Fracture resistance of premolar screw-retained implant-supported hybrid abutment crowns with monolithic restorations after thermomechanical aging

热机械老化后,前磨牙螺丝固位种植体支持式混合基台冠与整体式修复体的抗折强度

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Abstract

PURPOSE: This study evaluated the fracture resistance of premolar screw-retained implant-supported hybrid abutment crowns (HACs) fabricated from different monolithic restorative materials following artificial aging. MATERIALS AND METHODS: Forty-four titanium implant analogs were restored with HACs fabricated from four materials: 5 mol% yttria-partially stabilized monolithic zirconia (ST), strength-gradient multilayered zirconia (YM), lithium disilicate ceramic (LD), and resin composite containing dispersed nanoparticles (CM) (n = 11 per group). All specimens were subjected to thermocycling (10,000 cycles) and mechanical loading (1.2 million cycles) to simulate 5 years of clinical service. Fracture resistance was evaluated under compressive loading, and failure modes were analyzed using optical microscopy and scanning electron microscopy. Statistical analysis was performed using the Kruskal-Wallis and Steel-Dwass tests (α = 0.05). RESULTS: Significant differences were found among all groups (P = 0.00033-0.0022). The YM group exhibited the highest median fracture resistance (2.06 kN, IQR: 2.00 - 2.60 kN), followed by ST (1.74 kN, IQR: 1.69 - 1.80 kN), LD (1.29 kN, IQR: 1.14 - 1.41 kN), and CM (0.87 kN, IQR: 0.79 - 0.92 kN). All specimens survived the artificial aging protocols. Distinct fracture patterns were observed depending on the restorative material, with zirconia-based groups showing more favorable resistance than resin composite. CONCLUSION: All tested HACs exhibited fracture resistance values exceeding maximum bite forces, supporting their clinical applicability. Strength-gradient multilayered zirconia demonstrated superior reliability after simulated 5-year aging, emphasizing its structural advantage and broader safety margin compared with other restorative materials.

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