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    Fatigue resistance and fracture strength of narrow-diameter one-piece zirconia implants with angled abutments
    (Wiley, 2022) Atalay, Pelin; Oztas, Dogan Derya
    Objective Zirconia implants are assumed to satisfy the esthetic requirements that titanium implants cannot meet, however, there are not enough studies in the literature about narrow-diameter and angled zirconia implants that can be preferred especially in the anterior region. This in vitro study aimed to evaluate the fatigue resistance and fracture strength of narrow-diameter zirconia implants with angled abutments. Materials and Methods Forty-eight one-piece experimental zirconia implants and monolithic zirconia crowns were produced from 3-YTZP blanks. The implant diameters (3.0 or 3.7 mm) and the restoration types were determined according to three intraoral regions (upper central incisors, lower central incisors, and upper canine), and abutments were designed as straight or 15 degrees angled. The samples were subjected to chewing simulation corresponding to 5 years of clinical performance and then the static loading test. The survival rates of groups were measured by the Kaplan-Meier log-rank test, and the fracture load values were estimated by using Kruskal-Wallis and Mann-Whitney U tests (p < 0.05). Results All 3.0 mm diameter implants failed the fatigue test. The fatigue resistance of the implants with angled abutments was significantly lower than the straight abutments, and different crown designs were found to affect survival rates significantly. The fracture strengths of the surviving groups were above the maximum physiological chewing forces, and the differences were not significant. Conclusions The implant diameter, abutment angle, and restoration type have a significant effect on the fatigue behavior of zirconia implants. Clinical Significance The fracture strengths of the one-piece zirconia implants with a 3.7 mm diameter and a 15 degrees abutment angle are above the chewing forces for the anterior intraoral region.