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 Table of Contents  
ORIGINAL ARTICLE
Year : 2021  |  Volume : 13  |  Issue : 6  |  Page : 1093-1097  

Geometry of implant abutment surface improving cement effectiveness: An In vitro study


1 Department of Prosthodontics, Al-Badar Rural Dental College and Hospital, Gulbarga, Karnataka, India
2 Department of Periodontics and Oral Implantology, Kalinga Institute of Dental Sciences, KIIT Deemed to be University, Bhubaneswar, Odisha, India
3 Department of Dentistry, Koppal Institute of Medical Sciences, Koppal, Karnataka, India
4 Department Prosthodontics and Crown and Bridge, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
5 Department of Pedodontics, Post Graduate Institute of Dental Sciences, Rohtak, Haryana, India
6 Department of Prosthetic Dental Sciences, College of Dentistry, Prince Sattam Bin AbdulAziz University, 11942 Alkharj, Saudi Arabia

Date of Submission03-Feb-2021
Date of Decision14-Feb-2021
Date of Acceptance15-Feb-2021
Date of Web Publication10-Nov-2021

Correspondence Address:
Shrinivas
Department of Dentistry, Koppal Institute of Medical Sciences, Koppal, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpbs.jpbs_176_21

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   Abstract 


Aim: The aim of the study was to investigate whether the surface geometry or topography of implant abutments affects the retentive strength of prosthesis cemented with zinc phosphate on standard machined, sandblasted, and grooved implant abutments and to compare the results between them. Materials and Methods: Fifteen similarly shaped implant abutments (MDcpk61; MIS Implant Technologies Ltd.,) (height 6.0 mm and 6-degree taper) were divided into three groups (n = 05): Group I – standard machined abutments without grooves, Group II – sandblasted abutments (same as Group I but sandblasted with 50 μ aluminum oxide), and Group III – abutment with prefabricated circumferential grooves. Further in these groups of 15 abutments, 5 abutments each are to be taken to check the retentive force of zinc phosphate cement. Fifteen identical cast copings was prepared to fit all 15 abutments. The castings will be cemented to each group of abutments with an above-mentioned luting agent. After thermal cycling and storage for 6 days in a water bath, a retention test is to be done with a tensile testing machine (Instron) (5 mm/min) and retentive forces will be recorded. Data will be subjected to one-way ANOVA test and Student's t-test. Results: For zinc phosphate cement, F = 30.53 (>3.59 for P = 0.05) shows a statistically significant difference between all the three groups. Conclusion: Circumferential grooves on implant abutments give better retention when compared with standard machined (plain) and sandblasted abutments despite marked difference.
Clinical Significance: Retention of restoration depends on the surface of the abutment as well as the luting agents used. Incorporation of retentive grooves can enhance retention of prosthesis, especially in situation of short abutments.

Keywords: Circumferential grooved implant abutments, luting agents, retentive strength


How to cite this article:
Rathod A, Jalaluddin M, Shrinivas, Devadiga TJ, Jha S, Alzahrani KM. Geometry of implant abutment surface improving cement effectiveness: An In vitro study. J Pharm Bioall Sci 2021;13, Suppl S2:1093-7

How to cite this URL:
Rathod A, Jalaluddin M, Shrinivas, Devadiga TJ, Jha S, Alzahrani KM. Geometry of implant abutment surface improving cement effectiveness: An In vitro study. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Aug 16];13, Suppl S2:1093-7. Available from: https://www.jpbsonline.org/text.asp?2021/13/6/1093/329998




   Introduction Top


The implant-supported prosthodontics introduced by the Brånemark group was directed toward the treatment of fully edentulous patients, the abutments developed by the Brånemark team had a limited esthetic capability. As the osseointegrated implants were created to treat mostly edentulous patients, there was a solid need to present a few alterations for the transmucosal projections.[1],[2] It was not until the beginning of the 1980s when an implant prototype version with a removable abutment was used clinically. Experiments with two-part implants were carried out in the 1970s. The use of the removable abutment version allowed better handling of temporary restoration and wider prosthetic choices, especially in conditions of single-tooth replacements, particularly in the anterior region of the maxilla or in cases of misaligned implants or difficult interocclusal space conditions.[3]

An implant restoration is said to be successful when it performs its function for which it is placed. The success of oral rehabilitation of dental implants not only depends on osseointegration but also on maintenance of the prosthesis on the implant abutment.[4] Implant restorations can be[5] screw retained, cement retained, or combination of both. Many dental professionals concluded that[6],[7] cement-retained crowns are finer for esthetics and occlusion; screw-retained crowns are a necessity for easy retrievability.

According to Goodacre et al., common mechanical implant complications are[8] loss of retention of prosthesis (376/113 prostheses) is 30%, prosthesis screw loosening (4501/312 screws) is 7%, and prosthesis screw fracture (7094/282 screws) is 4%.

According to the above study, loss of retention of the cemented prosthesis is the most common mechanical complication. Hence, it is more important for us to concentrate on increasing the retention of the cement-retained prosthesis on the implant abutment. In fact, the use of cement-retained prosthesis has increased, because of its ability to optimize occlusal interdigitation, enhance esthetics, provide a passive fit, decrease the cost, and improve loading characteristics.

The retention of cemented prosthesis has been shown to be influenced by various parameters such as abutment size (height and width), abutment texture, and the convergence angle between the walls of the abutment and the cements.

Factors controlled by clinician are[9] surface roughness and luting agents. Surface roughness increases the retention due to resulting microretentive ridge and groove patterns. The surface treatment was done to increase the retention[10], increasing the size and increasing the surface area by following methods: Sandblast (50-μm aluminum oxide), roughened with diamond bur, also making retentive uiding grooves, occlusogingival preparation height, parallelism of opposing walls and controlling taper.

The present study is conducted to investigate whether the surface geometry or topography of implant abutments affects the retentive strength of prosthesis cemented with zinc phosphate on standard machined, sandblasted, and grooved implant abutments and to compare the results between them.


   Materials and Methods Top


Preparation of specimens

Fifteen similarly shaped implant abutments (MDcpk61; MIS Implant Technologies Ltd.) (height 6.0 mm and 6° taper) were divided into three groups (n = 05) [Figure 1]:
Figure 1: (a) Standard machine abutment, (b) sandblasted abutment, (c) grooved abutment

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  • Group I – Standard machined abutments without grooves
  • Group II – Standard machined abutments (same as Group I but sandblasted with 50 μ aluminum oxide), and
  • Group III – Abutment with prefabricated circumferential grooves (each groove of MIS Implant Tech measured using stereomicroscope ×20 magnification was 175.2 μm wide and 86.6 μm deep)
  • The surface topography of the tested abutments obtained using optimal microscopy (stereomicroscopy zoom) under ×10 magnification


Surface roughness parameters

  • Recorded using surface roughness measuring instrument (Mitutoyo, Praj Laboratory) [Table 1]


    1. Standard machine abutment
    2. Sandblasted abutment
    3. Grooved abutment.
Table 1: Surface roughness parameters

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Preparation of specimens

All 15 analogs were embedded in self-curing acrylic resin blocks. Each implant abutment was placed in each analog.

  • Standard machined abutment: 5 (without any alteration)
  • Sandblasted: 5 (the surfaces of standard machined abutment were sandblasted with 50 μm aluminum oxide at the pressure for 10 s at a distance of 10 mm maintained between the specimen and sandblasting gun tip)
  • Grooved implant abutment: 5 (each groove of MIS Implant Tech measured using stereomicroscope × 20 magnification was 175.2 μm wide and 86.6 μm deep)


Fifteen identical NiCr cast copings were prepared to fit all 15 abutments. So first, 15 individual wax copings were formed directly on the abutments. Then., no. 10 wax sprue was used to form a loop and added to the occlusal surface of each coping to allow the samples to be attached to the tensile testing machine [Figure 2].
Figure 2: Application of spacer, wax pattern, casted abutment

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Prior to cementation, the abutment implant assemblies were cleaned in an ultrasonic bath for 15 min with distilled water and then steam cleaned.

Luting of copings

Each coping was cemented onto the respective abutments with zinc phosphate following standard procedures. A static load of 50 N was applied for 10 min on the abutment and after setting, excess cement was removed [Figure 3].
Figure 3: Cementation of coping under a static load of 50N using digital weighing balance machine

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Then, specimens were stored in 100% humidity at 37°C for 1 h and thermocycled 500 times between 5°C and 55°C with a dwell time of 10 s.

Testing for tensile strength

At that point, the examples were amassed in the universal testing machine (computerized, programming based: Star Testing System; Model no. STS-248) and were exposed to a pullout test (maintenance) at a crosshead speed of 5.0 mm/min. The powers needed to eliminate the copings were recorded in Newtons.

The copings and abutment were assessed for disappointment mode as indicated by the area of the residual cement. Full-thickness buildups on the abutment or giving were indicated a role as cement failure. Durable failure was meant when the disappointment was inside the cement and fractional thickness buildups were seen on the abutment and the contradicting surface of the projecting this mix of adhesive and cohesive failure was viewed as a blended failure [Figure 4].
Figure 4: (a) Adhesive type of cement failure, (b) Mixed type of cement failure (c) Mixed type of cement failure

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   Results Top


All the statistical tests were conducted at P = 0.05 [Table 2], [Table 3] and [Graph 1] which showed a statistically significant difference between the three groups. Moreover, comparison between two groups each was done by Student's t-test [Table 3] according to which there was a statistically significant difference between sandblast (853.89N) and standardized machine (267.93 N), a statistically significant difference between standardized machine (267.93 N) and grooved abutment (1005.31 N) was also observed, and finally, there was no statistically significant difference between sandblasted abutments and grooved abutment. However when we compare all the three groups according to readings, grooved implant abutment gives 3.59 times better retention.
Table 2: Readings of pullout test using a universal testing machine

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Table 3: Comparision between two groups by Student's t-test

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   Discussion Top


Zinc phosphate has been indicated for the permanent cementation of implant-supported crowns because it yields high retentive strength when compared to most luting agents.[11],[12],[13] According to many studies, the surface topography of implant abutment has a greater impact on crown retention when cements with lower mechanical strengths are used for example:

In a study done by Kim et al.,[4] the retention of implant-supported single restorations showed a significant interaction between the type of temporary cement and abutment surface condition (machined, air abraded, and roughened with diamond bur). A study done by Cano-Batalla et al.[14] compared between standard machine implant abutment and sandblasted abutments (50 μm aluminum oxide) and concluded that airborne-particle abrasion and abutment height can significantly influence the retention of implant-supported crowns.

Another similar study was performed by de Campos et al.[15] where they compared standard machined, sandblasted, and grooved implant abutments without thermocycling and concluded that sandblasted and grooved had approximately 2.4 times greater mean uniaxial retentive strength than standard, whereas SB (822 N) and grooved (871 N) showed almost similar retentive strength.


   Conclusion Top


Among all the three groups, i e., standard machined (267.93 N), sandblasted (853.89 N), and grooved implant abutment (1005.31 N), grooved implant abutment gives better retention than the other two. Hence, the geometry of the implant-abutment surface improves the cement effectiveness by increasing the surface area.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Adell R, Lekholm U, Rockler B, Brånemark PI. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416.  Back to cited text no. 1
    
2.
Branemark PI, Albrektsson T. Endosteal dental implants in the treatment of the edentulous jaw. The Branemark implant. In: Fonseca RJ, Davis WH, editors. Reconstructive Preprosthetic Oral and Maxillofacial Surgery. Philadelphia: WB Saunders; 1986. p. 210-24.  Back to cited text no. 2
    
3.
Scacchi M. The development of the ITI dental implant system part 1: A review of the literature. Clin Oral Impl Res 2000;11:8-21.  Back to cited text no. 3
    
4.
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;95:450-5.  Back to cited text no. 4
    
5.
Preiskel HW, Tsolka P, Dip DS. Cement- and screw-retained implant-supported prostheses: Up to 10 years of follow-up of a new design. Int J Oral Maxillofac Implants 2004;19:87-91.  Back to cited text no. 5
    
6.
Chee W, Jivraj S. Screw versus cemented implant supported restorations. Br Dent J 2006;201:501-7.  Back to cited text no. 6
    
7.
Lee A, Okayasu K, Wang HL. Screw- versus cement-retained implant restorations: Current concepts. Implant Dent 2010;19:8-15.  Back to cited text no. 7
    
8.
Goodacre CJ, Bernal GB, Rungcharassaeng K. Clinical complication with implants and implant prostheses. J Prosthet Dent 2003;90:121-32.  Back to cited text no. 8
    
9.
Lewinstein I, Block L, Lehr Z, Ormianer Z, Matalon S. An in vitro assessment of circumferential grooves on the retention of cement-retained implant-supported crowns. J Prosthet Dent 2011;106:367-72.  Back to cited text no. 9
    
10.
Lowe RA. Direct preparation of preexisting implant abutments. J Dent Res Dent Clin Dent Prospect 2004;6:98-102.  Back to cited text no. 10
    
11.
Carter GM, Hunter KM, Herbison P. Factors influencing the retention of cemented implant supported crowns. N Z Dent J 1997;93:36-8.  Back to cited text no. 11
    
12.
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;13:343-8.  Back to cited text no. 12
    
13.
Covey DA, Kent DK, St Germain HA Jr., 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.  Back to cited text no. 13
    
14.
Cano-Batalla J, Soliva-Garriga J, Campillo-Funollet M, Munoz-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;27:36-41.  Back to cited text no. 14
    
15.
de Campos TN, Adachi LK, Miashiro K, Yoshida H, Shinkai RS, Neto PT, et al. Effect of surface topography of implant abutments on retention of cemented single-tooth crowns. Int J Periodontics Restorative Dent 2010;30:409-13.  Back to cited text no. 15
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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