Retention and Marginal Integrity of CAD/CAM Fabricated Crowns Adhesively Cemented to Titanium Base Abutments—Influence of Bonding System and Restorative Material
Felix Burkhardt, Irena Sailer, Vincent Fehmer, Philippe Mojon, João Pitta
Abstract
PURPOSE: To assess the influence of the bonding system and restorative material on the marginal integrity and pull-off forces of monolithic all-ceramic crowns bonded to titanium base (ti-base) abutments. MATERIALS AND METHODS: A total of 108 ti-bases were sandblasted and divided into nine experimental groups (n = 12) according to the combination of crown material (polymer-infiltrated ceramic-network [PI], lithium-disilicate [LD], and zirconia [ZI]) and bonding system (Multilink Hybrid-Abutment [MH], Panavia V5 [PV], RelyX Ul5mate [RU]) with the respective primers. After bonding the crowns to the ti-base abutments, the restorations were screw-retained on implants and thermomechanically aged (1,200,000 cycles, 49 N, 1.67 Hz, 5 to 55°C). Marginal integrity and bonding failures were evaluated under a light microscope, and pull-off forces (N) were calculated. Chi-square tests for marginal integrity as well as one-way and two-way ANOVA statistical tests for pull-off forces were applied (a = .05). RESULTS: PI presented higher marginal integrity than LD (P = .023). Bonding system PV revealed higher marginal integrity than MH (P =.005) and RU (P =.029). Differences in pull-off forces were found between restorative material and resin cements (P < .001), with the highest values for ZI + RU (598 ± 192 N), PI + PV (545 ± 114 N), LD + MH (532 ± 116 N), and PI + RU (528 ± 81 N). Specimens with marginal integrity revealed higher pull-off forces than those with alteration (P = .006). Specimens presenting bonding failures (micromovements) showed lower pull-off forces than those without bonding failures (P < .001). CONCLUSIONS: The tested CAD/CAM materials show favorable bonding performances with different bonding systems, nevertheless for each restorative material a specific bonding system has to be recommended. Int J Prosthodont 2023;36:e88-e102.