Biologic width around different implant-abutment interface configurations. A radiographic evaluation of the effect of horizontal offset and concave abutment profile in the canine mandible.

PURPOSE: The purpose of this experimental study was to analyze radiographically in a dog model how different implant-abutment interface configurations influence alveolar crestal bone changes. MATERIALS AND METHODS: Six different experimental implant-abutment connections were evaluated in six mixed-breed dogs. The following parameters were tested: absence of microgap, microgap proximal to bone crest, and microgap distant from bone crest. In addition, two different cervical abutment profiles, one straight and one featuring a supracrestal concavity, were evaluated. Implants were based on a cylindrical full-body screw design and made from cold-worked grade IV commercially pure titanium. The diameter (at thread tips) measured 4.1 mm, whereas the inner diameter was 3.5 mm. Standardized periapical digital radiographs were obtained for comparative analysis at baseline and at 3, 4, 5, 6, 7, 8, and 9 months after implant placement. Radiographs were randomized and calibrated for linear measurements. For statistical analysis, mixed-model repeated-measures analysis of variance was used. RESULTS: All implants integrated successfully and remained stable during the entire period of the study. Radiographically, when comparing groups with straight profiles, crestal bone remodeling in group C (one-piece design) was significantly less than in group A (matching diameters) and B (nonmatching diameters). In fact, implant group C showed the least crestal bone remodeling of all groups. When comparing groups with a concave profile but different microgap configurations, all three designs demonstrated bone loss with no significant differences among the three groups. CONCLUSION: A nonsubmerged one-piece implant design demonstrated the least amount of bone remodeling of all groups. Implant-abutment connections with a concave profile established crestal bone levels immediately apical to the concavity regardless of the microgap variable.

Microleakage of all-ceramic crowns using self-etching resin luting agents.

Self-etching adhesive systems are a new generation of materials that possess acidic methacrylates that can generate self-adhesion. There is limited data reported on the marginal leakage of ceramic restorations bonded with self-etching adhesive materials. This study assessed and compared the amount of microleakage of bonded ceramic crowns using three different types of self-etching adhesive systems with and without a die spacer. Eighteen human molars were prepared for all-ceramic IPS Empress crowns and the teeth were randomly assigned to each experimental group. The buccal side had the preparation finish line 1.5 mm below the CEJ, and the lingual finish line was 1.5 mm above the CEJ, creating margins in enamel and dentin. Two die-spacing techniques were used (three layers or no layer of die spacer). Each crown restoration was cemented with one of three self-etching resin luting agents (Panavia F 2.0, Multilink and RelyX Unicem). The specimens were thermally cycled for 1000 cycles, then immersed in a 5% methylene blue dye solution for 24 hours. The teeth were then rinsed, embedded in clear epoxy resin and sectioned. A total of 60 sections were evaluated for each type of resin luting agent using digital image analysis at 70x magnification. A novel formula, using mean percentage of microleakage, was developed by dividing the extent of dye penetration along the tooth/resin luting cement interphase and the total perimeter of the tooth crown surface. The data were analyzed using three-way analysis of variance at the 0.05 level of significance. Fisher's PLSD intervals were calculated for comparing significant means. Panavia F 2.0 showed a lower degree of microleakage than RelyX Unicem and Multilink at both the enamel and dentin margins. Interactions of the main effects (cement, margin and die spacer technique) were all highly significant (p< or =0.004). The degree of microleakage was higher on the dentin margins than on the enamel margins (p<0.0001). The degree of microleakage for the die spacer group was not significantly different from the group with no die spacer technique (p>0.1). Overall, Panavia F 2.0 showed the least microleakage, followed by RelyX Unicem and Multilink, respectively.