Microleakage assessment of CAD-CAM Cobalt-Chrome and Zirconia abutments on a conical connection dental implant: A comparative in vitro study

Abstract

Objective: To assess the marginal and bacterial microleakage in zirconia and CAD-CAM or cast Co-Cr implant abutments.

Methods: Sixty-four conical connection implants with their respective abutments were divided into four groups (Co-Cr (milled, laser-sintered, and cast) and Zirconia (milled)). All specimens were subjected to a chewing simulation and thermocycling. After aging process, specimens were submerged in a 0.2% methylene blue solution with Porphyromonas gingivalis (P.g) for 48 h. The marginal microleakage was measured using a 40× optical microscopy at the internal part of the implant, and when positive microleakage was observed, a DNA isolation with a polymerase chain reaction (PCR) test was used. The microbiological assessment was based on colony forming units (CFUs).

Results: Thirty (47%) implant-abutments presented microleakage and the PCR was performed on those specimens (1 Zirconia, 1 Co-Cr milled, 14 Co-Cr laser-sintered and 14 cast). Seven specimens (1 Co-Cr laser-sintered and six cast) presented values below the PCR detection limit (< 100 CFUs). The lowest CFUs count occurred in the Co-Cr milled group (5.17E+02 CFUs/ml) followed by zirconia (7.70E+03 CFUs/ml). The Co-Cr cast (9.39E+03 CFUs/ml) and laser-sintered (2.4E+05 CFUs/ml) groups had higher bacterial count. The CFU count comparison performed between Co-Cr cast and laser-sintered resulted in a statistically significant differences in favor of Co-CrCL (p < .05).

Conclusions: The abutment material and fabrication technique affected the implant-abutment microleakage. Although the CAD-CAM abutments presented favorable results, all tested groups presented microleakage.

Keywords: dental implant abutment connection; dental implant abutment design; dental implants; implant supported dental prosthesis; microleakage; polymerase chain reaction.