Keynote Address: Factors Affecting the Survival of Implant-supported Ceramic-ceramic Prostheses: A Translational Approach

Abstract Body: A randomized clinical trial was performed on implant-supported three-unit fixed denture prostheses (FDPs) to determine design parameters affecting their survival. A total of 129 FDPs on 96 participants were randomized to groups of different materials (ceramic-ceramic versus metal-ceramic) and were further subdivided into subgroups of (1) occlusal veneer thickness (0.5, 1.0, 1.5 mm); (2) connector height (3, 4, 5 mm) and; (3) diameter of curvature at the gingival embrasure (0.5, 1.0, 1.5 mm). Patients were recalled yearly for five years to ascertain the integrity of the FDP as well as the health of the implants supporting them. 29/129 FDPs or 22% demonstrated chipping and fractures at different periods of recall. Three of the 27 necessitated repairs, only one needed to be replaced because of fracture of the substructure, the rest were polished, and two were removed because of failure of one of the implant abutments. A systematic failure analysis was conducted to determine possible causes of failure. Fractographic analysis, fractal analysis and finite element analysis were used to determine the origin of failure, progression of failure and design parameters for survival.