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Each group was divided according to the fabricated and cemented CAD\/CAM milled crown into two equal subgroups: Nano-zirconia \u2033NZr\u2033 and monolithic lithium disilicate \u2033MLD\u2033 (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200910). The ceramic crowns were surface treated and cemented to the abutments by applying the recommended adhesive resin cement. Those study specimens underwent thermo-mechanical aging (49\u00a0N, 1.2\u2009\u00d7\u200910\n                    <jats:sup>6<\/jats:sup>\n                    cycles, 5\u201355\u00a0\u00b0C). Afterward, the fracture resistance test was performed, and the statistical analyses were made for all subgroups using two-way (ANOVA) analysis of variance and the Tukey post hoc tests (\n                    <jats:italic>\u03b1<\/jats:italic>\n                    \u2009=\u20090.05).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    Nano-zirconia implant abutments cemented to NZr crowns exhibited the highest fracture resistance values of all subgroups. In addition, \u2033CR PEEK\u2033 implant abutments reported higher fracture resistance values than those of \u2033PEKK\u2033. Within each implant abutment group \u2033NZr\u2033 crowns demonstrated significant high fracture resistance values over their \u2033MLD\u2033 counterparts (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    Considering limitations of the presented in vitro study, after thermomechanical aging, recently introduced \u2033NZr\u2033 implant abutments exhibited higher fracture resistance than \u2033CR PEEK\u2033 that again reported higher fracture resistance than \u2033PEKK\u2033 abutments. Generally, all abutment materials might withstand the physiologic occlusal forces. Information about the long-term survival of these recently studied implant abutments types seems limited.\n                  <\/jats:p>","DOI":"10.1186\/s12903-026-09150-4","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T08:45:46Z","timestamp":1785746746000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparing fracture resistance of CAD\/CAM polyetherketoneketone \u2033PEKK\u2033, carbon reinforced polyetheretherketone \u2033CR PEEK\u2033 and nano-zirconia implant abutments receiving digitally milled nano-zirconia and glass ceramic crowns: an in vitro study"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9595-5220","authenticated-orcid":false,"given":"Mohamed Atif","family":"Elkholy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9324-5792","authenticated-orcid":false,"given":"Hoda A.","family":"Fansa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1445-7321","authenticated-orcid":false,"given":"Ahmed","family":"Sameh Abd El Shakour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2375-4185","authenticated-orcid":false,"given":"Hoda Gaafar","family":"Hassan Hammad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"issue":"1","key":"9150_CR1","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1186\/s12903-024-04597-9","volume":"24","author":"SS Elsareef","year":"2024","unstructured":"Elsareef SS, Azer AS, Morsy N. 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