Comparison of fatigue lifetime of new generation CAD/CAM crown materials on zirconia and titanium abutments in implant-supported crowns: a 3D finite element analysis.

OBJECTIVES: Due to the dynamic character of the stomatognathic system, fatigue life experiments simulating the cyclic loading experienced by implant-supported restorations are critical consideration. The aim of this study was to examine the effect of different crown and abutment materials on fatigue failure of single implant-supported crowns. METHODS: Models were created for 10 different designs of implant-supported single crowns including two zirconia-reinforced lithium silicates (crystallized and precrystallized), monolithic lithium disilicate, polymer-infiltrated ceramic networks, and polyetheretherketone supported by zirconia and titanium abutments. A cyclic load of 179 N with a frequency of 1 Hz was applied on palatal cusp of a maxillary first premolar at a 30° angle in a buccolingual direction. RESULTS: In the models with titanium abutments, the polymer-infiltrated ceramic network model had a lower number of cycles to fatigue failure values in the implant (5.07), abutment (2.30), and screw (1.07) compared to others. In the models with zirconia abutments, the crystallized zirconia-reinforced lithium silicate model had a higher number of cycles to fatigue failure values in the abutment (8.52) compared to others. Depending on the fatigue criteria, polyetheretherketone implant crown could fail in less than five year while the other implant crowns exhibits an infinite life on all models. CONCLUSIONS: The type of abutment material had an effect on the number of cycles to fatigue failure values for implants, abutments, and screws, but had no effect on crown materials. The zirconia abutment proved longer fatigue lifetime, and should thus be considered for implant-supported single crowns.

Static and dynamic stress analysis of different crown materials on a titanium base abutment in an implant-supported single crown: a 3D finite element analysis.

BACKGROUND: This Finite Element Analysis was conducted to analyze the biomechanical behaviors of titanium base abutments and several crown materials with respect to fatigue lifetime and stress distribution in implants and prosthetic components. METHODS: Five distinct designs of implant-supported single crowns were modeled, including a polyetheretherketone (PEEK), polymer-infiltrated ceramic network, monolithic lithium disilicate, and precrystallized and crystallized zirconia-reinforced lithium silicates supported by a titanium base abutment. For the static load, a 100 N oblique load was applied to the buccal incline of the palatal cusp of the maxillary right first premolar. The dynamic load was applied in the same way as in static loading with a frequency of 1 Hz. The principal stresses in the peripheral bone as well as the von Mises stresses and fatigue strength of the implants, abutments, prosthetic screws, and crowns were assessed. RESULTS: All of the models had comparable von Mises stress values from the implants and abutments, as well as comparable maximum and minimum principal stress values from the cortical and trabecular bones. The PEEK crown showed the lowest stress (46.89 MPa) in the cervical region. The prosthetic screws and implants exhibited the highest von Mises stress among the models. The lithium disilicate crown model had approximately 9.5 times more cycles to fatique values for implants and 1.7 times more cycles to fatique values for abutments than for the lowest ones. CONCLUSIONS: With the promise of at least ten years of clinical success and favorable stress distributions in implants and prosthetic components, clinicians can suggest using an implant-supported lithium disilicate crown with a titanium base abutment.

Impact of various aging treatments on the microhardness and surface roughness of CAD-CAM monolithic restorative materials.

PURPOSE: Dental ceramics deteriorate as a result of thermal aging and exposure to acidic solutions, which change their microhardness and surface roughness. This study assessed the resistance of several computer-aided design and computer-aided manufacturing (CAD-CAM) restorative dental materials in terms of surface roughness and microhardness following exposure to acidic solutions and thermal aging. MATERIALS AND METHODS: Five different monolithic CAD-CAM restorative materials, two leucite-reinforced glass ceramics (G-Ceram and CEREC Blocs), a zirconia-infiltrated lithium silicate (Celtra Duo), a resin nanoceramic (Grandio), and monolithic zirconia (inCoris TZI), were used to create 2-mm-thick rectangular specimens (n = 100). After being immersed in either acidic saliva (pH = 4.0) (ST) or gastric juice (pH = 1.2) (GT), each material was subjected to 10,000 cycles of thermal aging. The Vickers microhardness and average surface roughness of the specimens were assessed at baseline, following thermal aging and exposure to either gastric juice or acidic saliva. The surface properties were examined using an atomic force microscope. The Mann‒Whitney U test with Bonferroni correction and the Wilcoxon signed-rank test was used for statistical analysis (a = 0.05). RESULTS: The surface roughness of two leucite-reinforced glass ceramics (G-ceram and CEREC) significantly decreased with ST (p = 0.027 and p = 0.044). Only the CEREC was affected when the aging protocols were compared, and the ST group had a significant reduction in roughness (p = 0.009). The microhardness values significantly decreased after both aging protocols in all groups except for the ST subgroup of G-Ceram. Only inCoris was affected when the aging protocols were compared, and the GT group exhibited a significant reduction in microhardness (p = 0.002). CONCLUSION: The surface roughness of the tested materials was not affected by the GT. Only leucite ceramics exhibited a decrease in surface roughness in the ST stage. Both aging processes produced a significant decrease in the microhardness of the tested ceramics. Leucite-reinforced glass-ceramic materials may be advantageous for patients with gastroesophageal reflux disease and those with a diet high in acidic foods due to their lower values for changes in microhardness and surface roughness compared to those of other CAD-CAM materials.

The effect of different abutment and restorative crown materials on stress distribution in single-unit implant-supported restorations: A 3D finite element stress analysis.

PURPOSE: To evaluate the effect of restorative materials with or without resin content, modeled on zirconia and titanium abutment materials, on the stress distribution on the alveolar bone, implant, and prosthetic crowns with a 3D finite element stress analysis. MATERIAL AND METHODS: Titanium and zirconia abutments were combined with three implant-supported crown materials (polymer infiltrated hybrid ceramic (PICN), lithium disilicate (LD), and zirconia-reinforced lithium silicate (ZLS)) to create six experimental groups. The 40 × 30 × 20 mm alveolar bone, 3.75 × 10 mm implant, esthetic abutment, and maxillary first premolar crown bonded over the abutment were the components of the finite element models. On the lingual cusp of the crown, the 150 N occlusal loading was applied in the buccolingual direction at a 30° angle. Equivalent von Mises stress and maximum and minimum principal stresses were used for both the qualitative and quantitative evaluation of the stress distribution of the created models. RESULTS: The von Mises stress in implant and abutment did not differ according to the crown materials. The use of a zirconia abutment resulted in higher von Mises stress values in the abutment but lower stress values in the implant. The highest stress values were obtained in ZLS (196.65 MPa) and LD (194.05 MPa) crowns. The use of titanium abutments, regardless of crown materials, resulted in higher von Mises stress values in restorative crowns than in zirconia abutments. The principal stress values in alveolar bone showed similar distribution and concentration in all models. CONCLUSIONS: Changes in crown material did not affect stress distribution in the implant and peripheral bone. However, the zirconia esthetic abutment resulted in a lower stress concentration on the implant.

Mechanical response of different frameworks for maxillary all-on-four implant-supported fixed dental prosthesis: 3D finite element analysis.

This study's purpose is to assess the stress distribution in the peri-implant bone, implants, and prosthetic framework using two different posterior implant angles. All-on-four maxillary prostheses fabricated from feldspathic-ceramic-veneered zirconia-reinforced lithium silicate (ZLS) and feldspathic-ceramic-veneered cobalt-chromium (CoCr) were designed with 17 or 30-degree-angled posterior implants. Posterior cantilever and frontal vertical loads were applied to all models. The distribution of maximum and minimum principal stresses (σmax and σmin) and von Mises stress (σVM) was evaluated. Under posterior cantilever load, with an increase in posterior implant angle, σmax decreased by 4 and 7 MPa in the cortical bone when ZLS and CoCr were used as a prosthetic framework, respectively. Regardless of the framework material, 17-degree-angled posterior implants showed the highest σVM (541.36 MPa under posterior cantilever load; 110.79 MPa under frontal vertical load) values. Regardless of the posterior implant angle, ZLS framework showed the highest σVM (91.59 MPa under posterior cantilever load; 218.99 MPa under frontal vertical load) values. Increasing implant angle from 17 to 30° caused a decrease in σmax values in the cortical bone. Designs with 30-degree posterior implant angles and ZLS framework material may be preferred in All-on-four implant-supported fixed complete dentures.

Biomechanical comparison of different prosthetic materials and posterior implant angles in all-on-4 treatment concept by three-dimensional finite element analysis.

The study aimed to evaluate the biomechanical behaviors of different prosthetic materials and posterior implant angles in All-on-4 implant-supported fixed maxillary prostheses with three-dimensional (3D) finite element analysis. The model of complete edentulous maxilla was created using the Rhinoceros and VRMesh Studio programs. Anterior vertical and 17°- and 30°-angled posterior implants were positioned with All-on-4 design. Straigth and angled multi-unit abutments scanned using a 3D scanner. Two different prosthetic superstructures (monolithic zirconia framework and lithium disilicate veneer (ZL) and monolithic zirconia-reinforced lithium silicate (ZLS)) were modeled. Four models designed according to the prosthetic structure and posterior implant angles. Posterior vertical bilateral loading and frontal oblique loading was performed. The principal stresses (bone tissues-Pmax and Pmin) and von Mises equivalent stresses (implant and prosthetic structures) were analyzed. In all models, the highest Pmax stress values were calculated under posterior bilateral loading in cortical bone. The highest von Mises stress levels occured in the posterior implants under posterior bilateral load (260.33 and 219.50 MPa) in the ZL-17 and ZL-30 models, respectively. Under both loads, higher stress levels in prosthetic structures were shown in the ZLS models compared with ZL models. There was no difference between posterior implant angles on stress distribution occurred in implant material and alveolar bone tissue. ZLS and ZL prosthetic structures can be reliably used in maxillary All-on-4 rehabilitation.

The Effect of Denture Cleansing Solutions on the Retention of Precision Attachments: An In Vitro Study.

This study aimed to investigate the effect of different cleansing solutions on the retention of precision attachments. A precision attachment patrix was embedded into acrylic resin and the matrix was placed onto the patrix. The red (high retention, 8 N), yellow (regular retention, 6 N), and green (reduced retention, 4 N) plastic matrixes of the attachments (n = 32) were soaked in three different denture cleansing solutions (sodium laureth sulfate, sodium bicarbonate-sodium perborate, sodium bicarbonate) for a duration simulating 6 months of clinical use. The control group was soaked in tap water. A universal testing machine was used to measure the retention values of attachments after they were soaked in denture cleansers. The retention values were compared among the groups with repeated-measures analysis of variance followed by the Tukey HSD test (p = 0.05). Yellow attachments were affected by sodium laureth sulfate, sodium bicarbonate-sodium perborate, and water (p = 0.012). Green attachments' retention increased after immersion in sodium laureth sulfate (p = 0.04) and water (p = 0.02). Red attachments' retention increased after immersion in sodium laureth sulfate or sodium bicarbonate-sodium perborate (p = 0.045). Water did not affect the retention of red attachments. Because sodium bicarbonate tablets did not affect the retention of attachments, clinicians may recommend their use as a cleanser. Clinicians also may inform patients using fixed and removable partial prostheses with precision attachments of a possible increase in retention after the use of sodium laureth sulfate or when using sodium bicarbonate-sodium perborate with yellow and red attachments.

Biaxial flexural strength and phase transformation characteristics of dental monolithic zirconia ceramics with different sintering durations: An in vitro study.

STATEMENT OF PROBLEM: Zirconia is a polymorphic metastable material which can react through a phase transformation from tetragonal to monoclinic when exposed to mechanical, physical, or chemical stimuli. PURPOSE: The purpose of this in vitro study was to investigate the fracture strength and phase structure of different high-translucency zirconia ceramics depending on the changes in sintering duration and thermocycling. MATERIAL AND METHODS: Two monolithic zirconia ceramics, Katana (KAT) and NexxZr (NEX), were used to prepare disk-shaped specimens (n=66). The sintering temperature was 1500 °C, and 3 different sintering durations were tested: 1 hour, 2 hours (recommended by the manufacturer), and 3 hours. Thermocycling was applied to half the specimens. Fracture strength was calculated, and the specimens were analyzed with an X-ray diffractometer (XRD) to determine the level of the phase transformation. The normal distribution of the data was analyzed by using the Shapiro-Wilk test. Two-way ANOVA was used to compare multiple groups (α=.05). The Fisher least significant difference test was applied to identify significant differences in fracture strength. The paired-specimen t test was applied to perform intragroup comparisons. RESULTS: Sintering duration significantly affected the fracture strength of KAT (P=.007). For nonthermocycled specimens, the fracture strength of NEX was significantly higher than that of KAT (P<.001). Thermocycling had a significant effect on fracture strength depending on sintering duration and zirconia ceramic interaction (P=.046). CONCLUSIONS: The sintering duration only affected the KAT zirconia, and the fracture strength of KAT decreased when sintered for 3 hours. Thermocycling decreased the fracture strength of both zirconias, except when the sintering duration was 2 hours for NEX. The fracture strength was higher for NEX than for KAT. Tetragonal-monoclinic phase transformation was not found for either zirconia according to the XRD analysis.

Measurements of surface scale changes in different denture base materials by stereophotogrammetric technique.

Background. This study aimed to evaluate the surface scale changes in the denture base material using different polymerization techniques, such as heat-cure/pressure polymerization system and injection molding technique with the stereophotogrammetric technique. The function of a complete denture is related to the adaptation of its base to the supporting areas. Proper adaptation of the base depends on the stability and retention of dentures. The surface scale changes of dentures during processing and in service are of great importance since they affect the denture base material's fit. Methods. This study focused on the use of a computer-assisted stereophotogrammetric method for measuring changes in the volume of three different denture base resins of an edentulous maxillary ridge. A stone master model simulating the shape of an edentulous maxillary arch was used to prepare three groups of denture base resins. The stereophotographs were evaluated to determine the surface scale differences of maxillary jaws. Results. The results showed no significant differences between the denture borders for three denture base materials (P > 0.05). Conclusion. In the evaluation made using this technique, no significant difference was found in the different polymerization techniques in terms of surface scale changes for three denture base materials. Stereophotogrammetry, especially the digital stereophotogrammetric technique, has several useful research applications in prosthodontics.

Effects of sintering time on translucency and color of translucent zirconia ceramics.

OBJECTIVE: To investigate the effect of sintering time on translucency and color of translucent zirconia ceramics. MATERIALS AND METHODS: Sixty translucent zirconia (5Y-TZP) specimens (12 × 1.6 mm, Katana (KAT) and NexxZr (NEX)) were divided into six groups (n = 10) according to sintering time; 1, 2 (specified by manufacturer-control), and 3 hs. Color differences (ΔEab) within same material when sintered using different times and between materials when same sintering time was used were calculated, as well as translucency parameters (TP) after the use of each sintering time. Data for ΔEab and TP were analyzed with two-way ANOVAs, pairwise comparisons, and Fisher's LSD Test (Post-hoc). RESULTS: When 1 or 3 h were used, color difference from the color of specimens when manufacturer-specified time (2 h) was used was similar for both KAT and NEX. ΔEab values of NEX were significantly higher than KAT when sintered for 1 or 3 h (P < 0.001). TP increased for KAT when sintered for 1 h, and was higher than NEX. TP for NEX increased when sintered for 3 h (P < 0.001), but was not significantly different than that of KAT. CONCLUSIONS: Effect of 1 or 3-h sintering on color was similar for both zirconias. For NEX, this effect resulted in greater differences from the color of specimens when manufacturer-specified time was used. Sintering for 1 h increased the translucency of KAT. CLINICAL SIGNIFICANCE: When high translucency is desired, clinicians may prefer 1-h sintering for KAT zirconia. When lower translucency is desired, 3-h sintering for NEX can be used. However, for NEX, the color after 1- or 3-h sintering was different than the color obtained with manufacturer-specified time, and this difference may affect the final color of restoration compared to the final color when manufacturer-specified time is used.