Marginal adaptation of all-ceramic crowns on implant abutments

Background: Studies focusing on the marginal accuracy of all‐ceramic crowns on implant abutments are in short supply. Purpose: This study evaluated the marginal accuracy of all‐ceramic crowns on different implant abutments. Materials and Methods: Ninety‐six standardized maxillary central incisor crowns (48 alumina and 48 zirconia) were fabricated for each of the six test groups (n = 16) (Ti1, titanium abutments–alumina crowns; Ti2, titanium abutments–zirconia crowns; Al1, alumina abutments–alumina crowns; Al2, alumina abutments–zirconia crowns; Zr1, zirconia abutments–alumina crowns; Zr2, zirconia abutments–zirconia crowns). The crowns were adhesively luted using a resin luting agent. The marginal gaps were examined on epoxy replicas before and after luting as well as after masticatory simulation at 200× magnification. Results: The geometrical mean (95% confidence limits) marginal gap values before cementation, after cementation, and after masticatory simulation were group Ti1: 39(37–42), 57(53–62), and 49(46–53); group Ti2: 43(40–47), 71(67–76), and 64(59–69); group Al1: 57(54–61), 87(85–90), and 67(65–69); group Al2: 66(63–69), 96(90–101), and 75(72–78); group Zr1: 54(51–57), 79(76–82), and 65(63–67); and group Zr2: 64(60–68), 85(80–91), and 75(70–81). The comparison between non‐cemented and cemented stages in each group demonstrated a significant increase in the marginal gap values after cementation in all groups (p < .001), while the comparison between cemented and aged stages in each group showed a significant decrease in the marginal gap values in groups Al1, Al2, and Zr1 (p < .0001). This reduction was not significant for groups Ti1, Ti2, and Zr2 (p > .05). Conclusion: The marginal accuracy of all tested restorations meets the requirements for clinical acceptance.     

Microcomputed tomography evaluation of cement shrinkage under zirconia versus lithium disilicate veneers

Statement of problemComputer-aided design and computer-aided manufacturing (CAD-CAM) technology and the improved translucency of recently developed high-strength monolithic zirconia could make them clinically acceptable for veneers if bonding to zirconia was as predictable as to glass-ceramics. Few studies have compared how resin cements behave between glass-ceramic and zirconia veneers before and after polymerization.PurposeThe purpose of this in vitro study was to evaluate the volumetric polymerization shrinkage of resin cement, marginal discrepancy, and cement thickness before and after polymerization for glass-ceramic and zirconia veneers with light-polymerizing resin cement.Material and methodsTen lithium disilicate veneers and 10 zirconia veneers were fabricated with a CAD-CAM workflow on extracted human maxillary anterior teeth with intact enamel surfaces. Zirconia veneers were treated with airborne-particle abrasion, and lithium disilicate veneers were etched with 5% hydrofluoric acid. All specimens were treated with ceramic primer and cemented with a light-polymerized resin cement. All specimens were scanned before and after resin cement polymerization by microcomputed tomography. The data were processed by the Amira software program to compare polymerization volumetric shrinkage, cement thickness, and marginal discrepancy. The data were compared by using a t test and analysis of variance (α=.05). Two bonded veneers were loaded in a mastication simulator for 400 000 cycles to investigate the effect of cyclic fatigue loading.ResultsMean volumetric polymerization shrinkage was 4.2 ±0.8% for the lithium disilicate group and 6.4 ±3.5% for the zirconia group. No significant difference was found for volumetric shrinkage between materials (P=.132). The mean ±standard deviations of the marginal discrepancies before and after polymerization were 178 ±41 μm and 158 ±37 μm for lithium disilicate and 115 ±33 μm and 107 ±32 μm for zirconia. A smaller marginal discrepancy was found for both materials after polymerization (P=.011) and for zirconia compared with lithium disilicate (P=.004). The mean ±standard deviation cement thickness values before and after polymerization were 157 ±27 μm and 147 ±27 μm for lithium disilicate and 162 ±53 μm and 147 ±52 μm for zirconia. Smaller cement thickness was found after polymerization (P<.001), whereas no significant difference was found in cement thickness between materials (P=.144). No changes were noted in marginal discrepancy and cement thickness as a result of the fatigue loading.ConclusionsThe difference in the volumetric polymerization shrinkage of cement between lithium disilicate and zirconia veneers was not statistically significant. Polymerization shrinkage resulted in smaller marginal discrepancy and cement thickness for both veneer materials.     

Resistance to dislodgement of zirconia copings cemented onto titanium abutments of different heights

STATEMENT OF PROBLEM: For patients with limited interocclusal space, standard height implant abutments may not be usable. Shorter abutments may be desirable. PURPOSE: The purpose of this study was to determine the effect of the height of titanium abutments on the tensile strength required to dislodge zirconia copings. MATERIAL AND METHODS: Two experimental groups of abutments were prepared: (1) 4.3-mm platform width implant abutment with a 6.5-mm height (control), and (2) a 4.3-mm platform width implant abutment with a 5.5-mm height (shorter). Each abutment had 5 zirconia copings (custom designed) fabricated through a 3-dimensional computer-assisted design (3-D CAD) process by scanning an identical wax pattern. The zirconia copings were designed to have a 6-mm projection above the titanium abutment to accommodate a 2-mm hole. A wire was inserted through this hole to attach the zirconia coping to a universal testing machine. Each abutment was placed onto an implant embedded in a brass base designed to fit onto the universal testing machine. The zirconia copings were cemented onto the abutments with a provisional luting agent (Improv), and a tensile force was applied at a crosshead speed of 0.5 mm/min. The removal force was recorded for each specimen. An unpaired t test was used for the statistical analysis (alpha =.05). RESULTS: The mean force (SD) necessary to remove the zirconia copings (Newtons) from the 6.5-mm titanium abutment (198.09 (28.83)) was higher (P=.0078) than for the 5.5-mm abutment (124.89 (36.388)). CONCLUSIONS: By increasing the height of the abutment 1 mm and maintaining the diameter of the abutment, the resistance to tensile forces increased significantly between the 2 abutment dimensions evaluated.     

Retention of zirconia ceramic copings bonded to titanium abutments

PURPOSE: The aim of this study was to evaluate the effect of 2 surface conditioning methods and 2 luting-gap sizes on the retention and durability of zirconia ceramic copings bonded to titanium abutments. MATERIALS AND METHODS: Zirconia ceramic copings (Camlog Biotechnologies, Winsheim, Germany) with a luting-gap size of either 30 microm or 60 microm were bonded to titanium abutments (Camlog Biotechnologies) using the composite resin cement Panavia F (Kuraray, Osaka, Japan). The bonding surfaces of the zirconia ceramic copings were either (a) pretreated with airborne particle abrasion and cleaned with alcohol or (b) just cleaned with alcohol, whereas the bonding surfaces of all titanium abutments had been abraded and cleaned. After the specimens had been stressed for either 1, 30, 60, or 150 days by water and thermal cycling, retention was measured. RESULTS: The surface conditioning method, luting-gap size, and storage time significantly (P = .001; 3-way analysis of variance [ANOVA]) influenced retention. Air abrasion increased the retention significantly. Failure modes were predominantly adhesive. Air-abraded copings bonded with 30-microm luting gap achieved significantly greater retention than those bonded with a 60-microm luting gap. CONCLUSION: Surface conditioning methods and the size of the luting gap have a significant influence on the retention of Camlog zirconia ceramic copings bonded to Camlog titanium abutments.     

Effect of repeated firings on the marginal and internal adaptation of implant-supported metal-ceramic restorations fabricated with different thicknesses and fabrication methods

Statement of problemThe effect of repeated firing on the marginal and internal adaptation of copings fabricated with different techniques, thicknesses, and alloy types is unclear.PurposeThe purpose of this in vitro study was to compare the effects of repeated firing cycles on the marginal and internal adaptation of metal copings with different thicknesses fabricated by using casting, selective laser sintering (SLS), presintered soft metal milling (PSMM), postsintered hard metal milling (PHMM), and titanium milling methods.Material and methodsSingle-unit implant-supported copings (N=120) were fabricated with 0.5-mm and 1.5-mm thicknesses, and porcelain was applied in accordance with the manufacturer's instructions (n=12). The marginal and internal adaptation of the metal copings were examined before the firing cycles and after the fourth and seventh firing cycles by using a silicone replica technique with a stereomicroscope at ×80 magnification. The results were analyzed by using 3-way analysis of variance for repeated measurements on a single factor, 2-way analysis of variance, and an independent samples t test (α=.05).ResultsAs a result of the repeated firing cycles, the changes in the marginal discrepancy and internal discrepancy values in the PSMM, PHMM, and titanium milling groups and the change in the internal discrepancy value in the casting group were statistically significantly different (P<.05). The effect of the interaction of the firing, method, and thickness difference on the marginal discrepancy and internal discrepancy values was not statistically significantly different (P>.05).ConclusionsAfter the firing cycles, the PSMM, SLS, and titanium milling groups were found to have better marginal and internal adaptation for both thicknesses than the casting and PHMM groups.     

In vitro fit of CAD-CAM complete arch screw-retained titanium and zirconia implant prostheses fabricated on 4 implants

Statement of problem

Computer-aided designed and computer-aided manufactured (CAD-CAM) titanium and zirconia implant-supported fixed implant prostheses on 4 implants have become popular. The precision and accuracy of their interface fit has not been widely researched.

Effect of surface treatment and luting agent type on shear bond strength of titanium to ceramic materials

PURPOSEThis study aimed to compare the effect of different surface treatments and luting agent types on the shear bond strength of two ceramics to commercially pure titanium (Cp Ti).MATERIALS AND METHODSA total of 160 Cp Ti specimens were divided into 4 subgroups (n = 40) according to surface treatments received (control, 50 µm airborne-particle abrasion, 110 µm airborne-particle abrasion, and tribochemical coating). The cementation surfaces of titanium and all-ceramic specimens were treated with a universal primer. Two cubic all-ceramic discs (lithium disilicate ceramic (LDC) and zirconia-reinforced lithium silicate ceramic (ZLC)) were cemented to titanium using two types of resin-based luting agents: self-cure and dual-cure (n = 10). After cementation, all specimens were subjected to 5000 cycles of thermal aging. A shear bond strength (SBS) test was conducted, and the failure mode was determined using a scanning electron microscope. Data were analyzed using three-way ANOVA, and the Tukey-HSD test was used for post hoc comparisons (P < .05).RESULTSSignificant differences were found among the groups based on surface treatment, resin-based luting agent, and ceramic type (P < .05). Among the surface treatments, 50 µm air-abrasion showed the highest SBS, while the control group showed the lowest. SBS was higher for dual-cure resin-based luting agent than self-cure luting agent. ZLC showed better SBS values than LDC.CONCLUSIONThe cementation of ZLC with dual-cure resin-based luting agent showed better bonding effectiveness to commercially pure titanium treated with 50 µm airborne-particle abrasion.     

Evaluation of marginal fit of 2 CAD-CAM anatomic contour zirconia crown systems and lithium disilicate glass-ceramic crown

PURPOSEThis study was to evaluate the marginal fit of two CAD-CAM anatomic contour zirconia crown systems compared to lithium disilicate glass-ceramic crowns.RESULTSThe mean marginal gap of lithium disilicate glass ceramic crowns (IPS e.max®press) was significantly lower than that of the CAD-CAM anatomic contour zirconia crown system (Prettau®Zirconia) (P<.05). Both fabrication systems and finish line configurations significantly influenced the absolute marginal discrepancy (P<.05).CONCLUSIONThe lithium disilicate glass ceramic crown (IPS e.max®press) had significantly smaller marginal gap than the CAD-CAM anatomic contour zirconia crown system (Prettau®Zirconia). In terms of absolute marginal discrepancy, the CAD-CAM anatomic contour zirconia crown system (ZENOSTAR®ZR translucent) had under-extended margin, whereas the CAD-CAM anatomic contour zirconia crown system (Prettau®Zirconia) and lithium disilicate glass ceramic crowns (IPS e.max®press) had overextended margins.     

Marginal and internal fit of three-unit fixed dental prostheses fabricated from translucent multicolored zirconia: Framework versus complete contour design

Statement of problemTranslucent multicolored zirconia materials enable more esthetic complete contour zirconia fixed dental prostheses (FDPs) than conventional zirconia, which exhibits low translucency and high opacity and is monochromatic. However, how the marginal and internal fit of translucent multicolored zirconia FDPs compare with those of traditional frameworks that require veneering is unclear.PurposeThe purpose of this in vitro study was to compare the marginal and internal fit of frameworks and complete contour 3-unit FDPs fabricated from translucent multicolored zirconia.Material and methodsFrameworks with a thickness of 0.5 mm and complete contour FDPs with a thickness of 0.8 to 1.5 mm were manufactured by using a workflow similar to one from a zirconia master model (mandibular left second premolar-mandibular left second molar). Two polyvinyl siloxane replicas were made for each specimen to measure the marginal and internal fit. Measurement locations were mesial, lingual, buccal, and distal for each abutment. In these locations, the marginal opening (MO), chamfer area (CA), axial wall (AW), and occlusal area (OC) were measured. The data were analyzed with 2-way ANOVA and the Bonferroni post hoc test (α=.05).ResultsFrameworks showed significantly better mean ±standard deviation fit values than complete contour 3-unit FDPs at measurement areas MO (frameworks: 112 ±22 μm, complete contour FDPs: 144 ±37 μm) (P=.013), CA (frameworks: 89 ±12 μm, complete contour FDPs: 110 ±22 μm) (P=.006), and OC (frameworks: 182 ±36 μm, complete contour FDPs: 244 ±64 μm) (P=.008). At the measurement area AW (frameworks: 47 ±7 μm, complete contour FDPs: 50 ±9 μm of each location, no significant difference was observed between frameworks and complete contour FDPs (P=.361).ConclusionsDesign differences in 3-unit FDPs fabricated from translucent multicolored zirconia influenced the marginal and internal fit. Frameworks had smaller marginal fit than complete contour FDPs for translucent multicolored zirconia.     

The effect of fatigue loading on the screw joint stability of zirconium abutment

PurposeThis study evaluated the effect of fatigue loading on the screw joint stability of a zirconium abutment connected to an external hexagon implant in vitro.Materials and methodsFifteen titanium and 15 zirconia abutments of 3 different heights (5, 8, and 11 mm) were connected to external titanium implants with titanium screws. A torque gauge was used to measure the reverse torque values before and after loading. An air cylindrical loading device was used to simulate mastication at a 45-degree angle to the longitudinal axis of the implant.ResultsThere were significant differences (P < 0.05) before and after the loading of titanium (5 mm) and zirconia (5, 8, and 11 mm) abutments.ConclusionZirconia abutments for external hexagon implants had durability rates similar to those of titanium abutments after repeating load on the reverse torque of the abutment screw, indicating that the zirconia abutment could be reliably used instead of the titanium abutment.     

Effect of aging on fracture resistance and torque loss of restorations supported by zirconia and polyetheretherketone abutments: An in vitro study

Statement of problemNew materials have been developed for digital processing, including implant abutments, but studies on their mechanical properties are lacking.PurposeThe purpose of this in vitro study was to compare the effect of aging on the fracture resistance, failure mode, and torque loss of restorations made of zirconia and ceramic-reinforced polyetheretherketone (PEEK) abutments with titanium bases.Material and methodsTitanium-based PEEK and zirconia abutments were milled and veneered with composite resin or feldspathic porcelain in the form of maxillary first premolars (n=10). All the specimens were subjected to an aging process and were assessed after every 250 000 cycles under a stereomicroscope, and torque loss was recorded with an electronic torque meter. Fracture resistance was measured under static load (crosshead speed of 1 mm/min), and failure modes and final torque were determined. A t test was conducted for statistical analyses (α=.05).ResultsThe fracture resistance of the zirconia restorations was significantly greater than the PEEK-based restorations (P=.001). Torque losses were not significantly different after aging (P=.18); however, significant difference was recorded after the fracture test (P=.007). The effect of fracture load was significantly greater for the zirconia group (P<.001). Unlike with the zirconia group, the failure mode in the PEEK-based restorations was mainly adhesive and favorable (9 of 10 specimens).ConclusionsCeramic-reinforced PEEK abutments had acceptable resistance to fracture, a favorable failure mode, and successfully sustained the aging process.     

Fatigue fracture resistance of titanium and chairside CAD-CAM zirconia implant abutments supporting zirconia crowns: An in vitro comparative and finite element analysis study

Statement of problemZirconia abutments with a titanium base are promising candidates to substitute for titanium abutments based on clinical studies reporting good short-term survival rates. However, information on the long-term performance of zirconia abutments supporting ceramic crowns is scarce.PurposeThis in vitro comparative and finite element analysis study compared the fatigue life performance of ceramic computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic restorations and zirconia abutments fabricated with a chairside workflow connected to a titanium interface versus titanium abutments.Material and methodsTwenty-two internal connection implants were divided into 2 groups, one with a zirconia abutment and monolithic ceramic zirconia crown (ZZ) and the other with a titanium abutment and zirconia crown (TiZ). They were subjected to a fatigue test to determine the fatigue limit and fatigue performance of each group as per International Organization for Standardization (ISO) 14801. Microstructural analysis of the fracture surfaces was conducted by using a scanning electron microscope (SEM). Simulations of the in vitro study were also conducted by means of finite element analysis (FEA) to assess the stress distribution over the different parts of the restoration.ResultsThe fatigue limit was 250 N for the TiZ group and 325 N for the ZZ group. In both groups, the screw was the part most susceptible to fatigue and was where the failure initiated. In the zirconia abutment models, the stress on the screw was reduced.ConclusionsChairside CAD-CAM zirconia abutments with a titanium base supporting zirconia crowns had higher fatigue fracture resistance compared with that of titanium abutments.     

Effect of digital impressions and production protocols on the adaptation of zirconia copings

Statement of problem

Proper marginal, axial, and occlusal adaptation of dental restorations is essential for their long-term success. Production protocols including digital impression systems have been developed, but little information is available on the adaptation of zirconia restorations produced via them.

The comparison of provisional luting agents and abutment surface roughness on the retention of provisional implant-supported crowns

STATEMENT OF PROBLEM: In immediate implant loading, it is important to keep provisional restorations in place during early-phase healing. Current luting agents for provisional restorations may provide inadequate retention, creating a clinical challenge. PURPOSE: This study compared the retention of provisional autopolymerizing acrylic resin implant-supported single restorations with combinations of different implant abutment surface conditions and provisional luting agents. MATERIAL AND METHODS: Thirty solid titanium implant abutments (ITI), 4 mm high, were divided into 3 groups. Ten abutments were unaltered, 10 were airborne-particle abraded with 50-microm aluminum oxide, and 10 were roughened with a medium-roughness diamond rotary cutting instrument. Thirty implant analogs (ITI) were mounted in autopolymerizing acrylic resin blocks. A solid titanium implant abutment was placed in each implant analog and torqued to 35 N.cm. After fabrication of 4 provisional acrylic resin crowns for each abutment, provisional luting agents TempBond, TempBond NE, Life, and Zone were used to secure the provisional crowns to the respective abutments. All specimens were luted with one of the provisional luting agents for a given test. After ultrasonic cleaning of the abutments, another provisional crown was luted with another luting agent. All specimens were stored in 100% humidity environment for 1 day at 37 degrees C prior to testing. Each provisional acrylic resin crown was pulled from the abutment with a 500-kg load cell in a universal testing machine at a crosshead speed of 0.5 cm/minute, and tensile strength was recorded (N). Data were analyzed using analysis of variance (ANOVA) and the Scheffe test (alpha=.05). RESULTS: Tensile strength was significantly higher for Life and TempBond NE than for TempBond and Zone, regardless of the surface conditions (P=.0001). The result of the 2-way ANOVA indicated that a significant interaction existed between the provisional luting agents and surface conditions (P=.0039). TempBond NE showed significantly higher tensile strength when combined with airborne-particle-abraded surfaces compared to other combinations (P=.011). However, no difference was found in tensile strength of Life and Zone between different combinations. The tensile strength of TempBond was lower when used with the unaltered surface compared to other combinations (P=.001). CONCLUSION: Surface modification of an implant abutment by airborne-particle abrasion or diamond rotary cutting instrument did not improve retention of a provisional acrylic crown when Life or Zone was used as the luting agent. Airborne-particle abrasion may be an effective method to increase retention of a provisional acrylic crown when TempBond NE is used.     

Mechanical stability of angulated zirconia abutments supporting maxillary anterior single crowns on narrow-diameter implants

Objectives

To investigate the fracture strength of angulated hybrid abutments supporting anterior single crowns on narrow-diameter implants (NDIs).

Material and methods

Zirconia abutment with angulations of labial inclination 0° (TZ0Z), 15° (TZ15Z), 30° (TZ30Z) and palatal inclination 15° (TZ???15Z) was designed on 3.3-mm titanium-zirconium (Ti–Zr) NDIs. Titanium abutment connected with Ti–Zr implant (TZ0T) and 0° zirconia abutment connected with pure titanium (Ti) implant (T0Z) were control groups. Thirty-six un-restored abutments and 36 abutments restored with highly translucent zirconia (HTZ) crowns were tested. Failure loads were compared among 6 groups, and bending moments were calculated for comparison between un-restored and restored abutments.

Results

Failure loads of un-restored abutments were affected by the abutment angle. Sixty-seven percent samples in TZ30Z and 83% samples in TZ???15Z group fractured at the thinnest part of the zirconia abutment and exhibited lower failure load (p?<?.05). Failure loads of restored abutments were close to or exceeded the maximum bite force of anterior teeth, and no differences were found among six groups (p?>?.05). Except TZ15Z and TZ0T group, the bending moment increased with the crown construction, especially for TZ30Z and TZ???15Z groups (p?<?.001).

Conclusions

The fracture strength of hybrid abutments restored with HTZ crown on Ti–Zr NDIs exceeded the bite forces of anterior teeth for all the groups and were not affected by the abutment angle.

Clinical relevance

In terms of fracture strength, Ti–Zr NDIs combined with angulated hybrid abutments and HTZ crowns can be used in the anterior region.

     

Effect of cementation and aging on the marginal fit of veneered and monolithic zirconia and metal-ceramic CAD-CAM crowns

Statement of problemMarginal fit of zirconia restorations is an important criterion for their long-term success. However, in spite of the wide use of zirconia in dentistry, the relationship between marginal fit and low-temperature degradation from aging is unclear.PurposeThe purpose of this in vitro study was to compare the marginal adaptation of veneered and monolithic zirconia and metal-ceramic computer-aided design and computer-aided manufacturing (CAD-CAM) crowns before and after cementation and to evaluate the influence of artificial aging on the adaptation of zirconia crowns.Material and methodsSeventy-two standardized dies were prepared to receive a posterior crown and randomly divided into 6 groups (n=12) as per the material and the presence or not of cement: metal-ceramic, veneered zirconia, and monolithic zirconia. The zirconia groups were subjected to accelerated low-temperature degradation through hydrothermal aging in an autoclave at 131 °C and 0.17 MPa for 5 and 20 hours. A scanning electron microscope with a magnification of ×1000 was used for marginal adaptation measurements, and X-ray diffraction (XRD) was used to characterize phase transformation degradation. The data were statistically analyzed using 2-way ANOVA, repeated measures ANOVA with Greenhouse-Geisser correction, and the t test (α=.05).ResultsNo significant differences in the marginal discrepancy were recorded among the analyzed groups. The presence of cement did not influence marginal fit in any treatment group. No significant differences were observed in the marginal adaptation values before and after aging (P>.05). After 20 hours of aging, the monoclinic phase increase to 8.3% on veneered zirconia and to 3.1% on monolithic crowns.ConclusionsMonolithic and bilayer CAD-CAM zirconia crowns showed marginal gaps that were within an acceptable range of clinical discrepancy, regardless of cementation. Marginal adaptation was not influenced by aging. Low-temperature degradation did not lead to a significant transformation from the tetragonal to monoclinic phase.     

Influence of elapsed time between airborne-particle abrasion and bonding to zirconia bond strength

ObjectiveThe airborne-particle abrasion of zirconia with alumina particle (APA) has been reported to result in the durable bonding of appropriate adhesive luting systems. However, whether a delay between APA and the application of the adhesive luting material might affect the resulting bond strength and its durability is unknown.MethodsA total of 140 disc-shaped zirconia specimens were divided according to the elapsed time between the APA of zirconia and its bonding into 5 test groups (15 min, 1 h, 4 h, 24 h, and 72 h). The specimens were airborne-particle abraded with 50-μm Al₂O₃, and then stored at room temperature according to the test group (n = 28/group). Surface free energy (SFE) was measured for 12 specimens per group using a goniometer. For each group 16 Plexiglas tubes filled with composite resin were bonded to the zirconia specimens with an adhesive luting resin (Panavia 21). Tensile bond strength (TBS) was tested for subgroups of 8 specimens after water storage for 3 days and for 150 days with 37,500 thermal cycles.ResultsSFE decreased significantly within 24 h after APA. TBS after 3 days of water storage ranged from 38.3 (1 h) to 28.4 MPa (24 h) and after 150 days with thermocycling from 38.3 (15 min) to 24.8 MPa (24 h).SignificanceBased on these results, the time between the APA of zirconia and the application of adhesive materials should be minimized when bonding nonretentive zirconia restorations clinically.     

Durability of resin bonding to zirconia ceramic after contamination and the use of various cleaning methods

ObjectivesThe aim of the study was to evaluate the influence of contamination and different cleaning methods on the tensile bond strength with a phosphate monomer containing luting resin to zirconia ceramic.MethodsAfter the contamination with saliva or silicone disclosing agent, 228 polished and airborne-particle abraded zirconia discs were ultrasonically cleaned with 99% isopropanol. In a second step, the specimens were either treated with argon-oxygen plasma, air plasma, enzymatic cleaning agent or did not undergo an additional cleaning process. Uncontaminated zirconia specimens were used as the control group. X-ray photoelectron spectroscopy (XPS) was used for chemical analysis of the bonding surfaces of specimens. Plexiglas tubes filled with composite resin were bonded to zirconia specimens with a phosphate monomer containing luting resin. Tensile bond strength (TBS) was tested after 3 days or 150 days water storage with 37,500 thermal cycles.ResultsXPS revealed a decrease of the carbon/oxygen ratio after plasma treatment and an increase after treatment with an enzymatic cleaning agent in all groups. All contaminated specimens showed high and durable TBS after cleaning with a combination of isopropanol and a non-thermal atmospheric plasma. After the cleaning with enzymatic cleaning agent the TBS was significantly reduced in all groups after 150 days thermal cycling.SignificanceThe combination of isopropanol and plasma cleaning was effective in removing salvia and disclosing agent contamination. Enzymatic clearing agent was not able to remove contamination effectively and had a negative impact on the TBS of non-contaminated specimens.     

Evaluation of removal forces of implant-supported zirconia copings depending on abutment geometry,luting agent and cleaning method during re-cementation

PURPOSE

To evaluate the effects of different abutment geometries in combination with varying luting agents and the effectiveness of different cleaning methods (prior to re-cementation) regarding the retentiveness of zirconia copings on implants.

MATERIALS AND METHODS

Implants were embedded in resin blocks. Three groups of titanium abutments (pre-fabricated, height: 7.5 mm, taper: 5.7°; customized-long, height: 6.79 mm, taper: 4.8°; customized-short, height: 4.31 mm, taper: 4.8°) were used for luting of CAD/CAM-fabricated zirconia copings with a semi-permanent (Telio CS) and a provisional cement (TempBond NE). Retention forces were evaluated using a universal testing machine. Furthermore, the influence of cleaning methods (manually, manually in combination with ultrasonic bath or sandblasting) prior to re-cementation with a provisional cement (TempBond NE) was investigated with the pre-fabricated titanium abutments (height: 7.5 mm, taper: 5.7°) and SEM-analysis of inner surfaces of the copings was performed. Significant differences were determined via two-way ANOVA.

RESULTS

Significant interactions between abutment geometry and luting agent were observed. TempBond NE showed the highest level of retentiveness on customized-long abutments, but was negatively affected by other abutment geometries. In contrast, luting with Telio CS demonstrated consistent results irrespective of the varying abutment geometries. Manual cleaning in combination with an ultrasonic bath was the only cleaning method tested prior to re-cementation that revealed retentiveness levels not inferior to primary cementation.

CONCLUSION

No superiority for one of the two cements could be demonstrated because their influences on retentive strength are also depending on abutment geometry. Only manual cleaning in combination with an ultrasonic bath offers retentiveness levels after re-cementation comparable to those of primary luting.