Influence of implant angulation on the fracture resistance of zirconia abutments.

PURPOSE: To investigate the effects of abutment design to correct for implant angulation and aging on the fracture resistance of zirconia abutments. Greater understanding of the fracture strength of the zirconia abutments under various clinical conditions may lead to improvement of clinical protocols and possibly limit potential failures of implant prosthetics. MATERIALS AND METHODS: Test specimens consisted of an implant-zirconia abutment-zirconia crown assembly with implant apex positioned at 0 degrees , 20 degrees to the facial (20F), and 20 degrees to the lingual (20L) with respect to a constant crown contour. To keep the abutment design as the only variable, CAD/CAM technology was used to generate monolithic zirconia crowns identical both in external and internal dimensions and marginal contours to precisely fit all the abutments in an identical fashion. The monolithic zirconia abutments were designed to fit the constant crown contours and the internal connection of the implant at the three angulations. The customized abutments for the three implant angulations varied in emergence profile, screw hole location, and material thickness around the screw hole. Half the specimens from each group were subjected to steam autoclaving and thermocycling to simulate aging of the restorations in vivo. To mimic the off-axis loading of the central incisor, the specimens were loaded at the recommended cephalometric interincisal relationship of 135 degrees between the long axis of the crown supported by the implant and the Instron force applicator simulating the mandibular incisor. The force applicator was positioned 2 mm from the incisal edge and loaded at a 1 mm/min crosshead speed. Data were evaluated by 2-way ANOVA (alpha = 0.05) and Tukey's HSD. RESULTS: The 20F group had the highest fracture values followed by the 0 degrees group, and the 20L group had the lowest fracture values. Aging did not yield any significant difference in fracture force magnitudes. CONCLUSION: Within the limitations of this study, tilting the implant apex to the lingual significantly reduced the fracture strength of angle-corrected zirconia abutments. Accordingly, while the angle between the occlusal force application and the long axis of the implant decreases, the resistance (force) to fracture decreases.