Department of Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA 90089-7792, USA.
Clin Oral Implants Res. 2012 Dec;23(12):1360-8. doi: 10.1111/j.1600-0501.2011.02360.x. Epub 2011 Nov 25.
This study assessed the fatigue resistance and failure mode of porcelain and composite resin crowns and onlays bonded to premolar custom zirconia implant abutments.
Sixty standardized zirconia implant abutments were milled (NeoShape) according to two different restoration designs (onlay or crown). Using Cerec 3, the corresponding onlays and crowns were fabricated either in ceramic (Paradigm C) or composite resin (Paradigm MZ100), resulting in four experimental groups (n = 15). The fitting surfaces of the abutments were airborne-particle abraded and cleaned. The intaglio surfaces of the restorations were HF-etched and silanated (Paradigm C) or airborne-particle abraded and silanated (Paradigm MZ100). Following insertion of the abutments into a Morse taper implant (Titamax CM), all restorations were bonded with a zirconia primer (Z-Prime Plus), adhesive resin (Optibond FL), and a preheated light curing composite resin (Filtek Z100). Cyclic isometric chewing (5 Hz) was simulated, starting with a load of 50N (5000×), followed by stages of 200N, 400N, 600N, 800N, 1000N, 1200N, and 1400N (25,000× each). Samples were loaded until fracture or to a maximum of 180,000 cycles. The four groups were compared using the life table survival analysis (Logrank test at P = 0.05).
All composite resin onlays and crowns survived (100% survival rate), while ceramic ones fractured at an average load of 1347N and 1280N, respectively, (survival rate of 46.7% and 20%) with a significant difference in survival probability (P < 0.0001). Fractures consisted in partial or total failure of the restoration only (no abutment failure, no screw loosening).
Composite resin onlays and crowns bonded to custom zirconia implant abutments presented a significant higher survival rate when compared to ceramic onlays and crowns.
本研究评估了烤瓷和复合树脂冠及嵌体粘结于前磨牙定制氧化锆种植体基台的耐疲劳性和失效模式。
根据两种不同的修复设计（嵌体或冠），用 NeoShape 铣床加工 60 个标准化氧化锆种植体基台。使用 Cerec 3，分别制作相应的嵌体和冠，采用陶瓷（Paradigm C）或复合树脂（Paradigm MZ100），共产生四个实验组（n=15）。用空气颗粒喷砂和清洁基台的结合面。修复体的凹面用 HF 酸蚀和硅烷化（Paradigm C）或空气颗粒喷砂和硅烷化（Paradigm MZ100）。将基台插入莫氏锥度种植体（Titamax CM）后，所有修复体均用氧化锆底漆（Z-Prime Plus）、粘结树脂（Optibond FL）和预热光固化复合树脂（Filtek Z100）粘结。以 50N（5000×）的初始载荷开始模拟等距循环咀嚼（5Hz），随后为 200N、400N、600N、800N、1000N、1200N 和 1400N（每次 25000×）。在样品断裂或达到 180000 次循环之前，施加不同的载荷。使用寿命表生存分析（Logrank 检验，P=0.05）比较四组。
所有复合树脂嵌体和冠均存活（存活率 100%），而陶瓷嵌体和冠分别在平均载荷 1347N 和 1280N 时发生断裂（存活率分别为 46.7%和 20%），生存概率有显著差异（P<0.0001）。断裂仅发生在修复体的部分或完全失效，而基台无断裂，螺丝无松动。
复合树脂嵌体和冠粘结于定制氧化锆种植体基台的存活率明显高于陶瓷嵌体和冠。
