Abstract: BACKGROUND: In implant restoration in the aesthetic area, zirconium dioxide is gradually becoming the most commonly used upper restorative material and has achieved better clinical results. Resin-ceramic composite, a new type of dental restorative material, begins to try to be used as an upper restorative material in implant restoration, but there is less research on the application of this material in implant restoration.
OBJECTIVE: To compare the biomechanical differences between resin ceramic crowns and zirconia all-ceramic crown implant restorations in three occlusal relationships for restoring maxillary central incisors.
METHODS: The cone-beam CT image data of a patient with single-crown implant restoration of maxillary central incisor were selected, and the maxillary bone model was extracted by using Mimics 21.0 software, and the model was imported into Solidworks 2020 software. The crown, adhesive, abutment, central screw, and implant were modeled, and the model of single-crown implant restoration of maxillary central incisor was assembled. After giving the model material property parameters (resin-ceramic composite and zirconia for the upper restoration materials) in ANSYS Workbench 2021 R1 software, three occlusal relationships (edge-to-edge occlusion, normal overjet and deep overbite) were simulated and loaded to analyze the stress distribution of the resin-ceramic crown and zirconia all-ceramic crown implant restoration models.
RESULTS AND CONCLUSION: (1) The stress concentration areas in the implant restoration models of the resin-ceramic crown group and the zirconia all-ceramic crown group in different occlusal relationships were distributed in the upper restoration loading point, the abutment-implant connection, the implant neck and the surrounding bone tissue. As the occlusal relationship changed from the edge-to-edge to normal and deep overbite, the peak equivalent forces of the restorative abutment, central screw, implant, and bone tissue in both the resin-ceramic and zirconia all-ceramic crown groups gradually decreased. The highest peak equivalent forces were observed for the upper restorations in deep overbite. The zirconia all-ceramic crown group had the highest peak equivalent force in the adhesive layer in the edge-to-edge relationship, and the resin-ceramic crown group had the highest peak equivalent force in the adhesive layer in the deep overbite. (2) In the edge-to-edge occlusion, the peak equivalent force of the adhesive layer and central screw in the resin-ceramic crown group was slightly smaller than that in the zirconia all-ceramic crown group, and there was no significant difference between the two groups in the peak equivalent force at the upper restoration, restoration abutment, implant, and bone tissue. The peak stresses in the upper restoration, adhesive layer, and central screw of the resin-ceramic crown group were slightly less than those of the zirconia all-ceramic crown group at normal fit, and there were no significant differences between the two groups in the peak equivalent forces at the restoration abutment, implant, and bone tissue. In deep overbite, the peak adhesive, abutment, and central screw stresses were greater in the resin-ceramic crown group than in the zirconia all-ceramic crown group, with no significant differences in the upper restorations, implants, or bone tissue. (3) The results showed that the upper restorative material had no significant effect on the stress distribution of the implant and bone tissue, and had some effects on the stress distribution of the upper restoration, adhesive, restoration abutment, and central screw, but the difference was not significant. The occlusal relationship has a significant influence on the stress distribution in all structures and bone tissue of the implant restoration. The resin-ceramic crowns have a buffering effect on the stresses in the case of edge-to-edge and normal occlusion.

Key words: aesthetic zone, implant restoration, occlusal relationship, upper restoration, resin-ceramic composite, zirconium dioxide, three-dimensional finite element, stress