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Mallmann, Fernando
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article
Effect of screw-access hole and mechanical cycling on fracture load of 3-unit implant-supported fixed dental prostheses
Abstract
<p>Statement of problem: The effect of screw-access holes and mechanical cycling on fracture resistance of 3-unit screw-retained zirconia-based implant-supported fixed dental prostheses (ISFDPs) is unknown. </p><p>Purpose: The purpose of this in vitro study was to evaluate the effect of screw-access holes on the maximum fracture load (L<sub>f</sub>) of 3-unit ISFDPs fabricated with the same abutment design for screw (s)-retained and cement (c)-retained with either a metal- or zirconia-based framework, testing the hypotheses that ISFDPs with screw-access holes have the lowest L<sub>f</sub> and that mechanical cycling decreases the L<sub>f</sub> of screw-retained ISFDPs. </p><p>Material and methods: Models with fiberglass bases with 2 implants were fabricated. Special abutments were designed to allow for both s- and c-retained ISFDPs. The study considered the type of framework (s-retained metal-based and s-retained zirconia-based), fixation (s and c), and aging (a) with mechanical cycling, resulting in the following experimental groups (n=12): c-retained metal-based ISFDP; s-retained metal-based ISFDP (Ms); s-retained zirconia-based ISFDP aged by mechanical cycling (Zsa); and s-retained metal-based ISFDP aged by mechanical cycling (Msa). All ISFDPs were porcelain veneered and subjected to compressive load to failure. Fracture load data were statistically analyzed using 1-way ANOVA and Tukey range tests (α=.05). Fractography was used to evaluate the fracture surfaces. </p><p>Results: Cement-retained ISFDP (Zc and Mc) showed the greatest L<sub>f</sub> values (P<.001). Zs prostheses showed higher L<sub>f</sub> values than those for Ms. Aging significantly decreased the L<sub>f</sub> of Zsa but had no effect on Msa. Chipping was the failure mode most frequently found. Only Zs and Zsa ISFDPs showed catastrophic failures. Conclusions ISFDPs with screw-access holes showed lower L<sub>f</sub> values, regardless of the framework type. Mechanical cycling affected the L<sub>f</sub> of screw-retained zirconia-based ISFDPs.</p>