Effect of Zirconia Thickness, Cement Color, and Titanium Implant Abutment Surface Treatment Type on the Esthetic Outcomes of High Translucency Monolithic Zirconia.

Abstract

To investigate the esthetic outcomes based on the color differences in zirconia of varying thickness, resin cement color, and types of titanium implant surface treatments. Twenty-eight HTMZ specimens were arranged into four groups based on zirconia thickness: 1.0, 1.5, 2.0, and 2.5 mm (n=7). Each group was tested using two resin cement colors (n=7) (clear and opaque) in combination with six surface-treated titanium groups (n=7): untreated titanium (UT), anodization (AN), 50-μm alumina airborne-particle abrasion followed by AN (SBAN), AN followed by 50-μm alumina airborne-particle abrasion (ANSB), 95% hydrofluoric acid followed by AN (HFAN), and AN followed by 95% hydrofluoric acid (ANHF) for the 48 experimental groups, and using composite resin (n=7) (A2D) for the four control groups. All the specimens were measured using a spectrophotometer and subsequently compared with composite resin (control) with the corresponding zirconia thickness to establish the color differences. A color difference of <2.7 was considered clinically acceptable. The data obtained were statistically analyzed using the analysis of variance and post hoc test (p=0.05). Zirconia thickness, resin cement color, and type of titanium implant surface treatment significantly affected the observed color differences (p<0.05). When using 2.5-mm HTMZ with clear resin cement on AN, UT, SBAN, HFAN, and ANSB, the mean color differences obtained were below the clinically acceptable values. However, when using 2.5-mm HTMZ with clear resin cement on AN, UT, and SBAN, the 95% confidence intervals of color differences obtained were below the clinically acceptable values. HTMZ with a minimum thickness of 2.5 mm and clear resin cement on AN, UT, and SBAN groups potentially result in acceptable color matching with 95% confidence intervals.