The Journal of Advanced Prosthodontics

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Effect of cement type, luting protocol, and ceramic abutment material on the shade of cemented titanium-based lithium disilicate crowns and surrounding peri-implant soft tissue: a spectrophotometric analysis

  • Peter Gehrke (Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt) ;
  • Maria Julia Pietruska (Private Practice for Oral Surgery and Implant Dentistry) ;
  • Johannes Ladewig (Private Practice for Implant Dentistry) ;
  • Carsten Fischer (Dental Laboratory, Sirius Ceramics) ;
  • Robert Sader (Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center, University Hospital, Goethe University Frankfurt) ;
  • Paul Weigl (Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt)
  • Received : 2024.04.17
  • Accepted : 2024.06.09
  • Published : 2024.08.31
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Abstract

PURPOSE. The objective of the study was to analyze the impact of cement, bonding pretreatment, and ceramic abutment material on the overall color results of CAD-CAM ceramic crowns bonded to titanium-based hybrid abutments. MATERIALS AND METHODS. For single implant restoration of a maxillary lateral incisor a total of 51 CAD-CAM-fabricated monolithic lithium disilicate crowns were fabricated and subsequently bonded onto 24 lithium disilicate Ti-base abutments, 24 zirconia Ti-base abutments and 3 resin abutment replicas as a control group. The 48 copings were cemented with three definitive and one provisional cement on both grit-blasted and non-blasted Ti-bases. The color of each restoration and surrounding artificial gingiva was measured spectrophotometrically at predefined measuring points and the CIELAB (ΔEab) color scale values were recorded. RESULTS. The color outcome of ceramic crowns bonded to hybrid abutments and soft tissues was affected differently by cements of different brands. Grit-blasting of Ti-bases prior to cementing CAD-CAM copings affected the color results of allceramic crowns. There was a significant difference (P = .038) for the median ΔE value between blasted and non-blasted reconstructions at the cervical aspect of the crown. Full-ceramic crowns on zirconia Ti-base abutments exhibited significantly lower ΔE values below the threshold of visibility (ΔE 1.8). In all subcategories tested, the use of a highly opaque temporary cement demonstrated the lowest median ΔE for both the crown and the artificial gingiva. CONCLUSION. Various cements, core ceramic materials and airborne particle abrasion prior to bonding can adversely affect the color of Ti-base supported ceramic crowns and peri-implant soft tissue. However, zirconia CAD-CAM copings and an opaque cement can effectively mask this darkening.

Keywords

Acknowledgement

The authors gratefully acknowledge Dr. Wolfgang Reimers for his contribution to data analysis and statistical support, and Patrick Muhlbeyer for his technical assistance. The authors thank Medentis medical GmbH for providing the ti-base specimens for the experimental investigation.

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