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Journal of Prosthetic Dentistry

Marginal fit and microbial leakage along the implant-abutment interface of fixed partial prostheses: An in vitro analysis using Checkerboard DNA-DNA hybridization

Published:September 07, 2015DOI:https://doi.org/10.1016/j.prosdent.2015.05.009

      Abstract

      Statement of problem

      Bidirectional leakage through the implant-abutment interface still constitutes a major concern in implant-supported restorations.

      Purpose

      The purpose of this in vitro study was to evaluate the marginal fit, before and after loading simulation, of 3-unit fixed partial prostheses supported by external hexagon or Morse cone implants and to identify and quantify up to 43 microbial species penetrating through the implant-abutment interface after loading.

      Material and methods

      Forty-eight dental implants with external hexagon (EH; n=24) or Morse cone (MC; n=24) connections were investigated. Experimental specimens were made from 2 implants restored with a 3-unit fixed partial prosthesis and divided into 2 groups (n=12) according to platform connection EH or MC. Vertical misfit at the implant-abutment interface was measured before and after loading (150 Ncm during 500 000 cycles at 1.8 Hz). checkerboard DNA-DNA hybridization was used to identify and quantify up to 38 bacterial and 5 Candida species colonizing the internal parts of the implants after loading. Generalized estimating equations were used for statistical analysis (α=.05).

      Results

      The mean values (mm, ±SD) of vertical misfit for EH were 0.0131 ±0.002 before loading and 0.0138 ±0.002 after loading and for MC were 0.0132 ±0.003 before loading and 0.0137 ±0.001 after loading. Twenty-one bacterial species, including periodontal pathogens and C. albicans, were found colonizing the inner surfaces of EH implants after loading. None of the target species were detected in the internal parts of MC implants.

      Conclusions

      EH implants showed higher microbial counts than MC implants, in which microbial colonization was not found after loading. Detected species included nonpathogens and microorganisms related to periodontal/periimplant diseases. Further studies are needed to evaluate the effect of loading simulation on the marginal misfit of 3-unit fixed partial prostheses supported by EH or MC implants, because no significant differences could be found either before or after loading.
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      References

        • Dias E.C.
        • Bisognin E.D.
        • Harari N.D.
        • Machado S.J.
        • da Silva C.P.
        • Soares G.D.
        • et al.
        Evaluation of implant-abutment microgap and bacterial leakage in five external-hex implant systems: an in vitro study.
        Int J Oral Maxillofac Implants. 2012; 27: 346-351
        • Gracis S.
        • Michalakis K.
        • Vigolo P.
        • Vult von Steyern P.
        • Zwahlen M.
        • Sailer I.
        Internal vs. external connections for abutments/reconstructions: a systematic review.
        Clin Oral Implants Res. 2012; 23: 202-216
        • Pimentel A.C.
        • Manzi M.R.
        • Sartori S.G.
        • da Graça Naclerio-Homem M.
        • Sendyk W.R.
        In vivo effectiveness of silicone gel sheets as barriers at the inner microgap between a prosthetic abutment and an external-hexagon implant platform.
        Int J Oral Maxillofac Implants. 2014; 29: 121-126
        • Ramos M.B.
        • Pegoraro L.F.
        • Takamori E.
        • Coelho P.G.
        • Silva T.L.
        • Bonfante E.A.
        Evaluation of UCLA implant-abutment sealing.
        Int J Oral Maxillofac Implants. 2014; 29: 113-120
        • Koutouzis T.
        • Neiva R.
        • Nonhoff J.
        • Lundgren T.
        Placement of implants with platform-switched Morse taper connections with the implant-abutment interface at different levels in relation to the alveolar crest: a short-term (1-year) randomized prospective controlled clinical trial.
        Int J Oral Maxillofac Implants. 2013; 28: 1553-1563
        • Jung U.W.
        • Choi J.Y.
        • Kim C.S.
        • Cho K.S.
        • Chai J.K.
        • Kim C.K.
        • et al.
        Evaluation of mandibular posterior single implants with two different surfaces: a 5-year comparative study.
        J Periodontol. 2008; 79: 1857-1863
        • Lang N.P.
        • Pjetursson B.E.
        • Tan K.
        • Bragger U.
        • Egger M.
        • Zwahlen M.
        A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. II. Combined tooth–implant-supported FPDs.
        Clin Oral Implants Res. 2004; 15: 643-653
        • Romeo E.
        • Lops D.
        • Margutti E.
        • Ghisolfi M.
        • Chiapasco M.
        • Vogel G.
        Long-term survival and success of oral implants in the treatment of full and partial arches: a 7-year prospective study with the ITI dental implant system.
        Int J Oral Maxillofac Implants. 2004; 19: 247-259
        • Chuang S.K.
        • Wei L.J.
        • Douglass C.W.
        • Dodson T.B.
        Risk factors for dental implant failure: a strategy for the analysis of clustered failure-time observations.
        J Dent Res. 2002; 81: 572-577
        • Nedir R.
        • Bischof M.
        • Szmukler-Moncler S.
        • Bernard J.P.
        • Samson J.
        Predicting osseointegration by means of implant primary stability.
        Clin Oral Implants Res. 2004; 15: 520-528
        • Turkyilmaz I.
        A comparison between insertion torque and resonance frequency in the assessment of torque capacity and primary stability of Branemark system implants.
        J Oral Rehabil. 2006; 33: 754-759
        • Sakka S.
        • Baroudi K.
        • Nassani M.Z.
        Factors associated with early and late failure of dental implants.
        J Invest Clin Dent. 2012; 3: 258-261
        • Kronstrom M.
        • Svenson B.
        • Hellman M.
        • Persson G.R.
        Early implant failures in patients treated with Branemark System titanium dental implants: a retrospective study.
        Int J Oral Maxillofac Implants. 2001; 16: 201-207
        • Shibli J.A.
        • Melo L.
        • Ferrari D.S.
        • Figueiredo L.C.
        • Faveri M.
        • Feres M.
        Composition of supra- and subgingival biofilm of subjects with healthy and diseased implants.
        Clin Oral Implants Res. 2008; 19: 975-982
        • Lindhe J.
        • Meyle J.
        Peri-implant diseases: consensus report of the sixth European workshop on periodontology.
        J Clin Periodontol. 2008; 35: 282-285
        • Teixeira W.
        • Ribeiro R.F.
        • Sato S.
        • Pedrazzi V.
        Microleakage into and from two-stage implants: an in vitro comparative study.
        Int J Oral Maxillofac Implants. 2011; 26: 56-62
        • do Nascimento C.
        • Miani P.K.
        • Watanabe E.
        • Pedrazzi V.
        • de Albuquerque Jr., R.F.
        In vitro evaluation of bacterial leakage along the implant-abutment interface of an external-hex implant after saliva incubation.
        Int J Oral Maxillofac Implants. 2011; 26: 782-787
        • Binon P.
        • Weir D.
        • Watanabe L.
        • Walker L.
        Implant component compatibility.
        in: Laney W.R. Tolman D.E. Tissue integration in oral orthopedic and maxillofacial reconstruction. Quintessence, Chicago1992: 218-226
        • Hamilton A.
        • Judge R.B.
        • Palamara J.E.
        • Evans C.
        Evaluation of the fit of CAD/CAM abutments.
        Int J Prosthodont. 2013; 26: 370-380
        • Sumi T.
        • Braian M.
        • Shimada A.
        • Shibata N.
        • Takeshita K.
        • Vandeweghe S.
        • et al.
        Characteristics of implant-CAD/CAM abutment connections of two different internal connection systems.
        J Oral Rehabil. 2012; 39: 391-398
        • Jemt T.
        • Book K.
        Prosthesis misfit and marginal bone loss in edentulous implant patients.
        Int J Oral Maxillofac Implants. 1996; 11: 620-625
        • Kosyfaki P.
        • del Pilar Pinilla Martín M.
        • Strub J.R.
        Relationship between crowns and the periodontium: a literature update.
        Quintessence Int. 2010; 41: 109-126
        • Boeckler A.F.
        • Stadler A.
        • Setz J.M.
        The significance of marginal gap and overextension measurement in the evaluation of the fit of complete crowns.
        J Contemp Dent Pract. 2005; 15: 26-37
        • Rosenberg E.S.
        • Cho S.C.
        • Elian N.
        • Jalbout Z.N.
        • Froum S.
        • Evian C.I.
        A comparison of characteristics of implant failure and survival in periodontally compromised and periodontally healthy patients: a clinical report.
        Int J Oral Maxillofac Implants. 2004; 19: 873-879
        • Gil F.J.
        • Rodriguez A.
        • Espinar E.
        • Llamas J.M.
        • Padullés E.
        • Juárez A.
        Effect of oral bacteria on the mechanical behaviour of titanium dental implants.
        Int J Oral Maxillofac Implants. 2012; 27: 64-68
        • Pozzi A.
        • Mura P.
        Clinical and radiologic experience with moderately rough oxidized titanium implants: up to 10 years of retrospective follow-up.
        Int J Oral Maxillofac Implants. 2014; 29: 152-161
        • Roos-Jansaker A.M.
        • Lindahl C.
        • Renvert H.
        • Renvert S.
        Nine- to fourteen-year follow-up of plant treatment. Part I: Implant loss and associations to various factors.
        J Clin Periodontol. 2006; 33: 283-289
        • Steinebrunner L.
        • Wolfart S.
        • Bossmann K.
        • Kern M.
        In vitro evaluation of bacterial leakage along the implant-abutment interface of different implant systems.
        Int J Oral Maxillofac Implants. 2005; 20: 875-881
        • do Nascimento C.
        • Miani P.K.
        • Pedrazzi V.
        • Gonçalves R.B.
        • Ribeiro R.F.
        • Faria A.C.
        • et al.
        Leakage of saliva through the implant-abutment interface: in vitro evaluation of three different implant connections under unloaded and loaded conditions.
        Int J Oral Maxillofac Implants. 2012; 27: 551-560
        • Coelho A.L.
        • Suzuki M.
        • Dibart S.
        • Da Silva N.
        • Coelho P.G.
        Cross-sectional analysis of the implant-abutment interface.
        J Oral Rehabil. 2007; 34: 508-516
        • Assenza B.
        • Tripodi D.
        • Scarano A.
        • Perrotti V.
        • Piattelli A.
        • Iezzi G.
        • et al.
        Bacterial leakage in implants with different implant-abutment connections: an in vitro study.
        J Periodontol. 2012; 83: 491-497
        • Silva-Neto J.P.
        • Prudente M.S.
        • Carneiro Tde A.
        • Nóbilo M.A.
        • Penatti M.P.
        • Neves F.D.
        Micro-leakage at the implant-abutment interface with different tightening torques in vitro.
        J Appl Oral Sci. 2012; 20: 581-587
        • Jaworski M.E.
        • Melo A.C.
        • Picheth C.M.
        • Sartori I.A.
        Analysis of the bacterial seal at the implant-abutment interface in external-hexagon and Morse taper-connection implants: an in vitro study using a new methodology.
        Int J Oral Maxillofac Implants. 2012; 27: 1091-1095
        • Baggi L.
        • Di Girolamo M.
        • Mirisola C.
        • Calcaterra R.
        Microbiological evaluation of bacterial and mycotic seal in implant systems with different implant-abutment interfaces and closing torque values.
        Implant Dent. 2013; 22: 344-350
        • Strub J.R.
        • Jurdzik B.A.
        • Tuna T.
        Prognosis of immediately loaded implants and their restorations: a systematic literature review.
        J Oral Rehabil. 2012; 39: 704-717
        • Bal B.T.
        • Caglar A.
        • Aydin C.
        • Yilmaz H.
        • Bankoglu M.
        • Eser A.
        Finite element analysis of stress distribution with splinted and nonsplinted maxillary anterior fixed prostheses supported by zirconia or titanium implants.
        Int J Oral Maxillofac Implants. 2013; 28: 27-38
        • Kan J.Y.K.
        • Rungcharassaeng K.
        • Bohsali K.
        • Goodacre C.J.
        • Lang B.R.
        Clinical methods for evaluating implant framework fit.
        J Prosthet Dent. 1999; 81: 7-13
        • Richter E.J.
        In vivo vertical forces on implants.
        Int J Oral Maxillofac Implants. 1995; 10: 99-108
        • Socransky S.S.
        • Smith C.
        • Martin L.
        • Paster B.J.
        • Dewhirst F.E.
        • Levin A.E.
        “Checkerboard” DNA-DNA hybridization.
        Biotechniques. 1994; 17: 788-792
        • do Nascimento C.
        • de Albuquerque Jr., R.F.
        • Monesi N.
        • Candido-Silva J.A.
        Alternative method for direct DNA probe labeling and detection using the checkerboard hybridization format.
        J Clin Microbiol. 2010; 48: 3039-3040
        • Bhering C.L.
        • Takahashi J.M.
        • Luthi L.F.
        • Henriques G.E.
        • Consani R.L.
        • Mesquita M.F.
        Influence of the casting technique and dynamic loading on screw detorque and misfit of single unit implant-supported prostheses.
        Acta Odontol Scand. 2013; 71: 404-409
        • Jorge J.R.
        • Barao V.A.
        • Delben J.A.
        • Assuncao W.G.
        The role of implant/abutment system on torque maintenance of retention screws and vertical misfit of implant-supported crowns before and after mechanical cycling.
        Int J Oral Maxillofac Implants. 2013; 28: 415-422
        • Jesus Tavarez R.R.
        • Bonachela W.C.
        • Xible A.A.
        Effect of cyclic load on vertical misfit of prefabricated and cast implant single abutment.
        J Appl Oral Sci. 2011; 19: 16-21
        • Loyola-Rodriguez J.P.
        • Morisaki I.
        • Kitamura K.
        • Hamada S.
        Purification and properties of extracellular mutacin, a bacteriocin from Streptococcus sobrinus.
        J Gen Microbiol. 1992; 138: 269-274