Effect of luting agent type on fracture loads of implant-supported ceramic premolar prostheses

To investigate the effect of luting agent type on fracture loads of implant-supported ceramic prostheses in premolar region. Ninety-nine implant-abutment complexes were divided into three different implant-supported prostheses: monolithic yttria-partially stabilized zirconia (Y-PSZ) restorations (MPZ specimens), porcelain layered on yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) restorations (PLZ specimens), and monolithic lithium disilicate ceramic restorations (MLD specimens). Implant-supported prostheses were luted with adhesive resin luting agent (RLA), glass ionomer cement (GIC), or zinc phosphate cement (ZPC). For MPZ and MLD specimens, fracture loads were significantly higher for RLA group than for GIC and ZPC groups. For PLZ specimens, fracture loads did not significantly differ in relation to luting agent. Fracture loads were significantly higher for MPZ specimens than for other test specimens, regardless of luting agent. Use of an adhesive resin luting agent is recommended for placement of premolar implant-supported monolithic Y-PSZ and lithium disilicate ceramic prostheses.