Evidence map›Paper›PMID 42288470›Full record

ArticleClinical oral implants research2026

Effect of Implant Design on Fracture Resistance, Mode, and Crystal Structure of One- and Two-Piece Zirconia Implants With Ceramic or Titanium Abutment Screws: An In Vitro Study.

Abdulaziz Gul, Evaggelia Papia, Siamak Eqtesadi, Magnus Anderson, Jonas P Becktor, Per Vult von Steyern

Abstract read
In one paragraph

Article in Clinical oral implants research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Abdulaziz GulDepartment of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden.ORCID https://orcid.org/0000-0001-7726-7086
Evaggelia PapiaDepartment of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden.ORCID https://orcid.org/0000-0001-6260-473X
Siamak EqtesadiThe Nordic Institute of Dental Materials, NIOM, Oslo, Norway.ORCID https://orcid.org/0009-0002-8409-1634
Magnus AndersonThe Nordic Institute of Dental Materials, NIOM, Oslo, Norway.ORCID https://orcid.org/0009-0005-2732-5467
Jonas P BecktorDepartment of Oral and Maxillofacial Surgery and Oral Medicine, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden.ORCID https://orcid.org/0000-0002-4132-9692
Per Vult von SteyernDepartment of Materials Science and Technology, Division 2, Faculty of Odontology, Malmö University, Malmö, Sweden.ORCID https://orcid.org/0000-0001-6593-0151

Funding

Knowledge Foundation 20250008Z-Systems AG (Oensingen, Switzerland)
6 · The paper itself

Abstract

objectivesTo evaluate the fracture resistance, fracture modes, and crystalline phase changes of zirconia one-piece implants (OPI) and bone-level (BLTPI) or tissue-level, two-piece implants (TLTPI), with ceramic (C) or titanium (T) abutment screws after dynamic preloading in a moist environment. MATERIALS AND

methodsDynamic preloading under moist conditions and subsequent static load-to-fracture testing were performed to evaluate fracture resistance and fracture mode. Scanning electron microscopy (SEM) analysis of fracture surfaces was employed to supplement the observations of macroscopic fracture modes. Crystalline phase changes were assessed using micro-Raman spectroscopy. Specimen preparations were performed in accordance with ISO 14801:2016. Five different ceramic (zirconia) implant designs were divided into the following groups: OPI, BLTPI (BLC, BLT), TLTPI (TLC, TLT). One-way and two-way ANOVA tests were used for comparisons and factor effect analysis.

resultsFracture resistance (N) and bending moment (N cm) differed significantly among the implant groups (p < 0.001), following the order TLTPI (775.2 ± 71 N) > OPI (605.7 ± 37 N) > BLTPI (498.3 ± 93 N). Within the two-piece implants (TPI), tissue-level designs (TL) outperformed bone-level designs (BL), while designs with different abutment screw materials showed no significant difference (p = 0.982).

conclusionsWithin the limitations of this in vitro study, the evaluated zirconia-based OPI, BLTPI, and TLTPI systems demonstrate sufficient fracture resistance to support further clinical investigation. Implant-level design (TL vs. BL) influences mechanical performance, whereas the influence of abutment screw material (ceramic vs. titanium) is less pronounced and varies according to the implant-level design.

Indexed as

CeramicsDental Implant-Abutment DesignDental ImplantsDental Prosthesis DesignDental Restoration FailureTitaniumZirconiumDental AbutmentsDental Stress AnalysisIn Vitro TechniquesMaterials TestingMicroscopy, Electron, ScanningSpectrum Analysis, RamanSurface PropertiesDental ImplantsTitaniumZirconiumzirconium oxidebone‐level implantsdental implantsimplant designimplant fracturetissue‐level implantszirconia implants

Identifiers

PMID42288470
PMCPMC13542745

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