Fracture resistance of zirconia-based implant abutments after artificial long-term aging.

Abstract Objective To investigate the survival rate, fracture strength, bending moments, loading to fracture and fracture modes of different designs of zirconia abutments after dynamic loading with thermocycling, and compare these values to titanium abutments. Methods A total of 80 abutment samples were divided into 5 test groups of 16 samples in each group. The study included the following groups, “Group 1” CAD/CAM produced all-zirconia abutments, “Group 2” titanium abutments, “Group 3” zirconia-abutments adhesively luted to a titanium base, “Group 4” prefabricated all-zirconia abutments and “Group 5” zirconia-abutments glass soldered to a titanium base. Half the number of samples in each group was exposed to 1.2 million loading cycles (5-years simulation) in the chewing simulator. The samples that survived the artificial aging were later tested for fracture strength in a universal testing machine. The remaining 8 samples of the group were directly tested for fracture strength. Results All samples exposed to the 5-years artificial aging survived except of six samples in one group (Group 1). The surviving samples were later fracture tested in the universal testing machine. The bending moments (N cm) values were as follow: Exposed groups: “Group 1” 94.5 N cm; “Group 2” 599.2 N cm; “Group 3” 477.5 N cm; “Group 4” 314.4 N cm; “Group 5” 509.4 N cm. Non-exposed groups: “Group 1” 269.3 N cm; “Group 2” 474.2 N cm; “Group 3” 377.6 N cm; “Group 4” 265.4 N cm; “Group 5” 372.4 N cm. Except in Group 1, the values were higher in the exposed groups, although, statistically there was no difference (p>0.05). The one-piece ZrO2-abutment group (Group 1 and Group 4) exhibited lower values, while the two-piece ZrO2-abutment groups (Group 3 and Group 5) showed similar values and fracture modes like the titanium abutment group. The titanium abutment group showed the highest values of bending moments among all groups. Conclusion The implant-abutment connection area appeared to influence the bending moment value and the fracture mode of the tested abutment groups, and it was found to be the weakest part of an internal connection one-piece zirconia abutment. The titanium base in the two-piece zirconia abutment worked as a substitute for the weakest part of the abutment. Therefore, the titanium base can reinforce the fracture strength of a zirconia abutment.