Bond strength of zirconia- or polymer-based copings cemented on implant-supported titanium bases

Syfte: Syftet med denna in-vitro-studie var att utvärdera bindningsstyrkan mellan zirkonia eller polymerbaserade överkonstruktioner cementerade på implantatstödda titanbasar med olika adhesiva cementsystem samt utvärdera om förbehandling (sandblästring) av polymerbaserade konstruktioner förbättrar bindningsstyrkan. Nollhypotesen är att oberoende av materialval, förbehandling och de olika adhesiva cementsystemen som används kommer det inte att påverka bindningsstyrkan. Material & metod: 120 provkroppar användes i denna studie, provkropparna bestod av en titanbas och en standardiserad överkonstruktion framställd av ett av tre material: Zirkonia (ZirCAD) eller polymerbaserade material (Nextdent MFH C&B och Telio CAD). Tre olika adhesiva cementsystem användes för att cementera titanbaserna till zirkonia eller till de polymerbaserade överkonstruktionerna. Grupperna delades upp enligt följande: Kontrollgrupp - titanbas med zirkonia (TZirconia); titanbas med oblästrad fräst polymetylmetakrylat, PMMA (TUNPMMA); titanbas med blästrad fräst PMMA (TBPMMA); titanbas med 3D-printad mikrofylld hybridresin (TMFH). De cementsystem som användes var Multilink Hybrid Abutment, Panavia V5 och RelyX Ultimate. Provkropparna förvarades torrt vid rumstemperatur under 24 timmar och utsattes sedan för termocykling under 5000 cykler mellan 5° C och 55° C. Bindningsstyrkan utvärderades med användning av ett draghållfasthetstest med en universal testmaskin med en tvärhuvudhastighet på 0,5 mm/min och analyserades statistiskt med icke parametriskt one-way ANOVA, Kruskal Wallis test a = 0,05. Resultat: TUNPMMA och TBPMMA cementerade med Multilink Hybrid Abutment visade en statistisk signifikant lägre bindningsstyrka jämfört med TZirconia. Det var ingen skillnad jämfört med TMFH. Grupperna cementerade med Panavia V5; TUNPMMA, TBPMMA och TMFH hade en statistisk signifikant lägre bindningsstyrka jämfört med kontrollgruppen, TZirconia. TUNPMMA och TBPMMA cementerade med Rely X Ultimate hade en statistisk signifikant lägre bindningsstyrka jämfört med kontrollgruppen, TZirconia. Slutsats: Inom begränsningarna för denna studie är bindningsstyrkan högst med Panavia V5 och Rely X Ultimate för permanent cementering av zirkonia. Det föredras att cementera polymerbaserade konstruktioner med dualhärdande cementsystem. Sandblästring behövs inte när PMMA konstruktioner ska cementeras till en titanbas, eftersom bindningsstyrkan för blästrad PMMA inte förbättrades genom sandblästring.Purpose: The aim of this in-vitro study was to evaluate the bond strength between zirconia or polymer-based copings cemented on implant-supported titanium-bases with different adhesive cement systems. Additionally to evaluate if pre-treatment (sandblasting) of the PMMA restoration enhance the bond strength. The null hypothesis is that irrespectively of material choice, pre-treatment and the different adhesive cement systems used it will not affect the bond strength. Material & method: 120 specimens were used in this study, the specimens consisted of a titanium-base and a standardized coping produced by one of three materials: Zirconia (ZirCAD), or polymer-based materials (Nextdent MFH C&B and Telio CAD). Three different adhesive cement systems were used to bond the titanium-bases to the zirconia or to the polymer-based copings. The groups were assigned as follows: Control group - titanium-base with zirconia (TZirconia); titanium-base with un-sandblasted milled polymethylmetacrylate, PMMA (TUNPMMA); titanium-base with sandblasted milled PMMA (TBPMMA); titanium-base with 3D-printed micro filled hybrid resin (TMFH).The cement systems used were Multilink Hybrid Abutment, Panavia V5 and RelyX Ultimate. The specimens were stored dry at room temperature for 24 hours and then subjected to thermocycling for 5000 cycles between 5°C and 55°C. The bond strength was evaluated by using a tensile strength test with a universal test machine at a crosshead speed of 0.5 mm/min and statistically analyzed with the Kruskal-Wallis test with α = 0.05. Results: TUNPMMA and TBPMMA cemented with Multilink Hybrid Abutment showed a statistic significance lower bond strength in comparison to TZirconia. There was no difference compared to TMFH. The groups cemented with Panavia V5; TUNPMMA, TBPMMA and TMFH had a statistic significance lower bond strength compared to the control group, TZirconia. TUNPMMA and TBPMMA cemented with Rely X Ultimate had a statistic significance lower bond strength in comparison to the control group, TZirconia. Conclusion: Within the limitations of this study, the bond strength is highest with Panavia V5 and Rely X Ultimate for permanent cementation with zirconia restoration. It is preferred to cement polymer-based restoration with dual polymerized cement system. Furthermore, sandblasting is not needed when PMMA restorations are to be bonded to a titanium base, since the bond strength of blasted PMMA was not improved by sandblasting

Bond strength of zirconia- or polymer-based copings cemented on implant-supported titanium bases – an in vitro study

Purpose To evaluate the bond strength between polymer-based copings and zirconia copings as positive control, cemented on implant-supported titanium bases with different adhesive cement systems. Moreover, to evaluate if airborne-particle abrasion of polymethylmetacrylate (PMMA) would enhance the bond strength. Methods Four groups of different materials were used to fabricate the copings, 30 in each group: airborne-particle abraded milled zirconia (TAZirconia, control group), milled PMMA (TPMMA), airborne-particle abraded milled PMMA (TAPMMA) and 3 D-printed micro filled hybrid resin (TAMFH). Each group of copings was cemented on titanium bases by three different adhesive cement systems, 10 each: Multilink Hybrid Abutment, Panavia V5, RelyX Ultimate. The specimens were stored dry at room temperature for 24 h, subjected to thermocycling for 5000 cycles followed by evaluating the bond strength by tensile strength test. Results TPMMA and TAPMMA cemented with Multilink Hybrid Abutment showed statistically significant lower bond strength in comparison to TAZirconia and TAMFH. No difference was observed between the latter two. TPMMA, TAPMMA and TAMFH had a statistically significant lower bond strength compared to the control group when cemented with Panavia V5. TPMMA and TAPMMA cemented with Rely X Ultimate showed statistically significant lower bond strength in comparison to the control group. Conclusion Almost all experimental groups, except 3 D-printed MFH, performed inferior than the positive control group where the highest bond strength was reported for the cementation of zirconia copings cemented with Panavia V5 or Rely X Ultimate. Airborne-particle abrasion did not improve the bond strength of the PMMA, except when Multilink Hybrid Abutment was used