Clinical Oral Investigations

, Volume 22, Issue 8, pp 2799–2807 | Cite as

Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP

  • M. NaumannEmail author
  • M. von Stein-Lausnitz
  • M. Rosentritt
  • C. Walter
  • H. Meyer-Lückel
  • G. Sterzenbach
Original Article



The aim of this in vitro study was an analysis of the impact of simulated reduced alveolar bone support and post-restored, endodontically treated distal abutment tooth on load capability of all-ceramic zirconia-based cantilever-fixed dental prosthesis (CFDP).

Material and methods

The roots of human lower sound premolars (n = 80) were divided into five experimental groups to be restored with all-ceramic zirconia-supported three-unit CFDP regarding bone loss (BL) relative to the cement-enamel junction (CEJ): 2 mm below CEJ = 0% BL (control group), group 25% distal BL, group 50% distal BL, group 50% mesial and distal BL, and group 50% distal BL and adhesive post-supported restoration. Specimens were exposed to simulated clinical function by thermo-mechanical loading (6.000 cycles 5°–55°; 1.2 × 106 cycles 0–50 N) and subsequent linear loading until failure.


Tooth mobility increased significantly for groups with simulated bone loss (p < 0.001). Four specimens failed during thermal cycling and mechanical loading (TCML). The maximum load capability ranged from 350 to 569 N, and did not differ significantly between experimental groups (p = 0.095). Groups with simulated bone loss revealed more tooth fractures at distal abutment teeth, whereas technical failures were more frequent in the control group (p = 0.024).


Differences of alveolar bone support and respectively increased tooth mobility between mesial and distal abutments did not influence load capability. A distal adhesively post-and-core-supported, root-treated abutment tooth did not increase risk of three-unit CFDP failure.

Clinical relevance

CFDPs are a treatment option used with caution when reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment teeth are involved.


Post-and-core Fixed dental prosthesis Load simulation Bone loss Fracture resistance 



Dentsply Sirona allowed the use of the milling machine to produce zirconia frameworks. No further external financial support was given.

Contribution to the paper

M. Naumann: idea, hypothesis, experimental design, and wrote the manuscript.

M. v. Stein-Lausnitz: idea, hypothesis, experimental design, and proofread the manuscript.

M. Rosentritt: performed TCML and proofread the manuscript.

C. Walter: contributed substantially to discussion and proofread the manuscript.

H. Meyer-Lückel: contributed substantially to discussion and proofread the manuscript.

G. Sterzenbach: experimental design, performed linear loading, and performed in part statistical evaluation.


The work was supported by the Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité – Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, D-14197, Berlin, Germany. This research was also supported by Ivoclar-Vivadent by Materials.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. All applicable international, national, and/or institutional guidelines for the care and use of animals were followed. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • M. Naumann
    • 1
    Email author
  • M. von Stein-Lausnitz
    • 1
  • M. Rosentritt
    • 2
  • C. Walter
    • 3
  • H. Meyer-Lückel
    • 4
  • G. Sterzenbach
    • 1
  1. 1.Department of Prosthodontics, Geriatric Dentistry and Craniomandibular DisordersCharité – Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of Prosthetic DentistryRegensburg University Medical CenterRegensburgGermany
  3. 3.Department of Periodontlogy, Cariology, and EndodontologyUniversity of BaselBaselSwitzerland
  4. 4.Department of Restorative, Preventive and Pediatric DentistryZMK Bern, University of BernBernSwitzerland

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