ABSTRACT
BACKGROUND: This study aimed to evaluate the mechanical, biological, and esthetic stability of a zirconium abutment according to evidence-based dentistry. MAIN TEXT: An electronic search was performed. Domestic studies were found using the keywords “zirconia abutments” and “zirconium abutment” in KMbase, KoreaMed, and the National Assembly Library, and international studies were found using the same keywords in PubMed. All identified studies were divided by evidence level from the viewpoint of the research type utilizing the evidence-based review manual. A total of 102 domestic studies (with Korean language) were found, and 9 of these studies were selected. In these nine studies, 3 had evidence level 3 and 6 had evidence level 4. A total of 97 international studies (with English language) were found, and 19 were selected. Among these 19 studies, 5 had evidence level 2 and 7 had evidence level 3, whereas the remainder had evidence level 4. According to the studies, zirconium abutments are mechanically, biologically, and esthetically stable, but the evidence level of these studies is low, and the follow-up duration is no longer than 5 years. CONCLUSIONS: All examined studies verified the mechanical stability of zirconium abutments for a period no longer than 5 years. Therefore, a long-term clinical observation is needed. Zirconium abutments are thought to be biologically stable, but they are not superior to titanium abutments. As the esthetic stability of such abutments had a low evidence level in the studies that examined here, a much higher evidence level is needed.
Subject(s)
Dental Implants , Evidence-Based Dentistry , Follow-Up Studies , Titanium , ZirconiumABSTRACT
Objetivo: verificar a precisão dimensional e a resistência à fadiga de conectores tipo link sobre pilares de zircônia. Material e métodos: oito implantes dentários de 3,5 mm X 8,5 mm foram montados em uma base de poliacetal (E=3GPa), em 30 graus de inclinação, e receberam links de titânio com plataformas hexagonais de 4,5 mm e 3,5 mm, ambos com comprimento de 11,5 mm. Depois, os pilares de zircônia foram apertados com 32 Ncm com uso de torquímetro digital. Três sequências de testes de fadiga foram usadas: link 4,5 carga inicial 100 N, incrementos de 100 N em intervalos de 12 mil ciclos; link 4,5 carga inicial 100 N, incrementos de 100 N em intervalos de 200 mil ciclos; e link 3,5 carga inicial 100 N, incrementos de 100 N em intervalos de 200 mil ciclos até a fratura. Os testes foram realizados em meio seco, e a força com variação senoidal entre 100 N e 800 N. As imagens das interfaces entre o link e a zircônia foram verificadas por microscopia eletrônica de varredura. Resultados: para o link 4,5, na primeira tentativa, a carga máxima foi de 700 N até os 96 mil ciclos (sem fratura), na segunda tentativa, a carga máxima foi de 800 N, não havendo fratura aos dois milhões de ciclos. Para o link 3,5, a carga máxima foi de 500 N e 814.578 ciclos, ocorrendo fratura na base da zircônia. O espaço entre a base do link e o pilar de zircônia foi de 437,1 nanômetros. Conclusão: a precisão no encaixe do componente protético ao implante aumentou a resistência à fadiga da estrutura. As cargas de fratura após a fadiga estão acima do esperado para componentes de zircônia. O espaço entre a base do link e o pilar de zircônia é menor que o tamanho médio das bactérias Mutans encontradas na cavidade oral, o que possivelmente reduzirá a infiltração bacteriana.
Objective: to analyze the fit accuracy and the fatigue strength of zirconia abutments with titanium link-type connectors. Material and methods: eight dental implants (3.5 x 8.5 mm) were inserted into a polyacetal base (E=3GPa) at 30-degree inclination and received zirconia abutments with Ti links (4.5 mm and 3.5 mm hex platforms; 11.5 mm length). Eight zirconia abutments were tightened to 32 Ncm with a digital torque wrench. Three fatigue test protocols were used: link 4.5: initial load 100 N (100 N increments after each 12,000 cycles); link 4.5: initial load 100 N (100 N increments after each 200,000 cycles), and link 3.5: initial load 100 N (100 N in increments after each 200,000 cycles) until fracture. The tests were performed in a dry environment with sinusoidal variation between 100 N and 800 N. The interfaces between the links and the zirconia abutments were observed by scanning electron microscopy. Results: the maximum load in the first fatigue test of link 4.5 was 700 N at 96,000 cycles (without fracture); on the second fatigue test, the maximum load was 800 N with no fracture until 2 million cycles. For the link 3.5, the maximum load was 500 N and the fracture at the base of the zirconia abutment occurred at 814,578 cycles. The space between the base of the Link and the zirconia abutment was 437.1 nm. Conclusion: the fit accuracy of the prosthetic component to the implant platform increased the fatigue resistance of the structure. The maximum fatigue load fracture is higher than expected for zirconia components. The space between the base of the link and the zirconia abutment is lower than the mutans spp. found in the oral cavity, which might reduce dental leakage.
Subject(s)
Humans , Dental Implants , Dental Leakage , Dimensional Measurement Accuracy , ZirconiumABSTRACT
Este estudio pretendió determinar el comportamiento mecánico entre pilares de Zirconio Zimmer® con anillo de Titanio en la base y sin ella, utilizando el método de análisis de elementos finitos Métodos: se diseñaron dos modelos de pilar en Zirconio sobre implante, conformados además por un implante de Titanio Zimmer® tornillo de unión, hueso cortical y hueso esponjoso y una corona cerámica de un incisivo central superior. Se aplicó fuerza en sentido oblicuo con una magnitud de 200N, ascendiendo en escala de 200N hasta que algún elemento superara el límite de proporcionalidad. Se calcularon los esfuerzos von Mises para cada elemento. Resultados: No se observaron diferencias en la magnitud de los esfuerzos de von Mises entre el pilar con anillo de Titanio y sin él; (280,1 MPa con anillo en Titanio, 280,4 MPa sin él) pero sí en el tornillo y el implante, siendo menores los esfuerzos para el modelo con anillo de Titanio (474 MPa 15 vs 576,7 MPa). El hueso y la corona reportaron no linealidad a 600N, implante y tornillo a 1000N y ambos pilares de Zirconio a 1400N. Conclusiones: Cuando el esfuerzo de precarga aplicado a ambos modelos es el recomendado, no hay diferencias entre los dos pilares.
The purpose of this study was to determine the mechanical behavior between Zimmer® zirconium implant abutments with and without a titanium washer at their base, by using the finite element analysis (FEA). Materials and Methods: two models of a zirconium abutment on implants were designed, composed of a Zimmer® titanium implant a fixation screw, cortical and cancellous bone, and the ceramic crown of an upper central incisor. An oblique force was applied with a magnitude of 200N, ascending in a scale of 200N until any of the components of the model exhibited a nonlinear behavior. Von Mises stresses were calculated for each element. Results: No significant differences on von Mises stresses were observed between the abutments with and without a titanium washer (280, 1MPa with a titanium washer, and 280, 4 MPa without it) but differences were found at the fixation screw and the implant: the stresses were lower in the model with a titanium washer (474MPa vs 576,7MPa). Both the bone and the crown exhibited non linearity at 600N, the implant and the screw at 1000N, and both zirconium abutments at 1400N. Conclusions: When the preload stress applied to both models is the adequate, no mechanical behavior differences between the abutments occur.
Este estudo procurou determinar o comportamento mecânico entre pilares anel Zimmer® Zircônio Titanium na base e sem ela, usando o método de análise de elementos finitos Métodos: Dois modelos de zircônia pilar no implante projetados também formadas por um implante Titanium parafuso de ligação Zimmer®, osso cortical e osso esponjoso e uma coroa de cerâmica de um incisivo central superior. A força foi aplicada com um ângulo com uma amplitude de 200N, 200N escala crescente, até um elemento excedido o limite de proporcionalidade. Esforços von Mises, foram calculados para cada elemento. Resultados: Não foram observadas diferenças na magnitude dos esforços von Mises entre Titanium anel de encosto sem ele; (280,1 MPa Titanium anel, 280,4 MPa sem ele), mas no parafuso eo implante, com esforços menores para o modelo com anel de titânio (474 vs 576,7 MPa 15 MPa). Osso e coroa não-linearidade informou a 600N, implante de parafuso 1000N e zircônio dois pilares 1400N. Conclusão: Quando a pré-carga esforço aplicado para ambos os modelos é recomendado, não há diferenças entre os dois pilares.