Retentive strength of CAD/CAM-fabricated all-ceramic crowns luted on titanium implant abutments using different ceramic materials and luting agents.

Abstract Objectives. This study aimed to determine the retentive strength of monolithic hybrid-all-ceramic crowns luted on titanium implant abutments. Material and Methods. In total, 450 crowns (75 each of Mark II, Empress CAD, e.max CAD, Suprinity, Enamic, Celtra Duo) were milled using a CAD/CAM system. The crowns were cemented onto sandblasted titanium implant abutments using five luting agents (Multilink Implant, Variolink II, RelyX Unicem, Fujicem, and Panavia 2.0). After thermocycling, the crowns were removed using a universal testing machine. The location of luting-agent residue on the abutment and inner crown surfaces was evaluated. Analyses of variance (ANOVA) with the Bonferroni correction were performed to evaluate differences of retentive strength depending on the crown material and the kind of the luting agent. Results. The retentive strength for the different ceramic materials were Vita Mark II: 652N-759N (SD:134N-146N), Empress CAD: 681N-822N (SD: 89N-146N), e.max CAD: 784N-1044N (SD: 109N-176N), Vita Enamic: 716N-1177N (SD: 132N-220N), Vita Suprinity: 867N-1488N (SD: 202N-278N) and Celtra Duo 772N-1335N (SD:151N-229N). After the removal trials, the visual documentation showed different adhesive residue location depending on the ceramic materials. Furthermore, the pull-off force was dependent on the choice of adhesives Conclusions. The ceramic material used seems to influence the retentive strength and the use of certain luting agents result for some ceramic materials in a higher retentive strength.