Mechanical Performance of Chairside Ceramic CAD/CAM Restorations and Zirconia Abutments with Different Internal Implant Connections: In Vitro Study and Finite Element Analysis.

(computer-aided design-computer-aided manufacturing) CAD/CAM monolithic restorations connected to zirconia abutments manufactured with a chairside workflow are becoming a more common restorative option. However, their mechanical performance is still uncertain. The aim of this study was to evaluate the mechanical behavior of a combination of a zirconia abutment and monolithic all-ceramic zirconia and lithium disilicate crown manufactured with a chairside workflow, connected to titanium implants with two types of internal connection-tube in tube connection and conical connection with platform switching. They were thermally cycled from 5 °C to 55 °C and were subjected to a static and fatigue test following ISO 14801. The fractured specimens from the fatigue test were examined by SEM (scanning electron microscopy). Simulations of the stress distribution over the different parts of the restorative complex during the mechanical tests were evaluated by means of (finite element analysis) FEA. The mechanical performance of the zirconia abutment with an internal conical connection was higher than that of the tube in tube connection. Additionally, the use of disilicate or zirconia all-ceramic chairside CAD/CAM monolithic restorations has similar results in terms of mechanical fracture and fatigue resistance. Stress distribution affects the implant/restoration complex depending on the connection design. Zirconia abutments and monolithic restorations seem to be highly reliable in terms of mechanical resistance.