Clinical Bonding of Resin Nano Ceramic Restorations to Zirconia Abutments: A Case Series within a Randomized Clinical Trial

Ulf Schepke; Henny Ja Meijer; Karin M Vermeulen; Gerry M Raghoebar; Marco S Cune

doi:10.1111/cid.12382

Clinical Bonding of Resin Nano Ceramic Restorations to Zirconia Abutments: A Case Series within a Randomized Clinical Trial

Clin Implant Dent Relat Res. 2016 Oct;18(5):984-992. doi: 10.1111/cid.12382. Epub 2015 Oct 12.

Authors

Ulf Schepke¹, Henny Ja Meijer², Karin M Vermeulen³, Gerry M Raghoebar⁴, Marco S Cune^{2

5}

Affiliations

¹ University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Fixed and Removable Prosthodontics and Biomaterials, The University of Groningen, Groningen, The Netherlands. u.schepke@umcg.nl.
² University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Fixed and Removable Prosthodontics and Biomaterials, The University of Groningen, Groningen, The Netherlands.
³ Medical Center Groningen, Department of Epidemiology, The University of Groningen, Groningen, The Netherlands.
⁴ University Medical Center Groningen, Groningen, Department of Oral and Maxillofacial Surgery, The University of Groningen, Groningen, The Netherlands.
⁵ Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital, Nieuwegein, The Netherlands.

PMID: 26456161
DOI: 10.1111/cid.12382

Abstract

Background: New dental materials are introduced and promoted in the field without extensive clinical testing. Using those materials in a clinical setting might result in unacceptable early failure rates.

Purpose: The purpose of this paper was to analyze bonding of a new dental restorative material to either zirconia stock abutments or zirconia customized abutments.

Materials and methods: Fifty participants seeking single implant treatment were included in a prospective study. Resin Nano Ceramic (RNC, Lava Ultimate, 3M ESPE, Seefeld, Germany) crowns were digitally manufactured and extraorally bonded to either a stock or a customized zirconia abutment (ZirDesign and ATLANTIS, DENTSPLY Implants, Mölndal, Sweden) by means of a resin composite cement (RelyX Ultimate in combination with Scotchbond Universal, 3M ESPE), strictly following the manufacturer's recommendations. The final restorations were screw-retained to the implants and followed during 12 months. Primary outcome parameter was uncompromised survival of the restoration, and secondary outcome parameter was mode of failure.

Results: No implants were lost. The uncompromised survival rate of the RNC crowns bonded to zirconia abutments after 1 year of clinical service was only 14% (n = 7). Catastrophic failure occurred in three cases (6%), whereas bonding failure between RNC crowns and zirconia abutments occurred in 80% of the cases (n = 40) within the first year of service. No statistical significant difference in uncompromised survival rate could be identified between abutment types (χ² = 1.495, p = .209). Uncompromised survival rate after 1 year was highly significantly different (χ² = 104.173, p < .001) from a reference standard, which was set at 95%.

Conclusion: RNC crowns luted to stock and customized zirconia implant abutments with the particular resin composite cement in this trial have a poor prognosis, regardless of the abutment type used.

Keywords: CAD/CAM polymers; Lava Ultimate; RNC; early clinical failure; premature medical device release; zirconia bonding.

Publication types

Randomized Controlled Trial

MeSH terms

Ceramics
Dental Abutments*
Dental Bonding*
Dental Restoration, Permanent*
Female
Humans
Male
Middle Aged
Prospective Studies
Treatment Outcome
Zirconium*

Substances

Zirconium
zirconium oxide