Objective: This in vitro study was performed to evaluate the stress analysis of CAD/CAM customized titanium, zirconia and high-resistance silicate ceramic abutments, and the fracture resistance of CAD/CAM customized titanium, zirconia and high-resistance silicate ceramic abutments.
Materials & Methods: Twenty-one titanium implant fixtures (4.0 mm diameter and 12 mm length) and three types of customized abutments materials were used in this study. The specimens were divided into three groups according to the abutment material type. Group A (n=7) received titanium abutments and Group B (n=7) received zirconium abutments and Group C (n=7) received the e.max abutments. All samples were subjected to strain gauge analysis test under load of 200N and fractured resistance test.
Results: A) The strain gauge test revealed that:
- High statistical significant differences were found between 3 groups at (F=156.36, P<0.001) by One Way ANOVA test analysis, and statistical significant (P<0.05) differencewithin all groups by Post hoc LSD testat buccal sides, similarly at lingual sides.
- And showed high statistical significant difference between e.max and zirconia abutments strain gauge at the buccal sides (t =21.7, P<0.001) and a non-statistically significant difference at the lingual sides (t =1.97, P=0.07). by Student t-test.
- High statistical significant difference in strain gauge between zirconia and titanium abutments at the buccal sides (t =11.3, P<0.001). and a non statistical significant difference at lingual sides (t=0.45, P=0.67 ) by Student t-test.
- Buccallywas founda high statistical significant difference recorded strain value betweene.max abutment and titanium abutment(t=9.7, P<0.001), and similarly high statistical significant (t=2.84, P=0.02) lingually by Student t- test .
- For e.max abutment: showed high statistical significant difference between 2 sides at (t=7.18, P<0.001). by Student t- test.
- For zirconia abutment: showed high statistical significant difference between 2 sides at (t=5.61, p < 0.001). by Student t -test.
- For titanium abutment:showed a non-statistical significant difference between 2 sides at (28.57, P=0.18). by Student t -test.
B) On the other hand, the result of fracture resistance:
- The highest resistance to fracture recorded in titanium abutment without fracture.
- And the higher mean fracture resistance in zirconia abutment thane.max abutment.
- High statistical significant difference between zirconia and e.max abutments at (t=8.4, P<0.001) by Student t-test.
The most commen fracture mode in e-max abutments appeared above the shoulder level of titanium base, while the most commen fracture mode in zirconia abutments was complete vertical splitting into two halves. And no fracture occure in titanium abutments.
Conclusions: Within the limitations of this in vitro study, the following conclusions could be drawn: Both ceramic (zirconia, e.max) and titanium abutments could withstand the functional loads developed during physiologic force in the premolar area. Abutment types significantly affect micro-strains around implants. Ceramic abutments could be considered as a valid alternative to metal abutments in esthetically demanding areas. The higher the modulus of elasticity of a material, the lower the internal stresses it can transfer to the surrounding structure.
Key words: e.max, zirconia and titanium abutments, titanium base, titanium implant fixtures, CAD/CAM, strain gauge, fracture resistance.