• Maxillofacial Plastic and Reconstructive Surgery
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• 제40권
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• pp.26.1-26.10
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• 2018

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.

• The Journal of Advanced Prosthodontics
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• 제8권6호
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• pp.423-432
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• 2016

PURPOSE. The aim of this work is to evaluate different types of materials used for making implant abutments, by means of an in vitro study and a review of the literature, in order to identify the indications for a better choice of an implant-supported restoration in the anterior section. MATERIALS AND METHODS. 5 implant abutments were tested in a random order in the superior anterior maxilla of pig gingiva (n = 8): titanium dioxide (Nobel Biocare); zirconium dioxide, Standard BO shade (Nobel Biocare, Kloten, Switzerland); zirconium dioxide, Light BI shade (Nobel Biocare); zirconium dioxide, Intense A 3.5 shade (Nobel Biocare); and aluminium oxide. Each abutment was tested for 2 mm and 3 mm thickness. To determine color variation, VITA Easyshade Advance spectrophotometer (Vita Zahnfabrik, Bad Sackingen, Germany) was used. RESULTS. Results showed that the color variation induced by the abutment would be affected by the abutment material and gingival thickness, when the gingival thickness is 2 mm. All materials except zirconium dioxide (Standard shade) caused a visible change of color. Then, as the thickness of the gingiva increased to 3 mm, the color variation was attenuated in a significant manner and became invisible for all types of abutments, except those made of aluminium oxide. CONCLUSION. Zirconium dioxide is the material causing the lowest color variation at 2 mm and at 3 mm, whereas aluminium oxide causes the highest color variation no matter the thickness.

• The Journal of Advanced Prosthodontics
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• 제6권1호
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• pp.35-38
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• 2014

PURPOSE. This study aimed to evaluate the correlation between microleakage and screw loosening at different types of implant-abutment connections and/or geometries measuring the torque values before and after the leakage tests. MATERIALS AND METHODS. Three different abutment types (Intenal hex titanium, internal hex zirconium, morse tapered titanium) with different geometries were connected to its own implant fixture. All the abutments were tightened with a standard torque value then the composition was connected to the modified fluid filtration system. After the measurements of leakage removal torque values were re-measured. Kruskal-wallis test was performed for non-parametric and one-way ANOVA was performed for parametric data. The correlation was evaluated using Spearman Correlation Test (${\alpha}=0.05$). RESULTS. Significantly higher microleakage was found at the connection of implant-internal hex zirconium abutment. Observed mean torque value loss was also significantly higher than other connection geometries. Spearman tests revealed a significant correlation between microleakage and screw loosening. CONCLUSION. Microleakage may provoke screw loosening. Removing torque values rationally decrease with the increase of microleakage.

• 대한치과보철학회지
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• 제45권2호
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• pp.240-249
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• 2007

Statement of problem: A phenomenon of screw-loosening in implant abutment is frequently occurred in a single and multiple implant restoration. Purpose: This study was performed to evaluate an effect of abutment material on screw-loosening before and after a cyclic loading. In a single-tooth implant, different materials of abutment, Type III Gold alloy and Zirconium composite$(ZrO_2/Al_2O_3)$ were used. Material and method: The Gold alloy(Type III) and Zirconium composite$(ZrO_2/Al_2O_3)$ were used to make a superstructure of implant, the one of types of UCLA, Each group was constituted of 5 sample with a 30-degree offset angulated loading platform. The external hexagonal fixture was rigidly hel d in a special holding zig to ensure solid fixation without rotation during the tightening and a cyclic loading. A Titanium-alloy screw was used to connect and controlled to be tighten in 20Ncm torque by a digital torque gauge. A 20 times of consecutive closing/opening cycle were performed to evaluate the immediate torque loss. In 5 sample of each material group, an initial opening torque was recorded during 3 closing/opening cycle, then 2Hz, 200N, 1,000,000 cyclic loadings were performed, then a opening torque was evaluated. Result & Conclusion: 1. In this limited study, titanium alloy screw tightened in 20Ncm, a cold-welding phenomen on was not observed during the 20 times of closing/opening cycle(p=0.11, p=0.18). 2. In titanium alloy abutment screw, repeated opening and closing of the screw caused to progressive decrease of opening torque(p=0.014). 3. The difference in preload of screw between gold alloy abutment and ceramic$(ZrO_2/Al_2O_3)$ abutment was not significant(p=0.78). 4. The difference in torque loss of screw between gold alloy abutment and ceramic$(ZrO_2/Al_2O_3)$ abutment was not significant after 2Hz,200N, 1,000,000 cyclic loading(p=0.92). 5. In titanium alloy abutment screw tightened by 20Ncm, the screw loosening was not significant on each group after 2Hz, 200Ncm, 1,000,000 cyclic loading(p=0.59).

• 대한치과기공학회지
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• 제43권2호
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• pp.42-47
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• 2021

Purpose: The purpose of this study was to evaluate the stability of abutment screws used with the zirconia fixture-based implant system and compare them with those used with the existing titanium fixture system via the finite element method. Methods: A single implant-supported restoration was designed for the finite element analysis. A universal analysis program was used to set 8 occlusal points along the direction to the long axis of the implant, and an occlusal load of 700 N was applied. Results: In all models (Zir and Ti-fixture model), the screw threads presented with the highest von Mises stress (VMS) values, whereas the head and end presented with the lowest VMS values. The VMS of the screw used in the zirconia-fixture model was 5.97% lower than that used in the titanium-fixture model (261.258 vs. 276.911 MPa, respectively) despite statistical significance. Furthermore, the zirconia fixture (352.912 MPa) had a higher stress value (8.42%) than the titanium fixture (332.331 MPa). In a completely tightened titanium fixture implant system, the stress was concentrated in the implant-abutment connection interface, the zirconia fixture presented with a stable stress distribution. Conclusion: Although the zirconia fixture demonstrated a high VMS value, owing to the stiffness and elasticity coefficients of the material, the stress generated in the abutment screws was similar in all models. In conclusion, the zirconia fixture-based implant system presented with a more stable stress distribution in the abutment screws than the titanium fixture-based implant system.

• 치위생과학회지
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• 제15권1호
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• pp.54-59
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• 2015

본 연구는 시중에 널리 사용되는 치과용 지르코니아 코어를 이용하여 서로 다른 형태의 지대치를 대상으로 작업모형을 제작한 후, 치과용 스캐너를 통해 3차원 디지털 모형을 전환한 데이터를 토대로 지르코니아 코어를 제작하였으며, 각 실험군별 변연 적합도를 측정하여 비교분석하고자 하였다. 이와 같은 결과로 형태가 다른 지대치가 CAD/CAM system으로 치과 보철물 제작 시 적합도의 영향여부를 비교하였다. 제한된 조건 하에서 수행된 본 연구에서 다름과 같은 결과를 보였다. 지대치의 형태가 다른 작업모형으로 제작된 지르코니아 코어의 변연 적합도는 큰 차이가 없었다(p>0.05). 작업모형의 부위를 4등분으로 나누어 측정한 변연 적합도 또한 통계적으로 유의한 차이를 보이지 않았다. 결론적으로 3종류의 다른 지대치 모두 유사한 지르코니아 코어의 변연 적합도를 보였으며, 측정된 결과는 선행연구에 비추어 볼 때 임상적으로 허용 가능한 수치($100{\sim}120{\mu}m$)를 초과하는 실험군은 없었다. 이와 같은 결과를 토대로 다른 형태의 지대치를 사용하여 제작되었더라도 지르코니아 코어의 변연 적합도에 큰 영향을 주지 않을 것으로 생각된다.

• 구강회복응용과학지
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• 제40권2호
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• pp.64-71
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• 2024

목적: 본 연구의 목적은 세 가지 높이를 가진 티타늄 베이스 임플란트 지대주에서 세 종류의 시멘트가 지르코니아 수복물에서 가지는 제거력을 비교하는 것이다. 연구 재료 및 방법:. 90개의 직경 4.0 mm 임플란트 아날로그가 레진 블록에 식립되었다. 이후 3 mm, 5 mm, 7 mm의 높이를 가지도록 임플란트 지대주를 30개씩 제작하였고, 각 지대주를 스캔하여 지르코니아 수복물 시편을 제작하였다. 임시 시멘트(TB), 반영구 시멘트(CI), 영구 시멘트(FC)를 각자 제조사의 지시에 따라 지대주에 접착하였다. 제작된 90개의 시편은 만능시험기에서 제거력을 시험하였으며, 모든 제거력은 부하량이 하락하기 직전 가장 높은 값에서 측정되었다. 통계 분석은 지대주의 높이, 시멘트의 종류에 대해 각각 Kruskal-Wallis test (P = 0.05) 후 Mann-Whitney U test (P = 0.0167)로 사후 검정 시행하였다. 결과: 임플란트 지대주의 높이에 상관없이 TB에 비해 FC의 제거력이 높았다. CI와 FC간에는 3 mm와 7 mm에서는 유의미한 차이가 있었으나 5 mm에서는 유의미한 차이가 없었다. TB와 CI간에는 5 mm에서만 유의미한 차이가 있었다. 결론: 시멘트의 종류는 지르코니아 수복물의 제거력에 유의미한 영향을 끼쳤으나, 임플란트 지대주의 높이는 유의미한 영향을 주지 않았다.

• The Journal of Advanced Prosthodontics
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• 제7권6호
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• pp.475-483
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• 2015

PURPOSE. The objective of this study was to evaluate the influence of various cement types on the stress distribution in monolithic zirconia crowns under maximum bite force using the finite element analysis. MATERIALS AND METHODS. The models of the prepared #46 crown (deep chamfer margin) were scanned and solid models composed of the monolithic zirconia crown, cement layer, and prepared tooth were produced using the computer-aided design technology and were subsequently translated into 3-dimensional finite element models. Four models were prepared according to different cement types (zinc phosphate, polycarboxylate, glass ionomer, and resin). A load of 700 N was applied vertically on the crowns (8 loading points). Maximum principal stress was determined. RESULTS. Zinc phosphate cement had a greater stress concentration in the cement layer, while polycarboxylate cement had a greater stress concentration on the distal surface of the monolithic zirconia crown and abutment tooth. Resin cement and glass ionomer cement showed similar patterns, but resin cement showed a lower stress distribution on the lingual and mesial surface of the cement layer. CONCLUSION. The test results indicate that the use of different luting agents that have various elastic moduli has an impact on the stress distribution of the monolithic zirconia crowns, cement layers, and abutment tooth. Resin cement is recommended for the luting agent of the monolithic zirconia crowns.

• 대한치과보철학회지
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• 제44권6호
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• pp.740-750
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• 2006

Statement of problems. In an attempt to reduce screw loosening, dry lubricant coatings such as pure gold or tefron have been applied to the abutment screw. However, under repeated tightening and loosening procedures, low wear resistance and adhesion strength of coating material produced free particles on the surface of abutment screw and increased frictional resistance resulting in screw tightening problems. Purpose. The aim of this study was to compare friction coefficient, adhesion strength, vickers hardness and evaluate coating surface of titanium alloy specimens coated with TiN(titanium nitride), ZrN(zirconium nitride) and WC(tungsten carbide). Material and method. Titanium alloy(Ti-6Al-4V) discs of 12mm in diameter and 1mm in thickness divided into 4 groups. TiN, ZrN and WC was coated for the specimens of 3 groups respectively, and those of 1 group were not coated. Each group was made up of 4 specimens. In this study, sputtering method was used among the PVD(Physical Vapor Deposition) techniques available for TiN, ZrN and WC coatings. Friction coefficient, adhesion strength, vickers hardness and coating surface of 4 groups were measured. Results. 1. For all three coating conditions, friction coefficient was significantly decreased. Especially, ZrN coated surface showed the lowest value. $TiN(0.39{\pm}0.02)$, $ZrN(0.24{\pm}0.01)$, $WC(0.31{\pm}0.03)$. 2. TiN coating showed the highest adhesion strength, however ZrN coating had the lowest value. $TiN(25.3N{\pm}1.6)$, $ZrN(14.8N{\pm}0.6)$, $ WC(18.4N{\pm}0.7)$. 3. Vickers hardness of all three coatings was remarkably increased as compared with that of none coated specimen. TiN coating had the highest Vickers hardness, however WC coating showed the lowest value. $TiN(1865.2{\pm}33.8)$, $ZrN(1814.4{\pm}18.6)$, $WC(1008.5{\pm}35.9)$. 4. The ZrN or WC coated specimen showed a homogeneous and smooth surface, however the rough surface with defects was observed for TiN coating. Conclusions. When TiN, ZrN and WC coating applied to the abutment screw, frictional resistance would be reduced, as a result, the greater preload and prevention of the screw loosening could be expected.

• The Journal of Advanced Prosthodontics
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• 제7권2호
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• pp.151-159
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• 2015

PURPOSE. To describe and characterize the surface topography and cleanliness of CAD/CAM manufactured zirconia abutments after steaming and ultrasonic cleaning. MATERIALS AND METHODS. A total of 12 ceramic CAD/CAM implant abutments of various manufacturers were produced and randomly divided into two groups of six samples each (control and test group). Four two-piece hybrid abutments and two one-piece abutments made of zirconium-dioxide were assessed per each group. In the control group, cleaning by steam was performed. The test group underwent an ultrasonic cleaning procedure with acetone, ethyl alcohol and antibacterial solution. Groups were subjected to scanning electron microscope (SEM) analysis and Energy-dispersive X-ray spectroscopy (EDX) to verify and characterize contaminant chemical characterization non- quantitatively. RESULTS. All zirconia CAD/CAM abutments in the present study displayed production-induced wear particles, debris as well as organic and inorganic contaminants. The abutments of the test group showed reduction of surface contamination after undergoing an ultrasonic cleaning procedure. However, an absolute removal of pollutants could not be achieved. CONCLUSION. The presence of debris on the transmucosal surface of CAD/CAM zirconia abutments of various manufacturers was confirmed. Within the limits of the study design, the results suggest that a defined ultrasonic cleaning process can be advantageously employed to reduce such debris, thus, supposedly enhancing soft tissue healing. Although the adverse long-term influence of abutment contamination on the biological stability of peri-implant tissues has been evidenced, a standardized and validated polishing and cleaning protocol still has to be implemented.