Implant volume loss, misfit, screw loosening, and stress in custom titanium and zirconia abutments

Abstract The aim of this study was to verify the effect of the implant volume loss, vertical misfit between abutment and prosthetic platform, prosthetic screw loosening torque, and screw stress distribution in titanium and zirconia abutments. Ten CAD/CAM system custom abutments of each material were milled and attached to the titanium implants. The implant volume loss was evaluated by microtomography, the vertical misfit with optical microscopy, and digital torque wrench measured the prosthetic screw loosening. All experimental analyses were performed before and after mechanical cycle (1,000,000 cycles, 100 N/2 Hz). Virtual models of the structures were created for finite element analysis, and the stress on the screw obtained with von Mises procedure. Data were analyzed using an independent t-test, two-way ANOVA for repeated measures, and Tukey's HSD test (a=0.05). There was no significant difference in the implant volume loss for the two abutment materials (p=0.662). Titanium abutments provided higher loosening torque values after mechanical cycling (p<0.001). Lesser marginal misfit was obtained with titanium abutments before and after mechanical cycling (p<0.001). The stress distribution on the screw was similar between abutment materials. In conclusion, CAD/CAM custom titanium abutment reduced the marginal misfit and increased the torque maintenance of prosthetic screws when compared to CAD/CAM custom zirconia abutment.

Resumo O objetivo neste estudo foi verificar o efeito da diminuição de volume do implante, desajuste vertical entre o pilar e plataforma protética, torque de afrouxamento do parafuso protético e distribuição da tensão no parafuso em pilares de titânio e zircônia. Dez pilares personalizados de cada material foram fresados e conectados aos implantes de titânio. A diminuição de volume do implante foi avaliada com microtomografia, o desajuste vertical com microscopia óptica e o torque de afrouxamento do parafuso protético com chave de torque digital. Todas as análises experimentais foram realizadas antes e após aplicação do ciclo mecânico (1.000.000 ciclos, 100 N/2 Hz). Modelos virtuais das estruturas foram criados para análise por elementos finitos e a tensão no parafuso obtida com valores de von Mises. Os dados foram analisados usando teste t independente, análise de varância dois fatores para medidas repetidas e teste de Tukey HSD (a=0,05). Não houve diferença significativa na diminuição de volume do implante para os dois materiais do pilar (p= 0,662). Os pilares de titânio proporcionaram maiores valores de torque de afrouxamento após o ciclo mecânico (p<0,001). O menor desajuste marginal foi obtido com os pilares de titânio antes e após o ciclo mecânico (p<0,001). A distribuição da tensão no parafuso foi similar entre os materiais. Em conclusão, os pilares personalizados de titânio reduziram o desajuste marginal e aumentaram a manutenção do torque dos parafusos protéticos quando comparados aos pilares de zircônia.

Evaluation of marginal adaptation in three-unit frameworks fabricated with conventional and powder-free digital impression techniques

PURPOSE: The purpose of this in vitro study was to evaluate the marginal misfits of three-unit frameworks fabricated with conventional and digital impressions techniques. MATERIALS AND METHODS: Thirty brass canine and second premolar abutment preparations were fabricated by using a computer numerical control machine and were randomly divided into 3 groups (n=10) as follows: conventional impression group (Group Ci), Cerec Omnicam (Group Cdi), and 3shape TRIOS-3 (Group Tdi) digital impression groups. The laser-sintered metal frameworks were designed and fabricated with conventional and digital impressions. The marginal adaptation was assessed with a stereomicroscope at ×30 magnification. The data were analyzed with 1-way analysis of variances (ANOVAs) and the independent simple t tests. RESULTS: A statistically significant difference was found between the frameworks fabricated by conventional methods and those fabricated by digital impression methods. Multiple comparison results revealed that the frameworks in Group Ci (average, 98.8 ± 16.43 µm; canine, 93.59 ± 16.82 µm; premolar, 104.10 ± 15.02 µm) had larger marginal misfit values than those in Group Cdi (average, 63.78 ± 14.05 µm; canine, 62.73 ± 13.71 µm; premolar, 64.84 ± 15.06 µm) and Group Tdi (average, 65.14 ± 18.05 µm; canine, 70.64 ± 19.02 µm; premolar, 59.64 ± 16.10 µm) (P=.000 for average; P=.001 for canine; P.05). CONCLUSION: The three-unit frameworks fabricated with digital impression techniques showed better marginal fit compared to conventional impression techniques. All marginal misfit values were clinically acceptable.