Arce Celin, Lawson Nathaniel C, Liu Perng-Ru, Lin Chee Paul, Givan Daniel A
Int J Oral Maxillofac Implants. 2018 May/June;33(3):530–535. doi: 10.11607/jomi.5915. Epub 2018 Jan 19.
Screw-retained zirconia implant crowns with an internal titanium base have favorable mechanical properties compared with single-piece zirconia implant crowns; however, the screw-retained implant crowns require adequate bonding between the zirconia crown and the titanium base. This study measured the retention between a titanium base and a full-contour zirconia implant crown following different surface treatments of their bonded surfaces.
Full-contour screw-retained zirconia implant crowns were fabricated to fit a titanium base. The crowns were bonded to the titanium bases following one of four treatment protocols (n = 15 per protocol group): no surface treatment (Control), 10-methacryloyloxydecyl dihydrogen phosphate (MDP) primer on the intaglio of crown and exterior of base (MDP), alumina airborne-particle abrasion of the intaglio of crown and exterior of base (Alu), and alumina airborne-particle abrasion and an MDP primer on the intaglio of crown and exterior of base (Alu+MDP). All crowns were bonded to the base with resin cement. Specimens were stored in water for 24 hours at 37°C and then thermocycled in water, with a temperature range of 5°C to 55°C, for 15,000 cycles with a 15-second dwell time. Crowns were separated from the titanium bases using a universal testing machine. The four treatment protocols were compared using one-way analysis of variance (ANOVA), followed by Tukey post hoc tests (P < .05). Sectioned specimens were examined with scanning electron microscopy (SEM).
Retention forces for Control (737.8 ± 148.9 N) and MDP (804.1 ± 114.5 N) were significantly greater than Alu+MDP (595.5 ± 122.2 N), which was significantly greater than Alu (428.2 ± 93.8 N). Visual inspection of the debonded specimens showed that the majority of the cement remnants were seen on the external surface of the titanium bases. Microscopic examination of the interface between the crown and the unaltered base shows that the cement gap is approximately 13 μm at the crest of the microgrooves and 50 μm within the channel of the microgrooves. After airborne-particle abrasion, the microgrooves became significantly dulled, and the cement gap increased to 27 to 40 μm at the crest and 55 to 58 μm in the channels.
Airborne-particle abrasion of titanium bases that contain retentive microgrooves prior to bonding is contraindicated. Application of an MDP primer demonstrated limited improvement in the retention of the zirconia implant crowns.
与一体式氧化锆种植体牙冠相比,带有内部钛基底的螺丝固位氧化锆种植体牙冠具有良好的机械性能;然而,螺丝固位种植体牙冠需要氧化锆牙冠与钛基底之间有足够的粘结。本研究测量了在钛基底和全轮廓氧化锆种植体牙冠的粘结面进行不同表面处理后的固位力。
制作全轮廓螺丝固位氧化锆种植体牙冠以适配钛基底。按照四种处理方案之一(每组n = 15)将牙冠粘结到钛基底上:不进行表面处理(对照组)、在牙冠内面和基底外面使用10 - 甲基丙烯酰氧基癸基二氢磷酸酯(MDP)底漆(MDP组)、对牙冠内面和基底外面进行氧化铝空气颗粒喷砂处理(Alu组)、对牙冠内面和基底外面进行氧化铝空气颗粒喷砂处理并使用MDP底漆(Alu + MDP组)。所有牙冠均用树脂粘结剂粘结到基底上。标本在37°C水中储存24小时,然后在5°C至55°C水温范围内进行15000次循环、每次循环停留15秒的热循环处理。使用万能试验机将牙冠与钛基底分离。采用单因素方差分析(ANOVA)对四种处理方案进行比较,随后进行Tukey事后检验(P < 0.05)。对切开的标本进行扫描电子显微镜(SEM)检查。
对照组(737.8 ± 148.9 N)和MDP组(804.1 ± 114.5 N)的固位力显著大于Alu + MDP组(595.5 ± 122.2 N),而Alu + MDP组又显著大于Alu组(428.2 ± 93.8 N)。对脱粘标本的目视检查表明,大部分粘结剂残余物见于钛基底的外表面。对牙冠与未处理基底之间界面的显微镜检查显示,在微沟顶部的粘结剂间隙约为13μm,在微沟通道内为50μm。空气颗粒喷砂处理后,微沟明显变钝,粘结剂间隙在顶部增加到27至40μm,在通道内增加到55至58μm。
在粘结前对带有固位微沟的钛基底进行空气颗粒喷砂处理是禁忌的。使用MDP底漆对氧化锆种植体牙冠的固位改善有限。