Fatigue reliability and failure modes of metal-ceramic, monolithic zirconia, and lithium disilicate implant-supported crowns cemented to titanium bases: A step-stress accelerated life testing study.

Authors

Eirini Zampara, Eleana Kontonasaki, Edmara T P Bergamo, Ronaldo Hirata, Caroline Vieira Maluf, Savvas Koltsakidis, Dimitrios Tzetzis, Marly Vale, Estevam A Bonfante, Leila Jahangiri, Lukasz Witek

Published in

The Journal of prosthetic dentistry. Oct 16, 2026. Epub Oct 16, 2026.

Abstract

The fatigue behavior under clinically relevant loading conditions of implant-supported screw-retained crowns cemented to titanium bases fabricated from different restorative materials remains insufficiently understood.
The purpose of this study was to evaluate the failure modes, fatigue reliability, and survival probabilities of metal-ceramic (MC), monolithic zirconia (3Y-TZP), and lithium disilicate (LD) single premolar implant-supported screw-retained crowns cemented to titanium bases using step-stress accelerated life testing (SSALT).
Sixty crowns were bonded to titanium bases (UNP RH 4 mm, GH 2 mm; Adin Dental Implant Systems Ltd), connected to internal hexagon implants (4.2-mm platform diameter, 10-mm length; Touareg S, Adin Dental Implant Systems Ltd), embedded in acrylic resin blocks, and subjected to single-load-to-failure testing (n=6) to determine stress profiles for SSALT (n=54). Use-level probability Weibull curves were calculated to estimate reliability for a mission of 100 000 cycles at 200 and 300 N. Failed specimens underwent polarized light stereomicroscopy and scanning electron microscopy (SEM) for fractographic analysis.
All specimens failed during SSALT loading profiles. Beta (β) values derived from use-level probability Weibull curves were greater than 1 for all groups, indicating fatigue-driven failure behavior. 3Y-TZP crowns demonstrated the highest fatigue reliability, with survival probabilities up to 98% at tested load levels (200 and 300 N). LD showed intermediate performance (93% at 200 N and 88% at 300 N), whereas MC crowns showed the lowest survival probabilities (86% at 200 N and 82% at 300 N). At 200 N, no statistically significant differences were observed among groups. At 300 N, 3Y-TZP crowns showed significantly higher survival probability than MC crowns (P=.038), while LD showed intermediate values and was not significantly different from either group. Fractographic analysis revealed material-specific fracture origins and crack propagation patterns.
All crown types demonstrated high survival probabilities. 3Y-TZP crowns showed higher fatigue reliability than MC crowns, while LD crowns demonstrated intermediate performance.

PMID:
42888136
Bibliographic data and abstract were imported from PubMed on 17 Oct 2026.

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