ArticleThe journal of advanced prosthodontics2026
Fracture resistance and failure modes in 4- vs. 6-implant supported zirconia full-arch prostheses with and without cantilevers: an
Article in The journal of advanced prosthodontics, 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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Abstract
purposeTo evaluate the fracture resistance and failure modes of IFCDPs supported by 4 versus 6 implants, with and without cantilever loading. MATERIALS AND
methodsForty monolithic zirconia IFCDP specimens (20 with 4 implants, 20 with 6 implants) were fabricated using CAD-CAM technology and bonded to titanium copings on titanium alloy casts. Specimens were divided into four groups (n = 10 each): Group A (4 implants, non-cantilever load at second premolar), Group B (4 implants, cantilever load at second molar), Group C (6 implants, non-cantilever load at second premolar), and Group D (6 implants, cantilever load at second molar). Mechanical testing was performed using a universal testing machine with a three-point bending fixture loading bilaterally. Failure modes (fracture or cement debonding) and maximum failure loads were recorded. Statistical analysis included Fisher's exact test for failure mode distribution and two-way ANOVA for failure load.
resultsNon-cantilever loading caused framework fractures at high mean loads (Group A: 25,105 ± 5744 N; Group C: 27,189 ± 5753 N), while cantilever loading led to cement debonding at significantly lower failure loads (Group B:1,070 ± 404 N; Group D: 828 ± 432 N). Loading site significantly influenced failure load (
conclusionBoth All-on-4 and All-on-6 zirconia full-arch prostheses show high static fracture resistance, but cantilever loading greatly reduces strength and induces debonding, underscoring the need to minimize cantilever length or improve bonding strategies.
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