Int J Oral Maxillofac Implants. 2022 Jul-Aug;37(4):677-684. doi: 10.11607/jomi.9657.
To compare the fracture resistance of a press-on ceramic custom implant restoration with pressed and cemented restorations.
Thirty-two (32) lithium disilicate (IPS e.max Press) custom hybrid abutment restorations were fabricated. The restorations were divided into two groups (n = 16) according to the construction technique: the commercial control group (C) and the press-on group (P). For the control group, lithium disilicate restorations were pressed and cemented on titanium bases. For the press-on group, lithium disilicate pressable ceramic (IPS e.max Press) was pressed on the titanium bases with injection molding. Each group was further divided according to the restoration design, either screw- or cement-retained, into two subgroups of eight specimens each. Specimens of C group were divided into screw-retained (cemented hybrid abutment crown, CHAC) or cement-retained (cemented hybrid abutment, CHA). Specimens of the P group were also divided into screw-retained (pressed hybrid abutment crown, PHAC) and cement-retained (pressed hybrid abutment, PHA). The specimens were subjected to static loading until failure with a universal testing machine. Two-way analysis of variance (ANOVA) was used to assess the effect of different techniques and designs on the fracture resistance of the samples (P < .05), followed by one-way ANOVA and Tukey honest significant difference (HSD) test (α = .05).
C group showed higher mean fracture resistance (812.443 ± 129.14 N) than P group (596.71 ± 108.83 N), and the difference was statistically significant (P < .05). Regarding restoration design, HA groups showed higher mean fracture resistance (742.621 ± 153.82 N) than HAC (666.53 ± 163.07 N) groups with no statistically significant difference. CHA showed the highest mean fracture resistance (817.65 ± 161.76 N), while PHAC showed the lowest mean fracture resistance values (525.83 ± 47.29 N).
The commercial cemented lithium disilicate restorations showed higher fracture resistance than the press-on restorations, although both showed a maximum load capacity that was greater than physiologic incisal force in the anterior region, and both hybrid abutments and hybrid abutment crowns were equally efficient in withstanding occlusal loading forces.
比较压入式陶瓷定制种植体修复体与压入式和粘结式修复体的抗折强度。
制作了 32 个锂硅玻璃陶瓷（IPS e.max Press）定制混合基台修复体。根据制作技术将修复体分为两组（n=16）：商业对照组（C 组）和压入组（P 组）。对于 C 组，将锂硅玻璃陶瓷修复体压入钛基底上。对于 P 组，将可压入式锂硅玻璃陶瓷（IPS e.max Press）压入钛基底上注塑成型。每组根据修复体设计进一步分为螺钉固位或粘结固位两组，每组 8 个样本。C 组的样本分为螺钉固位（粘结混合基台冠，CHAC）或粘结固位（粘结混合基台，CHA）。P 组的样本也分为螺钉固位（压入混合基台冠，PHAC）和粘结固位（压入混合基台，PHA）。用万能试验机对样本进行静载直至破坏。采用双因素方差分析（ANOVA）评估不同技术和设计对样本抗折强度的影响（P<.05），然后进行单因素 ANOVA 和 Tukey 诚实显著差异（HSD）检验（α=.05）。
C 组的平均抗折强度（812.443±129.14N）高于 P 组（596.71±108.83N），差异具有统计学意义（P<.05）。关于修复体设计，HA 组的平均抗折强度（742.621±153.82N）高于 HAC 组（666.53±163.07N），但差异无统计学意义。CHA 组的平均抗折强度最高（817.65±161.76N），而 PHAC 组的平均抗折强度最低（525.83±47.29N）。
商业粘结式锂硅玻璃陶瓷修复体的抗折强度高于压入式修复体，尽管两者的最大负载能力均大于前牙区的生理切力，且混合基台和混合基台冠均能有效承受咬合加载力。
