static loading, the mean (SD) load to failure was significantly higher for the PR group (525.89 [143.547] N) than for the ZR group (413.70 [35.515] N) for internal connection narrow platform bone-level implants (P=.025). Failure was initiated at the screw and internal connection level for both groups.

Conclusions: It is possible to fabricate PR abutments that are stronger than ZR abutments for Nobel Biocare internal connection NP bone-level implants. The screw and the internal connection are the weak links for both groups.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aluminum Silicates / chemistry
  • Ceramics / chemistry
  • Computer-Aided Design*
  • Crowns
  • Dental Abutments*
  • Dental Implant-Abutment Design*
  • Dental Materials / chemistry*
  • Dental Porcelain / chemistry
  • Dental Prosthesis Design
  • Dental Restoration Failure
  • Dental Stress Analysis / instrumentation
  • Humans
  • Materials Testing
  • Metal Ceramic Alloys / chemistry*
  • Resin Cements / chemistry
  • Stress, Mechanical
  • Temperature
  • Zirconium / chemistry*

Substances

  • Aluminum Silicates
  • Dental Materials
  • IPS e.max Press
  • Metal Ceramic Alloys
  • Resin Cements
  • lithia disilicate
  • multilink adhesive system
  • Dental Porcelain
  • leucite
  • Glass ceramics
  • Zirconium
  • zirconium oxide