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Laboratory study comparing the color influence of different cements and cementation protocols for titanium resin based single ceramic crowns
EAO Online Library. LIU X. Oct 9, 2018; 232556; P-BR-151
Xinran LIU
Xinran LIU
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The esthetic outcome is essential for the overall success of implant therapy. The color appearance of peri-implant soft tissue is one of the key factors influencing the esthetics. It has been often reported that titanium abutment may cause a change in color appearance of the peri-implant mucosa, especially when mucosa thickness is 2mm or less. However, it remains unclear whether the color appearance of the peri-implant mucosa would be influenced by different cements and cementation protocols.The aim of the laboratory study is to evaluate, utilizing spectrophotometers, the influence of different cements on the color of a titanium based lithium disilicate single crowns and the peri-implant soft tissue. Null hypothesis is distribution of Δ+E is the same across different cements.A case with implant supported screw retained crown on 12 was chosen. The morphology of the peri-implant soft tissue was reconstructed using artificial gingiva on a plastic model. 12 was replaced by a replica.48 monolithic disilicate crowns with identical design were fabricated (3 samples for each group). In 3 of the 15 test groups, 3 temporary cements were used to cement crowns on titanium abutments. In 6 groups, crowns were cemented with 6 different definitive cements on titanium abutments. In another 6 groups, the same 6 cements were used while the abutments were sandblasted. 3 abutments was made using composite die material duplicating the exact shape of the titanium abutment. 3 crowns were cemented with light Try-in paste on the composite die abutments as control groups. A spectrophotometer was used to measure color performance on middel and cervical sites of the crowns, and artificial soft tissue 1mm below the mucosa margin. Readings with CIE Lab color scale were recorded.Δ+E between test and control groups were calculated according to the formula- Δ+E=(Δ+L2+Δ+a2+Δ+b2)1 2. Δ+E mean values calculated were as follows- light Variolink Esthetic Try-in paste® (Ivoclar), 2.52+ translucent glue, 1.9+ zinc oxide temporary cement (Rely X®, 3M), 1.4+ self-curing resin based cement (HO 0, Multilink® Hybrid Abutment, Ivoclar), 1.29+ self-adhesive universal resin cement (A2, RelyX® Unicem, 3M), 2.445+ dual-cure resin cement (Clear, Panavia®V5, Kuraray), 2.92+ dual-cure resin cement (A2, Panavia®V5, Kuraray), 2.255+ dual-cure resin cement (White, Panavia®V5, Kuraray), 2.025+ dual-cure resin cement (Opaque, Panavia®V5, Kuraray), 1.87. Independent-Samples Kruskal-Wallis test was performed to compare the Δ+E values across different cements. The significance level was set at 0.05. The null hypothesis was rejected. Δ+E mean values measured on the 3 different sites were as follows- middle of the crown, 2.12+ cervical of the crown, 2.43+ 1mm below mucosa margin, 1.91.Within the limitation of the study, the following conclusions can be drawn- Cements with different shade from different brands may lead to different color performance on titanium based lithium disilicate single crowns and the peri-implant soft tissue. It appears that cements with more opaque shade lead to smaller color change. The influence of cements on the color performance are different across tested sites, including middle and cervical parts of the crown, and 1mm below mucosa margin.
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