Incidence of undetected cement on CAD/CAM monolithic zirconia crowns and customized CAD/CAM implant abutments. A prospective case series

Abstract

The aim of this study was to assess the frequency of cement residues after cementation of CAD/CAM monolithic zirconia crowns on customized CAD/CAM titanium abutments. Sixty premolars and molars were restored on Astra Tech Osseospeed TX^™ implants using single monolithic zirconia crowns fixed on two types of custom-made abutments: Atlantis^™ titanium or Atlantis^™ Gold Hue. Occlusal openings providing access to the abutment screws were designed for retrievability of the crown/abutment connection. After fixation with glass ionomer cement, the crown/abutment units were unscrewed to evaluate the presence of residual cement. Dichotomous assessment of the presence or absence of cement at the crown/abutment unit and peri-implant tissues was performed. Clinically undetected cement excess was visible on 44 of 60 restorations (73.3%). There was no interdependency between residual cement presence and implant location or diameter. However, a dependency between the presence of residual cement and the aspect of the abutment/crown connection could be noted. The majority of the residues were observed on the distal (17.9%) and mesial (15%) aspects. While on the palatal/lingual aspect, the cement was visible in 8.8%; only 3.4% of all surfaces displayed cement residues. Within the limitations of the study, it can be concluded that the use of customized CAD/CAM abutments do not guarantee avoidance of subgingival cement residues after crown cementation.