Donmez Mustafa Borga, Diken Turksayar Almira Ada, Olcay Emin Orkun, Sahmali Sevil Meral
Biruni University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey.
J Prosthodont. 2022 Apr;31(4):348-355. doi: 10.1111/jopr.13415. Epub 2021 Aug 30.
To evaluate the fracture resistance and fracture patterns of single implant-supported crowns with different prosthetic designs and materials.
One hundred and forty-four identical crowns were fabricated from zirconia-reinforced lithium silicate (ZLS), leucite-based (LGC), and lithium disilicate (LDS) glass-ceramics, reinforced composite (RC), translucent zirconia (ZR), and ceramic-reinforced polyetheretherketone (P). These crowns were divided into 3 subgroups according to restoration design: cementable crowns on a prefabricated titanium abutment, cement-retained crown on a zirconia-titanium base abutment, and screw-cement crown (n = 8). After adhesive cementation, restorations were subjected to thermal-cycling and loaded until fracture. The fracture patterns were evaluated under a stereomicroscope. Statistical analysis was performed by using 2-way ANOVA/Bonferroni multiple comparison post hoc test (α = 0.05).
For each prosthetic design, ZR presented the highest fracture resistance (p ≤ 0.005). Other than the differences with ZLS and RC for screw-cement crowns (p > 0.05) and RC for crowns on zirconia-titanium base abutments (p > 0.05), LGC showed the lowest fracture resistance. P endured higher loads than LDS (p < 0.001), except for the crowns on zirconia-titanium base abutments (p > 0.05). Cementable crowns presented the highest fracture resistance (p < 0.001), other than LGC and LDS. The differences between LGC crowns (p > 0.05) or LDS crowns on prefabricated titanium and zirconia-titanium abutments were nonsignificant (p = 0.133). Fragmented crown fracture was predominant in most of the restorations. Screw and abutment fractures were observed in ZR screw-cement crowns, and all P crowns were separated from the abutments.
Restorative material and restoration design affect the fracture resistance and fracture pattern of implant-supported single-unit restorations. Clinicians may restore single-unit implants in premolar sites with the materials and prosthetic designs tested in the present study.
评估不同修复设计和材料的单颗种植体支持式冠的抗折性和折裂模式。
用氧化锆增强硅酸锂（ZLS）、白榴石基（LGC）、二硅酸锂（LDS）玻璃陶瓷、增强复合材料（RC）、半透明氧化锆（ZR）和陶瓷增强聚醚醚酮（P）制作144个相同的冠。这些冠根据修复设计分为3个亚组：预制钛基台上的可粘结冠、氧化锆-钛基台上的粘结固位冠和螺丝-粘结冠（n = 8）。粘结粘固后，修复体进行热循环并加载直至折裂。在体视显微镜下评估折裂模式。采用双向方差分析/邦费罗尼多重比较事后检验进行统计分析（α = 0.05）。
对于每种修复设计，ZR的抗折性最高（p≤0.005）。除了螺丝-粘结冠与ZLS和RC之间的差异（p>0.05）以及氧化锆-钛基台上的冠与RC之间的差异（p>0.05）外，LGC的抗折性最低。除了氧化锆-钛基台上的冠（p>0.05）外，P承受的载荷高于LDS（p<0.001）。除LGC和LDS外，可粘结冠的抗折性最高（p<0.001）。预制钛基台和氧化锆-钛基台上LGC冠（p>0.05）或LDS冠之间的差异无统计学意义（p = 0.133）。大多数修复体中主要为冠碎裂折裂。在ZR螺丝-粘结冠中观察到螺丝和基台折裂，所有P冠均与基台分离。
修复材料和修复设计影响种植体支持的单单位修复体的抗折性和折裂模式。临床医生可以使用本研究中测试的材料和修复设计来修复前磨牙区的单单位种植体。
