Survival Rate, Fracture Strength and Failure Mode of Ceramic Implant Abutments After Chewing Simulation

The aim of this study was to compare titanium-reinforced ZrO2 and pure Al2O3 abutments regarding their outcome after chewing simulation and static loading. Forty-eight standard diameter implants with an external hexagon were divided into three groups of 16 implants each and restored with three different types of abutments (group A: ZrO2 abutments with titanium inserts; group B: densely sintered high-purity Al2O3 abutments; group C: titanium abutments). All abutments were fixated on the implants with gold-alloy screws at 32 Ncm torque, and metal crowns were adhesively cemented onto the abutments. The specimens were exposed to 1.2 million cycles in a chewing simulator. Surviving specimens were subsequently loaded until fracture in a static testing device. Fracture loads (N) and fracture modes were recorded. A Wilcoxon Rank test to compare fracture loads among the 3 groups and a Fisher exact test to detect group differences in fracture modes were used for statistical evaluation (