Stiffness, Strength, and Failure Modes of Implant-Supported Monolithic Lithium Disilicate Crowns: Influence of Titanium and Zirconia Abutments

Joda, Tim; Bürki, Alexander; Bethge, Stefan; Brägger, Urs; Zysset, Philippe (2015). Stiffness, Strength, and Failure Modes of Implant-Supported Monolithic Lithium Disilicate Crowns: Influence of Titanium and Zirconia Abutments. International journal of oral & maxillofacial implants, 30(6), pp. 1272-1279. Quintessence Publ. 10.11607/jomi.3975

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The objective of this study was to evaluate stiffness, strength, and failure modes of monolithic crowns produced using computer-aided design/computer-assisted manufacture, which are connected to diverse titanium and zirconia abutments on an implant system with tapered, internal connections.


Twenty monolithic lithium disilicate (LS2) crowns were constructed and loaded on bone level-type implants in a universal testing machine under quasistatic conditions according to DIN ISO 14801. Comparative analysis included a 2 × 2 format: prefabricated titanium abutments using proprietary bonding bases (group A) vs nonproprietary bonding bases (group B), and customized zirconia abutments using proprietary Straumann CARES (group C) vs nonproprietary Astra Atlantis (group D) material. Stiffness and strength were assessed and calculated statistically with the Wilcoxon rank sum test. Cross-sections of each tested group were inspected microscopically.


Loaded LS2 crowns, implants, and abutment screws in all tested specimens (groups A, B, C, and D) did not show any visible fractures. For an analysis of titanium abutments (groups A and B), stiffness and strength showed equally high stability. In contrast, proprietary and nonproprietary customized zirconia abutments exhibited statistically significant differences with a mean strength of 366 N (Astra) and 541 N (CARES) (P < .05); as well as a mean stiffness of 884 N/mm (Astra) and 1,751 N/mm (CARES) (P < .05), respectively. Microscopic cross-sections revealed cracks in all zirconia abutments (groups C and D) below the implant shoulder.


Depending on the abutment design, prefabricated titanium abutment and proprietary customized zirconia implant-abutment connections in conjunction with monolithic LS2 crowns had the best results in this laboratory investigation.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Surgical Technology & Biomechanics ISTB [discontinued]
04 Faculty of Medicine > School of Dental Medicine > Department of Reconstructive Dentistry and Gerodontology

UniBE Contributor:

Joda, Tim, Bürki, Alexander, Brägger, Urs, Zysset, Philippe


500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health




Quintessence Publ.




Eveline Carmen Schuler

Date Deposited:

29 Mar 2016 10:22

Last Modified:

05 Dec 2022 14:52

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

abutment connection, dental implants, DIN ISO 14801, failure mode, lithium-disilicate (LS2), stiffness, strength, titanium, zirconia


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