Yeniden simantasyonun CAD/CAM zirkonya kuronların kısa titanyum ve zirkonya abutmentler üzerine tutunmasına etkisi

Year 2020, , 78 - 83, 01.09.2020

Nurullah Türker , Mehmet Mustafa Özarslan

https://doi.org/10.17214/gaziaot.621820

Abstract

Amaç: Bu çalışmanın amacı yeniden simantasyon işleminin bir self adeziv rezin siman ile kısa titanyum ve zirkonya dayanaklara yapıştırılan zirkonya kopinglerin tutuculuğuna etkilerinin karşılaştırmalı olarak değerlendirilmesidir.

Gereç ve Yöntem: Bu in vitro çalışmada 12 adet titanyum (Nucleoss T4 implants, NucleOSS T4 flat abutment, İzmir, Türkiye) ve 12 adet zirkonya (Zirkonzahn, Zirkonzahn GmbH, Bruneck, İtalya) dayanak kullanıldı. Titanyum dayanakların boyu 3 mm’ye indirildi ve analoglara sabitlenerek akrilik içine gömüldü. Titanyum dayanaklar taranarak bilgisayar destekli tasarım ve imalat (CAD/CAM) yöntemi ile zirkonyum dayanaklar ve zirkonyum kopingler üretildi. Tüm zirkonyum kopingler bir self adeziv rezin siman ile titanyum ve zirkonyum dayanaklara simante edildi. Örnekler universal test cihazında pull-out testine tabi tutuldu ve bağlanma dayanımı değerleri kaydedildi. Dayanaklar ve kopingler üzerindeki siman kalıntıları anguldruvaya takılan bir çelik rond frez ve sond ile temizlendi. Kopingler yeniden simante edildi, tekrar pull-out testi uygulandı ve bağlanma dayanımı değerleri kaydedildi. Verilere tanımlayıcı istatistikler uygulandı, ortalama ve standart sapma değerleri elde edildi. Grup ve test etkisini karşılaştırmak için ikili karşılaştırmalı Bonferroni düzeltmeleri kullanıldı. p <0.01 değerleri istatistiksel olarak anlamlı kabul edildi.

Bulgular: Ön test ve son testin bağlanma dayanımı üzerindeki etkisi (p<0.001), titanyum ve zirkonyum grup farklılığı etkisi (p<0.001) ve test-grup interaksiyon etkisi (p<0.001) istatistiksel olarak anlamlı bulundu. Titanyum ve zirkonyum örneklerde ilk test ve ikinci test arasında bağlanma dayanımı açısından anlamlı farklılık gözlendi (Titanyum: p<0.05, Zirkonyum: p<0.001). Son test bağlanma dayanımı değerleri, öntest bağlanma dayanımı değerlerinden istatistiksel olarak anlamlı derecede düşüktü. İlk testen son teste bağlanma dayanımı değerlerinin değişiminde titanyum ve zirkonyum örnekler arasında anlamlı farklılık gözlendi, bağlanma değerlerindeki azalma zirkonyum örneklerde daha fazlaydı (p<0.001). 

Sonuç: Yeniden simantasyon durumunda kısa dayanaklar üzerindeki tek üye restorasyonların retansiyonu olumsuz etkilenebilir. Resimantasyon durumunda zirkonyum dayanaklarda titanyum dayanaklara göre daha fazla tutuculuk kaybı oluşur.

Keywords

diş implantı, titanyum, yapıştırma, zirkonyum

Influence of re-cementation on the retention of CAD/CAM zirconia copings over short titanium and zirconia abutments

Abstract

Objective: The aim of this study was to comparatively evaluate the effects of re-cementation on the retention of zirconia copings, which were cemented to short titanium and zirconia abutments with self-adhesive resin cement.

Materials and Method: Twelve titanium (Nucleoss T4 implants, NucleOSS T4 flat abutment, İzmir, Turkey) and 12 zirconia abutments (Zirkonzahn, Zirkonzahn GmbH, Bruneck, Italy) were used in this in vitro study. The titanium abutments were shortened to 3 mm and embedded in acrylic by fixing them with analogues. The zirconia abutments and copings were produced by scanning the abutments using the computer-aided design and manufacturing (CAD/CAM) method. All zirconia copings were cemented to the titanium and zirconia abutments with self-adhesive resin cement. Samples were subjected to a pull-out test in a universal testing device, and the bond strength values were recorded. Cement residues on the abutments and copings were removed with a handpiece that had a round head carbon steel bur, and an explorer. The copings were then re-cemented and retested using the pull-out test, and the strength values were recorded. Descriptive statistics were applied to the data, and the mean and standard deviation values were calculated. Bonferroni corrections with pairwise comparisons were used to compare the group and test effect at each level. P<0.01 was considered as statistically significant.

Results: The effect of the pre-test and end-test on bond strength (p<0.001), the group effect on titanium and zirconia (p<0.001) and the test-group interaction effect (p<0.001) were all found to be statistically significant. A significant difference was observed between the titanium and zirconia samples in terms of bond strength when the pre-test and end-tests were compared (titanium: p<0.05, zirconia: p<0.001). The end-test bond strength values were significantly lower than the pre-test bond strength values. Additionally, there was a significant difference between the titanium and zirconia samples in terms of bond strength change on comparison of the pre-test and the end-test. Decrease in bond strength values was higher in the zirconia samples (p<0.001).

Conclusion: Re-cementation may adversely affect the bond strength of single-unit restorations on short abutments. In the case of re-cementation, a higher retention loss may occur in zirconia abutments than in titanium abutments.

Keywords

abutment, dental implant, titanium, zirconium

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