Objective: To investigate the probability of survival and failure modes of four-unit implant-supported porcelain fused to metal (PFM) dentogingival prostheses subjected to step-stress accelerated life testing (SSALT).
Materials and methods: Eighteen implant-supported PFM dentogingival prostheses with thin metallic infrastructures, which provided minimal ceramic support and improved esthetics were fabricated over external hexagonal connection UCLA abutments. SSALT was performed until specimen failure. Use level probability Weibull curve and reliability were calculated and plotted. Weibull modulus (m) and characteristic strength (η) were also calculated. Polarized light microscope and scanning electron microscope were used to characterize fractures.
Results: Failures were dictated by material strength rather than fatigue damage accumulation. The probability of survival for loads reaching 100 and 150 N in 100,000 cycles was 92 and 61%, respectively. No cracks or fractures were identified in the veneered porcelain, whereas abutment fixation screw fracture was the chief failure mode.
Conclusion: Implant-supported PFM four-unit dentogingival prostheses with minimum metal framework dimensions presented favorable lifetime prediction under fatigue testing. Fractures were restricted to fixation screws.
Clinical significance: In-vitro fatigue testing and failure mode analyses evidenced favorable lifetime prediction for 4-unit implant-supported dentogingival prostheses with minimum metal frameworks. Abutment fixation screw fracture might be the most frequent clinical complication. Since this proof of concept has been tested in-vitro, further studies including different restorative materials, as well as long-term clinical trials are warranted.
Keywords: dentogingival prostheses; fatigue testing; fixed dental prostheses; implant supported; pink ceramic.
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