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Irena Sailer - One of the best experts on this subject based on the ideXlab platform.
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A systematic review of the influence of the implant-Abutment connection on the clinical outcomes of ceramic and metal implant Abutments supporting fixed implant reconstructions
Clinical Oral Implants Research, 2018Co-Authors: Bjarni E. Pjetursson, Marcel Zwahlen, Irena Sailer, Cristina Zarauz, Malin Strasding, Anja ZembicAbstract:OBJECTIVES The objective of this systematic review was to assess the influence of implant-Abutment connection and Abutment material on the outcome of implant-supported single crowns (SCs) and fixed dental prostheses (FDPs). METHODS An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective and retrospective studies with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using robust Poisson regression, and comparisons were made with multivariable Poisson regression models. RESULTS The search provided 1511 titles and 177 abstracts. Full-text analysis was performed for 147 articles resulting in 60 studies meeting the inclusion criteria. Meta-analysis of these studies indicated an estimated 5-year survival rate of 97.6% for SCs and 97.0% for FDPs supported by implants with internal implant-Abutment connection and 95.7% for SCs and 95.8% for FDPs supported by implants with external connection. The 5-year Abutment failure rate ranged from 0.7% to 2.8% for different connections with no differences between the types of connections. The total number of complications was similar between the two connections, yet, at external connections, Abutment or occlusal screw loosening was more predominant. Ceramic Abutments, both internally and externally connected, demonstrated a significantly higher incidence of Abutment fractures compared with metal Abutments. CONCLUSION For implant-supported SCs, both metal and ceramic Abutments with internal and external connections exhibited high survival rates. Moreover, implant-supported FDPs with metal Abutments with internal and external connections for also showed high survival rates.
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fracture strength of zirconia implant Abutments on narrow diameter implants with internal and external implant Abutment connections a study on the titanium resin base concept
Clinical Oral Implants Research, 2018Co-Authors: Irena Sailer, Bjarni E. Pjetursson, Asgeir G Asgeirsson, Daniel S Thoma, Vincent Fehmer, Thor Aspelund, Mutlu OzcanAbstract:BACKGROUND: There is limited knowledge regarding the strength of zirconia Abutments with internal and external implant Abutment connections and zirconia Abutments supported by a titanium resin base (Variobase, Straumann) for narrow diameter implants. OBJECTIVES: To compare the fracture strength of narrow diameter Abutments with different types of implant Abutment connections after chewing simulation. MATERIAL AND METHODS: Hundred and twenty identical customized Abutments with different materials and implant Abutment connections were fabricated for five groups: 1-piece zirconia Abutment with internal connection (T1, Cares-Abutment-Straumann BL-NC implant, Straumann Switzerland), 1-piece zirconia Abutment with external hex connection (T2, Procera Abutment-Branemark NP implant, Nobel Biocare, Sweden), 2-piece zirconia Abutments with metallic insert for internal connection (T3, Procera Abutment-Replace NP implant, Nobel Biocare), 2-piece zirconia Abutment on titanium resin base (T4, LavaPlus Abutment-VarioBase-Straumann BL-NC implant, 3M ESPE, Germany) and 1-piece titanium Abutment with internal connection (C, Cares-Abutment-Straumann BL-NC implant, Straumann, Switzerland). All implants had a narrow diameter ranging from 3.3 to 3.5 mm. Sixty un-restored Abutments and 60 Abutments restored with glass-ceramic crowns were tested. Mean bending moments were compared using ANOVA with p-values adjusted for multiple comparisons using Tukey's procedure. RESULTS: The mean bending moments were 521 ± 33 Ncm (T4), 404 ± 36 Ncm (C), 311 ± 106 Ncm (T1) 265 ± 22 Ncm (T3) and 225 ± 29 (T2) for un-restored Abutments and 278 ± 84 Ncm (T4), 302 ± 170 Ncm (C), 190 ± 55 Ncm (T1) 80 ± 102 Ncm (T3) and 125 ± 57 (T2) for restored Abutments. For un-restored Abutments, C and T4 had similar mean bending moments, significantly higher than those of the three other groups (p < .05). Titanium Abutments (C) had significantly higher bending moments than identical zirconia Abutments (T1) (p < .05). Zirconia Abutments (T1) with internal connection had higher bending moments than zirconia Abutments with external connection (T2) (p < .05). For all test groups, the bending moments were significantly reduced when restored with all-ceramic crowns. CONCLUSIONS: For narrow diameter Abutments, the fracture strength of 2-piece internal connected zirconia Abutments fixed on titanium resin bases was similar to those obtained for 1-piece titanium Abutments. Narrow diameter zirconia Abutments with internal connection exhibited higher fracture strength than zirconia Abutments with an external connection. Titanium Abutments with an internal connection were significantly stronger than identical zirconia Abutments.
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bending moments and types of failure of zirconia and titanium Abutments with internal implant Abutment connections a laboratory study
International Journal of Oral & Maxillofacial Implants, 2012Co-Authors: Christian R. Leutert, Christoph H F Hammerle, Bogna Stawarczyk, Thomas C. Truninger, Irena SailerAbstract:PURPOSE: The aim of this study was to examine the bending moments and fracture patterns of different zirconia Abutments with internal implant-Abutment connections after static loading and to compare their bending moments to those of internally connected titanium Abutments. Materials and METHODS: Three types of customized zirconia Abutments (Straumann CARES Abutments/Straumann BL implants [T1], Astra ZirDesign Abutments/Astra Micro Thread OsseoSpeed implants [T2], Zirabut prototype Abutments/Straumann SP implants [T3]) and one type of customized titanium Abutment (control group, Straumann CARES Abutments/Straumann BL implants [C]) were included. All Abutments were one-piece Abutments with an internal implant-Abutment connection and were customized to the same shape but featured different implant-Abutment connection designs. For each group, 20 identical copies of a master Abutment were fabricated and fixed on their corresponding implants. Half of the Abutments in each group were left unrestored, and the other 10 received glass-ceramic crowns. Static loading was applied at a 30-degree angle to the palatal surface until failure, and bending moments were calculated. The type of failure was characterized visually by dismounting the Abutments and by examination of cross-sections of the embedded specimens. The results were analyzed statistically. RESULTS: The mean range of bending moments was higher for the unrestored groups (158.2 to 678.2 Ncm) than for the restored groups (117.9 to 419.4 Ncm). The highest mean bending moments were seen in the control group, both restored and unrestored (419.4/678.2 Ncm). Unrestored, T1 and T2 exhibited significantly higher bending moments than T3. This was also observed in the restored groups. CONCLUSION:Both the Abutment material and the implant-Abutment connection design affected the bending moments of Abutments after static loading. Internally connected zirconia Abutments with horizontal mismatch to the implant exhibited significantly higher bending moments compared to those without horizontal mismatch.
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bending moments of zirconia and titanium Abutments with internal and external implant Abutment connections after aging and chewing simulation
Clinical Oral Implants Research, 2012Co-Authors: Thomas C. Truninger, Thomas Sailer, Bogna Stawarczyk, Christoph H F Hammerle, Christian R. Leutert, Irena SailerAbstract:Objectives: To test the fracture load of zirconia Abutments with different types of implant-Abutment connections after chewing simulation and to compare their bending moments to internally connected identical titanium Abutments. Materials and methods: Forty-eight identical customized zirconia Abutments with different implant-Abutment connections were fabricated for four different test groups: one-piece internal implant-Abutment connection (BL; Straumann Bonelevel), two-piece internal implant-Abutment connection (RS; Nobel Biocare Replace Select), external implant-Abutment connection (B; Branemark MK III), two-piece internal implant-Abutment connection (SP; Straumann Standard Plus). Twelve titanium Abutments with one-piece internal implant-Abutment connection (T; Straumann Bonelevel) served as control group. After aging by means of thermocycling (5-50°C, 120 s) and chewing simulation (1,200,000 cycles, 49 N load, 1.67 Hz), static load was applied at a 30° angle to the palatal surface until failure. Bending moments were calculated for comparison of the groups. Data were analyzed descriptively and by performing the Kruskal-Wallis test with Bonferroni correction. Results: The mean bending moments of the Abutments were 714.1 ± 184.9 N cm (T), 331.7 ± 57.8 N cm (BL), 429.7 ± 62.8 N cm (RS), 285.8 ± 64.4 N cm (B) and 379.9 ± 59.1 N cm (SP). The bending moments of control group T were significantly higher than those of all other groups. The values of group RS were significantly higher than those of group B but within the value range of groups SP and BL. Conclusion: The bending moments of the different tested types of zirconia Abutments vary with different implant-Abutment connections after chewing simulation. The use of a secondary metallic component might have a beneficial influence on the stability of zirconia Abutments. To cite this article: Truninger TC, Stawarczyk B, Leutert CR, Sailer TR, Hammerle CHF, Sailer I. Bending moments of zirconia and titanium Abutments with internal and external implant-Abutment connections after aging and chewing simulation. Clin. Oral Impl. Res. 23, 2012; 12-18. doi: 10.1111/j.1600-0501.2010.02141.x.
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single tooth implant reconstructions esthetic factors influencing the decision between titanium and zirconia Abutments in anterior regions
The European journal of esthetic dentistry : official journal of the European Academy of Esthetic Dentistry, 2007Co-Authors: Irena Sailer, Anja Zembic, Christoph H F Hammerle, Ronald E Jung, Alessandro MattiolaAbstract:Implant-supported single crowns have become a valid alternative to conventional fixed dental prostheses due to their excellent clinical long-term results. However, along with good survival rates, esthetic factors are important for success in anterior regions. Today, several kinds of implant Abutments are offered by implant manufacturers. A choice must be made between standardized and customized Abutments; further, different Abutment materials such as titanium or various ceramics (alumina, zirconia) are available. Finally, the reconstruction can be cemented on the Abutment or screw-retained directly on the implant. When choosing an Abutment for an anterior single-unit case, several factors should be considered: visibility of the region (eg, high vs low smile line); biotype of the gingiva; color of the neighboring teeth; and finally, esthetic expectations of the patient. In esthetically demanding situations, customized ceramic Abutments are indicated. In patient situations with thin peri-implant soft tissues, zirconia Abutments and all-ceramic crowns should be used in combination. In cases with thick mucosa, titanium can be used as the Abutment material, combined with metal-ceramic crowns. In order to avoid difficulties removing excess cement, screw-retained reconstructions may be preferred; however, the screw access hole should be positioned palatal to the incisal edge.
Marco S Cune - One of the best experts on this subject based on the ideXlab platform.
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stock versus cad cam customized zirconia implant Abutments clinical and patient based outcomes in a randomized controlled clinical trial
Clinical Implant Dentistry and Related Research, 2017Co-Authors: Ulf Schepke, Henny J A Meijer, Wouter Kerdijk, Gerry M Raghoebar, Marco S CuneAbstract:Background Single-tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the Abutment remain unclear. Purpose This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant Abutments with respect to preservation of marginal bone level and several clinical and patient-based outcome measures. Material and Methods Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Molndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Molndal, Sweden) zirconia Abutment therapy. Peri-implant bone level (primary outcome), Plaque-index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. Results No implants were lost and no complications related to the Abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia Abutments could not be demonstrated for any of the operationalized variables. Conclusion The use of a CAD/CAM customized zirconia Abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia Abutment.
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early bacterial colonization and soft tissue health around zirconia and titanium Abutments an in vivo study in man
Clinical Oral Implants Research, 2011Co-Authors: Ralph Van Brakel, Marco S Cune, Arie Jan Van Winkelhoff, Cornelis De Putter, J W Verhoeven, Wil A Van Der ReijdenAbstract:Aim: To compare the early bacterial colonization and soft tissue health of mucosa adjacent to zirconia (ZrO2) and titanium (Ti) Abutment surfaces in vivo. Materials and methods: Twenty edentulous subjects received two endosseous mandibular implants. The implants were fitted with either a ZrO2 or a Ti Abutment (non-submerged implant placement, within-subject comparison, left-right randomization). Sulcular bacterial sampling and the assessment of probing pocket depth, recession and bleeding on probing were performed at 2 weeks and 3 months post-surgery. Wilcoxon matched-pairs, sign-rank tests were applied to test differences in the counts of seven marker bacteria and the clinical parameters that were associated with the ZrO2 and Ti Abutments, at the two observation time points. Results: ZrO2 and Ti Abutments harboured similar counts of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Peptostreptococcus micros, Fusobacterium nucleatum and Treponema denticola at 2 weeks and 3 months. Healthy clinical conditions were seen around both ZrO2 and Ti Abutments at all times, without significant differences in most clinical parameters of peri-implant soft tissue health. Mean probing depths around Ti Abutments were slightly deeper than around ZrO2 Abutments after 3 months (2.2 SD 0.8 mm vs. 1.7 SD 0.7 mm, P=0.03). Conclusions: No difference in health of the soft tissues adjacent to ZrO2 and Ti Abutment surfaces or in early bacterial colonization could be demonstrated, although somewhat shallower probing depths were observed around ZrO2 Abutments after 3 month.
Bjarni E. Pjetursson - One of the best experts on this subject based on the ideXlab platform.
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A systematic review of the influence of the implant-Abutment connection on the clinical outcomes of ceramic and metal implant Abutments supporting fixed implant reconstructions
Clinical Oral Implants Research, 2018Co-Authors: Bjarni E. Pjetursson, Marcel Zwahlen, Irena Sailer, Cristina Zarauz, Malin Strasding, Anja ZembicAbstract:OBJECTIVES The objective of this systematic review was to assess the influence of implant-Abutment connection and Abutment material on the outcome of implant-supported single crowns (SCs) and fixed dental prostheses (FDPs). METHODS An electronic Medline search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective and retrospective studies with a mean follow-up time of at least 3 years. Patients had to have been examined clinically at the follow-up visit. Failure and complication rates were analyzed using robust Poisson regression, and comparisons were made with multivariable Poisson regression models. RESULTS The search provided 1511 titles and 177 abstracts. Full-text analysis was performed for 147 articles resulting in 60 studies meeting the inclusion criteria. Meta-analysis of these studies indicated an estimated 5-year survival rate of 97.6% for SCs and 97.0% for FDPs supported by implants with internal implant-Abutment connection and 95.7% for SCs and 95.8% for FDPs supported by implants with external connection. The 5-year Abutment failure rate ranged from 0.7% to 2.8% for different connections with no differences between the types of connections. The total number of complications was similar between the two connections, yet, at external connections, Abutment or occlusal screw loosening was more predominant. Ceramic Abutments, both internally and externally connected, demonstrated a significantly higher incidence of Abutment fractures compared with metal Abutments. CONCLUSION For implant-supported SCs, both metal and ceramic Abutments with internal and external connections exhibited high survival rates. Moreover, implant-supported FDPs with metal Abutments with internal and external connections for also showed high survival rates.
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fracture strength of zirconia implant Abutments on narrow diameter implants with internal and external implant Abutment connections a study on the titanium resin base concept
Clinical Oral Implants Research, 2018Co-Authors: Irena Sailer, Bjarni E. Pjetursson, Asgeir G Asgeirsson, Daniel S Thoma, Vincent Fehmer, Thor Aspelund, Mutlu OzcanAbstract:BACKGROUND: There is limited knowledge regarding the strength of zirconia Abutments with internal and external implant Abutment connections and zirconia Abutments supported by a titanium resin base (Variobase, Straumann) for narrow diameter implants. OBJECTIVES: To compare the fracture strength of narrow diameter Abutments with different types of implant Abutment connections after chewing simulation. MATERIAL AND METHODS: Hundred and twenty identical customized Abutments with different materials and implant Abutment connections were fabricated for five groups: 1-piece zirconia Abutment with internal connection (T1, Cares-Abutment-Straumann BL-NC implant, Straumann Switzerland), 1-piece zirconia Abutment with external hex connection (T2, Procera Abutment-Branemark NP implant, Nobel Biocare, Sweden), 2-piece zirconia Abutments with metallic insert for internal connection (T3, Procera Abutment-Replace NP implant, Nobel Biocare), 2-piece zirconia Abutment on titanium resin base (T4, LavaPlus Abutment-VarioBase-Straumann BL-NC implant, 3M ESPE, Germany) and 1-piece titanium Abutment with internal connection (C, Cares-Abutment-Straumann BL-NC implant, Straumann, Switzerland). All implants had a narrow diameter ranging from 3.3 to 3.5 mm. Sixty un-restored Abutments and 60 Abutments restored with glass-ceramic crowns were tested. Mean bending moments were compared using ANOVA with p-values adjusted for multiple comparisons using Tukey's procedure. RESULTS: The mean bending moments were 521 ± 33 Ncm (T4), 404 ± 36 Ncm (C), 311 ± 106 Ncm (T1) 265 ± 22 Ncm (T3) and 225 ± 29 (T2) for un-restored Abutments and 278 ± 84 Ncm (T4), 302 ± 170 Ncm (C), 190 ± 55 Ncm (T1) 80 ± 102 Ncm (T3) and 125 ± 57 (T2) for restored Abutments. For un-restored Abutments, C and T4 had similar mean bending moments, significantly higher than those of the three other groups (p < .05). Titanium Abutments (C) had significantly higher bending moments than identical zirconia Abutments (T1) (p < .05). Zirconia Abutments (T1) with internal connection had higher bending moments than zirconia Abutments with external connection (T2) (p < .05). For all test groups, the bending moments were significantly reduced when restored with all-ceramic crowns. CONCLUSIONS: For narrow diameter Abutments, the fracture strength of 2-piece internal connected zirconia Abutments fixed on titanium resin bases was similar to those obtained for 1-piece titanium Abutments. Narrow diameter zirconia Abutments with internal connection exhibited higher fracture strength than zirconia Abutments with an external connection. Titanium Abutments with an internal connection were significantly stronger than identical zirconia Abutments.
Mutlu Ozcan - One of the best experts on this subject based on the ideXlab platform.
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fracture strength of zirconia implant Abutments on narrow diameter implants with internal and external implant Abutment connections a study on the titanium resin base concept
Clinical Oral Implants Research, 2018Co-Authors: Irena Sailer, Bjarni E. Pjetursson, Asgeir G Asgeirsson, Daniel S Thoma, Vincent Fehmer, Thor Aspelund, Mutlu OzcanAbstract:BACKGROUND: There is limited knowledge regarding the strength of zirconia Abutments with internal and external implant Abutment connections and zirconia Abutments supported by a titanium resin base (Variobase, Straumann) for narrow diameter implants. OBJECTIVES: To compare the fracture strength of narrow diameter Abutments with different types of implant Abutment connections after chewing simulation. MATERIAL AND METHODS: Hundred and twenty identical customized Abutments with different materials and implant Abutment connections were fabricated for five groups: 1-piece zirconia Abutment with internal connection (T1, Cares-Abutment-Straumann BL-NC implant, Straumann Switzerland), 1-piece zirconia Abutment with external hex connection (T2, Procera Abutment-Branemark NP implant, Nobel Biocare, Sweden), 2-piece zirconia Abutments with metallic insert for internal connection (T3, Procera Abutment-Replace NP implant, Nobel Biocare), 2-piece zirconia Abutment on titanium resin base (T4, LavaPlus Abutment-VarioBase-Straumann BL-NC implant, 3M ESPE, Germany) and 1-piece titanium Abutment with internal connection (C, Cares-Abutment-Straumann BL-NC implant, Straumann, Switzerland). All implants had a narrow diameter ranging from 3.3 to 3.5 mm. Sixty un-restored Abutments and 60 Abutments restored with glass-ceramic crowns were tested. Mean bending moments were compared using ANOVA with p-values adjusted for multiple comparisons using Tukey's procedure. RESULTS: The mean bending moments were 521 ± 33 Ncm (T4), 404 ± 36 Ncm (C), 311 ± 106 Ncm (T1) 265 ± 22 Ncm (T3) and 225 ± 29 (T2) for un-restored Abutments and 278 ± 84 Ncm (T4), 302 ± 170 Ncm (C), 190 ± 55 Ncm (T1) 80 ± 102 Ncm (T3) and 125 ± 57 (T2) for restored Abutments. For un-restored Abutments, C and T4 had similar mean bending moments, significantly higher than those of the three other groups (p < .05). Titanium Abutments (C) had significantly higher bending moments than identical zirconia Abutments (T1) (p < .05). Zirconia Abutments (T1) with internal connection had higher bending moments than zirconia Abutments with external connection (T2) (p < .05). For all test groups, the bending moments were significantly reduced when restored with all-ceramic crowns. CONCLUSIONS: For narrow diameter Abutments, the fracture strength of 2-piece internal connected zirconia Abutments fixed on titanium resin bases was similar to those obtained for 1-piece titanium Abutments. Narrow diameter zirconia Abutments with internal connection exhibited higher fracture strength than zirconia Abutments with an external connection. Titanium Abutments with an internal connection were significantly stronger than identical zirconia Abutments.
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Dislodgement Resistance of Zirconia Copings Cemented onto Zirconia and Titanium Abutments.
Implant dentistry, 2017Co-Authors: Umut Guler, Yasemin Budak, José Renato Cavalcanti Queiroz, Mutlu OzcanAbstract:PURPOSE To determine the effect of the cement type and Abutment material on the tensile strength required to dislodge zirconia copings. MATERIALS AND METHODS Two experimental groups of Abutments were prepared: (1) titanium Abutments (n = 30) and (2) zirconia Abutments (n = 30). Sixty zirconia copings (custom designed) were fabricated using 3-dimensional computer-assisted design to have a 6-mm projection above the Abutment to accommodate a hole, through which a wire was inserted to attach the zirconia coping to a universal testing machine. Each Abutment was placed onto an implant analog embedded in acrylic resin blocks to fit onto the universal testing machine. The zirconia copings were cemented onto the Abutments with a provisional luting agent, zinc phosphate (ZP) cement, and adhesive resin cement, and after 5500 thermocycles, a tensile force was applied at a crosshead speed of 0.5 mm/min. The removal force was recorded for each specimen. Two-way analysis of variance (ANOVA) and 1-way ANOVA were used for the statistical analysis (P < 0.05). RESULTS The mean forces necessary to remove the zirconia copings from titanium Abutments were 6.52, 83.09, and 251.18 N for temporary cement, ZP cement, and resin cement, respectively. For zirconia Abutments, the required forces were 17.82, 116.41, and 248.72 N. CONCLUSIONS The Abutment material had no effect on retention, but the cement type affected the retention of the zirconia copings.
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fracture strength and failure mode of maxillary implant supported provisional single crowns a comparison of composite resin crowns fabricated directly over peek Abutments and solid titanium Abutments
Clinical Implant Dentistry and Related Research, 2012Co-Authors: Hendrik J Santing, Gerry M Raghoebar, Henny J A Meijer, Mutlu OzcanAbstract:Background: Polyetheretherketone (PEEK) temporary Abutments have been recently introduced for making implant-supported provisional single crowns. Little information is available in the dental literature on the durability of provisional implant-supported restorations. Purpose: The objectives of this study were to evaluate the fracture strength of implant-supported composite resin crowns on PEEK and solid titanium temporary Abutments, and to analyze the failure types. Material and Methods: Three types of provisional Abutments, RN synOcta Temporary Meso Abutment (PEEK; Straumann), RN synOcta Titanium Post for Temporary Restorations (Straumann), and Temporary Abutment Engaging NobRplRP (Nobel Biocare) were used, and provisional screw-retained crowns using composite resin (Solidex) were fabricated for four different locations in the maxilla. The specimens were tested in a universal testing machine at a crosshead speed of 1 mm/minute until fracture occurred. The failure types were analyzed and further categorized as irreparable (Type 1) or reparable (Type 2). Results: No significant difference was found between different Abutment types. Only for the position of the maxillary central incisor, composite resin crowns on PEEK temporary Abutments showed significantly lower (p <0.05) fracture strength (95 +/- 21 N) than those on titanium temporary Abutments (1,009 +/- 94 N). The most frequently experienced failure types were cohesive fractures of the composite resin crowns (75 out of 104), followed by screw loosening (18 out of 104). According to reparability, the majority of the specimens were classified as Type 1 (82 out of 104). Type 2 failures were not often observed (22 out of 104). Conclusions: Provisional crowns on PEEK Abutments showed similar fracture strength as titanium temporary Abutments except for central incisors. Maxillary right central incisor composite resin crowns on PEEK temporary Abutments fractured below the mean anterior masticatory loading forces reported to be approximately 206 N.
Gerry M Raghoebar - One of the best experts on this subject based on the ideXlab platform.
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stock versus cad cam customized zirconia implant Abutments clinical and patient based outcomes in a randomized controlled clinical trial
Clinical Implant Dentistry and Related Research, 2017Co-Authors: Ulf Schepke, Henny J A Meijer, Wouter Kerdijk, Gerry M Raghoebar, Marco S CuneAbstract:Background Single-tooth replacement often requires a prefabricated dental implant and a customized crown. The benefits of individualization of the Abutment remain unclear. Purpose This randomized controlled clinical trial aims to study potential benefits of individualization of zirconia implant Abutments with respect to preservation of marginal bone level and several clinical and patient-based outcome measures. Material and Methods Fifty participants with a missing premolar were included and randomly assigned to standard (ZirDesign, DentsplySirona Implants, Molndal, Sweden) or computer aided design/computer aided manufacturing (CAD/CAM) customized (Atlantis, DentsplySirona Implants, Molndal, Sweden) zirconia Abutment therapy. Peri-implant bone level (primary outcome), Plaque-index, calculus formation, bleeding on probing, gingiva index, probing pocket depth, recession, appearance of soft tissues and patients' contentment were assessed shortly after placement and one year later. Results No implants were lost and no complications related to the Abutments were observed. Statistically significant differences between stock and CAD/CAM customized zirconia Abutments could not be demonstrated for any of the operationalized variables. Conclusion The use of a CAD/CAM customized zirconia Abutment in single tooth replacement of a premolar is not associated with an improvement in clinical performance or patients' contentment when compared to the use of a stock zirconia Abutment.
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fracture strength and failure mode of maxillary implant supported provisional single crowns a comparison of composite resin crowns fabricated directly over peek Abutments and solid titanium Abutments
Clinical Implant Dentistry and Related Research, 2012Co-Authors: Hendrik J Santing, Gerry M Raghoebar, Henny J A Meijer, Mutlu OzcanAbstract:Background: Polyetheretherketone (PEEK) temporary Abutments have been recently introduced for making implant-supported provisional single crowns. Little information is available in the dental literature on the durability of provisional implant-supported restorations. Purpose: The objectives of this study were to evaluate the fracture strength of implant-supported composite resin crowns on PEEK and solid titanium temporary Abutments, and to analyze the failure types. Material and Methods: Three types of provisional Abutments, RN synOcta Temporary Meso Abutment (PEEK; Straumann), RN synOcta Titanium Post for Temporary Restorations (Straumann), and Temporary Abutment Engaging NobRplRP (Nobel Biocare) were used, and provisional screw-retained crowns using composite resin (Solidex) were fabricated for four different locations in the maxilla. The specimens were tested in a universal testing machine at a crosshead speed of 1 mm/minute until fracture occurred. The failure types were analyzed and further categorized as irreparable (Type 1) or reparable (Type 2). Results: No significant difference was found between different Abutment types. Only for the position of the maxillary central incisor, composite resin crowns on PEEK temporary Abutments showed significantly lower (p <0.05) fracture strength (95 +/- 21 N) than those on titanium temporary Abutments (1,009 +/- 94 N). The most frequently experienced failure types were cohesive fractures of the composite resin crowns (75 out of 104), followed by screw loosening (18 out of 104). According to reparability, the majority of the specimens were classified as Type 1 (82 out of 104). Type 2 failures were not often observed (22 out of 104). Conclusions: Provisional crowns on PEEK Abutments showed similar fracture strength as titanium temporary Abutments except for central incisors. Maxillary right central incisor composite resin crowns on PEEK temporary Abutments fractured below the mean anterior masticatory loading forces reported to be approximately 206 N.
