Effect of the Unfilled Space Size of the Abutment Screw Access Hole on the Extruded Excess Cement and Retention of Single Implant Zirconia Crowns

Al-Johany, Sulieman S.; Amri, Mohammad D. Al; Al-Bakri, Ahmed S.; Al-Qarni, Mohammed N.

doi:10.1111/jopr.12580

Cited by 9 publications

(4 citation statements)

References 17 publications

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“…Although cement-retained crowns are favored by dentists, their shortcomings are obvious: when they need to be retrieved, the crowns have to be broken, 1 , 10 , 19 excess cement residue underneath the gingiva is difficult or impossible to avoid, 20 , 21 and such excess cement may lead to peri-implant disease. 22 Therefore, previous studies have reported various methods for reducing residual cement around the abutment margin of cement-retained implant crowns, such as making venting holes, 23–27 using polytetrafluoroethylene tape 28 , 29 or a rubber dam, 30 reducing the amount of cement applied, 31 modifying the shape of the abutment 32 or increasing the unfilled space of the abutment, 33 , 34 using the pre-seating technique 19 , 35 by accustomed abutment duplication, avoiding placing the crowns’ restorative margin into a deep place underneath the gingiva 36 and so on.…”

Section: Discussionmentioning

confidence: 99%

Esthetic Evaluation and Acceptability of Different Hole Designs on Implant Crowns from the Perspective of Patients and Dentists in China

Wen¹,

Jiang²,

Zhang³

et al. 2022

PPA

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Purpose Abutment access hole on dental implant crowns may facilitate crown retrieval and reduce cement overflow but present esthetic obstacle for patients. This study aimed to investigate the esthetic evaluation and acceptability of implant crowns with different hole designs from the perspective of patients and dentists. Materials and Methods Anterior and posterior implant zirconia crowns were fabricated into three types: no hole (NH), 1 mm micro hole (MH), and 2.5 mm regular hole (RH). The NH crown was set as the control, and the anterior and posterior crowns with MH and RH were evaluated. The subjects, who were recruited randomly, were comprised of lay patients (n=60) and professional dentists (n=30). All subjects were invited to evaluate the esthetic performance of MH and RH crowns on a Visual Analog Scale (VAS), rate them from 0 to 10, state their acceptability of these crowns, and label them as acceptable and unacceptable. Results The ANOVA analysis of the VAS esthetic evaluation showed that the size of the hole, the position of the teeth, and the professional background of the subject significantly and independently affected esthetic perception. Crowns with MH in the posterior position had higher esthetic scores and acceptability compared with crowns with RH in the anterior position, and dentists tended to show higher acceptance and better esthetic rating for crowns with holes compared with lay patients. Conclusion The hypothesis that patients and dentists hold similar esthetic evaluations or acceptability towards implant crown hole designs was rejected. Lay patients had a lower tolerance for venting holes than dentists. Crowns with 1 mm micro holes were more recommendable than crowns with regular abutment access holes from the point of view of satisfying patients’ esthetic needs.

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Section: Discussionmentioning

confidence: 99%

Esthetic Evaluation and Acceptability of Different Hole Designs on Implant Crowns from the Perspective of Patients and Dentists in China

Wen¹,

Jiang²,

Zhang³

et al. 2022

PPA

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“…The presence of REC may increase suppuration, bleeding on probing and possibly peri‐implant attachment loss 34 . To prevent these problems caused by excess cement, various methods have been investigated, as follows: leaving different space sizes of the abutment screw‐access channel (SAC), 19,20 creating a vent hole on the crown, 21,22 reducing the amount of cement loaded into the crown, 23 using a rubber dam or polytetrafluoroethylene tape, 24,25 and using a custom‐made duplicate or practice abutment 26…”

Section: Discussionmentioning

confidence: 99%

“…While cement‐retained restorations are suspected of causing more biological complications, 15,16 screw‐retained fixed prostheses appear to be more prone to technical failures 17,18 . Many methods have been investigated to prevent the problems caused by REC, 19–26 such as creating a vent hole on the crown surface 21,22 …”

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confidence: 99%

Effect of Vent Hole and Cement Type on Fracture Resistance of CAD‐CAM Monolithic Zirconia Crowns

Çevlik

Demetoğlu

Yıldız

2022

Journal of Prosthodontics

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Purpose To assess the fracture resistance of monolithic zirconia crowns cemented with different types of cement on cement‐retained implant abutments. Materials and methods Forty implant analogs were positioned in acrylic resin blocks, and cement‐retained straight implant abutments were fastened to the analogs. Crowns were designed with/without occlusal vent holes and produced from monolithic zirconia blocks by the CAD‐CAM technique. The two crown types were divided into two groups and cemented with resin and zinc‐polycarboxylate cement under 5 kg weight. A universal testing machine applied compressive forces to the crowns until fracture. Fracture resistance values were analyzed using two‐way ANOVA and the independent samples t‐test with statistical significance set at p < 0.05. Results According to the two‐way ANOVA results, although the crown design did not have a significant effect on fracture resistance (1417.65 ± 337.39 N, 1565.16 ± 517.12 N; crowns with and without vent holes, respectively), the main effect of the cement variable on the fracture resistance was significant. Zinc‐polycarboxylate cement (1680.1 ± 375.23 N) showed higher fracture resistance than resin cement (1302.71 ± 420.64 N) in the crowns designed with vent holes (p < 0.005). Conclusion The use of cement‐retained implant‐supported monolithic zirconia crowns with an occlusal vent hole is safe, and zinc‐polycarboxylate cement use may be an appropriate choice for cementation of these crowns.

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“…Although cement-retained implant crowns are favored by dentists for their low cost and easy handling, their disadvantage is obvious: it is difficult and sometimes impossible to avoid excessive subgingival cement residue, which can lead to peri-implant disease [ 11 , 18 ]. Due to the deleterious effect of the extruded cement residue, attempts have been made to find methods to eliminate these drawbacks, such as opening holes of different diameters on the crown [ 19 , 20 ], increasing the unfilled space of the abutment screw access hole [ 19 ], loading a precise amount of cement on the crown [ 21 ], placing the crown’s margin supragingivally [ 22 ], using polytetrafluoroethylene tape or a rubber dam as a barrier [ 23 , 24 ], and applying customized abutment analogs prior to final cementing to obtain a customized cement film thickness [ 25 ]. Of all these methods, opening a vent hole on the crown is the easiest, and it requires no additional time or costs, making it practical and worthy of clinical application [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Should the vent hole of posterior implant crowns be placed on the lateral surface? An in vitro study of the hydrodynamic feature of cement extrusion and retention ability

Zhou²,

Lyu³

et al. 2022

PLoS ONE

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Although placing a vent hole on the occlusal surface of the implant crown can reduce cervical marginal cement extrusion, it has disadvantages. Transferring the hole to the buccal or lingual surface of the posterior implant crown could therefore be an alternative solution. This study investigated the effect of transferring the vent hole to the lateral side of the implant posterior crown on the hydrodynamics of excess cement extrusion and the crown’s retention ability. Specially fabricated posterior implant crowns were divided into five groups: crowns with an occlusal hole (OH), occlusal lateral hole (OLH), middle lateral hole (MLH), cervical lateral hole (CLH), and no hole (NH). Each set of implant analog-abutment-crown specimens was wrapped in a polymethylacrylate base. The base of the implant crown was divided into four 90-degree quadrants along the diagonal of the square base with a pen mark. Cement was used to bond the crowns and the abutments, and the weight of cement extrusions at the vent holes and the abutment cervical margins were calculated. The distribution of cement extrusion at the margin was photographed in each quadrant, and the areas of surface coverage of cement extrusion were compared with ImageJ software. Retentive strength was measured as the dislocation force using a universal testing machine. One-way analysis of variance was used for result analysis. The cervical marginal cement extrusions of crowns with lateral holes (OLH, MLH, and CLH) were significantly less than that of NH crowns (P<0.05), but more than that of OH crowns (P<0.05). Subgroup analysis among the lateral hole groups indicated that the higher the position of the lateral hole, the lower the weight of the cement extrusion, and the smaller the total distribution area of cement extrusion. The cement extrusion distribution area was larger in the quadrant with the hole than in those opposite and next to the hole. Retention strength comparison indicated no significant difference between crowns with NH, OH, or lateral holes. Transferring the vent hole of the posterior implant crown to the lateral side could reduce cement extrusion at the cervical margin while reducing retention strength deterioration and the esthetic drawbacks caused by occlusal hole opening.

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Effect of the Unfilled Space Size of the Abutment Screw Access Hole on the Extruded Excess Cement and Retention of Single Implant Zirconia Crowns

Abstract: The amount of extruded excess cement was reduced by more than half when a 2-mm space of the screw access hole was left unfilled in comparison to the nonspaced counterpart. The retention of zirconia copings was not affected by the reported technique.

Cited by 9 publications

References 17 publications

Esthetic Evaluation and Acceptability of Different Hole Designs on Implant Crowns from the Perspective of Patients and Dentists in China

Esthetic Evaluation and Acceptability of Different Hole Designs on Implant Crowns from the Perspective of Patients and Dentists in China

Effect of Vent Hole and Cement Type on Fracture Resistance of CAD‐CAM Monolithic Zirconia Crowns

Should the vent hole of posterior implant crowns be placed on the lateral surface? An in vitro study of the hydrodynamic feature of cement extrusion and retention ability

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