Abstract
Statement of problem
Information is lacking about the fatigue resistance of computer-aided design and computer-aided
manufacturing (CAD-CAM) tooth-colored implant custom abutment materials.
Purpose
The purpose of this in vitro study was to investigate the reliability of different
types of CAD-CAM tooth-colored implant custom abutments.
Material and methods
Zirconia (Lava Plus), lithium disilicate (IPS e.max CAD), and resin-based composite
(Lava Ultimate) abutments were fabricated using CAD-CAM technology and bonded to machined
titanium-6 aluminum-4 vanadium (Ti-6Al-4V) alloy inserts for conical connection implants
(NobelReplace Conical Connection RP 4.3×10 mm; Nobel Biocare). Three groups (n=19)
were assessed: group ZR, CAD-CAM zirconia/Ti-6Al-4V bonded abutments; group RC, CAD-CAM
resin-based composite/Ti-6Al-4V bonded abutments; and group LD, CAD-CAM lithium disilicate/Ti-6Al-4V
bonded abutments. Fifty-seven implant abutments were secured to implants and embedded
in autopolymerizing acrylic resin according to ISO standard 14801. Static failure
load (n=5) and fatigue failure load (n=14) were tested. Weibull cumulative damage
analysis was used to calculate step-stress reliability at 150-N and 200-N loads with
2-sided 90% confidence limits. Representative fractured specimens were examined using
stereomicroscopy and scanning electron microscopy to observe fracture patterns.
Results
Weibull plots revealed β values of 2.59 for group ZR, 0.30 for group RC, and 0.58
for group LD, indicating a wear-out or cumulative fatigue pattern for group ZR and
load as the failure accelerating factor for groups RC and LD. Fractographic observation
disclosed that failures initiated in the interproximal area where the lingual tensile
stresses meet the compressive facial stresses for the early failure specimens. Plastic
deformation of titanium inserts with fracture was observed for zirconia abutments
in fatigue resistance testing.
Conclusions
Significantly higher reliability was found in group ZR, and no significant differences
in reliability were determined between groups RC and LD. Differences were found in
the failure characteristics of group ZR between static and fatigue loading.
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Article info
Publication history
Published online: March 03, 2016
Footnotes
Supported in part by American Academy of Fixed Prosthodontics Stanley D. Tylman Research Grant Program and Department of Restorative Dentistry, University of Washington, grant 66-7812. This project was awarded Second Place at the Tylman Research competition in 2015.
Identification
Copyright
Copyright © 2016 by the Editorial Council for The Journal of Prosthetic Dentistry.
