A influência do uso de dois tipos diferentes de munhão na quantidade de cimento na região periimplantar

Abstract

The present study aims to evaluate whether the use of a personalized abutment is capable of facilitating the removal of cement excess after implant prosthesis cementation at different cementation depths when compared to a universal abutment. 60 plaster models were made with 30 universal abutment analogs and 30 morse cone analogs fixed in type IV plaster surrounded by flexible artificial gums. The models were divided into 6 groups (n = 10): three groups with universal abutment installed at three depths (GU1 = 1 mm; GU2 = 2 mm; GU3 = 3 mm) of the cementation line from the buccal margin. In the other 3 groups, Morse cone analogues with a depth of 5 mm were installed; then EUCLAs were waxed and cast to make personalized abutment with 3 depths (GP1 = 1 mm; GP2 = 2 mm; GP3 = 3 mm) cementation from the gingival margin. Metal crowns were made and polished, then cemented and cement excess was removed. After one day the crown/abutment sets were removed from the cast models for analysis. Images of the 4 faces of the specimens (mesial, distal, buccal and palatal) were obtained and then the cement presente on the faces was measured in mm² using the AxioCam Erc 5s software. All procedures were performed by a single operator. Intra-examiner agreement analysis was performed by intraclass correlation test and Bland-Altman plot in a random sample of 30% of the images obtained. Data normality analysis was performed by Shapiro Wilk test. Due to the non-parametric data distribution, Mann-Whitney (p <0.05) and Kruskall-Wallis (p <0.05) tests were applied.Finally, a linear regression analysis was performed, with the dependent variable being the sum of the excess cement on all faces with a significance level of p = 0.05. The intraclass correlation test showed values greater than 90% in all replicated measures. All specimens showed cement excess. The personalized group (GP) presented higher amounts of cement on all faces (p <0.005), except the buccal face. Regarding the different cementation depths, the GP presented a significant increase of cement excess according to the increase of the cementation line depth, while in GU this increase was not statistically significant (p> 0.05). Linear regression indicates that the type of component had a greater influence on the total amount of cement excess in relation to the cementation depth. Given the limitations of the present in vitro study, it was possible to conclude that the excess cement removal procedure in PSI is a sensitive technique when the margins are subgingival. Despite its anatomical design, the personalized abutment did not facilitate the removal of excess cement. In cases where cemented prostheses are the option of choice, it is indicated that the cementation margin should be gingival and that the universal abutment should be used.