Yeniden simantasyonun CAD/CAM zirkonya kuronların kısa titanyum ve zirkonya abutmentler üzerine tutunmasına etkisi

Yıl 2020, Cilt: 37 Sayı: 3, 78 - 83, 01.09.2020

Nurullah Türker , Mehmet Mustafa Özarslan

https://doi.org/10.17214/gaziaot.621820

Öz

Amaç: Bu çalışmanın amacı yeniden simantasyon işleminin bir self adeziv rezin siman ile kısa titanyum ve zirkonya dayanaklara yapıştırılan zirkonya kopinglerin tutuculuğuna etkilerinin karşılaştırmalı olarak değerlendirilmesidir.

Gereç ve Yöntem: Bu in vitro çalışmada 12 adet titanyum (Nucleoss T4 implants, NucleOSS T4 flat abutment, İzmir, Türkiye) ve 12 adet zirkonya (Zirkonzahn, Zirkonzahn GmbH, Bruneck, İtalya) dayanak kullanıldı. Titanyum dayanakların boyu 3 mm’ye indirildi ve analoglara sabitlenerek akrilik içine gömüldü. Titanyum dayanaklar taranarak bilgisayar destekli tasarım ve imalat (CAD/CAM) yöntemi ile zirkonyum dayanaklar ve zirkonyum kopingler üretildi. Tüm zirkonyum kopingler bir self adeziv rezin siman ile titanyum ve zirkonyum dayanaklara simante edildi. Örnekler universal test cihazında pull-out testine tabi tutuldu ve bağlanma dayanımı değerleri kaydedildi. Dayanaklar ve kopingler üzerindeki siman kalıntıları anguldruvaya takılan bir çelik rond frez ve sond ile temizlendi. Kopingler yeniden simante edildi, tekrar pull-out testi uygulandı ve bağlanma dayanımı değerleri kaydedildi. Verilere tanımlayıcı istatistikler uygulandı, ortalama ve standart sapma değerleri elde edildi. Grup ve test etkisini karşılaştırmak için ikili karşılaştırmalı Bonferroni düzeltmeleri kullanıldı. p <0.01 değerleri istatistiksel olarak anlamlı kabul edildi.

Bulgular: Ön test ve son testin bağlanma dayanımı üzerindeki etkisi (p<0.001), titanyum ve zirkonyum grup farklılığı etkisi (p<0.001) ve test-grup interaksiyon etkisi (p<0.001) istatistiksel olarak anlamlı bulundu. Titanyum ve zirkonyum örneklerde ilk test ve ikinci test arasında bağlanma dayanımı açısından anlamlı farklılık gözlendi (Titanyum: p<0.05, Zirkonyum: p<0.001). Son test bağlanma dayanımı değerleri, öntest bağlanma dayanımı değerlerinden istatistiksel olarak anlamlı derecede düşüktü. İlk testen son teste bağlanma dayanımı değerlerinin değişiminde titanyum ve zirkonyum örnekler arasında anlamlı farklılık gözlendi, bağlanma değerlerindeki azalma zirkonyum örneklerde daha fazlaydı (p<0.001). 

Sonuç: Yeniden simantasyon durumunda kısa dayanaklar üzerindeki tek üye restorasyonların retansiyonu olumsuz etkilenebilir. Resimantasyon durumunda zirkonyum dayanaklarda titanyum dayanaklara göre daha fazla tutuculuk kaybı oluşur.

Anahtar Kelimeler

diş implantı, titanyum, yapıştırma, zirkonyum

Influence of re-cementation on the retention of CAD/CAM zirconia copings over short titanium and zirconia abutments

Öz

Objective: The aim of this study was to comparatively evaluate the effects of re-cementation on the retention of zirconia copings, which were cemented to short titanium and zirconia abutments with self-adhesive resin cement.

Materials and Method: Twelve titanium (Nucleoss T4 implants, NucleOSS T4 flat abutment, İzmir, Turkey) and 12 zirconia abutments (Zirkonzahn, Zirkonzahn GmbH, Bruneck, Italy) were used in this in vitro study. The titanium abutments were shortened to 3 mm and embedded in acrylic by fixing them with analogues. The zirconia abutments and copings were produced by scanning the abutments using the computer-aided design and manufacturing (CAD/CAM) method. All zirconia copings were cemented to the titanium and zirconia abutments with self-adhesive resin cement. Samples were subjected to a pull-out test in a universal testing device, and the bond strength values were recorded. Cement residues on the abutments and copings were removed with a handpiece that had a round head carbon steel bur, and an explorer. The copings were then re-cemented and retested using the pull-out test, and the strength values were recorded. Descriptive statistics were applied to the data, and the mean and standard deviation values were calculated. Bonferroni corrections with pairwise comparisons were used to compare the group and test effect at each level. P<0.01 was considered as statistically significant.

Results: The effect of the pre-test and end-test on bond strength (p<0.001), the group effect on titanium and zirconia (p<0.001) and the test-group interaction effect (p<0.001) were all found to be statistically significant. A significant difference was observed between the titanium and zirconia samples in terms of bond strength when the pre-test and end-tests were compared (titanium: p<0.05, zirconia: p<0.001). The end-test bond strength values were significantly lower than the pre-test bond strength values. Additionally, there was a significant difference between the titanium and zirconia samples in terms of bond strength change on comparison of the pre-test and the end-test. Decrease in bond strength values was higher in the zirconia samples (p<0.001).

Conclusion: Re-cementation may adversely affect the bond strength of single-unit restorations on short abutments. In the case of re-cementation, a higher retention loss may occur in zirconia abutments than in titanium abutments.

Anahtar Kelimeler

abutment, dental implant, titanium, zirconium

Kaynakça

• Carnaggio TV, Conrad R, Engelmeier RL, Gerngross P, Paravina R, Perezous L et al. Retention of CAD/CAM all‐ceramic crowns on prefabricated implant abutments: an in vitro comparative study of luting agents and abutment surface area. J Prosthodont 2012;21:523-8.
• Covey DA, Kent DK, Germain Jr HAS, Koka S. Effects of abutment size and luting cement type on the uniaxial retention force of implant-supported crowns. J Prosthet Dent 2000;83:344-8.
• Kim Y, Yamashita J, Shotwell JL, Chong K-H, Wang H-L. The comparison of provisional luting agents and abutment surface roughness on the retention of provisional implant-supported crowns. J Prosthet Dent 2006;95:450-5.
• Cano-Batalla J, Soliva-Garriga J, Campillo-Funollet M, Muñoz-Viveros CA, Giner-Tarrida L. Influence of abutment height and surface roughness on in vitro retention of three luting agents. Int J Oral Maxillofac Implants 2012;27:36-43.
• Safari S, Hosseini Ghavam F, Amini P, Yaghmaei K. Effects of abutment diameter, luting agent type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments. J Adv Prost 2018;10:1-7.
• Felton DA, Kanoy BE, White JT. Recementation of dental castings with zinc phosphate cement: effect on cement bond strength. J Prosthet Dent 1987;58:579-83.
• Ayad MF, Johnston WM, Rosenstiel SF. Influence of tooth preparation taper and cement type on recementation strength of complete metal crowns. J Prosthet Dent 2009;102:354-61.
• Simon RL. Single implant-supported molar and premolar crowns: a ten-year retrospective clinical report. J Prosthet Dent 2003;90:517-21.
• Bresciano M, Schierano G, Manzella C, Screti A, Bignardi C, Preti G. Retention of luting agents on implant abutments of different height and taper. Clin Oral Implants Res 2005;16:594-8.
• Sadig WM, Al Harbi MW. Effects of surface conditioning on the retentiveness of titanium crowns over short implant abutments. Implant Dent 2007;16:387-96.
• Ho R. Handbook of univariate and multivariate data analysis and interpretation with SPSS. 2nd ed. Florida: Chapman and Hall/CRC; 2006.
• George D, Mallery P. SPSS for Windows Step by Step: A Simple Guide and Reference. 10th ed. Boston: Pearson; 2010.
• Ayad MF, Rosenstiel SF, Woelfel JB. The effect of recementation on crown retention. Int J Prosthodont 1998;11:177-82.
• Pommer B, Zechner W, Watzak G, Ulm C, Watzek G, Tepper G. Progress and trends in patients' mindset on dental implants. I: level of information, sources of information and need for patient information. Clin Oral Implants Res 2011;22:223-9.
• Pommer B, Zechner W, Watzak G, Ulm C, Watzek G, Tepper G. Progress and trends in patients' mindset on dental implants. II: implant acceptance, patient‐perceived costs and patient satisfaction. Clin Oral Implants Res 2011;22:106-12.
• Vichi A, Louca C, Corciolani G, Ferrari M. Color related to ceramic and zirconium restorations: a review. Dent Mater 2011;27:97-108.
• Sharma A, Rahul G, Poduval ST, Shetty K. Short clinical crowns (SCC)–treatment considerations and techniques. J Clin Exp Dent 2012;4:e230-6.
• Karimipour-Saryazdi M, Sadid-Zadeh R, Givan D, Burgess JO, Ramp LC, Liu P-R. Influence of surface treatment of yttrium-stabilized tetragonal zirconium oxides and cement type on crown retention after artificial aging. J Prosthet Dent 2014;111:395-403.
• Wandscher VF, Prochnow C, Rippe MP, Dorneles LS, Callegari GL, Baldissara P, et al. Retentive strength of y-tzp crowns: comparison of different silica coating methods on the intaglio surfaces. Oper Dent 2017;42:121-33.
• Nejatidanesh F, Savabi O, Jabbari E. Effect of surface treatment on the retention of implant-supported zirconium restorations over short abutments. J Prosthet Dent 2014;112:38-44.
• Kurt M, Külünk T, Ural Ç, Külünk Ş, Danişman Ş, Savaş S. The effect of different surface treatments on cement-retained implant-supported restorations. J Oral Implantol 2013;39:44-51.
• Carter SM, Wilson PR. The effect of die-spacing on crown retention. Int J Prosthodont 1996;9:21-9.
• Mehl C, Harder S, Steiner M, Vollrath O, Kern M. Influence of cement film thickness on the retention of implant‐retained crowns. J Prosthodont 2013;22:618-25.
• Joda T, Bürki A, Bethge S, Brägger U, Zysset P. Stiffness, strength, and failure modes of implant-supported monolithic lithium disilicate crowns: influence of titanium and zirconium abutments. Int J Oral Maxillofac Implants 2015;30:1272-9.
• Foong JK, Judge RB, Palamara JE, Swain MV. Fracture resistance of titanium and zirconium abutments: an in vitro study. J Prosthet Dent 2013;109:304-12.
• Ho WF, Chen WK, Wu SC, Hsu HC. Structure, mechanical properties, and grindability of dental Ti–Zr alloys. J Mater Sci Mater Med 2008;19:3179-86.
• Kobayashi E, Matsumoto S, Doi H, Yoneyama T, Hamanaka H. Mechanical properties of the binary titanium‐zirconium alloys and their potential for biomedical materials. J Biomed Mater Res 1995;29:943-50.