Influence of cement type and ceramic primer on retention of polymer-infiltrated ceramic crowns to a one-piece zirconia implant
Abstract
Statement of problem
The best procedure for cementing a restoration to zirconia implants has not yet been established.
Purpose
The
purpose of this in vitro study was to measure the retention of
polymer-infiltrated ceramic crowns to zirconia 1-piece implants using a
wide range of cements. The effect of ceramic primer treatment on the
retention force was also recorded. The retention results were correlated
with the shear bond strength of the cement to zirconia and the indirect
tensile strength of the cements to better understand the retention
mechanism.
Material and methods
The
retention test was performed using 100 polymer-infiltrated ceramic
crowns (Vita Enamic) and zirconia implants (ceramic.implant CI) The
crowns were cemented with either temporary cement (Harvard Implant
semipermanent, Temp Bond), glass-ionomer cement (Ketac Cem),
self-adhesive cement (Perma Cem 2.0, RelyX Unicem Automix 2, Panavia
SA), or adhesive cement (Multilink Implant, Multilink Automix, Vita
Adiva F-Cem, RelyX Ultimate, Panavia F 2.0, Panavia V5 or Panavia 21)
(n=5). Additionally ceramic primer was applied on the intaglio crown
surface and implant abutment before cementation for all adhesive cements
(Multilink Implant, Multilink Automix: Monobond plus; RelyX Ultimate
Scotchbond Universal; Vita Adiva F-Cem: Vita Adiva Zr-Prime; Panavia
F2.0, Panavia V5: Clearfil Ceramic Primer) and 1 self-adhesive cement
containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP) (Panavia
SA: Clearfil Ceramic Primer). Crown debond fracture patterns were
recorded. Shear bond strength was determined for the respective cement
groups to polished zirconia (n=6). The diametral tensile strength of the
cements was measured (n=10). Statistical analysis was performed using
1-way or 2-way analysis of variance followed by the Fisher LSD test
(α=.05) within each test parameter.
Results
Adhesive
and self-adhesive resin cements had shear bond strength values of 0.0
to 5.3 MPa and revealed similar retention forces. Cements containing MDP
demonstrated shear bond strength values above 5.3 MPa and displayed
increased retention. The highest retention values were recorded for
Panavia F 2.0 (318 ±28 N) and Panavia 21 (605 ±82 N). All other adhesive
and self-adhesive resin cements attained retention values between 222
±16 N (Multilink Automix) and 270 ±26 N (Panavia SA), which were
significantly higher (P<.05) than glass-ionomer (Ketac Cem:
196 ±34 N) or temporary cement (Harvard Implant semipermanent: 43 ±6 N,
Temp Bond: 127 ±13 N). Application of manufacturer-specific ceramic
primer increased crown retention significantly only for Panavia SA.
Conclusions
Products
containing MDP provided a high chemical bond to zirconia. Self-adhesive
and adhesive resin cements with low chemical bonding capabilities to
zirconia provided retention force values within a small range (220 to
290 N).
Comments