Adjustment of retention of all-ceramic double-crown attachments

Objectives: Double-crown attachments, such as conical crowns (CCs), can retain removable partial prostheses. Digital manufacturing enables the use of innovative materials such as zirconia, and new workflows. The aim of this study was to investigate options for the adjustment of retention forces of all-zirconia CCs. Materials and methods: Single zirconia primary crowns were produced with convergence angles (α) of 3 and 4 degrees, together with monolithic zirconia secondary crowns (n = 8 for α = 3 degrees; n = 8 for α = 4 degrees). Retention was measured by fitting the crowns with forces F = 12.5 to 100 N, and evaluating the magnitudes of the forces required for loosening (L). L/F ratios were recorded, and the coefficient of friction (µ0) was calculated. To limit the maximum force required for loosening, and to prevent high tensile stresses within the crowns, the width of the occlusal gap between the primary and secondary crowns was limited by the implementation of occlusal stops. Results: True convergence angles were more conical than expected, by approximately 0.3 degrees. For α = 3 degrees and α = 4 degrees, L/F ratios were 0.308 (SD 0.04) and 0.208 (SD 0.068), respectively. The overall coefficient of static friction was µ0 = 0.113. Maximum retention forces were successfully controlled; the average values were 12.1 N (SD 4.5 N) for zirconia occlusal stops, and 12.8 N (SD 3.3 N) for composite occlusal stops. Conclusion: The clinically desired L/F ratio of 1/3 was achieved by selecting 3-degree burs for fabrication of all-zirconia CCs. It is possible to limit retention, thereby reducing tensile stress in the circumferential direction in secondary crowns. Keywords: CAD/CAM, prosthetic dentistry, bioengineering, biomechanics, ceramics, removable dental prosthesis