Autoclaving of zirkonia abutments
Background
Medical devices and instruments are classified as semi‐critical medical devices and must be sterilized after each use or after each possible contamination. Steam sterilisation in autoclaves is a recognised standard sterilisation method. This sterilization method is not harmful for metal devices and instruments, but the steam (moisture) and heat used could very well have a negative effect on the individual heat‐sensitive zirconium‐titanium hybrid abutments or their adhesive connection.
Aim/Hypothesis
The aim of the present study was to assess the influence of a standard autoclaving protocol on the retention of zirconia abutments glued on titanium bases in two‐piece implant abutments.
Material and Methods
24 CAD CAM‐generated zirconia abutments were adhesively cemented on prefabricated titanium bases using dual‐curing, self‐adhesive resin cement after conditioning of the bonding surfaces by air‐abrasion. After mechanical (49 N × 1,200,000 cycles) and thermal (5 °C 55 °C, 5,000 cycles) aging, the specimens were divided into two groups. Group 1 was subjected to a standard steam autoclaving protocol (135 °C, 2 bar), group 2 remained untreated as control. Tensile strength in all specimens was evaluated by a standardized pull‐off test limited to a maximum force of 1000 N. Data were analysed by performing chi‐square test and Fisher's exact test, as well as nonparametric tests.
Results
One sample each in both groups did not survive artificial aging. 11 samples in both groups were subjected to pull‐off testing. Ten samples in group 1 and three samples in group 2 failed during testing, all others reached the maximum pull‐off force of 1000N. This difference was statistically significant. The mean retention values for the failed samples were 694.53 ± 369.10 N in Group 1 and 890.78 ± 25.90 N in Group 2, not differing in statistically significant way.
Conclusion and Clinical Implications
A standard autoclaving protocol does not reduce tensile strength of two‐piece zirconia abutments. Clinical sterilization processes as recommended by regulatory authorities seem to be harmless concerning the structural integrity of two‐piece zirconia implant abutments, at least with regard to retention of the components.
Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1111/clr.13509
DOI: 10.1111/clr.13509
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