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J Korean Acad Prosthodont. 2017 Jan;55(1):9-17. Korean.
Published online Jan 25, 2017.  https://doi.org/10.4047/jkap.2017.55.1.9
© 2017 The Korean Academy of Prosthodontics
Effects of abutment angulation and type of connection on the fracture strength of zirconia abutments
Ho-Seong Kim and Hye-Won Cho
Department of Prosthodontics, College of Dentistry, Wonkwang University, Iksan, Republic of Korea.

Corresponding Author: Hye-Won Cho. Department of Prosthodontics, College of Dentistry, Wonkwang University, 460 Iksan-Daero, Iksan 54538, Republic of Korea. +82 (0)63 859 2938: Email: hwcho@wku.ac.kr
Received December 05, 2016; Revised December 23, 2016; Accepted January 04, 2017.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Purpose

The purpose of this study was to evaluate the fracture strength of straight and angled zirconia abutments for internal hex and external hex implants.

Materials and methods

Twenty internal hex implants and 20 external hex implants were prepared. The prefabricated straight zirconia abutments and 17-degree-angled zirconia abutments were connected to those 40 implants. The specimens were classified into 4 groups depending on the connection type and abutment angulation; internal hex implant/straight abutment, group INS; internal hex implant/angled abutment, group INA; external hex implant/straight abutment, group EXS; external hex implant/angled abutment, group EXA. All specimens were loaded at a 30-degree angle with a crosshead speed of 1 mm/min using universal testing machine. The fracture loads were analyzed using 2-way ANOVA and independent t-test (α= .05).

Results

The mean fracture load for INS was 955.91 N, 933.65 N for INA, 1267.20 N for EXS, and 1405.93 N for EXA. External hex implant showed a significantly higher fracture load, as compared to internal hex implant (P < .001). No significant differences in fracture loads were observed between the straight and angled abutment in internal hex implants (P = .747) and external hex implants (P = .222). Internal hexes of abutments were fractured horizontally in internal connection implants, while lingual cervical neck portions were fractured in external connection implants.

Conclusion

The zirconia abutments with external hex implants showed significantly higher fracture strength than those with internal hex implants. However there was no difference in fracture strength between the straight and 17-degree-angled zirconia abutment connected to both implant systems.

Keywords: Zirconia; Implant abutment; Angled abutment; Implant abutment connection

Figures


 Fig. 1
Schematic drawing of zirconia abutment configuration. (A) ZioCera abutment with internal hex, (B) ZioCera angled abutment with internal hex, (C) ZioCera abutment with external hex, (D) ZioCera angled abutment with external hex, (E) Internal hex dimension, (F) External hex dimension.
Click for larger image


Fig. 2
Four types of specimens with different connection type and abutment angulation. (A) INS, internal hex implant/straight abutment, (B) INA, internal hex implant/angled abutment, (C) EXS, external hex implant/straight abutment, (D) EXA, external hex implant/angled abutment.
Click for larger image


Fig. 3
(A) Fracture load test using universal testing machine, (B) Schematic diagram of loading on straight abutment specimen, (C) Schematic diagram of loading on angled abutment specimen.
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Fig. 4
Fracture modes of zirconia abutments. (A) Internal hex and vertical fracture of INS specimen, (B) Internal hex fracture of INA specimen, (C) Vertical fracture of EXS specimen, (D) Cervical fracture of EXA specimen.
Click for larger image


Fig. 5
Scanning electron micrographs of specimens (×18). (A) Fractured internal hex, (B) Fractured external hex.
Click for larger image

Tables


 Table 1
Classification of experimental groups
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Table 2
Summary of fracture load in experimental groups (N)
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Table 3
Results for two-way ANOVA
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Notes

This study was partially supported by Wonkwang University 2017.

Acknowledgments

The authors thank Osstem for its generous support to make specimens.

References
1. Albosefi A, Finkelman M, Zandparsa R. An in vitro comparison of fracture load of zirconia custom abutments with internal connection and different angulations and thickness: part I. J Prosthodont 2014;23:296–301.
2. Moon SJ, Heo YR, Lee GJ, Kim HJ. Axial wall thickness of zirconia abutment in anterior region. J Korean Acad Prosthodont 2015;53:345–351.
3. Yildirim M, Fischer H, Marx R, Edelhoff D. In vivo fracture resistance of implant-supported all-ceramic restorations. J Prosthet Dent 2003;90:325–331.
4. Sailer I, Sailer T, Stawarczyk B, Jung RE, Hämmerle CH. In vitro study of the influence of the type of connection on the fracture load of zirconia abutments with internal and external implant-abutment connections. Int J Oral Maxillofac Implants 2009;24:850–858.
5. Truninger TC, Stawarczyk B, Leutert CR, Sailer TR, Hämmerle CH, Sailer I. Bending moments of zirconia and titanium abutments with internal and external implant-abutment connections after aging and chewing simulation. Clin Oral Implants Res 2012;23:12–18.
6. Cavallaro J Jr, Greenstein G. Angled implant abutments: a practical application of available knowledge. J Am Dent Assoc 2011;142:150–158.
7. Maeda Y, Satoh T, Sogo M. In vitro differences of stress concentrations for internal and external hex implant-abutment connections: a short communication. J Oral Rehabil 2006;33:75–78.
8. Segundo RM, Oshima HM, da Silva IN, Burnett LH Jr, Mota EG, Silva LL. Stress distribution of an internal connection implant prostheses set: a 3D finite element analysis. Stomatologija 2009;11:55–59.
9. Kitagawa T, Tanimoto Y, Odaki M, Nemoto K, Aida M. Influence of implant/abutment joint designs on abutment screw loosening in a dental implant system. J Biomed Mater Res B Appl Biomater 2005;75:457–463.
10. Thulasidas S, Givan DA, Lemons JE, O'Neal SJ, Ramp LC, Liu PR. Influence of implant angulation on the fracture resistance of zirconia abutments. J Prosthodont 2015;24:127–135.
11. Sethi A, Kaus T, Sochor P. The use of angulated abutments in implant dentistry: five-year clinical results of an ongoing prospective study. Int J Oral Maxillofac Implants 2000;15:801–810.
12. Saab XE, Griggs JA, Powers JM, Engelmeier RL. Effect of abutment angulation on the strain on the bone around an implant in the anterior maxilla: a finite element study. J Prosthet Dent 2007;97:85–92.
13. Papavasiliou G, Kamposiora P, Bayne SC, Felton DA. Three-dimensional finite element analysis of stress-distribution around single tooth implants as a function of bony support, prosthesis type, and loading during function. J Prosthet Dent 1996;76:633–640.
14. Tsuge T, Hagiwara Y. Influence of lateral-oblique cyclic loading on abutment screw loosening of internal and external hexagon implants. Dent Mater J 2009;28:373–381.
15. Canullo L, Coelho PG, Bonfante EA. Mechanical testing of thin-walled zirconia abutments. J Appl Oral Sci 2013;21:20–24.
16. Kajiwara N, Masaki C, Mukaibo T, Kondo Y, Nakamoto T, Hosokawa R. Soft tissue biological response to zirconia and metal implant abutments compared with natural tooth: microcirculation monitoring as a novel bioindicator. Implant Dent 2015;24:37–41.
17. Hjerppe J, Lassila LV, Rakkolainen T, Narhi T, Vallittu PK. Load-bearing capacity of custom-made versus prefabricated commercially available zirconia abutments. Int J Oral Maxillofac Implants 2011;26:132–138.
18. Aboushelib MN, Salameh Z. Zirconia implant abutment fracture: clinical case reports and precautions for use. Int J Prosthodont 2009;22:616–619.
19. Yilmaz B, Salaita LG, Seidt JD, McGlumphy EA, Clelland NL. Load to failure of different zirconia abutments for an internal hexagon implant. J Prosthet Dent 2015;114:373–377.
20. Adatia ND, Bayne SC, Cooper LF, Thompson JY. Fracture resistance of yttria-stabilized zirconia dental implant abutments. J Prosthodont 2009;18:17–22.
21. De Boever JA, McCall WD Jr, Holden S, Ash MM Jr. Functional occlusal forces: an investigation by telemetry. J Prosthet Dent 1978;40:326–333.
22. Waltimo A, Könönen M. A novel bite force recorder and maximal isometric bite force values for healthy young adults. Scand J Dent Res 1993;101:171–175.
23. Haraldson T, Carlsson GE, Ingervall B. Functional state, bite force and postural muscle activity in patients with osseointegrated oral implant bridges. Acta Odontol Scand 1979;37:195–206.
24. Al-Omari WM, Shadid R, Abu-Naba'a L, El Masoud B. Porcelain fracture resistance of screw-retained, cement-retained, and screw-cement-retained implant-supported metal ceramic posterior crowns. J Prosthodont 2010;19:263–273.
25. Dittmer MP, Dittmer S, Borchers L, Kohorst P, Stiesch M. Influence of the interface design on the yield force of the implant-abutment complex before and after cyclic mechanical loading. J Prosthodont Res 2012;56:19–24.
26. Ribeiro CG, Maia ML, Scherrer SS, Cardoso AC, Wiskott HW. Resistance of three implant-abutment interfaces to fatigue testing. J Appl Oral Sci 2011;19:413–420.
27. Freitas AC Jr, Bonfante EA, Rocha EP, Silva NR, Marotta L, Coelho PG. Effect of implant connection and restoration design (screwed vs. cemented) in reliability and failure modes of anterior crowns. Eur J Oral Sci 2011;119:323–330.
28. Karl M, Kelly JR. Influence of loading frequency on implant failure under cyclic fatigue conditions. Dent Mater 2009;25:1426–1432.
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ORCID iDs

Hye-Won Cho
https://orcid.org/http://orcid.org/0000-0003-0623-5647

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