DOI QR코드

DOI QR Code

Biomechanical behavior of CAD/CAM cobalt-chromium and zirconia full-arch fixed prostheses

  • 투고 : 2020.03.25
  • 심사 : 2020.07.20
  • 발행 : 2020.12.31

초록

PURPOSE. To verify the influence of computer-aided design/computer-aided manufacturing (CAD/CAM) implant-supported prostheses manufactured with cobalt-chromium (Co-Cr) and zirconia (Zr), and whether ceramic application, spark erosion, and simulation of masticatory cycles modify biomechanical parameters (marginal fit, screw-loosening torque, and strain) on the implant-supported system. MATERIALS AND METHODS. Ten full-arch fixed frameworks were manufactured by a CAD/CAM milling system with Co-Cr and Zr (n=5/group). The marginal fit between the abutment and frameworks was measured as stated by single-screw test. Screw-loosening torque evaluated screw stability, and strain analysis was explored on the implant-supported system. All analyses were performed at 3 distinct times: after framework manufacturing; after ceramic application in both materials' frameworks; and after the spark erosion in Co-Cr frameworks. Afterward, stability analysis was re-evaluated after 106 mechanical cycles (2 Hz/150-N) for both materials. Statistical analyses were performed by Kruskal-Wallis and Dunn tests (α=.05). RESULTS. No difference between the two materials was found for marginal fit, screwloosening torque, and strain after framework manufacturing (P>.05). Ceramic application did not affect the variables (P>.05). Spark erosion optimized marginal fit and strain medians for Co-Cr frameworks (P<.05). Screw-loosening torque was significantly reduced by masticatory simulation (P<.05) regardless of the framework materials. CONCLUSION. Co-Cr and Zr frameworks presented similar biomechanical behavior. Ceramic application had no effect on the biomechanical behavior of either material. Spark erosion was an effective technique to improve Co-Cr biomechanical behavior on the implant-supported system. Screw-loosening torque was reduced for both materials after masticatory simulation.

키워드

참고문헌

  1. Papaspyridakos P, Bordin TB, Natto ZS, Kim YJ, El-Rafie K, Tsigarida A, Chochlidakis K, Weber HP. Double full-arch fixed implant-supported prostheses: Outcomes and complications after a mean follow-up of 5 years. J Prosthodont 2019; 28:387-97. https://doi.org/10.1111/jopr.13040
  2. Rojas Vizcaya F. Retrospective 2- to 7-year follow-up study of 20 double full-arch implant-supported monolithic zirconia fixed prostheses: measurements and recommendations for optimal design. J Prosthodont 2018;27:501-8. https://doi.org/10.1111/jopr.12528
  3. Jokstad A, Shokati B. New 3D technologies applied to assess the long-term clinical effects of misfit of the full jaw fixed prosthesis on dental implants. Clin Oral Implants Res 2015; 26:1129-34. https://doi.org/10.1111/clr.12490
  4. de Torres EM, Rodrigues RC, de Mattos Mda G, Ribeiro RF. The effect of commercially pure titanium and alternative dental alloys on the marginal fit of one-piece cast implant frameworks. J Dent 2007;35:800-5. https://doi.org/10.1016/j.jdent.2007.07.013
  5. Ciocca L, Meneghello R, Savio G, Scheda L, Monaco C, Gatto MR, Micarelli C, Baldissara P. Manufacturing of metal frameworks for full-arch dental restoration on implants: A comparison between milling and a novel hybrid technology. J Prosthodont 2019;28:556-63. https://doi.org/10.1111/jopr.13067
  6. Abduo J, Lyons K. Effect of vertical misfit on strain within screw-retained implant titanium and zirconia frameworks. J Prosthodont Res 2012;56:102-9. https://doi.org/10.1016/j.jpor.2011.09.001
  7. Burguete RL, Johns RB, King T, Patterson EA. Tightening characteristics for screwed joints in osseointegrated dental implants. J Prosthet Dent 1994;71:592-9. https://doi.org/10.1016/0022-3913(94)90443-X
  8. Presotto AGC, Oliveira LV, Pisani MX, Barao VAR, Mesquita MF. Influence of spark erosion on the fit of screw-retained Co-Cr fixed complete denture frameworks veneered with different materials. J Prosthet Dent 2018;119:797-803. https://doi.org/10.1016/j.prosdent.2017.07.003
  9. Abduo J. Fit of CAD/CAM implant frameworks: a comprehensive review. J Oral Implantol 2014;40:758-66. https://doi.org/10.1563/AAID-JOI-D-12-00117
  10. Abduo J, Lyons K, Waddell N, Bennani V, Swain M. A comparison of fit of CNC-milled titanium and zirconia frameworks to implants. Clin Implant Dent Relat Res 2012;14:e20-9. https://doi.org/10.1111/j.1708-8208.2010.00334.x
  11. de França DG, Morais MH, das Neves FD, Carreiro AF, Barbosa GA. Precision fit of screw-retained implant-supported fixed dental prostheses fabricated by CAD/CAM, copymilling, and conventional methods. Int J Oral Maxillofac Implants 2017;32:507-13. https://doi.org/10.11607/jomi.5023
  12. de França DG, Morais MH, das Neves FD, Barbosa GA. Influence of CAD/CAM on the fit accuracy of implant-supported zirconia and cobalt-chromium fixed dental prostheses. J Prosthet Dent 2015;113:22-8. https://doi.org/10.1016/j.prosdent.2014.07.010
  13. Beuer F, Schweiger J, Edelhoff D. Digital dentistry: an overview of recent developments for CAD/CAM generated restorations. Br Dent J 2008;204:505-11. https://doi.org/10.1038/sj.bdj.2008.350
  14. Drago C, Howell K. Concepts for designing and fabricating metal implant frameworks for hybrid implant prostheses. J Prosthodont 2012;21:413-24. https://doi.org/10.1111/j.1532-849X.2012.00835.x
  15. Bhering CL, Marques Ida S, Takahashi JM, Barao VA, Consani RL, Mesquita MF. The effect of casting and masticatory simulation on strain and misfit of implant-supported metal frameworks. Mater Sci Eng C Mater Biol Appl 2016;62: 746-51. https://doi.org/10.1016/j.msec.2016.02.035
  16. Pieralli S, Kohal RJ, Rabel K, von Stein-Lausnitz M, Vach K, Spies BC. Clinical outcomes of partial and full-arch all-ceramic implant-supported fixed dental prostheses. A systematic review and meta-analysis. Clin Oral Implants Res 2018;29:224-36.
  17. Kunii J, Hotta Y, Tamaki Y, Ozawa A, Kobayashi Y, Fujishima A, Miyazaki T, Fujiwara T. Effect of sintering on the marginal and internal fit of CAD/CAM-fabricated zirconia frameworks. Dent Mater J 2007;26:820-6. https://doi.org/10.4012/dmj.26.820
  18. Abduo J, Swain M. Influence of vertical misfit of titanium and zirconia frameworks on peri-implant strain. Int J Oral Maxillofac Implants 2012;27:529-36.
  19. Faucher RR, Nicholls JI. Distortion related to margin design in porcelain-fused-to-metal restorations. J Prosthet Dent 1980;43:149-55. https://doi.org/10.1016/0022-3913(80)90178-X
  20. Nakaoka MM, Nunez-Pantoja JM, Takahashi JM, Consani RL, Mesquita MF. Misfit of pure titanium frameworks: effect of veneer coverage and spark erosion process. Acta Odontol Scand 2011;69:238-42. https://doi.org/10.3109/00016357.2011.554860
  21. Silva TB, De Arruda Nobilo MA, Pessanha Henriques GE, Mesquita MF, Guimaraes MB. Influence of laser-welding and electroerosion on passive fit of implant-supported prosthesis. Stomatologija 2008;10:96-100.
  22. Jemt T. Failures and complications in 391 consecutively inserted fixed prostheses supported by Branemark implants in edentulous jaws: a study of treatment from the time of prosthesis placement to the first annual checkup. Int J Oral Maxillofac Implants 1991;6:270-6.
  23. Farina AP, Spazzin AO, Consani RL, Mesquita MF. Screw joint stability after the application of retorque in implant-supported dentures under simulated masticatory conditions. J Prosthet Dent 2014;111:499-504. https://doi.org/10.1016/j.prosdent.2013.07.024
  24. Bickford JH. An Introduction to the designs and behavior of bolted joints. New York: Marcel Dekker; 1995. p. 515-64.
  25. Gomes EA, Tiossi R, Faria AC, Rodrigues RC, Ribeiro RF. Torque loss under mechanical cycling of long-span zirconia and titanium-cemented and screw-retained implant-supported CAD/CAM frameworks. Clin Oral Implants Res 2014;25:1395-402. https://doi.org/10.1111/clr.12286
  26. Bhering CL, Mesquita MF, Kemmoku DT, Noritomi PY, Consani RL, Barao VA. Comparison between all-on-four and all-on-six treatment concepts and framework material on stress distribution in atrophic maxilla: A prototyping guided 3D-FEA study. Mater Sci Eng C Mater Biol Appl 2016;69:715-25. https://doi.org/10.1016/j.msec.2016.07.059
  27. Presotto AG, Bhering CL, Mesquita MF, Barao VA. Marginal fit and photoelastic stress analysis of CAD-CAM and overcast 3-unit implant-supported frameworks. J Prosthet Dent 2017;117:373-9. https://doi.org/10.1016/j.prosdent.2016.06.011
  28. Presotto AGC, Barao VAR, Bhering CLB, Mesquita MF. Dimensional precision of implant-supported frameworks fabricated by 3D printing. J Prosthet Dent 2019;122:38-45. https://doi.org/10.1016/j.prosdent.2019.01.019
  29. Wiskott HW, Nicholls JI, Belser UC. Stress fatigue: basic principles and prosthodontic implications. Int J Prosthodont 1995;8:105-16.
  30. ISO 14801. Dentistry - Implants - Dynamic loading test for endosseous dental implants. International Standards Organization (ISO); Geneva; Switzerland, 2016. Available at: http://www.iso.org/iso/home/store/catalogue_tc/catalogue_detail.htm?csnumber=61997.
  31. Braian M, Jonsson D, Kevci M, Wennerberg A. Geometrical accuracy of metallic objects produced with additive or subtractive manufacturing: A comparative in vitro study. Dent Mater 2018;34:978-93. https://doi.org/10.1016/j.dental.2018.03.009
  32. Abduo J, Lyons K, Bennamoun M. Trends in computer-aided manufacturing in prosthodontics: a review of the available streams. Int J Dent 2014;2014:783948. https://doi.org/10.1155/2014/783948
  33. Frost HM. A 2003 update of bone physiology and Wolff's Law for clinicians. Angle Orthod 2004;74:3-15.
  34. Papanagiotou HP, Morgano SM, Giordano RA, Pober R. In vitro evaluation of low-temperature aging effects and finishing procedures on the flexural strength and structural stability of Y-TZP dental ceramics. J Prosthet Dent 2006;96:154-64. https://doi.org/10.1016/j.prosdent.2006.08.004
  35. Svanborg P, Norstrom Saarva V, Stenport V, Eliasson A. Fit of 3Y-TZP complete-arch implant-supported fixed dental prostheses before and after porcelain veneering. J Prosthet Dent 2019;122:137-41. https://doi.org/10.1016/j.prosdent.2018.12.021
  36. Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent 1983;49:843-8. https://doi.org/10.1016/0022-3913(83)90361-X
  37. Breeding LC, Dixon DL, Nelson EW, Tietge JD. Torque required to loosen single-tooth implant abutment screws before and after simulated function. Int J Prosthodont 1993;6:435-9.
  38. Worni A, Kolgeci L, Rentsch-Kollar A, Katsoulis J, Mericske-Stern R. Zirconia-based screw-retained prostheses supported by implants: A retrospective study on technical complications and failures. Clin Implant Dent Relat Res 2015;17:1073-81. https://doi.org/10.1111/cid.12214