The influence of two different cements on remaining cement excess in cement-retained implant-supported zirconia crowns. An in vitro study

Jazmin Hidalgo,Anders Falk,Desirée Baghernejad,Christel Larsson

doi:10.1038/s41405-021-00063-8

Abstract

AimTo compare the amount of remaining cement excess after cementation of implant-supported zirconia crowns with zinc phosphate or calcium aluminate glass ionomer cement.MATERIALS AND METHODSTwenty zirconia crowns were cemented on dental implant abutments using a calcium aluminate glass ionomer cement (n = 10) and zinc phosphate cement (n = 10). After removal of cement excess, remaining cement excess were measured with pixel area calculation method and by weighing. Differences in amount of remaining cement excess were analyzed using Independent Samples t-Test. Level of significance was set at p = 0.05.ResultsZinc phosphate cement had a significantly greater amount of remaining cement excess than calcium aluminate glass ionomer cement in terms of total number of pixels (p = 0.002) and amount in grams (p = 0.005).ConclusionThe study suggests that the amount of remaining cement excess can be affected by the type of cement. Calcium aluminate glass ionomer cement may be a more suitable choice for cement-retained dental implant restorations, and possibly reduce the risk of complications related to cement excess such as peri-implant disease. Further studies are needed to verify the results from the present study.

Highlights

Dental implants have become a widely used treatment for the rehabilitation of partially and completely edentulous patients.[1,2]Implant-supported dental restorations can be retained through screw- or cement-retention.[3]
The independent Samples t-Test revealed a statistically significant difference, where zinc phosphate (ZNPH) had a greater amount of remaining cement excess than CAGIC, in terms of mean of total number of pixels (p value = 0.002) (Fig. 8) and mean of total amount in grams (p value = 0.005) (Fig. 9)
The brittle properties of zinc phosphate cement were thought to be favorable as the cement does not adhere to the circumjacent surfaces.[17]

Summary

Introduction

Dental implants have become a widely used treatment for the rehabilitation of partially and completely edentulous patients.[1,2]Implant-supported dental restorations can be retained through screw- or cement-retention.[3]. Remains of cement excess can irritate surrounding peri-implant tissue in a manner similar to subgingival tartar.[4] In addition, bacteria can adhere to the rough surface of the remaining cement excess and cause inflammation.[5,6,7] These processes have been suggested as major[7] etiological factor behind peri-implant disease.[8] Peri-implant disease is a multifactorial process where factors such as smoking, poor oral hygiene, genetics and history of periodontal infection are predisposing risk factors, but there is no general agreement regarding which factor is more consequential.[8] According to Wittneben et al.[9] biological complications such as fistulas and suppuration, are more frequently found among cement-retained dental implant restorations than screw-retained ones. A water-based hybrid glass ionomer cement, composed of calcium aluminate and glass ionomer (CAGIC),[15] is said to have a rubber-like consistency during setting. This property may allow for easier removal than conventional cements such as zinc phosphate (ZNPH). Compressive strength for CAGIC is ~160 MPa and thereby higher than the ISO requirements for water-based cements (50 MPa) and higher than ZNPH and glass ionomer

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Conclusion