Corresponding Author: Dr. Kwok-Hung Chung, Department of Restorative Dentistry, University of Washington School of Dentistry, 1959 NE Pacific Street, D-770 HSC, Box 357456, Seattle, WA 98195-7456, USA; e-mail: [email protected]Search for more papers by this author

Chandur Wadhwani BDS, MSD,

Chandur Wadhwani BDS, MSD

Instructor

Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA

Search for more papers by this author

Sabine Goodwin MS,

Sabine Goodwin MS

senior engineer

Technical Marketing, CD-adapco, Marietta, GA, USA

Search for more papers by this author

Kwok-Hung Chung DDS, PhD,

Corresponding Author

Kwok-Hung Chung DDS, PhD

professor

Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA

First published: 05 September 2014

https://doi.org/10.1111/cid.12258

Citations: 21

Share a link

Email
Wechat
Bluesky

Abstract

Background

Cementing restorations to implants is a widely used clinical procedure. Little is known about the dynamics of this process. Using a systems approach and advanced computing software modeling this can be investigated virtually. These models require validation against real-life models.

Purpose

The study aims to consider the system effect of a crown, abutment, and cement flow under different conditions and comparing real physical models to virtual computer simulations.

Materials and Methods

A physical model of implant abutments and crowns provided three groups according to abutment screw access modification (n = 9): open (OA), closed (CA), and internal vented (IVA) abutment groups. Crowns were cemented using standardized amounts and site application. Proportion of cement retained within the crown–abutment system was recorded and compared. Differences among groups were identified using analysis of variance (ANOVA) with Tukey's post hoc test (α ≤ 0.05). Three-dimensional multiphysics numerical stimulation software (STAR-CCM+, CD-adapco) with computational fluid dynamics (CFD) approach was applied to a virtual model system of a scanned abutment and crown system. Three-dimensional real-time model simulations of cement and air displacement were produced, evaluating cement application site, speed of crown seating, and abutment modifications.

Results

Statistically significant differences in cement retained within the system (p < 0.01) were found among the IVA > OA > OCA abutment groups. The CFD virtual simulations followed this trend. Site application and speed of seating also affected cement extrusion and cement marginal infill. Fast crown seating and occlusal cement site application produced air incorporation at the margins.

Conclusions

The CFD approach provides a convenient way to evaluate crown–cement–implant abutment systems with respect to cement flow. Preliminary evaluation indicates that the results achieved follow those of a physical actual cement-retained crown–implant abutment study.

References

1Ericcsson I, Lindhe J. Probing depth at implants and teeth. An experimental study in the dog. J Clin Periodontol 1993; 20: 623–627.
10.1111/j.1600-051X.1993.tb00706.x
PubMed Google Scholar
2Stern IB. Current concepts of the dentogingival junction: the epithelial and connective tissue attachments to the tooth. J Periodontol 1981; 52: 465–476.
10.1902/jop.1981.52.9.465
CAS PubMed Web of Science® Google Scholar
3James RA, Schultz RL. Hemidesmosomes and the adhesion of the junctional epithelial cells to metal implants – a preliminary report. Oral Implantol 1974; 4: 294–302.
PubMed Google Scholar
4Buser D, Weber HP. Soft tissue reactions to non-submerged unloaded titanium implants in beagle dogs. J Periodontol 1992; 63: 225–235.
10.1902/jop.1992.63.3.225
CAS PubMed Web of Science® Google Scholar
5Akagawa Y, Takata T, Matsumoto T, Nikai H, Tsuru H. Correlation between clinical and histological evaluations of the peri-implant gingiva around the single-crystal sapphire endosseous implant. J Oral Rehabil 1989; 16: 581–587.
10.1111/j.1365-2842.1989.tb01381.x
PubMed Web of Science® Google Scholar
6Schroeder A, van der Zypen E, Stich H, Sutter F. The reactions of bone, connective tissue, and epithelium to endosteal implants with titanium-sprayed surfaces. J Maxillofac Surg 1981; 9: 15–25.
10.1016/S0301-0503(81)80007-0
CAS PubMed Web of Science® Google Scholar
7Hansson HA, Albrektsson T, Brånemark P. Structural aspects of the interface between tissue and titanium implants. J Prosthet Dent 1983; 50: 108–113.
10.1016/0022-3913(83)90175-0
CAS PubMed Web of Science® Google Scholar
8Hermann JS, Buser D, Schenk RK, Schoolfield JD, Cochran DL. Biologic width around one- and two-piece titanium implants. Clin Oral Implants Res 2001; 12: 559–571.
10.1034/j.1600-0501.2001.120603.x
CAS PubMed Web of Science® Google Scholar
9Wadhwani C, Hess T, Pineyro A, Opler R, Chung K-H. Cement application techniques in luting implant-supported crowns: a quantitative and qualitative survey. Int J Oral Maxillofac Implants 2012; 27: 859–864.
PubMed Web of Science® Google Scholar
10Rosenstiel SF, Land MF, Crispin BJ. Dental luting agents: a review of the current literature. J Prosthet Dent 1998; 80: 280–301.
10.1016/S0022-3913(98)70128-3
CAS PubMed Web of Science® Google Scholar
11Tarica DY, Alvarado VM, Troung ST. Survey of United States dental schools on cementation protocols for implant crown restoration. J Prosthet Dent 2010; 103: 68–79.
10.1016/S0022-3913(10)00016-8
PubMed Web of Science® Google Scholar
12Wadhwani C, Schwedhelm R. The role of cements in dental implant success, Part 1. Dent Today 2013; 32: 74–79.
PubMed Google Scholar
13 American Academy of Periodontology. Peri-implant mucositis and peri-implantitis: a current understanding of their diagnoses and clinical implications. J Periodontol 2013; 84: 436–643.
10.1902/jop.2013.134001
PubMed Web of Science® Google Scholar
14Hebel KS, Gajjar R. Cement-retained versus screw-retained implant restorations: achieving optimal occlusion and esthetics in implant dentistry. J Prosthet Dent 1997; 77: 28–35.
10.1016/S0022-3913(97)70203-8
CAS PubMed Web of Science® Google Scholar
15Taylor TD, Agar JR. Twenty years of progress in implant prosthodontics. J Prosthet Dent 2002; 88: 89–95.
10.1067/mpr.2002.126818
PubMed Web of Science® Google Scholar
16Beun S, Bailly C, Devaux J, Leloup G. Rheological properties of flowable resin composites and pit and fissure sealants. Dent Mater 2008; 24: 548–555.
10.1016/j.dental.2007.05.019
CAS PubMed Web of Science® Google Scholar
17Wadhwani CP, Chung KH. The role of cements in dental implant success, Part 2. Dent Today 2013; 32: 46–51.
PubMed Google Scholar
18Arvand A, Hormes M, Reul H. A validated computational fluid dynamics model to estimate hemolysis in a rotary blood pump. Artif Organs 2005; 29: 531–540.
10.1111/j.1525-1594.2005.29089.x
CAS PubMed Web of Science® Google Scholar
19Tokuda Y, Song MH, Ueda Y, et al. Three-dimensional numerical simulation of blood flow in the aortic arch during cardiopulmonary bypass. Eur J Cardiothorac Surg 2008; 33: 164–167.
10.1016/j.ejcts.2007.11.021
PubMed Web of Science® Google Scholar
20Boutsioukis C, Lambrianidis T, Kastrinakis E. Irrigant flow within a prepared root canal using various flow rates: a computational fluid dynamics study. Int Endod J 2009; 42: 144–155.
10.1111/j.1365-2591.2008.01503.x
CAS PubMed Web of Science® Google Scholar
21Gao Y, Haapasalo M, Shen Y, et al. Development and validation of a three-dimensional computational fluid dynamics model of root canal irrigation. J Endod 2009; 35: 1282–1287.
10.1016/j.joen.2009.06.018
PubMed Web of Science® Google Scholar
22Snjaric D, Carija Z, Braut A, Halaji A, Kovacevic M, Kuis D. Irrigation of human prepared root canal–ex vivo based computational fluid dynamics analysis. Croat Med J 2012; 53: 470–479.
10.3325/cmj.2012.53.470
PubMed Web of Science® Google Scholar
23Moráguez OD, Belser UC. The use of polytetrafluoroethylene tape for the management of screw access channels in implant-supported prostheses. J Prosthet Dent 2010; 103: 189–191.
10.1016/S0022-3913(10)60029-7
CAS PubMed Web of Science® Google Scholar
24Patel D, Invest JCF, Tredwin CJ, Setchell DJ, Moles DR. An analysis of the effect of a vent hole on excess cement expressed at the crown-abutment margin for cement-retained implant crowns. J Prosthodont 2009; 18: 54–59.
10.1111/j.1532-849X.2008.00374.x
CAS PubMed Web of Science® Google Scholar
25Wadhwani C, Piñeyro A, Hess T, Zhang H, Chung KH. Effect of implant abutment modification on the extrusion of excess cement at the crown-abutment margin for cement-retained implant restorations. Int J Oral Maxillofac Implants 2011; 26: 1241–1246.
PubMed Web of Science® Google Scholar
26Oliva RA, Lowe JA, Ozaki MM. Film thickness measurements of a paint-on die spacer. J Prosthet Dent 1988; 60: 180–184.
10.1016/0022-3913(88)90312-5
CAS PubMed Web of Science® Google Scholar
27Wiskott HWA, Belser UC, Scherrer SS. The effect of film thickness and surface texture on the resistance of cemented extracoronal restorations to lateral fatigue loading. Int J Prosthodont 1999; 12: 255–262.
CAS PubMed Web of Science® Google Scholar
28Brezzi F, Lipnikov K, Simoncini V. A family of mimetic finite difference methods on polygonal and polyhedral meshes. Math Models Methods Appl Sci 2005; 15: 1533–1553.
10.1142/S0218202505000832
Web of Science® Google Scholar
29Hirt CW, Nichols BD. Volume of fluid (VOF) method for the dynamics of free boundaries. J Comput Phys 1981; 39: 201–225.
10.1016/0021-9991(81)90145-5
Web of Science® Google Scholar
30Tang HS, Kalyon DM. Estimation of the parameters of Herschel–Bulkley fluid under wall slip using a combination of capillary and squeeze flow viscometers. Rheol Acta 2004; 43: 80–88.
10.1007/s00397-003-0322-y
CAS Web of Science® Google Scholar
31Assif D, Rimer Y, Aviv I. The flow of zinc phosphate cement under a full-coverage restoration and its effect on marginal adaptation according to the location of cement application. Quintessence Int 1987; 18: 765–774.
CAS PubMed Google Scholar
32Cardoso M, Torres MF, Rego MR, Santiago LC. Influence of application site of provisional cement on the marginal adaptation of provisional crowns. J Appl Oral Sci 2008; 16: 214–218.
10.1590/S1678-77572008000300010
PubMed Web of Science® Google Scholar
33Tarica DY, Alvarado VM, Truong ST. Survey of United States dental schools on cementation protocols for implant crown restorations. J Prosthet Dent 2010; 103: 68–79.
10.1016/S0022-3913(10)00016-8
PubMed Web of Science® Google Scholar
34Wadhwani C, Hess T, Pineyro A, Chung KH. Effects of abutment and screw access channel modification on dislodgement of cement-retained implant-supported restorations. Int J Prosthodont 2013; 26: 54–56.
10.11607/ijp.3069
PubMed Web of Science® Google Scholar
35Lee JH, Ulm CM, Lee IB. Rheological properties of resin composites according to variations in monomer and filler composition. Dent Mater 2006; 22: 515–526.
10.1016/j.dental.2005.05.008
CAS PubMed Web of Science® Google Scholar
36Beun S, Bailly C, Dabin A, Vreven J, Devaux J, Leloup G. Rheological properties of experimental Bis-GMA/TEGDMA flowable resin composites with various macrofiller/microfiller ratio. Dent Mater 2009; 25: 198–205.
10.1016/j.dental.2008.06.001
CAS PubMed Web of Science® Google Scholar

Citing Literature

Volume18, Issue1

February 2016

Pages 97-106

Cementing an Implant Crown: A Novel Measurement System Using Computational Fluid Dynamics Approach

Abstract

Background

Purpose

Materials and Methods

Results

Conclusions

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley