Effect of implant luting cements on the retention of cement-retained, implant-supported zirconia restorations fabricated using CAD-CAM technology – an in vitro study
DOI:
https://doi.org/10.2340/biid.v12.45073Keywords:
Cement retained prosthesis, fixed dental prosthesis, implant-supported restoration, luting cements, retention, ZirconiaAbstract
Objective: The study focused on drawing a comparative evaluation amongst four commercially available implant luting cements used to retain implant-supported zirconia restorations fabricated using a Computer-Aided Design-Computer-Aided Manufacturing (CAD-CAM) system.
Materials and methods: A heat-activated polymethyl methacrylate (PMMA) model was fabricated to mount four implant abutment-analogue complexes. These complexes were scanned using a digital laboratory scanner to mill 60 zirconia copings using CAD-CAM software. The copings were divided into four groups depending on the type of implant luting cement used (n = 15). The zirconia copings were then cemented over titanium abutments and a tensile load at a crosshead speed of 1 mm/min was applied to the samples to perform a pull-out test using Universal Testing Machine. Thereafter, the load required to de-cement each coping was obtained, thus the retention for each coping was measured.
Statistical analysis: One-way analysis of variance (ANOVA) was advocated to statistically analyse the results and the post hoc Bonferroni test was used for multiple comparison using Statistical Package for the Social Sciences (SPSS) software.
Results: Multilink implant showed highest tensile strength (2.24 ± 1.01 kgf/mm2) being statistically significantly different from the other three cements (p < 0.001). This was followed by TgImplaCem (0.82 ± 0.32 kgf/mm2) and Temp-Bond NE (0.71 ± 0.13 kgf/mm2). The lowest tensile strength was exhibited by ImplaLute (0.31 ± 0.10 kgf/mm2). Intergroup comparison between TgImplaCem, Temp-Bond NE, and ImplaLute cements did not show statistically significant difference in tensile strength values (p < 0.001).
Conclusion: It was concluded that both non-eugenol zinc oxide provisional luting cement (TgImplaCem) and dual-curing resin-based implant cement (Temp-Bond NE) can be advocated to cement implant-supported prostheses since they both permit adequate retention with ease of retrievability.
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References
Hebel KS, Gajjar RC. Cement-retained versus screw-retained implant restorations: achieving optimal occlusion and aesthetics in implant dentistry. J Prosthet Dent. 1997;77(1):28–35. https://doi.org/10.1016/s0022-3913(97)70203-8 DOI: https://doi.org/10.1016/S0022-3913(97)70203-8
Kapoor R, Singh K, Kaur S, Arora A. Retention of implant-supported metal crowns cemented with different luting agents: a comparative in vitro study. J Clin Diagn Res. 2016;10(4):61–4. https://doi.org/10.7860/JCDR/2016/15912.7635 DOI: https://doi.org/10.7860/JCDR/2016/15912.7635
Sarfaraz H, Hassan A, Shenoy KK, Shetty M. An in vitro study to compare the influence of newer luting cements on retention of cement-retained implant-supported prosthesis. J Ind Prosthodont Soc. 2019;19(2):166–72. https://doi.org/10.4103/jips.jips_235_18. DOI: https://doi.org/10.4103/jips.jips_235_18
Prithviraj DR, Garg P, Pujari ML, Shruthi DP. Selection of dental cements for fixed implant-supported restorations: current perspectives. Int J Clin Dent. 2010;3(3):191–9.
Kheur M, Parulekar N, Jambhekar S. Clinical considerations for cementation of implant retained crowns. J Ind Dental Assoc. 2010;2(2):180–1.
Gervais MJ, Wilson PR. A rationale for retrievability of fixed, implant-supported prostheses: a complication based analysis. Int J Prosthodont. 2007;20(1):13–24.
Covey DA, Kent DK, St Germain Jr, HA, Koka S. Effects of abutment size and luting cement type on the uniaxial retention force of implant‑supported crowns. J Prosthet Dent. 2000;83(3):344–8. https://doi.org/10.1016/s0022-3913(00)70138-7 DOI: https://doi.org/10.1016/S0022-3913(00)70138-7
Akca K, Iplikcioglu H, Cehreli MC. Comparison of uniaxial resistance forces of cements used with implant‑supported crowns. Int J Oral Maxillofac Implants. 2002;17(4):536–42.
Kent DK, Koka S, Froeschle ML. Retention of cemented implant‑supported restorations. J Prosthodont. 1997;6(3):193–6. https://doi.org/10.1111/j.1532-849x.1997.tb00090.x. DOI: https://doi.org/10.1111/j.1532-849X.1997.tb00090.x
Kim Y, Yamashita J, Shotwell JL, Chong KH, Wang HL. The comparison of provisional luting agents and abutment surface roughness on the retention of provisional implant-supported crowns. J Prosthet Dent. 2006;95(6):450–5. https://doi.org/10.1016/j.prosdent.2006.03.020 DOI: https://doi.org/10.1016/j.prosdent.2006.03.020
Gultekin P, Gultekin BA, Aydin M, Yalcin S. Cement selection for implant-supported crowns fabricated with different luting space settings. J Prosthodont. 2013;22(2):112–9. https://doi.org/10.1111/j.1532-849X.2012.00912.x DOI: https://doi.org/10.1111/j.1532-849X.2012.00912.x
Pan YH, Lin CK. The effect of luting agents on the retention of dental implant-supported crowns. Chang Gung Med J. 2005;28(6):403–10.
Nejatidanesh F, Savabi O, Ebrahimi M, Savabi G. Retentiveness of implant-supported metal copings using different luting agents. Dent Res J. 2012;9(1):13–8. https://doi.org/10.4103/1735-3327.92921 DOI: https://doi.org/10.4103/1735-3327.92921
Naumova EA, Roth F, Geis B, Baulig C, Arnold WH, Piwowarczyk A. Influence of luting materials on the retention of cemented implant-supported crowns: an in vitro study. Materials. 2018;11(10):1–14. https://doi.org/10.3390/ma11101853 DOI: https://doi.org/10.3390/ma11101853
Vojdani M, Torabi K, Farjood E, Khaledi A. Comparison the marginal and internal fit of metal copings cast from wax patterns fabricated by CAD/CAM and conventional wax up techniques. J Dent. 2013;14(3):118–29.
Maiti N, Mahapatra N, Patel D, Chanchad J, Shah AS, Rahaman SKM, et al. Application of CAD-CAM in dentistry. Bioinformation. 2024;20(5):547–50. https://doi.org/10.6026/973206300200547 DOI: https://doi.org/10.6026/973206300200547
Kuşçu S, Hayran Y. Selection of cement materials and isolation techniques for the effective removal of residual cement in the cementation. Clin Implant Dent Relat Res. 2025;27(2):e70040. https://doi.org/10.1111/cid.70040 DOI: https://doi.org/10.1111/cid.70040
Tarica DY, Alvarado VM, Truong ST. Survey of United States dental schools on cementation protocols for implant crown restorations. J Prosthet Dent. 2010;103(2):68–79. https://doi.org/10.1016/S0022-3913(10)00016-8 DOI: https://doi.org/10.1016/S0022-3913(10)00016-8
Mansour A, Ercoli C, Graser G, Tallents R, Moss M. Comparative evaluation of casting retention using the ITI solid abutment with six cements. Clin Oral Implants Res. 2002;13(4):343–8. https://doi.org/10.1034/j.1600-0501.2002.130401.x DOI: https://doi.org/10.1034/j.1600-0501.2002.130401.x
Bernal G, Okamura M, Muñoz CA. The effects of abutment taper, length and cement type on resistance to dislodgement of cement‑retained, implant‑supported restorations. J Prosthodont. 2003;12(2):111–5. https://doi.org/10.1016/S1059-941X(03)00006-8 DOI: https://doi.org/10.1016/S1059-941X(03)00006-8
Garg P, Gupta G, Prithviraj DR, Pujari M. Retentiveness of various luting agents used with implant‑supported prostheses: a preliminary in vitro study. Int J Prosthodont. 2013;26(1):82–4. https://doi.org/10.11607/ijp.2572 DOI: https://doi.org/10.11607/ijp.2572
Chandra Shekar S, Giridhar K, Rao KS. An in vitro study to evaluate the retention of complete crowns prepared with five different tapers and luted with two different cements. J Ind Prosthodont Soc. 2010;10(2):89–95. https://doi.org/10.1007/s13191-010-0017-x DOI: https://doi.org/10.1007/s13191-010-0017-x
Al Hamad KQ, Al Rashdan BA, Abu‑Sitta EH. The effects of height and surface roughness of abutments and the type of cement on bond strength of cement‑retained implant restorations. Clin Oral Implants Res. 2011;22(6):638–44. https://doi.org/10.1111/j.1600-0501.2010.02011.x DOI: https://doi.org/10.1111/j.1600-0501.2010.02011.x
Saber FS, Abolfazli N, Nuroloyuni S, Khodabakhsh S, Bahrami M, Nahidi R, et al. Effect of abutment height on retention of single cement‑retained, wide‑ and narrow‑platform implant‑supported restorations. J Dent Res Dent Clin Dent Prospects. 2012;6(3):98–102. https://doi.org/10.5681/joddd.2012.021
Kunt GE, Ceylon G, Yilmaz N. Effect of surface treatments on implant crown retention. J Dent Sci. 2010;5(3):131–5. https://doi.org/10.1016/S1991-7902(10)60019-0 DOI: https://doi.org/10.1016/S1991-7902(10)60019-0
Meshramkar R, Nadiger R, Nayak A, Kavlekar A, Krishnapillai L. A study to evaluate the effect of taper on retention of straight and angled implant abutment. J Dent Implants. 2015;5(1):3–5. https://doi.org/10.4103/0974-6781.154414 DOI: https://doi.org/10.4103/0974-6781.154414
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(8):618–25. https://doi.org/10.1111/jopr.12058 DOI: https://doi.org/10.1111/jopr.12058
Abu-Obaid A. Effects of cementation technique and cement thickness on the retention and amount of excess cement in implant-supported restorations. Saudi Dent J. 2024;36(9):1203–8. https://doi.org/10.1016/j.sdentj.2024.06.018 DOI: https://doi.org/10.1016/j.sdentj.2024.06.018
Hendi A, Falahchai M, Sigaroodi SH, Asli HN. Comparison of marginal leakage and retentive strength of implant‑supported milled zirconia and cobalt‑chromium copings cemented with different temporary cements. Dent Res J. 2023;20:117. https://doi.org/10.4103/drj.drj_344_23 DOI: https://doi.org/10.4103/drj.drj_344_23
Worni A, Gholami H, Marchand L, Katsoulis J, Mericske-Stern R, Enkling N. Retrievability of implant-supported crowns when using three different cements: a controlled clinical trial. Int J Prosthodontics. 2015;28(1):22–9. https://doi.org/10.11607/ijp.4119 DOI: https://doi.org/10.11607/ijp.4119
Volkmann H, Rauch A, Koenig A, Schierz O. Pull-off force of four different implant cements between zirconia crowns and titanium implant abutments in two different abutment heights. Int J Periodontics Restorative Dent. 2022;42(3):e67–74. https://doi.org/10.11607/prd.4926 DOI: https://doi.org/10.11607/prd.4926
Sheets JL, Wilcox C, Wilwerding T. Cement selection for cement‑retained crown technique with dental implants. J Prosthodont. 2008;17(2):92–6. https://doi.org/10.1111/j.1532-849X.2007.00262.x DOI: https://doi.org/10.1111/j.1532-849X.2007.00262.x
Bukhari SA, AlHelal A, Kattadiyil MT, Wadhwani CPK, Taleb A, Dehom S. An in vitro investigation comparing methods of minimising excess luting agent for cement-retained implant-supported fixed partial dentures. J Prosthet Dent. 2020;124(6):706–15. https://doi.org/10.1016/j.prosdent.2019.11.016 DOI: https://doi.org/10.1016/j.prosdent.2019.11.016
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