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EAO-294 / OC-BR-006 | Mechanical stability of abutment-free zirconia implant crowns on a novel implant-crown interface
Clinical Oral Implants Research ( IF 4.3 ) Pub Date : 2021-12-28 , DOI: 10.1111/clr.5_13855


Jenni Hjerppe*; Ronald Jung; Christoph Hämmerle; Mutlu Özcan; Sven Mühlemann

Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland

Background: Titanium base abutments supported all-ceramic implant-crowns have shown high survival rates in short term clinical studies (De Angelis et al. 2020; Joda et al. 2017). Yet, the design of the transmucosal part of such reconstructions is critical and there might be an increased risk for biological complications (Stucki et al. 2021). To overcome the possible complications and to further simplify the digital workflow for all-ceramic implant reconstructions, a novel implant connection was developed.

Aim/Hypothesis: To test failure load and failure mode of an implant-crown interface specifically designed for personalized, abutment-free monolithic zirconia CAD-CAM crowns compared to conventional implant-abutment interfaces involving prefabricated or centrally manufactured abutments for zirconia CAD-CAM crowns.

Material and Methods: 48 implants were divided into four groups (n = 12) according to different implant-abutment designs: (a) internal conical connection with customized, centrally manufactured zirconia CAD-CAM abutments (Cen-Abut-Zr), (b) prefabricated titanium base abutments from manufacturer 1 (Ti-Base-1), (c) an additional prefabricated titanium base abutments from manufacturer 2 (Ti-Base-2) and (d) a novel internal implant connection with personalized, abutment-free CAD-CAM crowns (Abut-Free-Zr) (Figure 1a–d). All specimens were restored with a screw-retained laboratory-made monolithic zirconia CAD-CAM molar crown and subjected to thermomechanical aging (1 200 000 cycles, 49 N, 1.67 Hz, 30° angulation, thermocycling 5-50°C). Subsequently static load until failure was applied by means of a universal testing machine. Failure modes were analyzed descriptively under light microscope. Mean failure load values were statistically analyzed with significance level of p < 0.05.

Results: All the specimens survived thermomechanical aging, while two specimens in group Ti-Base-1 exhibited abutment screw loosening translating into a non-catastrophic failure rate of 16.7% (2/12). The screws were re-tightened and all the specimens were exposed to static loading. The mean failure loads were 1332 N (Abut-Free-Zr), 1462 N (Cen-Abut-Zr), 1561 N (Ti-Base-1), and 1601 N (Ti-Base-2). Ti-Base-2 specimens exhibited higher failure load compared to Abut-Free-Zr specimens (p=0.04), whereas no differences between the other study groups were seen. The predominant failure mode per group was crown fracture above implant connection (Abut-Free-Zr, 75%, 9/12), abutment fracture below implant neck (Cen-Abut-Zr, 83%, 10/12), crown fracture leaving an intact abutment (Ti-Base-1 and Ti-Base-2, 100%, 12/12).

Conclusion and Clinical implications: A novel implant-crown interface specifically designed for in-house or laboratory-made, fully personalized CAD-CAM monolithic zirconia crowns exhibited similar failure loads compared to conventional implant-abutment interfaces involving a prefabricated titanium base or centrally manufactured custom-made zirconia abutment.
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Disclosure of Interest: J. Hjerppe: None Declared, R. Jung Conflict with: Straumann, TRI Dental Implants, Conflict with: TRI Dental Implants, C. Hämmerle: None Declared, M. Özcan: None Declared, S. Mühlemann Conflict with: Straumann.

Keywords: CAD/CAM, monolithic ceramic, screw-retained



中文翻译:

EAO-294 / OC-BR-006 | 新型种植体-冠界面上无基台氧化锆种植体冠的机械稳定性

珍妮·耶尔佩* ; 荣格; 克里斯托夫·哈默勒;穆特鲁厄兹坎;斯文·穆勒曼

再造牙科诊所,苏黎世大学,苏黎世,瑞士

背景:钛基基台支持的全瓷种植体冠在短期临床研究中显示出较高的存活率(De Angelis 等人,2020 年;Joda 等人,2017 年)。然而,这种重建的跨粘膜部分的设计至关重要,并且可能会增加生物并发症的风险(Stucki 等人,2021 年)。为了克服可能出现的并发症并进一步简化全瓷种植体重建的数字工作流程,开发了一种新型种植体连接。

目的/假设:测试专为个性化、无基台整体氧化锆 CAD-CAM 牙冠设计的种植体-牙冠界面的失效载荷和失效模式,与涉及氧化锆 CAD-CAM 冠的预制或集中制造基台的传统种植体-基台界面相比.

材料和方法: 48 个种植体分为四组(n= 12) 根据不同的种植体基台设计:(a) 内部锥形连接与定制的、集中制造的氧化锆 CAD-CAM 基台 (Cen-Abut-Zr),(b) 来自制造商 1 的预制钛基基台 (Ti-Base- 1)、(c) 来自制造商 2 (Ti-Base-2) 的额外预制钛基基台和 (d) 具有个性化、无基台 CAD-CAM 牙冠 (Abut-Free-Zr) 的新型内部种植体连接(图1a-d)。所有标本都用螺钉固位的实验室制造的整体氧化锆 CAD-CAM 磨牙冠修复,并进行热机械老化(1 200 000 次循环,49 N,1.67 Hz,30° 角度,5-50°C 热循环)。随后通过万能试验机施加静载荷直至失效。在光学显微镜下对失效模式进行描述性分析。p < 0.05。

结果:所有样本都经受住了热机械老化,而 Ti-Base-1 组中的两个样本表现出基台螺钉松动,转化为 16.7% (2/12) 的非灾难性故障率。重新拧紧螺钉,所有试样都承受静载荷。平均破坏载荷为 1332 N(无邻基 Zr)、1462 N(Cen-Abut-Zr)、1561 N(Ti-Base-1)和 1601 N(Ti-Base-2)。与无基台 Zr 试样相比,Ti-Base-2 试样表现出更高的失效载荷 ( p=0.04),而其他研究组之间没有差异。每组的主要失效模式是种植体连接上方的牙冠断裂(Abut-Free-Zr,75%,9/12),种植体颈部下方的基台断裂(Cen-Abut-Zr,83%,10/12),牙冠断裂离开完整的基台(Ti-Base-1 和 Ti-Base-2,100%,12/12)。

结论和临床意义:一种专为内部或实验室制造的、完全个性化的 CAD-CAM 整体氧化锆牙冠设计的新型种植体 - 冠界面与涉及预制钛基或集中制造定制的传统种植体 - 基台界面相比表现出相似的失效载荷- 制成的氧化锆基台。
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利益披露:J. Hjerppe:未声明,R. Jung 与:Straumann、TRI Dental Implants 冲突,与:TRI Dental Implants、C. Hämmerle:未声明、M. Özcan:未声明、S. Mühlemann 冲突与:斯特劳曼。

关键词: CAD/CAM, 整体陶瓷, 螺丝固位

更新日期:2021-12-29
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