To investigate the effects of implant-supported zirconia crowns with various vent designs on the marginal excess cement (MEC) and retention values under different cement application patterns. Cercon zirconia crowns (n=36) were divided into the following groups: no venting (NV group), a small occlusal vent hole (SOV group), a large occlusal vent hole (LOV group), and a small palatal-occlusal vent hole (SPV group). The cement was applied to the crowns with different methods: occlusally half axial walls (OH), cervically half axial walls (CH) and all axial walls (AA), and different amounts of cement were applied with a chosen method. The weight of the MEC was calculated, and the retention force was recorded. ANOVA was used to analyze the MEC weights and retention values. In all vented groups, the OH application method resulted in no MEC and the least retention force, and the AA method expressed significantly less MEC (p < 0.01) than the CH method without retention force reduction. At each amount of cement (5, 10, 20, 30 mg), all three venting designs significantly reduced the MEC by the AA method, and the mean MEC of the LOV group was lower than that of any other group. Applying a thin layer of cement evenly to all axial walls of vented zirconia crowns showed excellent clinical effects regarding the MEC and the retention force. Residual excess cement was identified as a possible risk indicator for peri-implant diseases. Simply and effectively minimizing marginal extrusions without reducing the retention force has clinical value. The results of this study indicate that applying a thin layer of cement evenly to all axial walls of vented zirconia crowns is an acceptable method.
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