Objectives: To compare the stability of a screw-retained connection in a novel two-piece zirconia implant to a conventional titanium-based connection in an in vitro chewing simulation including artificial ageing.
Material and methods: Incisor (I) and molar (M) shaped monolithic zirconia crowns were screw-retained on either two-piece zirconia (test) or two-piece titanium (control) implants resulting in 4 groups of 8 samples (titanium implants with incisor-shaped crowns (T-I), titanium implants with molar-shaped crowns (T-M), zirconia implants with incisor-shaped crowns (Z-I) and zirconia implants with molar-shaped crowns (Z-M). These were subjected to artificial ageing by thermal cycling (TC: 2 × 3000 × 5°C/55°C cycles of 2 min) and mechanical loading (ML: 1.2 × 106 cycles of 50 N, f = 1 Hz). Surviving samples additionally underwent a fracture force test. Kaplan-Meier plots were drawn, and two-way ANOVA was calculated taking anatomical localisation and material variables as factors.
Results: The mean corresponding survival times were lower for T-M (0.86 × 106 ± 0.31 × 106 cycles) and Z-I (0.84 × 106 ± 0.21 × 106 cycles) compared to T-I (1.14 × 106 ± 0.10 × 106 cycles) and Z-M (1.20 × 106 ± 0.10 × 106 cycles). In one-way ANOVAs for survival time dependent on either location or material, no statistically significant differences could be found (location: p = .31; material: p = .62) in one-way ANOVAs. The interaction of location and material showed significant differences (F = 21.3, p < .001).
Conclusion: The connection of the tested screw-retained zirconia crowns in two-piece zirconia implants is comparable to standard titanium implants in the specific in vitro testing.
Keywords: biomaterials; ceramic implants; titanium; two-piece implants; zirconia.
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