1
|
Graf T, Lyko A, Dahmer I, Stimmelmayr M, Dieterich H, Aggstaller H, Güth JF. Clinical performance and risk factors of all-ceramic screw-retained implant crowns in the posterior region based on a retrospective investigation. Clin Oral Implants Res 2024. [PMID: 38594815 DOI: 10.1111/clr.14264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Clinical data on all-ceramic screw-retained implant crowns (SICs) luted on titanium base abutments (TBAs) over more than 3 years are sparse. This study aimed to evaluate the clinical performance and potential risk factors for these restorations. MATERIALS AND METHODS Analysis took place based on the medical patient-records of three dental offices. Implant survival and prosthetic complications over time were evaluated. The study included SICs in premolar and molar regions made from monolithic lithium disilicate ceramic (M_LiDi) or veneered zirconia (V_ZiO) luted on a TBA documented over an observation time of at least 3 years. Survival and complication rates were calculated and compared by a log-rank test. Cox-Regressions were used to check potential predictors for the survival (p < .05). RESULTS Six hundred and one crowns out of 371 patients met the inclusion criteria and follow-up period was between 3.0 and 12.9 (mean: 6.4 (SD: 2.1)) years. Over time, six implants had to be removed and 16 restorations had to be refabricated. The estimated survival rates over 10 years were 93.5% for M_LiDi and 95.9% for V_ZiO and did not differ significantly among each other (p = .80). However, V_ZiO showed significantly higher complication rates (p = .003). Material selection, sex, age, and implant diameter did not affect the survival of investigated SICs but crown height influences significantly the survival rate (hazard ratio, HR = 1.26 (95%CI: 1.08, 1.49); p = .043). CONCLUSIONS Screw-retained SICs luted on TBAs that were fabricated from monolithic lithium disilicate ceramic or veneered zirconia showed reliable and similar survival rates. Increasing crown heights reduced survival over the years.
Collapse
Affiliation(s)
- Tobias Graf
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Iulia Dahmer
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | | | | | - Jan-Frederik Güth
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| |
Collapse
|
2
|
Laforì A, Sailer I, Fehmer V, Mojon P, Burkhardt F, Pitta J. Influence of sterilization on the retention forces of lithium disilicate and polymer-infiltrated ceramic-network crowns bonded to titanium base abutments: An in-vitro study. Clin Oral Implants Res 2024; 35:377-385. [PMID: 38170349 DOI: 10.1111/clr.14234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate the effect of sterilization on the retention forces of lithium disilicate (LD) and polymer-infiltrated ceramic network (PICN) crowns bonded to titanium base (Ti-base) abutments. MATERIALS AND METHODS Forty LD and 40 PICN crowns were milled and then bonded to 80 Ti-bases with two resin composite cements: Multilink Hybrid Abutment (mh) and Panavia V5 (pv) for a total of 8 groups (n = 10). Half of the specimens (test) underwent an autoclaving protocol (pressure 1.1 bar, 121°C, 20.5 min) and the other half not (control). Restorations were screw-retained to implants, and retention forces (N) were measured with a pull-off testing machine. The surfaces of the Ti-bases and the crowns were inspected for the analysis of the integrity of the marginal bonding interface and failure mode. Student's t-test, chi-square test, and univariate linear regression model were performed to analyze the data (α = 0.05). RESULTS The mean pull-off retention forces ranged from 487.7 ± 73.4 N to 742.2 ± 150.3 N. Sterilized groups showed statistically significant overall higher maximum retention forces (p < .05), except for one combination (LD + mh). Sterilization led to an increased presence of marginal gaps and deformities compared to no-sterilization (p < .001), while no statistically significant relationship was found between failure mode and sterilization (p > .05). CONCLUSIONS Sterilization may have a beneficial effect on the retention forces of LD and PICN crowns bonded to titanium base abutments, although it may negatively influence the integrity of the marginal bonding interface.
Collapse
Affiliation(s)
- Andreina Laforì
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Vincent Fehmer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Philippe Mojon
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Felix Burkhardt
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
3
|
Rohr N, Karakas-Stupar I, Karlin S, Zitzmann NU, Zaugg LK. Effect of implant type on the stability of cantilever fixed dental prostheses: An in vitro study. Clin Oral Implants Res 2024; 35:419-426. [PMID: 38329172 DOI: 10.1111/clr.14240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/30/2023] [Accepted: 01/11/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES To simulate the replacement of a premolar with an implant-supported cantilever fixed dental prosthesis (ICFDP) and how the fracture load is affected by implant type, positioning within the zirconia blank, and aging protocol. MATERIALS AND METHODS Seventy-two ICFDPs were designed either within the enamel- or dentin layer of a 4Y-PSZ blank for bone-level and tissue-level titanium-zirconium implants. Fracture load was obtained on the cantilever at baseline (no aging) or after aging in a chewing simulator with the load applied within the implant axis (axial aging) or on the cantilever (12 groups with n = 6). A three-way ANOVA was applied (α = .05). RESULTS A three-way ANOVA revealed a significant effect on fracture load values of implant type (p = .006) and aging (p < .001) but not for the position within the zirconia blank (p = .847). Fracture load values significantly increased from baseline bone level (608 ± 118 N) and tissue level (880 ± 293 N) when the implants were aged axially, with higher values for tissue level (1065 ± 182 N) than bone level (797 ± 113 N) (p < .001). However, when the force was applied to the cantilever, fracture load values decreased significantly for tissue-level (493 ± 70 N), while values for bone-level implants remained stable (690 ± 135 N). CONCLUSIONS For ICFDPs, the use of bone-level implants is reasonable as catastrophic failures are likely to be restricted to the restoration, whereas with tissue-level implants, the transmucosal portion of the implant is susceptible to deformation, making repair more difficult.
Collapse
Affiliation(s)
- Nadja Rohr
- Biomaterials and Technology, Department of Research, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Irina Karakas-Stupar
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Sabrina Karlin
- Biomaterials and Technology, Department of Research, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Lucia K Zaugg
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| |
Collapse
|
4
|
Riera C, Karasan D, Sailer I, Mojon P, Fehmer V, Pitta J. Mechanical stability of posterior implant-supported monolithic zirconia cantilever on titanium-base abutments. An in vitro study. Clin Oral Implants Res 2024. [PMID: 38415804 DOI: 10.1111/clr.14251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Investigate survival and technical complications of two-unit posterior implant-supported cantilever made of monolithic zirconia on titanium-base abutments (Zr-TiB) vs. porcelain-fused-to-metal on castable gold abutments (PFM-GA) using two different implant connections, internal butt-joint (IBJ) and internal conical (IC). MATERIALS AND METHODS Forty-eight implants (4.3 mm diameter) were divided into four groups (n = 12) to support 2-unit mandibular premolar cantilevers with two different materials (Zr-TiB vs. PFM-GA) and two connection types (IBJ vs. IC). Tested groups were as follows: (1) IBJ/Zr-TiB; (2) IBJ/PFM-GA; (3) IC/Zr-TiB; and (4) IC/PFM-GA. Specimens were thermomechanical aged (1,200,000 cycles, 98 N, 5-55°C) with occlusal axial load on the pontic. Catastrophic and non-catastrophic events were registered, and removal torque values measured before and after aging. Specimens surviving aging were subjected to loading until failure. Survival, total complication rates, torque loss (%), and bending moments were calculated. RESULTS From 48 specimens, 38 survived aging. Survival rates significantly varied from 16.7% (IC/PFM-GA) to 100% (IBJ/Zr-TiB; IBJ/PFM-GA; IC/Zr-TiB) (p < .01). Internal conical connection revealed significantly higher torque loss (IC/ZrTiB - 67%) compared to internal butt-joint (IBJ/Zr-TiB - 44%; IBJ/PFM-GA - 46%) (p < .01). Bending moments were higher in internal butt-joint connections than in internal conical (p < .05). CONCLUSION AND CLINICAL IMPLICATIONS Two-unit posterior implant-supported cantilever FDPs replacing mandibular premolars composed of monolithic zirconia on titanium-base abutments demonstrated higher mechanical stability compared to porcelain-fused-to-metal on castable gold abutments in this in vitro study. The internal conical connection combined with porcelain-fused-to-metal on gold abutments revealed a high number of failures; therefore, their clinical use may be considered cautiously for this indication.
Collapse
Affiliation(s)
- Carme Riera
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Phillipe Mojon
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Vincent Fehmer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|
5
|
Schubert O, Goob J, Schweiger J, Güth JF, Edelhoff D, Graf T. Clinical performance of monolithic lithium disilicate hybrid abutment crowns over at least 3.5 years. J Prosthodont 2024; 33:34-40. [PMID: 37243453 DOI: 10.1111/jopr.13719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
PURPOSE Hybrid abutment crowns (HACs) made from monolithic ceramics represent an efficient option for single restorations on implants. However, long-term data are scarce. The purpose of this clinical trial was to evaluate the survival and complication rates of CAD-CAM fabricated HACs over a time period of at least 3.5 years. MATERIALS AND METHODS Twenty-five patients with a total of 40 HACs made of monolithic lithium disilicate ceramic bonded to a titanium base CAD-CAM abutment were retrospectively evaluated. All implants and screw-retained restorations were placed and manufactured in the same department of a university hospital. Only crowns that had been in service for more than 3.5 years were included in the study. HACs were evaluated regarding technical and biological complications. Functional Implant Prosthodontic Scores (FIPS) were obtained. RESULTS The mean observation time was 5.9 ± 1.4 years. Implant survival was 100%, and HAC survival was 97.5%. Over the observation period, one crown fracture was observed, necessitating refabricating of the restoration. Three minor biological complications were found. The overall mean FIPS score was 8.69 ± 1.12 points. CONCLUSIONS Within the limitations of this study, monolithic screw-retained HACs milled from lithium disilicate ceramics and bonded to titanium bases appeared to be a reliable treatment option over more than 3.5 years due to their low biological and technical complication rates.
Collapse
Affiliation(s)
- Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Janosch Goob
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Jan-Frederik Güth
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Graf
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| |
Collapse
|
6
|
Karasan D, Pitta J, Zarauz C, Strasding M, Liu X, Fehmer V, Sailer I. The influence of titanium-base abutment geometry and height on mechanical stability of implant-supported single crowns. Clin Oral Implants Res 2023. [PMID: 37929698 DOI: 10.1111/clr.14207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/22/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023]
Abstract
AIM This study aimed to investigate the influence of titanium base (ti-base) abutment macro- and micro-geometry on the mechanical stability of polymer-infiltrated ceramic network (PICN) screw-retained implant-supported single crowns (iSCs). MATERIALS AND METHODS Twelve specimens per group were used, comprising six different implant/ti-base abutment combinations restored with PICN iSCs: Nb-T (gingival height [GH]: 1.5 mm, prosthetic height [PH]: 4.3 mm), CC (GH: 0.8 mm, PH: 4.3 mm), CC-P (GH: 0.8 mm, PH: 7 mm), Nb-V (GH: 1.5 mm, PH: 6 mm), St (GH: 1.5 mm, PH: 5.5 mm), and Th (GH: 0.5 mm, PH: 9 mm). The specimens underwent thermo-mechanical aging, and those that survived were subsequently subjected to static loading until failure. The data were analyzed using a one-way ANOVA test followed by Tukey post hoc test (α = .05). RESULTS All specimens survived thermo-mechanical aging without complications, namely, visible cracks, debonding, or screw loosening. Th group demonstrated the highest strength values among all the groups, with significant differences compared to Nb-T (p < .05), CC (p < .001), and St (p < .001). Additionally, CC-P group exhibited significantly superior fracture strength results compared to CC (p < .05) and St (p < .05). CONCLUSION The choice of ti-base, particularly prosthetic height, had a significant influence on fracture resistance of PICN iSCs. Nevertheless, the height or geometrical features of the ti-base did not exhibit a significant influence on the mechanical behavior of the iSC/ti-base assembly under thermomechanical loading, as all specimens withstood the aging without complication or failure.
Collapse
Affiliation(s)
- Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Cristina Zarauz
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Xinran Liu
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
- Department of Comprehensive Dentistry, Peking University and Hospital of Stomatology First Clinical Division, Beijing, China
| | - Vincent Fehmer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| |
Collapse
|