Purpose: This in vitro study aimed to compare by finite element analysis the stress distribution created in restoration components and the bone-implant interface by the effect of different abutment and crown esthetic material combinations. Materials and Methods: A model of an implant in the maxillary central incisor region was generated. 5 materials with varying moduli of elasticity (E) and 6 combinations were used for the crown and abutment to generate 6 models. The models’ abutment/crown materials were as follows: PEEK / lithium disilicate, PEEK / composite resin, hybrid ceramics / lithium disilicate, hybrid ceramics / hybrid ceramics, PEEK / hybrid ceramics, zirconia / lithium disilicate. A static load of 500 N was applied and structural analysis was started. von Mises (mvM) and principal stress values on the bone-implant interface and (mvM) values for cement lines, and restorative materials were evaluated separately. Results: All models had the same (mvM) distribution in the bone implant interface. Models with abutments having higher (E) values (zirconia and hybrid ceramics) showed lower (mvM) distribution in crowns and overlying cement than abutments with lower (E) values (PEEK). The model PEEK/composite showed the highest (mvM) in the crown and underlying cement while the model zirconia/lithium disilicate showed the lowest. Conclusions: Higher (E) values abutments showed better stress distribution compared to those with low (E) values. Clinical relevance: Restoring anterior dental implants with abutment materials having high (E) values is more successful than materials with low (E) values. PEEK abutment and composite crown showed significantly high stress in the cement between crown and abutment which might be a cause of debonding. PEEK abutments and composite crowns are not recommended for definitive hybrid abutments and crowns.
Keywords: dental implants, finite element method, high-performance polymer PEEK, zirconia, lithium disilicate, hybrid ceramics