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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (1): 69-75. doi: 10.19723/j.issn.1671-167X.2021.01.011

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Comparison of residual cement between CAD/CAM customized abutments and stock abutments via digital measurement in vitro

YUE Zhao-guo1,ZHANG Hai-dong1,YANG Jing-wen2,HOU Jian-xia1,Δ()   

  1. 1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Department of Prosthetics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2020-10-12 Online:2021-02-18 Published:2021-02-07
  • Contact: Jian-xia HOU E-mail:jxhou@163.com
  • Supported by:
    Research Foundation of Peking University School and Hospital of Stomatology(YS020217)

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Abstract:

Objective: To compare the residual cement between computer aided design/computer aided manufacturing customized abutments (CCA) and stock abutments (SA), and to evaluate the feasibility of digital measurement for residual cement volume by three-dimensional scanning.Methods: Twenty master models needed in this study were all taken from one 47-year-old patient with arrested periodontitis, who had already had an implant placed at his right upper central incisor site in the Department of Periodonto-logy, Peking University School and Hospital of Stomatology. After 4 weeks of soft tissue conditioning by means of customized healing abutment, the height of peri-implant soft tissue was measured, from the implant platform to mucosal margin, as 5 mm. Using customized impression coping, the impression was taken and twenty models were fabricated and allocated to 4 groups according to the type of abutments: CCA1 (5 mm transmucosal height CCA, with margin at tissue level), CCA2 (4 mm transmucosal height CCA, with 1 mm submucosal margin), SA1 (3 mm transmucosal height SA, with 2 mm submucosal margin) and SA2 (1 mm transmucosal height SA, with 4 mm submucosal margin). Crowns were cemented to the abutments, which were seated on the working models. Excess cement was removed by a prosthodontic specialist. Thereafter, the volume of residual cement was evaluated by using three-dimensional scanning technique. The area proportion of residual cement was calculated on photographs taken by a single lens reflex camera. The weight of residual cement was weighed by an analytical balance. And the correlation of residual cement volume data with residual cement area proportion or weight of residual cement acquired by traditional methods was analyzed.Results: Residual cement was observed on all the experiment samples. The residual cement volume of CCA was significantly less than that of SA [(0.635 3±0.535 4) mm3 vs. (2.293 8±0.943 8) mm 3, P<0.001]. Consistently, CCA had less residual cement area proportion and weight than those of SA [area proportion: 7.57%±2.99% vs. 22.68%±10.06%,P<0.001; weight: (0.001 5±0.001 0) g vs. (0.003 7±0.001 4) g, P<0.001]. The residual cement volume was strongly correlated with the residual cement area proportion and residual cement weight (r>0.75, P<0.001).Conclusion: These in vitro results suggest that CCA minimized the residual cement more effectively than SA. The method to digitally evaluate the residual cement volume is feasible, but its validity and reliability need to be further studied.

Key words: Dental implant-abutment design, Computer-aided design, Dental cements, Imaging, three-dimensional, In vitro

CLC Number: 

  • R783

Figure 1

Allocation of different abutments A, CAD/CAM customized abutments (CCA) with 5 mm transmucosal height, margins at tissue level (CCA1); B, CCA with 4 mm transmucosal height, 1 mm submucosal margins (CCA2); C, stock abutments (SA) with 3 mm transmucosal height, 2 mm submucosal margins (SA1); D, SA with 1 mm transmucosal height, 4 mm submucosal margins (SA2)."

Figure 2

Digital measurement of residual cement volume"

Figure 3

Measurement of residual cement area proportion A, the abutment and crown were erected using silicone rubber material; B, taking photo with a single lens reflex camera at a constant distance (250 mm); C, four aspects (buccal-, lingual-, mesial- and distal-) of each sample were snapshotted for analysis; D, calculating residual cement area proportion using software."

Table 1

Less residual cement in CCA group than in SA group"

Group Volume/mm3 Area proportion/% Weight/g
CCA 0.635 3±0.535 4 7.57±2.99 0.001 5±0.001 0
SA 2.293 8±0.943 8 22.68±10.06 0.003 7±0.001 4
t 5.044 4.908 4.236
P <0.001 <0.001 <0.001

Table 2

Comparison of the amount of residual cement between CCA group and SA group"

Items CCA1 group CCA2 group SA1 group SA2 group
Volume/mm3 0.709 2±0.526 2 0.561 4±0.595 3 2.144 2±1.165 1*## 2.443 4±0.768 7**##
Area proportion/% 7.81±2.63 7.32±3.62 22.10±13.77*## 23.26±6.10**##
Weight/g 0.001 6±0.001 3 0.001 3±0.000 9 0.003 5±0.001 5*# 0.004 0±0.001 4*##

Figure 4

Undercuts around stock abutments ☆, the undercut is the distance between the cementation line and the restoration emergence profile margin."

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