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Ribeiro RF, da Mata VB, Tomaselli LDO, Simionato AA, Santos EDS, Faria ACL, Rodrigues RCS, do Nascimento C. Microbial Leakage through Three Different Implant-Abutment Interfaces on Morse Taper Implants In Vitro. Dent J (Basel) 2024; 12:226. [PMID: 39057013 PMCID: PMC11275855 DOI: 10.3390/dj12070226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/20/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
The objective of this study was to evaluate microbial leakage by means of genome counts, through the implant-abutment interface in dental implants with different Morse taper abutments. Fifty-six samples were prepared and divided in four groups: CMC TB (14 Cylindrical Implants-14 TiBase Abutments), CMX TB (14 Conical Implants-14 TiBase Abutments), CMX PU (14 Conical Implants-14 Universal Abutment) and CMX U (14 Tapered Implants-14 UCLA Abutments). Assemblies had their interface submerged in saliva as the contaminant. Samples were subjected either to thermomechanical cycling (2 × 106 mechanical cycles with frequency of 5 Hz and load of 120 N simultaneously with thermal cycles of 5-55 °C) or thermal cycling (5-55 °C). After cycling, the contents from the inner parts of assemblies were collected and analyzed using the Checkerboard DNA-DNA hybridization technique. Significant differences in the total genome counts were found after both thermomechanical or thermal cycling: CMX U > CMX PU > CMX TB > CMC TB. There were also significant differences in individual bacterial counts in each of the groups (p < 0.05). Irrespective of mechanical cycling, the type of abutment seems to influence not only the total microbial leakage through the interface, but also seems to significantly reflect differences considering individual target species.
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Affiliation(s)
- Ricardo Faria Ribeiro
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil; (V.B.d.M.); (L.d.O.T.); (A.A.S.); (A.C.L.F.); (R.C.S.R.)
| | - Victor Barboza da Mata
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil; (V.B.d.M.); (L.d.O.T.); (A.A.S.); (A.C.L.F.); (R.C.S.R.)
| | - Lucas de Oliveira Tomaselli
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil; (V.B.d.M.); (L.d.O.T.); (A.A.S.); (A.C.L.F.); (R.C.S.R.)
| | - Anselmo Agostinho Simionato
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil; (V.B.d.M.); (L.d.O.T.); (A.A.S.); (A.C.L.F.); (R.C.S.R.)
| | - Emerson de Souza Santos
- Department of Clinical Analysis, Toxicology, and Food Science, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirão Preto 14040-903, Brazil;
| | - Adriana Cláudia Lapria Faria
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil; (V.B.d.M.); (L.d.O.T.); (A.A.S.); (A.C.L.F.); (R.C.S.R.)
| | - Renata Cristina Silveira Rodrigues
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil; (V.B.d.M.); (L.d.O.T.); (A.A.S.); (A.C.L.F.); (R.C.S.R.)
| | - Cássio do Nascimento
- Department of Dental Materials and Prostheses, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirão Preto 14040-904, Brazil; (V.B.d.M.); (L.d.O.T.); (A.A.S.); (A.C.L.F.); (R.C.S.R.)
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Herrero-Climent F, Martínez-Rus F, Salido MP, Roldán D, Pradíes G. Comparative in vitro evaluation of microgap in titanium stock versus cobalt-chrome custom abutments on a conical connection implant: Effect of crown cementation and ceramic veneering. Clin Oral Implants Res 2024. [PMID: 38884385 DOI: 10.1111/clr.14317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/02/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To compare the implant-abutment connection microgap between computer-aided design and computer-aided manufacturing (CAD/CAM) milled or laser-sintered cobalt-chrome custom abutments with or without ceramic veneering and titanium stock abutments with or without crown cementation. MATERIAL AND METHODS Six groups of six abutments each were prepared: (1) CAD/CAM cobalt-chrome custom abutments: milled, milled with ceramic veneering, laser-sintered, and laser-sintered with ceramic veneering (four groups: MIL, MIL-C, SIN, and SIN-C, respectively) and (2) titanium stock abutments with or without zirconia crown cementation (two groups: STK and STK-Z, respectively). Abutments were screwed to the implants by applying 30 Ncm torque. All 36 samples were sectioned along their long axes. The implant-abutment connection microgap was measured using scanning electron microscopy on the right and left sides of the connection at the upper, middle, and lower levels. Data were analyzed using the Kruskal-Wallis test (p < .05). RESULTS Mean values (μm) of the microgap were 0.54 ± 0.44 (STK), 0.55 ± 0.48 (STK-Z), 1.53 ± 1.30 (MIL), 2.30 ± 2.2 (MIL-C), 1.53 ± 1.37 (SIN), and 1.87 ± 1.8 (SIN-C). Although significant differences were observed between the STK and STK-Z groups and the other groups (p < .05), none were observed between the milled and laser-sintered groups before or after ceramic veneering. The largest microgap was observed at the upper level in all groups. CONCLUSIONS Titanium stock abutments provided a closer fit than cobalt-chrome custom abutments. Neither crown cementation nor ceramic veneering resulted in significant changes in the implant-abutment connection microgap.
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Affiliation(s)
- Federico Herrero-Climent
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Francisco Martínez-Rus
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - María Paz Salido
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - David Roldán
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
| | - Guillermo Pradíes
- Department of Conservative and Prosthetic Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain
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Rutkunas V, Kules D, Mischitz I, Huber S, Revilla-León M, Larsson C, Janda M. Misfit simulation on implant-supported prostheses with different combinations of engaging and nonengaging titanium bases: Part 3: A radiographic evaluation. J Prosthet Dent 2024:S0022-3913(24)00044-1. [PMID: 38418304 DOI: 10.1016/j.prosdent.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/13/2024] [Accepted: 01/17/2024] [Indexed: 03/01/2024]
Abstract
STATEMENT OF PROBLEM The fit of implant-supported prostheses plays an important role in their mechanical and biological stability. Clinically, the prosthetic fit is typically assessed radiographically, but this method relies on the operator's subjective evaluation. Whether available digital tools could optimize the evaluation of the prosthetic fit is uncertain. PURPOSE The purpose of this in vitro study was to evaluate the influence of an image processing program on the radiographic detection of discrepancies in the active and passive fit of implant-supported prostheses. Two-implant-supported screw-retained prostheses were analyzed by simulating the vertical and horizontal misfits of 3 different implant abutment configurations. MATERIAL AND METHODS Seven casts were fabricated using 2 internal-connection titanium implants: 1 control; 3 with vertical (V) misfit of 50 µm, 100 µm, 150 µm; and 3 with horizontal (H) misfit of 35 µm, 70 µm, 100 µm. Thirty bar-shaped zirconia frameworks were fabricated and divided into 3 groups (n=10) according to their attachment to 2 engaging (E-E), 2 nonengaging (NE-NE), and engaging and nonengaging (E-NE) titanium bases. Digital parallel periapical radiographs were made of each specimen in the passive and active fit situation on each cast (1-screw test), except for the E-E specimens, which were only seated on the control, H35, and H70 casts because the fit on the remaining casts was poor. The mean gray value (MGV) was measured at the chosen regions of interest on the second implant (side B) using the ImageJ software program. Differences in the MGV measurements between the passive and active conditions were tested using a t test (α=.05) and compared the different misfit levels using analysis of variance (1-way ANOVA), followed by the Tukey HSD test (α=.05). RESULTS The highest values for the differences between passive and active fit were found for the V150 and H100 misfit simulations (P<.05). Statistical differences between the MGVs were found with some exceptions: the smallest simulated misfits (H35 and V50) revealed statistically significant MGV differences from the highest simulated misfits (V150, H100) and from the H70 in the groups where an engaging component was present (P>.05). In the horizontal misfit group of NE-NE abutment configuration, H70 revealed no significant difference from the control group cast (P>.05). CONCLUSIONS Measuring MGV differences between passive and active fit could be a promising alternative for detecting 70- to 150-µm gaps in the implant-abutment connection that result from the misfit. However, the procedure was not adequate for detecting <50 µm gaps, cannot be uniformly applied to all types of implant-abutment connections, and requires 2 exposures to X-radiation.
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Affiliation(s)
- Vygandas Rutkunas
- Professor, Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; and Director, Digitorum Research Center, Vilnius, Lithuania
| | - Daniel Kules
- Postgraduate student, Department of Periodontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; and Researcher, Digitorum Research Center, Vilnius, Lithuania
| | - Ingrida Mischitz
- Dental Research Assistant, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Sandra Huber
- Attending, Department of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - Marta Revilla-León
- Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Faculty and Director, Digital Dentistry, Kois Center, Seattle, Wash.; and Affiliate Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass
| | - Christel Larsson
- Associate Professor, Faculty of Odontology, Malmö University, Malmö, Sweden; and Associate Visiting Professor, Faculty of Dentistry, Department of Prosthetic Dentistry, Riga Stradins University, Riga, Latvia
| | - Martin Janda
- Assistant Professor, Faculty of Odontology, Malmö University, Malmö, Sweden.
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Nassar HI, Fateen A. Accuracy of fit for cobaltchromium bar over two implants fabricated with different manufacturing techniques: an in-vitro study. BMC Oral Health 2023; 23:946. [PMID: 38031111 PMCID: PMC10688085 DOI: 10.1186/s12903-023-03700-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 11/22/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVE The purpose of the invitro research was to compare the fit of Cobalt Chromium customized bar fabricated with different manufacturing processes cast metal bar, milled bar and 3D printed bar using scanning electron microscope. MATERIALS AND METHODS Clear epoxy resin molds were prepared. In each mold two parallel implants with a 14 mm distance from each other were embedded. Thirty Co-Cr custom bars were constructed and were divided equally into three groups: Group (I) (Co-Cr conv), group (II) milled bar (Co-Cr milled), and group (III) printed bar (Co-Cr print). The marginal fit at implant-abutment interface was scanned using scanning electron microscope (SEM). RESULTS There was a significant difference between the three studied groups regarding marginal misfit the between implant and fabricated bars with p-value < 0.001. The highest value of micro-gap distance was found in Co-Cr conventional group (7.95 ± 2.21 μm) followed by Co-Cr 3D printed group (4.98 ± 1.73) and the lower value were found in Co-Cr milled (3.22 ± 0.75). CONCLUSION The marginal fit of milled, 3D printed and conventional cast for Co-Cr alloy were within the clinically acceptable range of misfit. CAD/CAM milled Co-Cr bar revealed a superior internal fit at the implant-abutment interface. This was followed by selective laser melting (SLM) 3D printed bar and the least fit was shown for customized bar with the conventional lost wax technique.
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Affiliation(s)
- Hossam I Nassar
- Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt.
| | - Ayman Fateen
- Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
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Adolfi D, Grangeiro MTV, Ausiello P, Bottino MA, Tribst JPM. Effect of Antirotational Two-Piece Titanium Base on the Vertical Misfit, Fatigue Behavior, Stress Concentration, and Fracture Load of Implant-Supported Zirconia Crowns. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4848. [PMID: 37445162 DOI: 10.3390/ma16134848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
This study investigated the effects of antirotational titanium bases on the mechanical behavior of CAD/CAM titanium bases used for implant-supported prostheses. The aim was to assess the impact on the marginal fit, fatigue behavior, stress concentration, and fracture load of implant-supported CAD/CAM zirconia crowns. Forty titanium implants were divided into two groups: those with antirotational titanium bases (ARs) and those with rotational titanium bases (RTs). Torque loosening and vertical misfit were evaluated before and after cyclic fatigue testing (200 N, 2 Hz, 2 × 106 cycles). Fracture resistance was assessed using a universal testing machine (1 mm/min, 1000 kgf), and failed specimens were examined with microscopy. Three-dimensional models were created, and FEA was used to calculate stress. Statistical analysis was performed on the in vitro test data using two-way analysis of variance and Tukey's test (α = 0.5). Results show that the presence of an antirotational feature between the implant and titanium base reduced preload loss and stress concentration compared to rotational titanium bases. However, there were no differences in vertical misfit and resistance to compressive load.
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Affiliation(s)
- Dario Adolfi
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José Dos Campos 12220-000, Brazil
| | - Manassés Tercio Vieira Grangeiro
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José Dos Campos 12220-000, Brazil
| | - Pietro Ausiello
- School of Dentistry, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Marco Antonio Bottino
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José Dos Campos 12220-000, Brazil
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, 1081 LA Amsterdam, The Netherlands
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Kowalski J, Puszkarz AK, Radwanski M, Sokolowski J, Cichomski M, Bourgi R, Hardan L, Sauro S, Lukomska-Szymanska M. Micro-CT Evaluation of Microgaps at Implant-Abutment Connection. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4491. [PMID: 37374674 DOI: 10.3390/ma16124491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/10/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023]
Abstract
The assessment of microgaps at the implant-abutment interface is an important factor that may influence clinical success. Thus, the aim of this study was to evaluate the size of microgaps between prefabricated and customised abutments (Astra Tech, Dentsply, York, PA, USA; Apollo Implants Components, Pabianice, Poland) mounted on a standard implant. The measurement of the microgap was performed using micro-computed tomography (MCT). Due to 15-degree rotation of samples, 24 microsections were obtained. Scans were performed at four levels established at the interface between the abutment and the implant neck. Moreover, the volume of the microgap was evaluated. The size of the microgap at all measured levels varied from 0.1 to 3.7 µm for Astra and from 0.1 to 4.9 µm for Apollo (p > 0.05). Moreover, 90% of the Astra specimens and 70% of the Apollo specimens did not exhibit any microgaps. The highest mean values of microgap size for both groups were detected at the lowest portion of the abutment (p > 0.05). Additionally, the average microgap volume was greater for Apollo than for Astra (p > 0.05). It can be concluded that most samples did not exhibit any microgaps. Furthermore, the linear and volumetric dimensions of microgaps observed at the interface between Apollo or Astra abutments and Astra implants were comparable. Additionally, all tested components presented microgaps (if any) that were clinically acceptable. However, the microgap size of the Apollo abutment was higher and more variable than that of the Astra one.
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Affiliation(s)
- Jakub Kowalski
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland
| | - Adam K Puszkarz
- Faculty of Material Technologies and Textile Design, Institute of Material Science of Textiles and Polymer Composites, Lodz University of Technology, 116 Zeromskiego Street, 90-924 Lodz, Poland
| | - Mateusz Radwanski
- Department of Endodontics, Medical University of Lodz, 92-213 Lodz, Poland
| | - Jerzy Sokolowski
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland
| | - Michal Cichomski
- Department of Material Technology and Chemistry, Faculty of Chemistry, University of Lodz, Pomorska 163, 90-236 Lodz, Poland
| | - Rim Bourgi
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut 1107 2180, Lebanon
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Departamento de Odontología, Facultad de Cienciasde la Salud, Universidad CEU-Cardenal Herrera, C/Del Pozo ss/n, Alfara del Patriarca, 46115 Valencia, Spain
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
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Simionato AA, Santos EDS, Faria ACL, do Nascimento C, Rodrigues RCS, Ribeiro RF. Bacterial Detection, Deformation, and Torque Loss on Dental Implants with Different Tapered Connections Compared with External Hexagon Connection after Thermomechanical Cycling. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16113904. [PMID: 37297037 DOI: 10.3390/ma16113904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/12/2023]
Abstract
The relationship between bacterial infiltration and internal conical Implant-Abutment Interfaces (IAIs) with different conicities still requires investigations that can offer valuable information in the clinical understanding of peri-implant health. The present study aimed to verify the bacterial infiltration of two internal conical connections with an angulation of 11.5° and 16° with the external hexagonal connection as a comparative after thermomechanical cycling using saliva as a contaminant. Test (n = 10) and control (n = 3) groups were set up. Evaluations were made on torque loss, Scanning Electron Microscopy (SEM), and Micro Computerized Tomography (MicroCT) after performing 2 × 106 mechanical cycles (120 N) and 600 thermal cycles (5°-55° C) with 2 mm lateral displacement. The contents of the IAI were collected for microbiological analysis. There was a difference (p < 0.05) in torque loss of the groups tested; groups from the 16° IAI obtained a lower percentage of torque loss. All groups presented contamination and the analysis of the results shows that the microbiological profile of the IAI differs qualitatively from the profile found in the saliva used for contamination. The mechanical loading affects the microbiological profile found in the IAIs (p < 0.05). In conclusion, the IAI environment may favor a microbiological profile different from that of saliva and the thermocycling condition may alter the microbial profile found in the IAI.
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Affiliation(s)
- Anselmo Agostinho Simionato
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto 14040-904, Brazil
| | - Emerson de Souza Santos
- Department of Clinical Analysis, Toxicology, and Food Science, School of Pharmaceutical Sciences of Ribeirao Preto, University of São Paulo, Ribeirao Preto 14040-903, Brazil
| | - Adriana Cláudia Lapria Faria
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto 14040-904, Brazil
| | - Cássio do Nascimento
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto 14040-904, Brazil
| | - Renata Cristina Silveira Rodrigues
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto 14040-904, Brazil
| | - Ricardo Faria Ribeiro
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of São Paulo, Ribeirao Preto 14040-904, Brazil
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Shah KK, Sivaswamy V. A Literature Review on Implant Abutment Types, Materials, and Fabrication Processes. J Long Term Eff Med Implants 2022; 33:57-66. [PMID: 36382705 DOI: 10.1615/jlongtermeffmedimplants.2022042720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Dental implantology has made great strides since Dr. Brånemark introduced it to the world of dentistry. In terms of materials and fabrication processes, a wide range of implants and their implant abutments are now widely available in the market. Such a wide range would undoubtedly put the clinician in a quandary when it comes to selecting an acceptable abutment, one that is scientifically based and also has a high clinical rate of success. As a result, this literature review is a straightforward attempt to shed light on the wide range of implant-abutment types, materials and fabrications that are now easily accessible on the market, as well as offer an overview of each specific type to avoid further dilemma for its clinical intent.
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Affiliation(s)
- Khushali K Shah
- Department of Prosthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Vinay Sivaswamy
- Department of Prosthodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600077, India
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9
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Bajoghli F, Sabouhi M, Pourali M, Davoudi A. Stability of implant-abutment connection in three different systems after fatigue test. J Indian Prosthodont Soc 2022; 22:338-342. [PMID: 36511067 PMCID: PMC9709864 DOI: 10.4103/jips.jips_247_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 10/20/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022] Open
Abstract
Aim Abutment screw loosening of implant-supported prosthesis causes a mismatch between the abutment and the implant. This screw loosening is influenced by the implant-abutment connection type, however, with contradictory results reported in different studies. The present study evaluates the stability of abutment-implant connections in three different systems before and after the fatigue test. Settings and Design Thirty implants (4.3 mm in diameter and 12 mm in length) were divided into three groups of 10: Implantium, Zimmer, and straight internal hexagonal connection (SIC) implants. Materials and Methods Two torques of 35 Ncm with an interval of 10 min were applied, followed by measuring removal torque value (RTV). The samples were re-torqued and then underwent a simulation of 1-year chewing clinical performance of dental implant under axial force of 400 N, with a frequency of 8 Hz (one million cycles). After fatigue test, the RTV was calculated and recorded. Statistical Analysis The mean RTVs obtained before and after cyclic load were analyzed by SPSS version 22 software using multivariate analysis. Results Significant differences in RTV and role of cyclic loading were found between SIC and Implantium groups (P = 0.006 and 0.021, respectively), as well as between Zimmer and SIC groups (P = 0.032 and 0.006, respectively), but not between Zimmer and Implantium groups (P = 0.771 and 0.248, respectively). Conclusion The type of connection could affect the screw loosening, the preload loss, and the implant component stability. SIC group revealed the highest RTVs before and after cyclic loading.
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Affiliation(s)
- Farshad Bajoghli
- Dental Implants Research Center, Department of Prosthodontics, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohmoud Sabouhi
- Dental Materials Research Center, Department of Prosthodontics, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohamad Pourali
- Department of Prosthodontics, School of Dentistry, Qom, Iran
| | - Amin Davoudi
- Department of Prosthodontics, School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Molinero-Mourelle P, Roccuzzo A, Yilmaz B, Lam WYH, Pow EHN, Del Río Highsmith J, Gómez-Polo M. Microleakage assessment of CAD-CAM Cobalt-Chrome and Zirconia abutments on a conical connection dental implant: A comparative in vitro study. Clin Oral Implants Res 2022; 33:945-952. [PMID: 35818785 PMCID: PMC9544167 DOI: 10.1111/clr.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
Objective To assess the marginal and bacterial microleakage in zirconia and CAD‐CAM or cast Co‐Cr implant abutments. Methods Sixty‐four conical connection implants with their respective abutments were divided into four groups (Co‐Cr (milled, laser‐sintered, and cast) and Zirconia (milled)). All specimens were subjected to a chewing simulation and thermocycling. After aging process, specimens were submerged in a 0.2% methylene blue solution with Porphyromonas gingivalis (P.g) for 48 h. The marginal microleakage was measured using a 40× optical microscopy at the internal part of the implant, and when positive microleakage was observed, a DNA isolation with a polymerase chain reaction (PCR) test was used. The microbiological assessment was based on colony forming units (CFUs). Results Thirty (47%) implant‐abutments presented microleakage and the PCR was performed on those specimens (1 Zirconia, 1 Co‐Cr milled, 14 Co‐Cr laser‐sintered and 14 cast). Seven specimens (1 Co‐Cr laser‐sintered and six cast) presented values below the PCR detection limit (< 100 CFUs). The lowest CFUs count occurred in the Co‐Cr milled group (5.17E+02 CFUs/ml) followed by zirconia (7.70E+03 CFUs/ml). The Co‐Cr cast (9.39E+03 CFUs/ml) and laser‐sintered (2.4E+05 CFUs/ml) groups had higher bacterial count. The CFU count comparison performed between Co‐Cr cast and laser‐sintered resulted in a statistically significant differences in favor of Co‐CrCL (p < .05). Conclusions The abutment material and fabrication technique affected the implant‐abutment microleakage. Although the CAD‐CAM abutments presented favorable results, all tested groups presented microleakage.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthetics. Faculty of Dentistry, Complutense University of Madrid.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland.,Department of Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland
| | - Walter Yu Hang Lam
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China
| | - Edmond H N Pow
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, PR China
| | - Jaime Del Río Highsmith
- Department of Conservative Dentistry and Orofacial Prosthetics. Faculty of Dentistry, Complutense University of Madrid
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthetics. Faculty of Dentistry, Complutense University of Madrid
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11
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Rasaie V, Abduo J, Falahchai M. Clinical and Laboratory Outcomes of Angled Screw Channel Implant Prostheses: A Systematic Review. Eur J Dent 2022; 16:488-499. [PMID: 35189643 PMCID: PMC9507569 DOI: 10.1055/s-0041-1740298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The purpose of this systematic review was to evaluate the clinical and laboratory outcomes of angled screw channel (ASC) restorations and to summarize the influencing factors. An electronic search of the English language literature was performed in four databases and enriched by manual searches. Retrieved studies were screened against the predefined exclusion and inclusion criteria. Eight clinical and seven laboratory studies were eligible for the analysis. The risk of bias for included observational studies was performed using the Newcastle–Ottawa quality assessment scale. Laboratory studies quality assessment method was adapted from previous published systematic reviews. Two clinical studies focused on technical outcomes and the rest reported the biological outcomes of the ASC restorations. Out of the seven laboratory studies, two studies investigated the fracture resistance of ASC restorations, four studies evaluated the reverse torque value of the nonaxially tightened screws, and one study evaluated both variables. The present review revealed that while the performance of ASC restorations is promising in short-term clinical studies, the evidence of their long-term reliability is still lacking. The laboratory studies indicated comparable fracture resistance results of the ASC restorations with the straight screw channel restorations. In addition, factors, such as initial torque value, configuration of the screw driver, screw design, abutment system, and the angulation of screw channel, were shown to influence the screw resistance to loosening.
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Affiliation(s)
- Vanya Rasaie
- Department of Prosthodontics, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Jaafar Abduo
- Department of Prosthodontics, Melbourne Dental School, Melbourne University, Melbourne, Australia
| | - Mehran Falahchai
- Department of Prosthodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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12
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Sutradhar W, Mishra SK, Chowdhary R. Evaluation of customized cobalt-chromium abutments fabricated with different manufacturing process versus titanium stock abutments on the marginal misfit -An in vitro study. J Indian Prosthodont Soc 2022; 22:225-232. [PMID: 36511051 PMCID: PMC9416951 DOI: 10.4103/jips.jips_381_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Aim Accurate fit of the abutment to the implant is required for the uniform load distribution throughout the assembly. The study aims to compare the marginal misfit of titanium stock abutments with the cobalt-chromium (CoCr) customized abutments fabricated with the different manufacturing processes in internal hex implant-abutment connection using an appropriate scanning technique. Setting and Design In vitro comparative study. Materials and Methods A total of 40 abutments were included in the study. Ten titanium stock abutments were used as control (Group CN) and 30 CoCr abutments were fabricated and taken as the test group. Stock abutments were scanned and from obtained images test group abutments were fabricated as follows: Ten cast abutments (Group CA), 10 sintered abutments (Group SA), and 10 milled abutments (Group MA). Endosseous implanst having internal hex connections were matched with 10 stock abutments and 30 customized CoCr abutments. Implants were mounted in a clear epoxy resin block and the abutments were then fitted onto the implants with a torque of 30Ncm. The marginal discrepancy at implant-abutment connections was measured with confocal laser scanning microscope. Statistical Analysis Used One-way ANOVA and Tukey's post hoc test was done for statistical analysis. Results One-way ANOVA revealed a significant difference in marginal misfit of abutments. The mean marginal misfit was lowest for stock abutments (0.35 ± 0.009 μm). Among the customized abutments, the mean marginal misfit was highest for cast abutments (2.44 ± 0.445 μm) followed by sintered abutments (1.67 ± 0.232 μm) and least for milled abutments (0.65 ± 0.041 μm). A significant difference was found in marginal misfit with cast abutments and sintered abutments when compared to stock abutments (P < 0.001). The difference in marginal misfit was insignificant between stock abutments and milled abutments (P = 0.052). Conclusion Difference in marginal misfit exists between the titanium stock abutments and customized CoCr abutments. Among the customized abutments, milled CoCr abutments have the least marginal discrepancy and cast CoCr abutments have a maximum marginal discrepancy. Milled CoCr abutments can be used as an alternative to titanium stock abutments.
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Affiliation(s)
- Writuraj Sutradhar
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
| | - Sunil Kumar Mishra
- Department of Prosthodontics, Rama Dental College, Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India,Address for correspondence: Dr. Ramesh Chowdhary, Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru - 560 098, Karnataka, India. E-mail:
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13
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Galindo-Moreno P, Concha-Jeronimo A, Lopez-Chaichio L, Rodriguez-Alvarez R, Sanchez-Fernandez E, Padial-Molina M. Marginal Bone Loss around Implants with Internal Hexagonal and Internal Conical Connections: A 12-Month Randomized Pilot Study. J Clin Med 2021; 10:jcm10225427. [PMID: 34830709 PMCID: PMC8621760 DOI: 10.3390/jcm10225427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/12/2021] [Accepted: 11/18/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to analyze the differences in terms of the marginal bone level (MBL) around implants with either an internal conical or an internal hexagonal implant–prosthesis connection. A randomized clinical trial included patients in need of a single implant-supported restoration. The implant–prosthesis connection was either internal conical or internal hexagonal while maintaining the same type of implant macro- and microarchitecture. Clinical and radiographical variables were registered up to 12 months of follow-up, including MBL. A total of 30 patients were included in the study. The main outcome variable, MBL 12 months after prosthesis delivery, was statistically different in both groups: −0.25 (0.12) vs. −0.70 (0.43) (conical vs. hexagonal; p = 0.033). Differences were also observed at the 3- and 6-month follow-up visits as well as for the MBL change from prosthesis delivery to the 12-month follow-up (−0.15 (0.13) vs. −0.56 (0.44); conical vs. hexagonal; p = 0.023). Correlations between MBL around the implants and radiographic measurements on the adjacent teeth, buccal bone to implant, tissue thickness or keratinized tissue were not significant neither globally nor when analyzed independently by group. In view of such results, it can be concluded that single-unit restorations with internal hexagonal-connection implants induce higher marginal bone loss after 12 months of follow-up from prosthesis delivery than internal conical-connection implants.
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Affiliation(s)
- Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain; (E.S.-F.); (M.P.-M.)
- Research Group in Oral Biology and Regeneration (CTS-1028), Junta de Andalucia, 18071 Granada, Spain;
- Correspondence:
| | - Ada Concha-Jeronimo
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain; (A.C.-J.); (L.L.-C.)
| | - Lucia Lopez-Chaichio
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain; (A.C.-J.); (L.L.-C.)
| | - Roque Rodriguez-Alvarez
- Research Group in Oral Biology and Regeneration (CTS-1028), Junta de Andalucia, 18071 Granada, Spain;
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain; (A.C.-J.); (L.L.-C.)
| | - Elena Sanchez-Fernandez
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain; (E.S.-F.); (M.P.-M.)
- Research Group in Oral Biology and Regeneration (CTS-1028), Junta de Andalucia, 18071 Granada, Spain;
| | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, 18071 Granada, Spain; (E.S.-F.); (M.P.-M.)
- Research Group in Oral Biology and Regeneration (CTS-1028), Junta de Andalucia, 18071 Granada, Spain;
- PhD Program in Clinical Medicine and Public Health, University of Granada, 18016 Granada, Spain; (A.C.-J.); (L.L.-C.)
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Fernandes PF, Grenho L, Fernandes MH, Sampaio-Fernandes JC, Sousa Gomes P. Microgap and microleakage of a hybrid connection platform-switched implant system in the absence or presence of a silicone-based sealing agent. Odontology 2021; 110:231-239. [PMID: 34448952 DOI: 10.1007/s10266-021-00652-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/21/2021] [Indexed: 11/26/2022]
Abstract
The present study aims to characterize, for the first time, the microgap and bacterial microleakage of a platform-switched implant system with hybrid connection, screwed at distinct torque values (manufacturer recommended torque-25 N cm-and a reduced torque-5 N cm-mimicking the long-term functional use), in the absence or presence of a silicon-based sealing agent. Microgap was determined through scanning electron microscopy and bacterial microleakage was evaluated in vitro, upon Enterococcus faecalis colonization of the system. The sealing efficacy was evaluated in the absence or presence of a commercially available silicon-based sealer. The cytotoxicity of the sealer was further addressed in vitro, with a fibroblastic cell line, in accordance with reference standards. A low microgap of the implant system was verified, regardless of the applied torque load-maximal values ranged around 0.25 and 1.25 µm, for 25 and 5 N cm torques, respectively. No bacterial microleakage was reported at 25 N cm, while at 5 N cm, leakage was verified on 38% of the samples. The application of a silicon-based sealer-with an adequate cytocompatible profile-was effective on preventing the bacterial microleakage on the assayed experimental setting. The assayed platform-switched implant system with hybrid connection presented a low interfacial misfit and an effective sealing capability at manufacturer recommended torque. Despite the increased microleakage at low torque conditions, the application of a cytocompatible silicon-based sealing agent restored the sealing effectiveness of the system. The use of a silicon-based sealing agent can assist on the maintenance of the sealing effectiveness even at low torque conditions.
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Affiliation(s)
- Pedro Ferrás Fernandes
- Faculty of Dental Medicine, U. Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal
| | - Liliana Grenho
- BoneLab, Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, U. Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal
- LAQV/REQUIMTE, U. Porto, Porto, Portugal
| | - Maria Helena Fernandes
- BoneLab, Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, U. Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal
- LAQV/REQUIMTE, U. Porto, Porto, Portugal
| | | | - Pedro Sousa Gomes
- BoneLab, Laboratory for Bone Metabolism and Regeneration, Faculty of Dental Medicine, U. Porto, Rua Dr. Manuel Pereira da Silva, 4200-393, Porto, Portugal.
- LAQV/REQUIMTE, U. Porto, Porto, Portugal.
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15
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Molinero-Mourelle P, Cascos-Sanchez R, Yilmaz B, Lam WYH, Pow EHN, Del Río Highsmith J, Gómez-Polo M. Effect of Fabrication Technique on the Microgap of CAD/CAM Cobalt-Chrome and Zirconia Abutments on a Conical Connection Implant: An In Vitro Study. MATERIALS 2021; 14:ma14092348. [PMID: 33946477 PMCID: PMC8125438 DOI: 10.3390/ma14092348] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 01/03/2023]
Abstract
The aim of this in vitro study was to investigate the microgaps at the implant-abutment interface when zirconia (Zr) and CAD/CAM or cast Co-Cr abutments were used. METHODS Sixty-four conical connection implants and their abutments were divided into four groups (Co-Cr (milled, laser-sintered and castable) and Zirconia (milled)). After chewing simulation (300,000 cycles, under 200 N loads at 2 Hz at a 30° angle) and thermocycling (10,000 cycles, 5 to 50 °C, dwelling time 55 s), the implant-abutment microgap was measured 14 times at each of the four anatomical aspects on each specimen by using a scanning electron microscope (SEM). Kruskal-Wallis and pair-wise comparison were used to analyze the data (α = 0.05). RESULTS The SEM analysis revealed smaller microgaps with Co-Cr milled abutments (0.69-8.39 μm) followed by Zr abutments (0.12-6.57 μm), Co-Cr sintered (7.31-25.7 μm) and cast Co-Cr (1.68-85.97 μm). Statistically significant differences were found between milled and cast Co-Cr, milled and laser-sintered Co-Cr, and between Zr and cast and laser-sintered Co-Cr (p < 0.05). CONCLUSIONS The material and the abutment fabrication technique affected the implant-abutment microgap magnitude. The Zr and the milled Co-Cr presented smaller microgaps. Although the CAD/CAM abutments presented the most favorable values, all tested groups had microgaps within a range of 10 to 150 μm.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Correspondence: ; Tel.: +34-913941922
| | - Rocio Cascos-Sanchez
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland
| | - Walter Yu Hang Lam
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Edmond Ho Nang Pow
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Jaime Del Río Highsmith
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
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16
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Gonzalo E, Vizoso B, Lopez-Suarez C, Diaz P, Pelaez J, Suarez MJ. Evaluation of Milled Titanium versus Laser Sintered Co-Cr Abutments on the Marginal Misfit in Internal Implant-Abutment Connection. MATERIALS 2020; 13:ma13214873. [PMID: 33143092 PMCID: PMC7663543 DOI: 10.3390/ma13214873] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 11/28/2022]
Abstract
The precision of fit at the implant-abutment connection is an important criterion for the clinical success of restorations and implants. Several factors are involved among which are the abutment materials and manufacturing techniques. The aim of this study was to investigate the effect of two materials and methods of manufacturing implant abutments, milled titanium versus laser sintered Co-Cr, on the marginal misfit at the implant-abutment interface. Scanning electron microscopes (SEM) were used to geometrically measure the marginal vertical discrepancy of a total of 80 specimens, classified into eight categories, according to the implant system and abutment. The data were statistically analyzed by Student’s paired t test, one-way and two-way ANOVA with the Bonferroni-Holm correction at the significance level of p = 0.05. Milled titanium abutments demonstrated the lowest misfit values in the implant systems analyzed. The marginal fit of all the groups was within the clinically acceptable range for implant prostheses.
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