The Conometric Concept: A Two‐Year Follow‐Up of Fixed Partial CEREC Restorations Supported By Cone‐In‐Cone Abutments

Degidi, Marco; Nardi, Diego; Sighinolfi, Gianluca; Degidi, Davide; Piattelli, Adriano

doi:10.1111/jopr.12962

Cited by 11 publications

(12 citation statements)

References 16 publications

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“…The frictional connection eliminates the use of cements or screws, allowing for easy retrieval of the restorations with regular maintenance. This restorative approach, named the “Acuris™ Conometric Concept” (Dentsply Sirona Implants, Bensheim, Germany), has been used to retain hybrid acrylic-composite [45], monolithic lithium disilicate [46, 47] and monolithic zirconia [48] implant restorations in the posterior region. The authors reported favorable mid-term results with high implant survival, stable hard and soft tissues, and few prosthetic complications.…”

Section: Discussionmentioning

confidence: 99%

Influence of margin location and luting material on the amount of undetected cement excess on CAD/CAM implant abutments and cement-retained zirconia crowns: an in-vitro study

Gehrke

Bleuel²,

Fischer³

et al. 2019

BMC Oral Health

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Background The flexibility in designing the submucosal part of CAD/CAM customized implant abutments and the individual positioning of its shoulder line has been suggested to reduce the risk of leaving undetected cement residues, thus preventing adverse effects on peri-implant tissues. A high correlation between excess cement left in the soft tissues and the occurrence of increased biofilm accumulation with sulcular bleeding and/ or suppuration has been reported. This in turn may cause peri-implant inflammation and peri-implant marginal bone loss. The aim of this study was to assess the frequency of cement remnants after the luting of zirconia crowns on CAD/CAM custom molar abutments with different margin levels and to evaluate the impact of the luting material. Material and methods A total of 20 titanium molar CAD/CAM implant abutments (BEGO Medical GmbH) with internal taper connection/ internal hex anti-rotation protection, and a convex emergence profile with different margin positions (0, 1, 2 and 3 mm below the mucosa), were virtually designed (Implant Studio, 3Shape) and manufactured. A master cast was scanned, duplicated by a 3D printer and individual gingival masks were produced to simulate peri-implant soft tissues. 20 corresponding zirconia crowns were designed (Cerec 3D, Dentsply Sirona), produced and cemented to the abutments with two different luting materials; a zinc oxide non-eugenol cement (Temp Bond NE) or a methacrylate cement (Panavia V5). To ensure retrievability of the crown/abutment connection, occlusal openings providing access to the abutment screws were designed. Excess cement was thoroughly removed and the crown/abutment units were unscrewed to evaluate the occurrence of cement residues. All the quadrants of each specimen were evaluated for calculation of the ratio between the cement remnant area and the total specimen area using Adobe Photoshop. Spearman analysis was performed to detect correlations between different variables. A two-sided t-test, ANOVA, Mann–Whitney, and Kruskal–Wallis tests were applied to detect differences between the groups. Results Cement remnants were found in every depth of the crown abutment complex and in almost every area investigated. The amount of cement residues increased as the crown-abutment margin was located more submucosally. Lingual areas were more prone to cement remnants than other surface areas ( p = 0.0291). Excess cement was not only found at the margins of the crown-abutment complex, but also underneath (basal) the abutment itself, where cleaning was impossible. No statistical difference in the effect of zinc oxide non-eugenol- and methacrylate cement on the frequency of excess material at the lateral abutment surfaces could be demonstrated in vitro. The proportion of basal abutment aspects covered with cement residues was, however, significantly smaller in Panavia V5 samples with an average of 4.9 ± 3.7% compared to Temp Bond samples with an a...

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Section: Discussionmentioning

confidence: 99%

Influence of margin location and luting material on the amount of undetected cement excess on CAD/CAM implant abutments and cement-retained zirconia crowns: an in-vitro study

Gehrke

Bleuel²,

Fischer³

et al. 2019

BMC Oral Health

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“…Only the outcome of long-term clinical trials on periodontal health will allow for a classification of relevance of the obtained in vitro results. The existing clinical results of conometrically fixed partial (FDP) and complete prosthesis (CP) using the same friction principle, demonstrated minimal technical and biological complications within a 2-and 5-year period, respectively [15,32]. Similar favorable clinical results can be assumed for the single-tooth replacement with Acuris.…”

Section: Discussionmentioning

confidence: 88%

“…The employment of conically coupled abutments with different designs indicated promising prosthetic results. Hybrid-acrylic prostheses and lithium disilicate or monolithic zirconia fixed partial dentures (FPDs) and single crowns (SCs) retained by conical friction showed minimal technical problems and healthy peri-implant soft-tissues [12][13][14][15][16]. The reported benefits of this concept are the avoidance of cements or the omission of additional retaining screws, the formation of an anatomical soft tissue profile, ease of maintenance, and the use of low-cost prefabricated components.…”

Section: Introductionmentioning

confidence: 99%

Marginal Adaptation and Microbial Leakage at Conometric Prosthetic Connections for Implant-Supported Single Crowns: An In Vitro Investigation

Gehrke

Hartjen

Smeets

et al. 2021

IJMS

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Encouraging clinical results were reported on a novel cone-in-cone coupling for the fixation of dental implant-supported crowns (Acuris, Dentsply Sirona Implants, Mölndal, Sweden). However, the presence or absence of a microgap and a potential bacterial leakage at the conometric joint has not yet been investigated. A misfit and a resulting gap between the conometric components could potentially serve as a bacterial reservoir that promotes plaque formation, which in turn may lead to inflammation of the peri-implant tissues. Thus, a two-fold study set-up was designed in order to evaluate the bidirectional translocation of bacteria along conometrically seated single crowns. On conometric abutments filled with a culture suspension of anaerobic bacteria, the corresponding titanium nitride-coated (TiN) caps were fixed by friction. Each system was sterilized and immersed in culture medium to provide an optimal environment for microbial growth. Positive and negative controls were prepared. Specimens were stored in an anaerobic workstation, and total and viable bacterial counts were determined. Every 48 h, samples were taken from the reaction tubes to inoculate blood agar plates and to isolate bacterial DNA for quantification using qrt-PCR. In addition, one Acuris test system was subjected to scanning electron microscopy (SEM) to evaluate the precision of fit of the conometric coupling and marginal crown opening. Throughout the observational period of one week, blood agar plates of the specimens showed no viable bacterial growth. qrt-PCR, likewise, yielded a result approaching zero with an amount of about 0.53 × 10−4 µg/mL DNA. While the luting gap/marginal opening between the TiN-cap and the ceramic crown was within the clinically acceptable range, the SEM analysis failed to identify a measurable microgap at the cone-in-cone junction. Within the limits of the in-vitro study it can be concluded that the Acuris conometric interface does not allow for bacterial translocation under non-dynamic loading conditions.

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“…Während über vielversprechende In-vivo-Ergebnisse für konometrische Verbindungen berichtet wurde [6,11,13,14,16,18], stehen nun auch aktuelle Informationen über die Passung und das Risiko einer bakteriellen Translokation an der Verbindungsstelle zwischen Abutment und der Restauration zur Verfügung [20]. Obwohl man davon ausgeht, dass die Dichtwirkung von konometrischen Systemen und deren Friktion durch einen Keileffekt erreicht wird, könnte eine Fehlpassung und ein daraus resultierender Mikrospalt zwischen den konometrischen Komponenten auf Höhe der Restaurationsränder als bakterielles Reservoir dienen, das die Plaquebildung fördert.…”

Section: Diskussionunclassified

Das konometrische Konzept für implantatgetragene Einzelkronen: die definitive Befestigung ohne Zement oder Schrauben

Gehrke¹,

Fischer²,

Weinhold³

et al. 2021

ZWR - Das Deutsche Zahnärzteblatt

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The Conometric Concept: A Two‐Year Follow‐Up of Fixed Partial CEREC Restorations Supported By Cone‐In‐Cone Abutments

Cited by 11 publications

References 16 publications

Influence of margin location and luting material on the amount of undetected cement excess on CAD/CAM implant abutments and cement-retained zirconia crowns: an in-vitro study

Influence of margin location and luting material on the amount of undetected cement excess on CAD/CAM implant abutments and cement-retained zirconia crowns: an in-vitro study

Marginal Adaptation and Microbial Leakage at Conometric Prosthetic Connections for Implant-Supported Single Crowns: An In Vitro Investigation

Das konometrische Konzept für implantatgetragene Einzelkronen: die definitive Befestigung ohne Zement oder Schrauben

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