The Effect of Different Surface Treatments on Cement-Retained Implant-Supported Restorations

The Effect of Different Surface Treatments on Cement-Retained Implant-Supported RestorationsMurat Kurt, DDS, PhD1*Tolga Kulunk, DDS, PhD1

Cagrı Ural, DDS, PhD1

Sxafak Kulunk, DDS, PhD1

Sxengul Danisxman, DDS, PhD2

Soner Savasx, DDS, PhD2

The purpose of this study was to evaluate the effects of the various surface treatment methods on the retention

of single crowns on implant abutments. The study included 50 single crowns that were cemented with adhesive

resin cement onto the ITI solid abutments. The specimens were randomly divided into 5 groups, each including

10 specimens according to the following surface treatments: group C, control, abutments remained unaltered as

control; group L, etching with CO2 laser; group SB, sandblasting with 50-lm Al2O3; group MS: coating with

titanium nitride (TiAlN) with a radiofrequency magnetron sputtering system; and group SP, silicoating by Silano-

Pen. After the surface treatment procedures were finished, the casted crowns were cemented onto the

abutments, and thermocycling was applied to simulate oral environment. The uniaxial tensile force was applied

to all test crowns using a universal test machine (Instron) with a crosshead speed of 0.5 mm/min. The load

required to dislodge each crown was recorded in Newton. The lowest tensile bond strength values were

obtained with group MS (223.26 6 14.30 N) and significantly differ from all other groups except group C. Group

SB showed highest test results (506.02 6 18.04 N) and differs from other groups (P , .05). The test values that

were obtained in group MS-group C did not show significant differences (P . .05). Sandblasting is an effective

method to increase bond strength. Also, Silano-Pen and laser application is advisable for increasing the crown

retention to abutments. Titanium aluminum nitride coating with magnetron sputtering technique seems to be

ineffective.

Key Words: implant abutment, retention, coating, surface treatment, laser

INTRODUCTION

Increasing numbers of edentulous and partiallyedentulous patients are being treated withimplant-supported prostheses.1 The long-termsuccess of dental implants is well-document-ed.2 Cast fixed partial prostheses for these

patients may be screw-retained or cement-retainedrestorations. Both of them have some advantagesand disadvantages. Screw-retained implant-sup-

ported prostheses may require additional mainte-nance because screws may loosen or break, andthese prostheses can also cause esthetic problemsin the anterior region.1 However, screw-retainedprostheses are also associated with nonpassivesuperstructures, partially unretained restorationsresulting from loosening or breakage of fasteningscrews and rapid loading of the implant interface.3

Cement-retained crown is a choice for manypatients who receive implants for several reasons,including esthetics, occlusal stability, overcomingangulation problems, and the fabrication of apassively fitting restoration. Cement-retained pros-theses, on the other hand, allow for optimalesthetics and occlusion.3 The crown retention on

1 Department of Prosthodontics, Faculty of Dentistry, Universityof Ondokuz Mayis, Turkey-Samsun.2 Department of Mechanical Engineering, Faculty of Engineering,University of Erciyes, Turkey-Kayseri.* Corresponding author, e-mail: [email protected]: 10.1563/AAID-JOI-D-10-00151

44 Vol. XXXIX / No. One / 2013

RESEARCH

abutment may cause significant problems for bothclinician and patient, so luting agents shouldeliminate problems noted with screw-retainedprostheses. Singer and Serfaty4 reported success incast restorations that were retained with provisionalluting agents. It has also been advocated that theluting agent may act as a shock absorber.4

In particular, the choice of the appropriatecement for a specific clinical situation is still basedon the clinician’s experience rather than specificdata. Ideally, the cement should be strong enoughto indefinitely retain the prosthesis in place, yetweak enough to allow the dentist to retrieve it ifnecessary.5 Factors that may affect the retention ofthe provisional restoration are the geometry ofabutment preparation, abutment taper or parallel-ism, surface area, abutment height, surface finish orroughness, and luting agent.3,6 It has been statedthat for tooth preparation, a 68 taper is ideal. This iswhy most manufacturers machine their abutmentsto a 68 taper.3 Surface roughness and luting agentsare factors that can be controlled by the clinician.7

Surface roughness increases the retention due toresulting microretentive areas. As reported, surfaceroughness enhanced crown retention as much as31%.7 Due to the improvement of lasers in dentistry,laser treatments are thought to be an alternativemethod to other surface treatment methodsbecause of their optical penetration depth.8

In dentistry, various surface coatings, including tinoxide, titanium aluminum nitride (TiAlN), titaniumnitride (TiN), aluminum (Al), aluminum nitride (AlN),gold, silicon nitride, calcium phosphates, glass com-posites, bioactive phosphosilicate glasses, glass ce-ramics, and hydroxyapatite have been reported.9–15

They were designed also for alloys and ceramics usedfor fixed partial dentures and prosthetic metallicimplants.9

Coatings have often been applied to dental alloysto improve the mechanical properties of the metallicdental alloy (hardness, wear, and corrosion resis-tance) and to provide good biocompatibility.16–18 Inprevious studies, TiN and TiAlN coatings were usedto minimize the oxidation and to enhance adhesionof dental porcelain and composite resin to titaniumfor titanium-ceramic restorations.16,19

Silane coupling on metallic surface can be madewith various methods. Tribochemical silica coating(Rocatec, CoJet), Silicoater Classic, Silicoater MD,and Siloc are some of these methods.20 While

tribochemical silica coating is a specially engineeredgrit-blasting system based on special chemicallydesigned silica-coated alumina particles for extra-oral conditioning of the substrate surface, SilicoaterClassic, Silicoater MD, and Siloc are pyrochemicalsilica-coating technologies based on the use ofelevated temperatures.20

A few years ago, a modification of the Silicoatertechnology concept was introduced. Silano-Pen isthe chairside version of Silicoater technology(Silicoater MD, Heraeus Kulzer, Wehrheim, Ger-many), applied by a hand held device (Silano-Penor PyrosilPen); using a flame treatment approach,could deliver reliable adhesion.20–22

There are a lot of studies about bond strengthbetween crown and implant abutment related withdifferent luting agents.3,23,24 But, there are limitedstudies that evaluate the surface-treated abutmentretention to cement-retained restorations. As fordifferent treatments such as TiAlN coating andsilicoating by Silano-Pen on implant abutments, noexperimental research has been undertaken to date.

The purpose of this study was to compare andevaluate the effect of different surface treatmentmethods on tensile bond strength of abutmentsand cement-retained restorations. It was hypothe-sized that the bond strength achieved between theimplant abutments and the crown restorations wasaffected by the various surface treatment methodsapplied on the surface of abutments.

MATERIALS AND METHODS

Fifty ITI solid abutments, 4 mm high, and 50 implantanalogs, burn out copings (Straumann, Basel,Switzerland) were used in this study. Autopolyme-rizing acrylic resin (Meliodent, Bayer Dental, Ger-many) blocks were fabricated, allowing the implantanalogs to be placed in the blocks perpendicular tothe block by the help of a parallelometer (Paraskop,Bego Dental, Bremen, Germany) (Figure 1). Fiftyabutments were divided into 5 groups based on thesurface treatment applied. They are describedbelow.

Group C (control): abutment’s surfaces were leftuntreated.

Group L (laser etched): abutment’s surfaces wereirradiated by CO2 laser (Smart US20D, Deka,Florence, Italy). Laser energy was delivered in apulse mode with a wavelength of 10.6 lm, pulse

Journal of Oral Implantology 45

Kurt et al

repetition rate of 1000 Hz, and pulse duration of 160

ms at an average power setting of 3W.

Group SB (sandblasted): abutment’s surfaces

were abraded with 50 lm alumina oxide (Al2O3)

particles (Korox 50, Bego) applied perpendicular to

the surface at 3 bar pressure for 10 seconds at 10

mm. After abrasion, the test specimens were

thoroughly rinsed with water spray for 30 seconds

then dried with oil-free air.

Group MS (TiAlN coated): abutment’s surfaces

were coated with titanium nitride (TiAlN) with a

reactive magnetron sputtering system; TiAlN coat-

ings were deposited by a dual magnetron sputter-

ing system as shown in Figure 2 using a compound

target (50% Ti, 50% Al) with a size of about 645 mm

3 110 mm 3 10 mm. The system has a stainless steel

vacuum chamber (600 mm in diameter and 800 mm

in height) and two unbalanced planar magnetrons

powered by 2 independent 12 kW DC generators

(12 MDX, Advanced Energy, Fort Collins, Colo). All of

the substrates (implants) were ultrasonically

cleaned in acetone and alcohol for 15 minutes

each, rinsed in distilled water, and dried before

being placed into the depositing chamber. Further-

more, cleaning was done using argon bombard-

ment at a negative DC substrate bias voltage of 850

V with argon gas to a pressure of 5 mtorr prior to

the deposition in the chamber. The chamber was

evacuated to a vacuum of 3.4 3 10�2 mtorr and

backfilled with argon gas to a pressure of 5 mtorr.

Firstly, the target was sputter cleaned in pure argon

in order to remove oxide and nitride layers on the

target surface. Then, as mentioned above, the

substrates were cleaned. To improve the adhesion

of the layers on the substrates, a thin TiAl interlayer

was deposited prior to TiAlN coating at a constant

argon gas pressure of 1.5 mtorr. Then, high purity

nitrogen gas (99.998%) was introduced to the

system. In the experiment, the flow rate of nitrogen

(16 sccm) and the flow rate of argon (15 sccm) were

controlled by mass flow controllers. Al and Ti target

powers were constant at 3000 W, and substrate bias

FIGURES 1–4. FIGURE 1. Placing implant analogs to acrylic block. FIGURE 2. Schematic illustrations of magnetron sputteringcoating system. FIGURE 3. Torqued abutments. FIGURE 4. Pulling the crowns from the abutments.


Effect of Surface Treatments on Restorations

voltage was about �100 V. During the depositionprocess, the temperature of the chamber was about808C, as measured by a thermocouple. A stainlesssteel substrate holder was designed as seen inFigure 2. The substrates came across the compoundtarget once in every rotation. The deposition timewas 120 minutes. The thickness of the coatingsdeposited on the substrates was measured by ball-cratering method. The deposition conditions arealso summarized in Table 1.

Group SP (flamed with Silano-Pen): abutment’ssurfaces were flamed with the Silano-Pen device(Bredent GmbH, Senden, Germany) for 5 s/cm2.After cooling down to room temperature, theSilano-Pen bonding agent (alcoholic solution of 3-methacryl oxyloxypropyltrimethoxy silane) wasbrushed on and air-dried for 3 minutes.

After surface treatment procedures, the abut-ments were connected to the implant analogs andtorqued to 35 N-cm (Figure 3). Crown copings wereconstructed by the same operator with the help ofthe prefabricated plastic burn-out copings of height7 mm (plastic coping 048.605, Straumann). Waxrings were added to the occlusal portion of thewaxed copings for attachment to the tensile testingdevice. The waxed patterns connected to plasticburn-out copings were sprued, invested, and castwith an alloy (Wiron 99, Bego), which contains 65%nickel, 22.5% chrome, 9.5% molybdenum, 1%niobium. Adhesive resin cement (Panavia F2.0,Kuraray, Osaka, Japan) was used for cementingthe casted crowns. Luting agents were mixedaccording to the manufacturer recommendations,and a thin layer was placed in the crowns, and theywere placed onto the abutments and held in placewith finger pressure for 10 seconds and were thenplaced under a 5 kg pressure for 10 minutes atroom temperature. Excess luting agent was re-moved with a cotton pellet.

After the cementation, the test specimens werestored in distilled water at 378C for 24 hours andthen thermocycled between 58C and 558C with 30-second dwell times for 5000 cycles. The acrylicblocks with the abutments were mounted in auniversal testing machine (Lloyd LRX, Lloyd Instru-ments PIC, Fareham, Hampshire, UK). Each speci-men was pulled from the abutment at a crossheadspeed of 0.5 cm/min, and the ultimate tensilestrength was recorded as Newton (Figure 4). Tensilebond strengths of the specimens were statisticallyanalyzed by one-way analysis of variance (ANOVA)and post-hoc Tukey tests (a ¼ .05).

To evaluate the effect of surface treatmentsmethods on abutments, 5 additional samples wereprepared. Four of the specimens were treated withthe same experimental protocol as describedpreviously. All specimens were coated with goldusing a sputter coater (S150B, Edwards, Crawley,UK) and examined under a field emission scanningelectron microscope (SEM) (CSM-6335F, JEOL, To-kyo, Japan) at 20 kV. The SEM photomicrographswere developed with 3250 magnification for visualinspection (Figure 5).

RESULTS

The results of one-way ANOVA (Table 2) indicatedthat the surface treatment methods affected theretention values significantly; the mean tensilebond strength values are presented in Table 3.The lowest tensile bond strength values wereobtained with group MS (223.26 6 14.30 N) andsignificantly differ from all other groups exceptgroup C. Group SB showed highest test results(506.02 6 18.04 N) and differs from other groups (P, .05). The test values that were obtained in groupMS-group C did not show significant differences (P. .05).

SEM images of treated implant abutmentsurfaces are shown in Figure 5. When comparedwith the control (Figure 5a), the laser-irradiatedabutment surfaces exhibited microcracks and mac-roretentive areas (Figure 5b). The sandblastedsurface of the implant abutment showed distinctirregularities (Figure 5c). The abutment surface thatis subjected to TiAlN coating showed smoothsurfaced (Figure 5d). Treatment with Silano-Pen(Figure 5e) did not change the superficial structurewhen compared with the control.

TABLE 1

Deposition parameters

Coating TiAlNSubstrate Ti implants

Bias voltages (�V) 100N2 pressures (mtorr) 0.3

Total working gas pressures (ArþN2) (mtorr) 1.8Target power (W) 3000

Coating time (min) 120Thickness of the coating (lm) 1.5


Kurt et al

DISCUSSION

Within the limitations of the present study, it can beconcluded that our hypothesis was particularlyconfirmed; the bond strengths between the abut-ments and the crown restorations were significantlyaffected by the investigated surface treatments,

except TiAlN coating.

The ITI solid abutment is a titanium color-coded

abutment with a distinctive nonrotational surfacecomprising one grooved and flat side. It is suppliedwith a prefabricated burn-out cap that snaps ontothe abutment and eliminates the need for diespacer. A 4-mm high solid abutment presented arelatively short, smooth surface. Various types of

intraoral forces and their combinations may inducehigh stress at the interface between an abutmentand cement layer, which results in crown dislodge-ment.7 Therefore, when short abutments were used

such as 4 mm high, an additional retention is

needed especially for single implant crown restora-

tions.

In the present study, the effect of surface

treatment performed on the solid abutment was

evaluated for its effect on the retention of short

abutments. It is well accepted that sandblasting

with alumina particles results in an increased

surface roughness and surface area. Kim et al7

stated that surface modification with either air-

borne-particle abrasion or treatment with a dia-

mond rotary cutting instrument would be an

effective way to improve retention when Temp-

Bond is used, and added that surface modifications

by airborne-particle abrasion and by treatment with

a diamond rotary cutting instrument would be

TABLE 2

One-way analysis of variance (ANOVA) results

Sum ofSquares df

Mean Square F Sig*

Between groups 553225.818 4 138306.454 211.470 .000Within groups 29431.014 45 654.023

Total 582656.832 49

*Sig indicates significance.

FIGURE 5. Scanning electron microscope view of the test groups. (a) Control. (b) Laser treated. (c) Sandblasted. (d) TiAlNcoated. (e) Flamed with Silano-Pen.

TABLE 3

Mean (Newton) and SD values of tensile bondstrength values

Group Surface Treatment Method Newton (6SD)*

C Control 249.41 (615.39) a

L Laser etched 315.14 (629.86) bSB Sandblasted 506.02 (618.04) c

MS TiAlN coated 223.26 (614.30) aSP Flamed with Silano-Pen 412.91 (640.15) d

*Values having same letters were not significantly differentfor post-hoc Tukey test (P . .05).



similarly effective for better retention. Similarly, weobserved that the sandblasting group showed thehighest bond strength values when compared withthe others.

Since the development of the ruby laser in 1960,lasers have become widely used in medicine anddentistry.25 The carbon dioxide (CO2) and Nd:YAGlasers are the most generally used instruments forboth intraoral soft tissue surgery and hard tissueapplications.26 By varying a number of parameters(pulse mode, irradiation time, frequency, andenergy outputs), several types of lasers have beenindicated for dental treatments.25,27,28 Murray et al29

indicated that laser treatment may be a suitablealternative to airborne-particle abrading or othersurface pretreatment techniques for enhancing thebond strength of dental materials to metal surfaces.

Gaggl et al30 reported that laser processing is anew method of treating implant surfaces toproduce a high degree of purity with adequatesurface roughness, in comparison with other surfacetreatments. Cho and Jung31 also demonstrated thatlaser etching is an effective method for producingan appropriate surface roughness for titanium. Itwas also reported that laser and electron-beamthermal treatments could be used for modificationof the microstructure of titanium surfaces withoutcontamination, providing optimal roughness; lasertreatment would be an effective method forproducing surface roughness without any contam-ination.30–32

In the present study, although the laser-treatedgroup showed higher values than the controlgroup, but lower values than the sandblasting andSilano-Pen groups, laser treatment could not createthe microretentive areas as sandblasting did.Although laser treatment has been pointed out asa promising technology in dentistry, there is stillneed of more research to determine appropriateparameters of laser treatment for application of thistechnology on dental materials.

In previous studies, TiN and TiAlN coatings wereused to enhance adhesion of porcelain veneer totitanium alloy19 and composite resin to gold,platinum, and silver alloy,16 and TiN coatingincreased bond strength of composite resin totitanium.16 TiAlN coatings show a number ofmechanical and technical characteristics (eg, highhardness, low wear, corrosion resistance, andoxidation resistance at high temperature). In

addition, the color of the TiAlN film can be modifiedby varying the composition. Thus, it has a potentialfor use in dental prostheses.17

Tanaka et al16 stated that TiN coating increasedthe bond strength of composite resin to Au-Pd-Agalloy due to the microscopic surface irregularities ofthe TiN coating. In the present study, it wasexpected that TiAlN coating would increase thebond strength values between abutment and resincement; however, this was not so as the lowestbond strength values were obtained with TiAlNcoating and no significant difference were observedbetween the TiAlN-treated group and the controlgroup. TiAlN coating created smooth surfaces(Figure 5d) that had negatively affected the micro-mechanical retention.

Results of this study demonstrated that theSilano-Pen–treated group showed higher bondstrength values than all groups, except the sand-blasting group. Silicoating with Silano-Pen (equiva-lent with the PyrosilPen) technology is fast andtrouble-free and is an effective surface treatmentmethod for achieving very good bond strengthbetween resin cements and restorative materials(metals and ceramics).21,22,33 Silano-Pen creates avery thin silicon dioxide-type layer on the alloy’ssurface by decomposing silanes during flaming.33 Itwas stated that heat application on metals andceramics increases surface hydroxyl groups.21,33

Tensile bond strength of the luting agent mustbe great enough to resist lateral and vertical forcesduring function.1 Polycarboxylate cements and so-called self-adhesive resins seem to be appropriateluting agents for permanent fixation because oftheir high retentive values.34 Crowns and fixedpartial dentures cemented on implant abutmentswith these kinds of cement will have a lower risk ofretention loss.35

When using smooth titanium implant abut-ments, the greater compressive strength of zincphosphate cements compared to polycarboxylateand zinc oxide cements probably does not play amajor role in providing retention.36 When choosingthe cement, the clinician should carefully evaluatethe height and the taper of the abutments, and alsobe aware of the relative retentive values of theavailable luting agents. The longer and moreparallel the abutments are, the less retentive thecement can be. In the presence of short, taperedabutments, zinc oxide cements should be avoided


Kurt et al

in favor of more retentive cements.5 When shortabutments are employed, a reduced convergenceangle is required to achieve adequate retention.Unfortunately, there are no indications of whichcement is the most indicated.5

In our study, the control group was not modifiedwith any treatment and therefore relatively smooth.This could have decreased cement abutment micro-mechanical interlocking, leading to decreasedcement retention values. In the present study, onetype of cement was used. Further investigations areneeded to evaluate the effect of different lutingcements.

Within the limitations of the present study, it canbe concluded that when short abutments have tobe used due to the limited interocclusal space, toincrease the retention of restorations, sandblastingis an effective method to increase bond strength.Also, Silano-Pen and laser application is advisablefor increasing the crown retention to abutments.Titanium aluminum nitride coating with magnetronsputtering technique seems to be ineffective.

ABBREVIATIONS

Al: aluminumAl2O3: alumina oxideAlN: aluminum nitrideANOVA: analysis of varianceCO2: carbon dioxideSEM: scanning electron microscopeTiAlN: titanium aluminum nitrideTiN: titanium nitride

REFERENCES

1. Ramp MH, Dixon DL, Ramp LC, Breeding LC, Barber LL.Tensile bond strengths of provisional luting agents used with animplant system. J Prosthet Dent. 1999;81:510–514.

2. Fiorellini JP, Martuscelli G, Weber HP. Longitudinal studiesof implant systems. Periodontol 2000. 1998;17:125–131.

3. Michalakis KX, Pissiotis AL, Hirayama H. Cement failureloads of 4 provisional luting agents used for the cementation ofimplant-supported fixed partial dentures. Int J Oral MaxillofacImplants. 2000;15:545–549.

4. Singer A, Serfaty V. Cement-retained implant-supportedfixed partial dentures: a 6-month to 3-year follow-up. Int J OralMaxillofac Implants. 1996;11:645–649.

5. Bresciano M, Schierano G, Manzella C, Screti A, Bignardi C,Preti G. Retention of luting agents on implant abutments ofdifferent height and taper. Clin Oral Implants Res. 2005;16:594–598.

6. Hebel KS, Gajjar RC. Cement-retained versus screw-retained implant restorations: achieving optimal occlusion andesthetics in implant dentistry. J Prosthet Dent. 1997;77:28–35.

7. Kim Y, Yamashita J, Shotwell JL, Chong KH, Wang HL. Thecomparison of provisional luting agents and abutment surfaceroughness on the retention of provisional implant-supportedcrowns. J Prosthet Dent. 2006;95:450–455.

8. Shiu P, De Souza-Zaroni WC, Eduardo Cde P, Youssef MN.Effect of feldspathic ceramic surface treatments on bond strengthto resin cement. Photomed Laser Surg. 2007;25:291–296.

9. Ferraris M, Verne E, Appendino P, et al. Coatings onzirconia for medical applications. Biomaterials. 2000;21:765–773.

10. Jevnikar P, Krnel K, Kocjan A, Funduk N, Kosmac T. Theeffect of nano-structured alumina coating on resin-bond strengthto zirconia ceramics. Dent Mater. 2010;26:688–696.

11. Lee KM, Cai Z, Griggs JA, Guiatas L, Lee DJ, Okabe T. SEM/EDS evaluation of porcelain adherence to gold-coated casttitanium. J Biomed Mater Res B Appl Biomater. 2004;68:165–173.

12. Ruddell DE, Thompson JY, Stoner BR. Mechanical proper-ties of a dental ceramic coated by RF magnetron sputtering. JBiomed Mater Res. 2000;51:316–320.

13. Wang RR, Welsch GE, Monteiro O. Silicon nitride coating ontitanium to enable titanium-ceramic bonding. J Biomed Mater Res.1999;46:262–270.

14. Zhang S, Kocjan A, Lehmann F, Kosmac T, Kern M.Influence of contamination on resin bond strength to nano-structured alumina-coated zirconia ceramic. Eur J Oral Sci. 2010;118:396–403.

15. Paital S, Dahotre N. Calcium phosphate coatings for bio-implant applications: materials, performance factors, and method-ologies. Materials Science and Engineering: R: Reports. 2009;66:1–70.

16. Tanaka K, Kimoto K, Sawada T, Toyoda M. Shear bondstrength of veneering composite resin to titanium nitride coatingalloy deposited by radiofrequency sputtering. J Dent. 2006;34:277–282.

17. Liu G, Duh J, Chung K, Wang J. Mechanical characteristicsand corrosion behavior of (Ti, Al)N. Surface and CoatingsTechnology. 2005;200:2100–2105.

18. Tek Z, Gugor M, Cal E, Sonugelen M, Artunc C, Oztarhan A.A study of the mechanical properties of TiN coating of Cr–Ni alloy.Surface and Coatings Technology. 2005;196:317–320.

19. Chung KH, Duh JG, Shin D, Cagna DR, Cronin RJ Jr.Characteristics and porcelain bond strength of (Ti, Al)N coating ondental alloys. J Biomed Mater Res. 2002;63:516–521.

20. Matinlinna JP, Vallittu PK. Silane based concepts onbonding resin composite to metals. J Contemp Dent Pract. 2007;8:1–8.

21. Janda R, Roulet JF, Wulf M, Tiller HJ. Resin/resin bonding: anew adhesive technology. J Adhes Dent. 2002;4:299–308.

22. Ozcan M, Nijhuis H, Valandro LF. Effect of various surfaceconditioning methods on the adhesion of dual-cure resin cementwith MDP functional monomer to zirconia after thermal aging. DentMater J. 2008;27:99–104.

23. Akca K, Iplikcioglu H, Cehreli MC. Comparison of uniaxialresistance forces of cements used with implant-supported crowns.Int J Oral Maxillofac Implants. 2002;17:536–542.

24. Covey DA, Kent DK, St Germain HA Jr, Koka S. Effects ofabutment size and luting cement type on the uniaxial retentionforce of implant-supported crowns. J Prosthet Dent. 2000;83:344–348.

25. Kim JT, Cho SA. The effects of laser etching on shear bondstrength at the titanium ceramic interface. J Prosthet Dent. 2009;101:101–106.

26. Convissar RA, Goldstein EE. A combined carbon dioxide/erbium laser for soft and hard tissue procedures. Dent Today. 2001;20:66–71.

27. Gurgan S, Alpaslan T, Kiremitci A, Cakir FY, Yazici E, GorucuJ. Effect of different adhesive systems and laser treatment on theshear bond strength of bleached enamel. J Dent. 2009;37:527–534.



28. Van Meerbeek B, De Munck J, Mattar D, Van Landuyt K,

Lambrechts P. Microtensile bond strengths of an etch&rinse and

self-etch adhesive to enamel and dentin as a function of surface

treatment. Oper Dent. 2003;28:647–660.

29. Murray AK, Attrill DC, Dickinson MR. The effects of XeCl

laser etching of Ni-Cr alloy on bond strengths to composite resin: a

comparison with sandblasting procedures. Dent Mater. 2005;21:

538–544.

30. Gaggl A, Schultes G, Muller WD, Karcher H. Scanning

electron microscopical analysis of laser-treated titanium implant

surfaces—a comparative study. Biomaterials. 2000;21:1067–1073.

31. Cho SA, Jung SK. A removal torque of the laser-treated

titanium implants in rabbit tibia. Biomaterials. 2003;24:4859–4863.

32. Wagner WC. A brief introduction to advanced surfacemodification technologies. J Oral Implantol. 1992;18:231–235.

33. Janda R, Roulet JF, Latta M, Damerau G. Spark erosion as ametal-resin bonding system. Dent Mater. 2007;23:193–197.

34. Wolfart M, Wolfart S, Kern M. Retention forces and seatingdiscrepancies of implant-retained castings after cementation. Int JOral Maxillofac Implants. 2006;21:519–525.

35. Mehl C, Harder S, Wolfart M, Kern M, Wolfart S.Retrievability of implant-retained crowns following cementation.Clin Oral Implants Res. 2008;19:1304–1311.

36. Mansour A, Ercoli C, Graser G, Tallents R, Moss M.Comparative evaluation of casting retention using the ITI solidabutment with six cements. Clin Oral Implants Res. 2002;13:343–348.


Kurt et al

The Effect of Different Surface Treatments on Cement-Retained Implant-Supported Restorations

Documents

Transcript of The Effect of Different Surface Treatments on Cement-Retained Implant-Supported Restorations