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Platform-Switching for Cemented Versus Screwed Fixed Dental Prostheses: Reliability and Failure Modes: An In Vitro
Rodolfo Brunieira Anchieta1,2,3, Lucas Silveira Machado1,2, Ronaldo Hirata1
1Department of Biomaterials and Biomimetics, New York University, College of Dentistry, New York, NY, USA.
Clinical Implant Dentistry and Related Research
|August 5, 2015
Summary
Cement-retained implant-supported fixed dental prostheses (ISFDP) show higher survival rates than screw-retained ones. This finding holds true regardless of whether regular or switching implant-abutment platforms are used, highlighting cement retention as a key factor for long-term success.
Area of Science:
- Biomaterials and Dental Implantology
- Prosthodontics and Restorative Dentistry
- Mechanical Engineering and Failure Analysis
Background:
- Implant-supported fixed dental prostheses (ISFDP) are crucial for replacing missing teeth.
- The choice between cemented and screw-retained prostheses, along with implant-abutment platform matching, impacts long-term survival.
- Understanding failure modes and survival probabilities is essential for clinical decision-making.
Purpose of the Study:
- To compare the survival probability of cemented versus screw-retained three-unit ISFDP.
- To investigate the influence of regular versus switching implant-abutment horizontal matching configurations on prosthesis survival.
- To analyze failure mechanisms under accelerated fatigue testing.
Main Methods:
- 168 implants with internal hexagon connections were divided into four groups based on platform configuration (regular/switching) and retention method (cemented/screw-retained).
- Three-unit metal bridges were fabricated, and implants were subjected to step-stress accelerated life testing (100,000 cycles at 400 N).
- Weibull distribution analysis determined survival probability, complemented by fractographic analysis using polarized light and scanning electron microscopy.
Main Results:
- Cement-retained ISFDP demonstrated significantly higher survival probabilities (IRC: 98%, ISC: 59%) compared to screw-retained groups (IRS: 23%, ISS: 0%).
- Failure was accelerated by fatigue in all groups except the regular platform cemented group (IRC).
- Screw-retained prostheses failed exclusively due to abutment-screw fractures, while cement-retained ones showed fractures at the implant/screw/abutment levels.
Conclusions:
- Cement-retained ISFDP exhibit superior survival rates compared to screw-retained ISFDP.
- The implant-abutment horizontal configuration (regular vs. switching) did not alter the superior survival outcome of cement-retained prostheses.
- Failure modes differ between cemented and screw-retained prostheses, with screw-retained designs being more susceptible to abutment-screw fractures.
