• The Journal of Advanced Prosthodontics
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• v.7 no.3
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• pp.183-190
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• 2015

PURPOSE. This study evaluated the fracture load of customized zirconia abutments with titanium insert according to preparation depths, with or without 5-year artificial aging. MATERIALS AND METHODS. Thirty-six identical lithium disilicate crowns (IPS e.max press) were fabricated to replace a maxillary right central incisor and cemented to the customized zirconia abutment with titanium insert on a $4.5{\times}10$ mm titanium fixture. Abutments were fabricated with 3 preparation depths (0.5 mm, 0.7 mm, and 0.9 mm). Half of the samples were then processed using thermocycling (temperature: $5-55^{\circ}C$, dwelling time: 120s) and chewing simulation (1,200,000 cycles, 49 N load). All specimens were classified into 6 groups depending on the preparation depth and artificial aging (non-artificial aging groups: N5, N7, N9; artificial aging groups: A5, A7, A9). Static load was applied at 135 degrees to the implant axis in a universal testing machine. Statistical analyses of the results were performed using 1-way ANOVA, 2-way ANOVA, independent t-test and multiple linear regression. RESULTS. The fracture loads were $539.28{\pm}63.11$ N (N5), $406.56{\pm}28.94$ N (N7), $366.66{\pm}30.19$ N (N9), $392.61{\pm}50.57$ N (A5), $317.94{\pm}30.05$ N (A7), and $292.74{\pm}37.15$ N (A9). The fracture load of group N5 was significantly higher than those of group N7 and N9 (P<.017). Consequently, the fracture load of group A5 was also significantly higher than those of group A7 and A9 (P<.05). After artificial aging, the fracture load was significantly decreased in all groups with various preparation depths (P<.05). CONCLUSION. The fracture load of a single anterior implant restored with lithium disilicate crown on zirconia abutment with titanium insert differed depending on the preparation depths. After 5-year artificial aging, the fracture loads of all preparation groups decreased significantly.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.389-403
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• 2010

Titanium and gold-alloy abutments have been used for a long-time in the clinical situations, but the use of zirconia abutments also increased. This study was designed to compare and evaluate the microgap differences according to types of abutment and dynamic loading. Titanium abutment, zirconia abutment and gold-alloy abutment (UCLA plastic) were connected into titanium implants of external hexagonal structure US II ${\phi}$ $3.75{\times}11.5$ mm (Osstem Co., Seoul, Korea) with the tightening torque of 30 Ncm. A sine type dynamic loading of 25-250 N and $30^{\circ}$ inclination from long axis was applied for $10^5$ times. Using the SEM both before and after the loadings, implant-abutment interfaces were analyzed on the labial, palatal, mesial and distal surface. The microgaps before and after the loading were compared, no statistically significant difference was observed caused by the dynamic loading on the labial, palatal, mesial or distal surface. Statistically significant difference was observed between UCLA and titanium group and between UCLA and zirconia group on both before and after the loading(p<0.05). No statistically significant difference was found between titanium and zirconia group. Loadings for $10^5$ times did not show significant effect to the microgaps between implants and abutments.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.2
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• pp.64-71
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• 2024

Purpose: The purpose of this study is to evaluate Ti-base abutment's three different heights and three different cement types on the pull-off force of zirconia-based restorations. Materials and Methods: A total of 90 fixture lab analogs were embedded in auto polymerizing resin bloack. 90 Ti-base abutments heights of 3 mm, 5 mm, 7 mm were scanned and zirconia restoration were prepared from scanned files. Zirconia restoration were cemented with three different types of cements (temporary, semi-permanent, permanent) following manufacturer's instructions. All 90 specimens were placed and tested in a universal testing machine for pull-out testing. Retention was measured by recording the force at load drop. Statistical analysis was performed using Kruskal-Wallis test for detecting whether there are any statistical significance along cement types or abutment heights. After that, Mann-Whitney test was used for figuring out differences regarding abutment height and the comparison between 3 cements. Results: Temp bond showed significantly lower pull-off force compared to Fujicem regardless of any abutment height. However, there were significant differences between Cem-implant and Fujicem in abutment height of 3 mm and 7 mm, but there was no significant difference in 5 mm. Temp bond and Cem-implant had significant differences only in abutment height of 5 mm. Conclusion: Although Ti-base abutment height did not influenced zirconia restorations' retentiveness, cement types showed significant differences.

• The Journal of Advanced Prosthodontics
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• v.12 no.3
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• pp.157-166
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• 2020

PURPOSE. The aim of this study was to evaluate the clinical performance and reliability of plasma sprayed nanostructured zirconia (NSZ) coating. MATERIALS AND METHODS. This study consisted of three areas of analysis: (1) Mechanical property: surface roughness of NSZ coating and bond strength between NSZ coating and titanium specimens were measured, and the microstructure of bonding interface was also observed by scanning election microscope (SEM). (2) Biocompatibility: hemolysis tests, cell proliferation tests, and rat subcutaneous implant test were conducted to evaluate the biocompatibility of NSZ coating. (3) Mechanical compatibility: fracture and artificial aging tests were performed to measure the mechanical compatibility of NSZ-coated titanium abutments. RESULTS. In the mechanical study, 400 ㎛ thick NSZ coatings had the highest bond strength (71.22 ± 1.02 MPa), and a compact transition layer could be observed. In addition, NSZ coating showed excellent biocompatibility in both hemolysis tests and cell proliferation tests. In subcutaneous implant test, NSZ-coated plates showed similar inflammation elimination and fibrous tissue formation processes with that of titanium specimens. Regarding fatigue tests, all NSZ-coated abutments survived in the five-year fatigue test and showed sufficient fracture strength (407.65-663.7 N) for incisor teeth. CONCLUSION. In this study, the plasmasprayed NSZ-coated titanium abutments presented sufficient fracture strength and biocompatibility, and it was demonstrated that plasma spray was a reliable method to prepare high-quality zirconia coating.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.227-237
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• 2008

STATEMENT OF PROBLEM: Zirconium oxide can be a substitute to titanium as implant materials to solve the esthetic problems of dark color in the gingival portion of implant restorations. PURPOSE: This study was performed to define attachment and growth behavior of osteoblast- like cells cultured on grooved surfaces of zirconium oxide and evaluate the genetic effect of zirconium oxide surfaces using the reverse transcriptase-polymerase chain reaction (RT-PCR). MATERIAL AND METHODS: MC3T3-E1 cells were cultured on (1) commercially pure titanium discs with smooth surface (T group), (2) yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) with machined surface (ZS group), and (3) Y-TZP with $100{\mu}m$ grooves (ZG group). Cell proliferation activity was evaluated through MTT assay and cell morphology was examined by SEM. The mRNA expression of Runx2, alkaline phosphatase, osteocalcin, TGF-${\beta}1$, IGF-1, G3PDH in E1 cells were evaluated by RT-PCR. RESULTS: From the MTT assay, after 48 hours of adhesion of MC3T3-E1 cells, the mean optical density value of T group and ZG group significantly increased compared to the ZS group. SEM images of osteoblast-like cells showed that significantly more cells were observed to attach to the grooves and appeared to follow the direction of the grooves. After 24 hours of cell adhesion, more spreading and flattening of cells with active filopodia formation occurred. Results of RT-PCR suggest that T group, ZS group, and ZG group showed comparable osteoblast-specific gene expression after 24 hours of cell incubation. CONCLUSION: Surface topography and material of implants can play an important role in expression of osteoblast phenotype markers. Zirconia ceramic showed comparable biological responses of osteoblast-like cells with titanium during a short-time cell culture period. Also, grooves influence cell spreading and guide the cells to be aligned within surface grooves.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.93-102
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• 2016

Purpose: The aim of this study was to evaluate the fit accuracy of two zirconia and titanium abutments in internal hexagonal implants. Materials and methods: One titanium abutment and two zirconia abutments were tested in internal hexagonal implants (TSV, Zimmer). Prefabricated zirconia abutments (ZirAce, Acucera) and customized zirconia abutments milled by the Zirkonzahn system (Zirkonzahn Max, Zirkonzahn) were selected and prefabricated titanium abutments (Hex-Lock, Zimmer) were used as a control. Eight abutments per group were connected to implants with 30 Ncm torque. The marginal gaps at abutment-implant interface, the internal gaps at internal hex, vertical and horizontal gaps between screws and screw seats in abutments were measured after sectioning the embedded specimens using a scanning electron microscope. Data analysis included one-way analysis of variance and the Scheffe test (n=16, ${\alpha}=0.05$). Results: The mean marginal gap of customized zirconia abutment was higher than those of two prefabricated zirconia and titanium abutments. The internal gaps at internal hex showed no significant differences between customized and prefabricated abutments and were higher than those of prefabricated titanium abutments. The mean vertical and horizontal gaps at screw in prefabricated zirconia abutment were higher than those of prefabricated titanium abutment. In the case of customized zirconia abutment, the mean horizontal gap at screw was higher than those of both the prefabricated zirconia and the titanium abutment but the mean vertical gap was not even measureable. The screw seats were clearly formed but did not match with abutment screws in prefabricated zirconia abutments. They were not, however, precisely formed in the case of customized zirconia abutments. Conclusion: Within the limitations of this study, the prefabricated titanium abutments showed better fit than the zirconia abutments, regardless of customized or prefabricated. Also, the customized zirconia abutments showed significantly higher marginal gaps and the fit was less accurate between screws and screw seats than the prefabricated abutments, titanium and zirconia.

• The Journal of Advanced Prosthodontics
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• v.14 no.6
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• pp.346-359
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• 2022

PURPOSE. Four and six implant-supported fixed full-arch prostheses with various framework materials were assessed under different loading conditions. MATERIALS AND METHODS. In the edentulous maxilla, the implants were positioned in a configuration of four to six implant modalities. CoCr, Ti, ZrO₂, and PEEK materials were used to produce the prosthetic structure. Using finite element stress analysis, the first molar was subjected to a 200 N axial and 45° oblique force. Stresses were measured on the bone, implants, abutment screw, abutment, and prosthetic screw. The Von Mises, maximum, and minimum principal stress values were calculated and compared. RESULTS. The maximum and minimum principal stresses in bone were determined as CoCr < ZrO₂ < Ti < PEEK. The Von Mises stresses on the implant, implant screw, abutment, and prosthetic screws were determined as CoCr < ZrO₂ < Ti < PEEK. The highest Von Mises stress was 9584.4 Mpa in PEEK material on the prosthetic screw under 4 implant-oblique loading. The highest maximum principal stress value in bone was found to be 120.89 Mpa, for PEEK in 4 implant-oblique loading. CONCLUSION. For four and six implant-supported structures, and depending on the loading condition, the system accumulated different stresses. The distribution of stress was reduced in materials with a high elastic modulus. When choosing materials for implant-supported fixed prostheses, it is essential to consider both the number of implants and the mechanical and physical attributes of the framework material.

• Journal of Periodontal and Implant Science
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• v.49 no.1
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• pp.58-58
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• 2019

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.1
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• pp.57-65
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• 2008

Purpose: Misfit of implant components was very important in terms of prosthodontics. they has been linked to prosthetic complications such as screw loosening and fracture. Although there are many results about rotational freedom or machining tolerance between fixture and abutments, the data about domestic implant systems are lacking. The aim of this in vitro study was to evaluate the rotational freedom of domestic external and internal connection implant systems between their fixtures/anlaogs and abutments comparing imported systems. Materials and Methods: Rotational freedom between abutments and fixtures/analogs was investigated by using digitalized rotational angle measuring device. (1) 1 domestic external connection system(Neobiotec) and 2 imported external connection systems(Nobel Biocare, Anthorgyr), (2) 1 domestic internal connection system(Dentium) and 4 imported external connection systems(Nobel Biocare, Anthorgyr, Straumann, Frident Dentsply), and (3) 1 domestic zirconia external connection abutment(ZirAce) were evaluated. Each group has 3 samples. Mean values for each group were analyzed. Results: The differences relative to rotational freedom between domestic and imported implant systems were observed but domestic external connection implant system showed about 2.67 degrees(in case of fixture) and internal connection system showed about 4.3 degrees(in case of fixture). Domestic zirconia abutment showed less than 3 degrees of rotational freedom in a situation where the abutment was connected to an implant fixture egardless of domestic or imported systems. Conclusion: Newly developed digitalized rotational angle measuring device has high measuring resolution. The rotational freedom of domestic implant systems were similar to imported implant systems.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.23 no.2
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• pp.70-76
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• 2014

After extraction of tooth, alveolar ridge resorption is inevitable in most cases. Clinicians confront with horizontal and vertical resorption of alveolar bone. Without massive amount of bone and soft tissue graft, dental implant will be placed apically to gain stability. In those cases, not only white esthetic part, but also pink esthetic part should be restored with pink porcelain. The margin of prosthesis should be located apically to reproduce natural look with adjacent teeth. However, when the margin is located apically, it is always hard to remove remaining cement, thus complications may arise. In this report, a novel design of implant prosthesis is introduced to solve those issues. The novel design is consisted of zirconia framework with pink porcelain and separate crowns on top of the framework. It eliminates the possibility of cement remnants by bringing the crown margin coronally. Pink esthetic part is incorporated in abutment part instead of crown part and the screw hole is covered with separate crowns.