Evaluation of Vertical Misfit and Torque Loss of Different Abutments for Tri-Channel Type Internal Connection Dental Implants After Mechanical Cycling.

The aim of this study was to evaluate the mechanical behavior of UCLA and Mini-conical abutments for implants with Tri-channel connections regarding torque loss and vertical misfit. Twenty 3-element metal-ceramic fixed partial dentures (FPD) supported by 2 implants were manufactured and divided into 2 groups (n = 10): UCLA (group 1) and Mini-conical Abutments (group 2). The evaluation of torque loss was carried out before and after mechanical cycling, while the vertical fit was evaluated throughout the different stages of manufacturing the prostheses, as well pre- and postcycling (300,000 cycles, 30 N). Statistical analyses of torque loss and vertical misfit were performed using the linear mixed effects model. Both groups showed torque loss after mechanical cycling (P < .05); however, there was no significant percentage differences between them (P = .795). Before cycling, the groups showed a significant difference in terms of vertical misfit values (P < .05); however, this difference was no long observed after cycling (P = .894). Both groups showed torque loss after the cycling test, with no significant difference (P > .05). There was no significant difference in vertical misfit after mechanical cycling; however, in group 1 (UCLA) there was accommodation of the implant-UCLA abutment interface, while group 2 (Mini-conical abutment) did not show changes in the interface with the implant after the test. Both groups behaved similarly regarding the torque loss of the prosthesis retention screws pre- and postmechanical cycling, with greater loss after the test.

Influence of Torque on Platform Deformity of the Tri-Channel Implant: Two- and Three-Dimensional Analysis Using Micro-Computed Tomography.

Background and Objectives: The insertion of the dental implant in the bone is an essential step in prosthetic rehabilitation. The insertion torque has the potential to distort the prosthetic platform, which can cause future biomechanical problems with the continuous action of occlusal forces. The aim of this study is to evaluate different insertion torques in the deformation of tri-channel platform connections through two- and three-dimensional measurements with micro-CT. Materials and Methods: A total of 164 implants were divided into groups (platform diameter and type): 3.5, 3.75, and 4.3 mm NP (narrow platform), and 4.3 mm RP (regular platform). Each implant-platform group was then divided into four subgroups (n = 10) with different torques: T45 (45 Ncm), T80 (80 Ncm), T120 (120 Ncm), and T150 (150 Ncm). The implant-abutment-screw assemblies were scanned and the images obtained were analyzed. Results: A significant difference was observed for the linear and volume measures between the different platforms (p < 0.01) and the different implant insertion torques (p < 0.01). Qualitative analysis suggested a higher deformation resistance for the 3.75 NP compared to the 3.5 NP, and RP was more resistant compared to the NP. Conclusions: The 0.25 mm increment in the implant platform did not increase the resistance to the applied insertion torques; the 4.3 mm implant was significantly stronger compared to the 3.5 mm implant; and the proposed micro-CT analysis was considered valid for both the 2D and 3D analyses of micro-gaps, qualitatively and quantitatively.

Bacterial Detection, Deformation, and Torque Loss on Dental Implants with Different Tapered Connections Compared with External Hexagon Connection after Thermomechanical Cycling.

The relationship between bacterial infiltration and internal conical Implant-Abutment Interfaces (IAIs) with different conicities still requires investigations that can offer valuable information in the clinical understanding of peri-implant health. The present study aimed to verify the bacterial infiltration of two internal conical connections with an angulation of 11.5° and 16° with the external hexagonal connection as a comparative after thermomechanical cycling using saliva as a contaminant. Test (n = 10) and control (n = 3) groups were set up. Evaluations were made on torque loss, Scanning Electron Microscopy (SEM), and Micro Computerized Tomography (MicroCT) after performing 2 × 106 mechanical cycles (120 N) and 600 thermal cycles (5°-55° C) with 2 mm lateral displacement. The contents of the IAI were collected for microbiological analysis. There was a difference (p < 0.05) in torque loss of the groups tested; groups from the 16° IAI obtained a lower percentage of torque loss. All groups presented contamination and the analysis of the results shows that the microbiological profile of the IAI differs qualitatively from the profile found in the saliva used for contamination. The mechanical loading affects the microbiological profile found in the IAIs (p < 0.05). In conclusion, the IAI environment may favor a microbiological profile different from that of saliva and the thermocycling condition may alter the microbial profile found in the IAI.

Mechanical comparison of milled fiber-reinforced resin composite and Co-Cr frameworks with different connector cross-sectional geometries: An in vitro study.

This study compared the effect of using milled fiber-reinforced resin composite and Co-Cr (milled wax and lost-wax technique) frameworks for 4-unit implant-supported partial fixed dental prostheses; and also, evaluated the influence of the connector's cross-sectional geometries on the mechanical behavior. Three groups of milled fiber-reinforced resin composite (TRINIA) for 4-unit implant-supported frameworks (n = 10) with three connectors geometries (round, square, or trapezoid), and three groups of Co-Cr alloy frameworks manufactured by milled wax/lost wax and casting technique, were analyzed. The marginal adaptation was measured before cementation using an optical microscope. Then, the samples were cemented, thermomechanical cycled (load of 100 N/2 Hz, 106 cycles; 5, 37, and 55 ᵒC, a total of 926 cycles at each one), and cementation and flexure strength (maximum force) analyzed. Analysis of stress distribution in framework veneered considering resin and ceramic properties for fiber-reinforced and Co-Cr frameworks, respectively, implant, and bone was by finite element analysis under three contact points (100 N) on the central region. ANOVA and Multiple paired test-t with Bonferroni adjustment (α = 0.05) were used for data analysis. Fiber-reinforced frameworks showed better vertical adaptation (mean ranged from 26.24 to 81.48 µm) compared to the Co-Cr frameworks (mean ranged from 64.11 to 98.12 µm), contrary to horizontal adaptation (respectively, means ranged from 281.94 to 305.38 µm; and from 150.70 to 174.82 µm). There were no failures during the thermomechanical test. Cementation strength showed three times higher for Co-Cr compared to fiber-reinforced framework, as well as flexural strength (P < .001). Regarding stress distribution, fiber-reinforced had a pattern of concentration in the implant-abutment complex. There were no significant differences in stress values or changes observed among the different connector geometries or framework materials. Trapezoid connector geometry had a worse performance for marginal adaptation, cementation (fiber-reinforced 132.41 N; Co-Cr 255.68 N) and flexural strength (fiber-reinforced 222.57 N; Co-Cr 614.27 N). Although the fiber-reinforced framework showed lower cementation and flexural strength, considering the stress distribution values and absence of failures in the thermomechanical cycling test, it can be considered for use as a framework for 4-unit implant-supported partial fixed dental prostheses in the posterior mandible. Besides, results suggest that trapezoid connectors mechanical behavior did not perform well compared to round or square geometries.

Mechanical Properties, Wear Resistance, and Reliability of Two CAD-CAM Resin Matrix Ceramics.

Background and Objectives: There are limited data regarding the behavior of resin matrix ceramics for current CAD-CAM materials. Further studies may be beneficial and can help clinicians planning to use these materials during prosthodontic rehabilitation. The aim of this study was to evaluate and compare the flexural strength and strain distributions, filler content, wear, and reliability of two resin matrix ceramic CAD-CAM materials. Materials and Methods: Two resin matrix ceramics, Ambarino High-Class (AH) and Vita Enamic (VE), were tested for flexural strength (n = 24), wear (n = 10), and reliability (n = 18). Thermogravimetric analysis was used to determine the percentage of filler by weight, and digital image correlation (DIC) was used for strain analysis in flexural strength test. Reliability of each resin matrix ceramic was compared after accelerated lifetime testing of crowns using a two-parameter Weibull distribution. Data of flexural strength, wear, and thermogravimetry were analyzed by independent t-tests with significance level at 5%. Results: The results of DIC analysis were analyzed by a qualitative comparison between the images obtained. The materials tested showed different flexural strength (p < 0.05) and strain distributions. The filler content was the same as informed by manufacturers. No difference was observed in the wear or reliability analysis (p > 0.05). The flexural strength of material AH was superior to VE, and the strain distribution was compatible with this finding. Conclusions: The two resin matrix ceramics tested showed similar behavior in wear and reliability analysis. Both can provide safe use for dental crowns.

Y-TZP Physicochemical Properties Conditioned with ZrO2 and SiO2 Nanofilms and Bond Strength to Dual Resin Cement.

Commercial Yttria-tetragonal zirconia polycrystalline (Y-TZP) was subjected to surface treatments, and the bond strength of dual resin cement to Y-TZP and failure modes were evaluated. Disks (12 mm × 2 mm), cylinders (7 mm × 3.3 mm), and bars (25 mm × 5 mm × 2 mm) were milled from Y-TZP CAD-CAM blocks, divided into seven groups, and subjected to different surface treatments; silicatization was used as control. On the basis of the literature, this study evaluated modifications with films containing SiO2 nanoparticles and silane; SiO2+ZrO2­SiO2 (50%) and ZrO2 (50%) nanoparticles, SiO2+ZrO2/Silane-SiO2 (50%) and ZrO2 (50%) nanoparticles, and silane. Specimens were analyzed by wettability (n = 3), surface free energy (n = 3), X-ray diffraction (n = 1), Fourier transform infrared spectroscopy (FTIR) (n = 1), roughness (n = 5), shear bond test (n = 10), and dynamic modulus (n = 3). Specimens treated with hydrofluoric acid­HF 40% presented significantly higher contact angle and lowest surface free energy (p < 0.05). The SiO2/Silane presented crystalline SiO2 on the surface. The surface roughness was significantly higher for groups treated with nanofilms (p < 0.05). Shear bond strength was significantly higher for silicatization, HF 40%/silicatization, SiO2/Silane, and SiO2+ZrO2/Silane groups. The proposed treatments with nanofilms had potentially good results without prejudice to the physicochemical characteristics of zirconia. Generally, groups that underwent silica surface deposition and silanization had better bond strength (p < 0.005).

Translucency and mechanical behavior of partially stabilized monolithic zirconia after staining, finishing procedures and artificial aging.

Partially stabilized zirconia (5Y-PSZ) has been widely used to manufacture indirect monolithic restorations, and the effect of finishing procedures on the optical and mechanical properties of these materials are still unclear. The purpose of this study was to evaluate the effect of staining, polishing and glazing on surface roughness, crystalline phase content, microhardness, fracture toughness, dynamic elastic modulus, three-point flexural strength, strain distribution, color (∆E00/∆L/∆a/∆b), and translucency before and after artificial accelerated aging (water spray and ultraviolet) of 5Y-PSZ. Bar-shaped and rectangle-shaped specimens of the 5Y-PSZ were prepared and divided into six groups, according to finishing procedure: GC (control), GS (staining), GG (glazing), GSG (staining and glazing), GP (polishing), GSP (staining and polishing). There was a significant difference between groups for surface roughness (p < 0.05), dynamic elastic modulus (p = 0.007), microhardness (p = < 0.05), ∆E00 (p = 0.010), and ∆a (p = 0.008). GC presented higher cubic phase content, and the stained groups (GS, GSG and GSP) presented higher monoclinic content. The different finishing procedures affected roughness, dynamic elastic modulus, microhardness, and color of 5Y-PSZ; polishing being the finish that provides minors changes to the 5Y- PSZ. Accelerated artificial aging caused color change, regardless of finishing procedure used.

Strain Behavior of Implant-Supported Full-Arch Fixed Dental Prostheses Supported by Four or Five Implants.

PURPOSE: Strains transferred to the supporting simulated bone structure by implant-supported full-arch fixed dental prostheses (FAFDPs) were analyzed by digital image correlation (DIC). MATERIALS AND METHODS: Polyurethane models were made using 3.75 × 11-mm implants and divided into the following groups with different implant numbers and design: EH5 (five implants/external hexagon), MT5 (five implants/internal taper), EH4 (four implants/external hexagon), and MT4 (four implants/internal taper). Both qualitative and quantitative (one-way analysis of variance [ANOVA] statistical comparison) analyses were performed by the DIC method after the application of a 250-N load in the central fossa of the mandibular first molar. Different regions of interest were selected in the polyurethane model for comparison between groups. RESULTS: Compressive strains were found in the cervical region of the models, and tensile strains were found in the apical region of the models. Significant differences were found in the different analyzed regions of interest for the different number of supporting implants and implant designs (P < .05). CONCLUSION: Groups with five implants showed more regions with less strain concentration compared to groups with four implants, but strain distribution was similar between groups. The different tested implant designs showed similar strain concentration and distribution to the supporting structures.

A completely digital workflow for an interim implant-supported crown: A clinical report.

This article describes a completely digital workflow for the diagnostic phase, surgical and prosthetic planning, extraction, immediate single implant placement by guided surgery, and interim implant-supported crown. From a virtual impression, zirconia abutments and a polymethylmethacrylate (PMMA) interim crown was planned in a computer-aided design (CAD) software program. This workflow shortened the time required for chairside placement of an interim restoration with enhanced function and esthetics while restoring an anterior mandibular tooth lost after trauma.

Genomic Evaluation of Formed Biofilm on Dental Implants with Different Surface Treatments Associated with Zirconia or Titanium Abutments: An In Vitro Study.

PURPOSE: The aim of this study was to evaluate the formed biofilm on two types of implant surfaces (hydrophilic or hydrophobic) associated with titanium (Ti) or zirconia (Zn) abutments. MATERIALS AND METHODS: Samples were separated into four groups according to type of surface and abutment used (n = 10): (1) hydrophobic/Ti abutment, (2) hydrophilic/Ti abutment, (3) hydrophobic/Zn abutment, and (4) hydrophilic/Zn abutment. Implant-abutment assemblies were incubated with human saliva and supragingival biofilm. Samples of biofilm were evaluated by DNA Checkerboard hybridization, identifying up to 41 species. Scanning electron microscopy (SEM) images were obtained from the implants and abutments. RESULTS: The microbial count was higher for samples from groups with the hydrophilic/Ti abutment, followed by hydrophobic/Zn abutment, hydrophilic/Ti abutment, and hydrophobic/Zn abutment (P < .05). Hydrophilic surfaces and Zn abutments showed the highest counts of microorganisms. Individual bacterial counts were variable between groups; the hydrophilic/Zn abutment group had the highest microbial diversity, including T forsythia, P nigrescens, S oralis, S sanguinis, L casei, M orale, P aeruginosa, P endodontalis, S aureus, S gallolyticus, S mutans, S parasanguinis, S pneumoniae, and C albicans. The hydrophilic/Ti abutment group had the highest count of T forsythia and T denticola, microorganisms of Socransky red complex. The SEM images showed the bacterial colonization in both surfaces of the implant and abutment. CONCLUSION: Different surfaces of implants and abutments showed significant differences in the count and diversity of species. The hydrophilic/Zn abutment group presented the highest count and diversity of target species.

Internal and Marginal Fit and Fracture Strength of Narrow Diameter Dental Implant-Abutment Assembly.

The aim of this study was to assess the internal and vertical marginal fit of metallic copings to abutments and the fracture strength of different narrow diameter dental implant/abutments, either submitted to thermomechanical cycling or not. Sixty-four implant/abutments (n=16) were divided into 4 groups according to diameter and abutment type: G3.5-UAC (morse taper implant Ø3.5mm + universal abutment with beveled chamfer finish); G2.9-UAS (morse taper implant Ø2.9mm + universal abutment with shoulder finish); G2.8-AA (morse taper friction implant Ø2.8mm + anatomical abutment) and G2.5-HP (one-piece implant Ø2.5mm with indexed hexagonal platform). Each group was divided into two subgroups (n=8): submitted and not submitted to thermomechanical cycling (TMC). To assess internal and vertical marginal fit of metallic copings, the assemblies were scanned using microtomography (micro-CT) (n=5). The samples were subjected to the compressive strength test on a universal test machine. Group G3.5-UAC showed the highest marginal misfit regardless of TMC (p<0.05). All other groups were similar after TMC. Group G2.8-AA showed the lowest internal misfit both with and without TMC (p<0.05). Group G2.8-AA showed the highest fracture strength, similar only to G2.5-HP without TMC and G3.5-UAC with TMC. The type of abutment affects the internal and marginal fit of metallic copings and the anatomical abutment led to the best internal and marginal coping fit. The narrow diameter dental implant/abutments differ in terms of fracture strength, the strongest assembly was that composed by implant of type V grade titanium without internal threads (friction implant).

Influence of Different Implants on the Biomechanical Behavior of a Tooth-Implant Fixed Partial Dentures: A Three-Dimensional Finite Element Analysis.

This study analyzed the biomechanical behavior of rigid and nonrigid tooth-implant supported fixed partial dentures. Different implants were used to observe the load distribution over teeth, implants, and adjacent bone using three-dimensional finite element analysis. A simulation of tooth loss of the first and second right molars was created with an implant placed in the second right molar and a prepared tooth with simulated periodontal ligament (PDL) in the second right premolar. Configurations of two types of implants and their respective abutments-external hexagon (EX) and Morse taper (MT)-were transformed into a 3D format. Metal-ceramic fixed partial dentures were constructed with rigid and nonrigid connections. Mesh generation and data processing were performed on the 3D finite element analysis (FEA) results. Static loading of 50 N (premolar) and 100 N (implant) were applied. When an EX implant was used, with a rigid or nonrigid connection, there was intrusion of the tooth in the distal direction with flexion of the periodontal ligament. Tooth intrusion did not occur when the MT implant was used independent of a rigid or nonrigid connection. The rigid or nonrigid connection resulted in a higher incidence of compressive forces at the cortical bone as well as stress in the abutment/pontic area, regardless of whether EX or MT implants were used. MT implants have a superior biomechanical performance in tooth-implant supported fixed partial dentures. This prevents intrusion of the tooth independent of the connection. Both types of implants studied caused a greater tendency of compressive forces at the crestal area.

Effects of surface treatments on mechanical behavior of sintered and pre-sintered yttria-stabilized zirconia and reliability of crowns and abutments processed by CAD/CAM.

PURPOSE: This study evaluates the micro shear bond strength of resin cement to an yttriastabilized zirconia ceramic and the survival probability of zirconia abutments and crowns after different surface treatments through a fatigue test. MATERIALS AND METHODS: The study was divided into two parts. For part 1, 95 zirconia disks were divided into five groups (n = 19): control, untreated, airborne particle abrasion with Al2O3 particles before sintering, airborne particle abrasion with Al2O3 particles after sintering, silicatization before sintering, and silicatization after sintering. Three samples of each group were used for evaluation of surface roughness by confocal laser scanning microscopy and afterward were prepared for surface microstructural analysis by scanning electron microscopy. Ten samples of each group were subjected to micro shear bond strength testing, and the interfaces of the remaining six were examined by scanning electron microscopy. In part 2, 70 external hex zirconia abutments and copings were made by computer-aided design/computer-aided manufacturing (n = 14). Marginal fit of abutment/coping was measured in a confocal laser scanning microscope. Afterward, a fatigue test was carried out with progressive load of 80 up to 320 N (40 N steps), 5 Hz frequency, and 20,000 cycles at each step. Thermal cycling was simultaneously performed (5°C to 55°C). RESULTS: The group treated after sintering with SiO achieved statistically higher micro shear bond strength (P < .01). Higher failure loads were associated with a combined failure. The surface changes in the group treated with SiO before sintering suggest silica deposition, and there was a lack of homogeneity, which was more evident on the surface of the groups treated before sintering. The marginal gap was higher for the group treated before sintering with SiO (P < .01), and the survival probability of the sets was similar for all tested groups (P = .57). CONCLUSION: The micro shear bond strength to zirconia was improved after silicatization after sintering, but the survival probability of crown/abutment/implant sets was not affected by different surface treatments.

Fracture loads and failure modes of customized and non-customized zirconia abutments.

OBJECTIVE: This study aimed to evaluate the fracture load and pattern of customized and non-customized zirconia abutments with Morse-taper connection. METHODS: 18 implants were divided into 3 groups according to the abutments used: Zr - with non-customized zirconia abutments; Zrc - with customized zirconia abutments; and Ti - with titanium abutments. To test their load capacity, a universal test machine with a 500-kgf load cell and a 0.5-mm/min speed were used. After, one implant-abutment assembly from each group was analyzed by Scanning Electron Microscopy (SEM). For fractographic analysis, the specimens were transversely sectioned above the threads of the abutment screw in order to examine their fracture surfaces using SEM. RESULTS: A significant difference was noted between the groups (Zr=573.7±11.66N, Zrc=768.0±8.72N and Ti=659.1±7.70N). Also, the zirconia abutments fractured while the titanium abutments deformed plastically. Zrc presented fracture loads significantly higher than Zr (p=0.009). All the zirconia abutments fractured below the implant platform, starting from the area of contact between the abutment and implant and propagating to the internal surface of the abutment. All the zirconia abutments presented complete cleavage in the mechanical test. Fractography detected differences in the position and pattern of fracture between the two groups with zirconia abutments, probably because of the different diameters in the transmucosal region. SIGNIFICANCE: Customization of zirconia abutments did not affect their fracture loads, which were comparable to that of titanium and much higher than the maximum physiological limit for the anterior region of the maxilla.

Influence of Manufacturing Methods of Implant-Supported Crowns on External and Internal Marginal Fit: A Micro-CT Analysis.

AIM: To evaluate the influence of different manufacturing methods of single implant-supported metallic crowns on the internal and external marginal fit through computed microtomography. METHODS: Forty external hexagon implants were divided into 4 groups (n = 8), according to the manufacturing method: GC, conventional casting; GI, induction casting; GP, plasma casting; and GCAD, CAD/CAM machining. The crowns were attached to the implants with insertion torque of 30 N·cm. The external (vertical and horizontal) marginal fit and internal fit were assessed through computed microtomography. Internal and external marginal fit data (µm) were submitted to a one-way ANOVA and Tukey's test (α = .05). Qualitative evaluation of the images was conducted by using micro-CT. RESULTS: The statistical analysis revealed no significant difference between the groups for vertical misfit (P = 0.721). There was no significant difference (P > 0.05) for the internal and horizontal marginal misfit in the groups GC, GI, and GP, but it was found for the group GCAD (P ≤ 0.05). Qualitative analysis revealed that most of the samples of cast groups exhibited crowns underextension while the group GCAD showed overextension. CONCLUSIONS: The manufacturing method of the crowns influenced the accuracy of marginal fit between the prosthesis and implant. The best results were found for the crowns fabricated through CAD/CAM machining.

Genome analysis and clinical implications of the bacterial communities in early biofilm formation on dental implants restored with titanium or zirconia abutments.

This cross-sectional study aimed to identify and quantify up to 42 target species colonizing the early biofilm of dental implants restored with titanium or zirconia abutments. A total of 720 samples from 20 healthy individuals were investigated. Biofilm samples were collected from the peri-implant sulci, inner parts of implants, abutment surfaces and prosthetic crowns over a functioning period of 30 days. Checkerboard DNA-DNA hybridization was used for microbial detection and quantitation. Clinical characteristics (probing depth, bleeding on probing, clinical attachment level and marginal bone loss) were also investigated during the monitoring period. Genome counts were low at the implant loading time point for both the abutment materials, and increased over time. Both the titanium and the zirconia groups presented similar microbial counts and diversity over time, and the microbiota was very similar to that colonizing the remaining teeth. Clinical findings were consistent with a healthy condition with no significant difference regarding marginal bone loss between the two materials.

Oral bacterial colonization on dental implants restored with titanium or zirconia abutments: 6-month follow-up.

OBJECTIVE: This investigation aimed to characterize in a 6-month follow-up the microbial profile of implants restored with either titanium or zirconia abutments at the genus or higher taxonomic levels. METHODS: Twenty healthy individuals indicative for implant-retained single restorations were investigated. Half of participants were restored with titanium and half with zirconia abutments. Biofilm was collected from the implant-related sites after 1, 3, and 6 months of loading. The 16S rDNA genes were amplified and sequenced with Roche/454 platform. RESULTS: A total of 596 species were identified in 360 samples and grouped in 18 phyla and 104 genera. Titanium- or zirconia-related sites as well as teeth showed similar total numbers of operational taxonomic units (OTUs) colonizing surfaces over time. Firmicutes, Proteobacteria, Fusobacteria, Bacteroidetes, and Actinobacteria were the most prevalent phyla with significant differences between different surfaces and time point. Unclassified genera were found in lower levels (1.71% up to 9.57%) on titanium and zirconia samples when compared with teeth, with no significant differences. CONCLUSION: Titanium- and zirconia-related surfaces are promptly colonized by a bacterial community similar to those found in the remaining adjacent teeth. Results suggest a selective adhesion of different bacterial genotypes for either titanium or zirconia surfaces. Data also indicate a significant interaction between the relative effects taxa, time point, and sampling site. CLINICAL RELEVANCE: The present study disclosed a wider spectrum of microorganisms colonizing either titanium- or zirconia-related microbiomes in very early stage of implant colonization, revealing differences and suggesting a probably specific mechanism for selective bacterial adhesion.

Custom Morse taper zirconia abutments: Influence on marginal fit and torque loss before and after thermomechanical cycling.

The use of zirconia abutments has increased because of aesthetics, but sometimes customization is necessary and its effect is unclear. This study evaluated the marginal fit and torque loss of customized and non-customized aesthetic zirconia abutments associated with Morse taper implants before and after thermomechanical cycling. Twenty-four implant/abutment/crown sets were divided into three groups (N = 8): Zr - non-customized zirconia abutments, Zrc - customized zirconia abutments, and Ti - titanium abutments. The ceramic crowns of the upper canines were made. All of the abutments were tightened with 15-N.cm torque, and the crowns were cemented on the abutments. The misfits and torque loss were measured before and after thermomechanical cycling. The marginal fit was evaluated in two planes throughout 10 different slices, 30 measurements for each face (i.e., buccal, palatal, mesial and distal) and 120 measurements for each sample. A load of 100N, a frequency of 2Hz and 1000,000 cycles with temperature variation of 5°-55°C were used for thermomechanical cycling. Thermomechanical cycling significantly decreased the marginal misfit only with the Zrc (p = 0.002), and the Ti was significantly different from the Zr and Zrc before and after thermomechanical cycling. Thermomechanical cycling did not affect the torque losses of the groups, but a significant difference between the Zr and Zrc (p = 0.0345) before cycling was noted. Customization of zirconia abutments does not significantly affect torque loss and marginal misfit after thermomechanical cycling suggesting that they can be safe for clinical utilization.

Strain transfer behavior of different planning options for mandibular single-molar replacement.

STATEMENT OF PROBLEM: The loss of the first molar and second premolar could lead to mesial movement of the second molar, thus limiting the restoration space for the 2 missing teeth. Placement of a larger first molar is a common choice, but the best implant number and position option remain controversial. PURPOSE: The purpose of this in vitro study was to test different planning options for replacing the mandibular first molar. MATERIAL AND METHODS: Two polyoxymethylene models simulated first molar edentulous spaces of 11 mm (conventional size first molar: control group) and 14 mm (enlarged first molar: all remaining groups other than control). Models included acrylic resin replicas of a first and second premolar, a second molar, and the first molar edentulous space. The following groups were established: control (CO), ø3.5-mm center implant; center implant (CI), ø3.5 mm; mesial implant (MI), ø3.5 mm; distal implant (DI), ø3.5 mm; center implant (WI), ø5.0; 2 implants (2I), 2 ø3.5-mm implants. Three Co-Cr molar crowns were fabricated for each group by using a computer-aided design and computer-aided manufacturing (CAD-CAM) technique. Model surface strains under a 250-N first molar load were calculated by 3-dimensional digital image correlation. Three regions of interest below the first molar were selected for comparison among groups. A test for unequal variances and a follow-up Welch ANOVA were used for statistical analysis (α=.05). RESULTS: The highest strains were found when the first molar was restored by using a 5.0-mm-wide implant (P<.05). Region of interest 1 showed that two 3.5-mm implants replacing the lost molar showed strain distribution similar to that of only one 3.5-mm implant (P>.05). Mesial and distal placement of the implant showed more neutral strain results than other restoration options (P<.05). CONCLUSIONS: Two small-diameter implants in an increased edentulous space show more optimized surface strain behavior than a single wide-diameter implant. However, a single 3.5-mm implant also showed reduced strains in the restoration of the same edentulous space.

Fracture toughness of three heat pressed ceramic systems

Aim: The aim of this study was to evaluate fracture toughness by indentation method of three dental ceramics processed by heat pressing. The ceramics evaluated were fluorapatite glass ceramic (ZIR), glass ceramic containing leucite (POM) and leucite-reinforced glass ceramic (EMP). Materials and methods: Ninety disks (13mm of diameter x 4mm of thickness) and nine rectangular specimens (25x4x2mm) were made to evaluate, respectively, microhardness/fracture toughness (n=30) and elastic modulus (n=3). Samples were obtained by pressing ceramic into refractory molds. After polishing, Vickers microhardness was evaluated under 4,904N load for 20s. Elastic modulus was measured by impulse excitation technique. Data from microhardness and elastic modulus were used to calculate fracture toughness, after measuring crack length under 19,6N load applied for 20s. Results were evaluated by ANOVA and Tukey´s test. Results: Microhardness (VHN) of POM (637.9±53.6) was statistically greater (p<0.05) than ZIR (593.0±14.3), followed by EMP (519.1±21.5); no significant difference (p=0.206) was noted for elastic modulus (GPa) (ZIR: 71.5±9.0; POM: 67.3±4.4; EMP: 61.7±2.3). Fracture toughness (MPa/m) of POM (0.873±0.066) was statistically lower (p<0.05) than ZIR (0.977±0.021) and EMP (0.965±0.035). Conclusion: The results suggest that fluorapatite glass ceramic (ZIR) and leucite-reinforced glass ceramic (EMP) processed by heat pressing presented greater fracture toughness, improving clinical prognosis of metal free restorations