Fracture of Zirconia Abutment with Metallic Insertion on Anterior Single Titanium Implant with Internal Hexagon: Retrieval Analysis of a Failure

European Journal of Prosthodontics and Restorative Dentisty (2016) 24, 164–168

Dental Implants Zirconia Prosthesis Failure Analyses Periprosthetic Fractures Dental Implant-Abutment Design Dental Porcelain

Fracture of Zirconia Abutment with Metallic Insertion on Anterior Single Titanium Implant with Internal Hexagon: Retrieval Analysis of a Failure

Prof. Marco Antonio Bottino *
(DDS, MSD, Chairman)

Dr Regina Furbino Villefort Rocha *
(DDS, MSD, PhD student)

Dr Lilian Costa Anami *
(DDS, MSD, PhD)

Dr Mutlu Özcan §

(Dr Med Dent, PhD)

Dr Renata Marques de Melo *
(DDS, MSD, PhD)

Address for Correspondence
Dr Regina Furbino Villefort Rocha *
Email: reginavillefort@gmail.com
* São Paulo State University, Institute of Science
and Technology, Department of Prosthodontics
and Dental Materials, São José dos Campos,
Brazil
University of Zurich, Head of Dental Materials
Unit, Center for Dental and Oral Medicine, Clinic
for Fixed and Removable Prosthodontics and
Dental Materials Science, Zurich, Switzerland

§

This case report presents a retrieval analysis of a screw-retained one-piece restoration with the veneering ceramic fired directly onto the zirconia abutment that fractured during insertion. A patient who experienced root fracture of a maxillary left central incisor received a titanium implant on the same day as extraction. After delayed implant loading, a two-piece zirconia abutment with metallic insertion was customized. Upon installation, a horizontal fracture of the crown just above the metallic portion was detected. The retrieval analysis of a fractured zirconia abutment showed crack formation and diffusion of glaze material that expanded the crack line during firing.

Patients expect success when replacing a lost dental element in the anterior region, and this requires careful planning. Currently, there are several treatment options for the restoration of missing anterior teeth, and clinicians should choose a predictable treatment based on scientific evidence. The use of implants for tooth restorations was first reported three decades ago as a treatment option for partially or fully edentulous patients.1 Since then, metal alloys, mainly titanium, have been accepted as reliable, biocompatible substructures for implant-supported crowns. However, their gray appearance may compromise aesthetics, especially after bone resorption. Furthermore, peri-implant soft-tissue recession may lead to exposure of the metallic abutment. For this reason, abutments of aluminum oxide or zirconium are often selected to circumvent this issue,2 since they are more aesthetic and fulfill biocompatibility requirements.2,3 Alumina and zirconia abutments have high fracture resistance and allow light to pass through, thus improving aesthetics.4-8 Most implant manufacturers today offer zirconia abutments for implant-supported metal-free restorations, to meet the demand for aesthetics. Such abutments are currently available in prefabricated or custom forms and may be prepared either by the dental technician through drilling or by computer-aided-design/computer-aided-manufacturing (CAD/CAM) systems via milling techniques.3

Received: 26-03-2016 Accepted: 20-04-2016

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