Advertisement
Journal of Prosthetic Dentistry

Evaluation of a shape memory implant abutment system: An up to 6-month pilot clinical study

  • Kumar C. Shah
    Correspondence
    Corresponding author: Dr Kumar C. Shah, Division of Advanced Prosthodontics University of California Los Angeles 10833 LeConte Avenue, B3-087 CHS, Los Angeles, CA 90095-1668
    Affiliations
    Associate Clinical Professor, Division of Advanced Prosthodontics and Director, Advanced Prosthodontics Residency Program, University of California Los Angeles School of Dentistry, Los Angeles, Calif
    Search for articles by this author
  • Chase S. Linsley
    Affiliations
    Assistant Adjunct Professor, Bioengineering, University of California Los Angeles, Los Angeles, Calif
    Search for articles by this author
  • Benjamin M. Wu
    Affiliations
    Professor and Chair, Division of Advanced Prosthodontics and Bioengineering, Materials, Science, and Orthopedic Surgery, University of California Los Angeles, Los Angeles, Calif
    Search for articles by this author

      Abstract

      Statement of problem

      Screw- and cement-based retention mechanisms are used to attach prostheses to dental implants; however, each approach can lead to clinical complications such as crown fracturing or peri-implantitis. A novel abutment and prosthesis retention system has been engineered to achieve the esthetics and retention force of cement-based fixation while maintaining the retrievability of screw-retained restorations.

      Purpose

      The purpose of this pilot clinical study was to evaluate the effectiveness of this innovative retention system on posterior tooth restorations.

      Material and methods

      This clinical study, with up to 6 months of follow-up, included 8 participants with posterior osseointegrated implants who met the eligibility criteria to receive the abutment and shape memory sleeve. Radiographs were used to evaluate crown seating. Crown stability was measured using the Periotest, and occlusal analysis was performed using the Tekscan system and shimstock. Peri-implant health was evaluated by probing, and the plaque and gingival indices were recorded. In addition, patient-reported outcomes were recorded.

      Results

      Minimal differences were observed between baseline and endpoint assessment of the plaque and gingival indices, probing depth, and proximal and occlusal contacts. There were no patient-reported problems or complaints about discomfort. The overall peri-implant health remained unchanged from the baseline evaluations for all participants. Proximal contact around the restoration was present at the baseline and at the conclusion of the study for 7 of the participants. Occlusal contact was observed to be either light (5 participants) or holding (3 participants). In addition, visual inspection of retrieved crowns revealed clean surfaces free of macroparticle ingress, and bacterial accumulation at the coping-abutment interface was not detected.

      Conclusions

      The safety and efficacy findings of this pilot clinical study suggest that this new shape memory alloy–based retention system may provide a suitable alternative for implant prosthodontics. The retention system allowed for easy prosthesis seating and retrieval.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Prosthetic Dentistry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Chee W.
        • Jivraj S.
        Screw versus cemented implant supported restorations.
        Br Dent J. 2006; 201: 501-507
        • Torrado E.
        • Ercoli C.
        • Al Mardini M.
        • Graser G.N.
        • Tallents R.H.
        • Cordaro L.
        A comparison of the porcelain fracture resistance of screw-retained and cement-retained implant-supported metal-ceramic crowns.
        J Prosthet Dent. 2004; 91: 532-537
        • Wilson T.G.
        The positive relationship between excess cement and peri-implant disease: a prospective clinical endoscopic study.
        J Periodontol. 2009; 80: 1388-1392
        • Gapski R.
        • Neugeboren N.
        • Pomeranz A.Z.
        • Reissner M.W.
        Endosseous implant failure influenced by crown cementation: a clinical case report.
        Int J Oral Maxillofac Implants. 2008; 23: 943-946
        • Linkevicius T.
        • Vindasiute E.
        • Puisys A.
        • Linkeviciene L.
        • Maslova N.
        • Puriene A.
        The influence of the cementation margin position on the amount of undetected cement. A prospective clinical study.
        Clin Oral Implants Res. 2013; 24: 71-76
        • Korsch M.
        • Obst U.
        • Walther W.
        Cement-associated peri-implantitis: a retrospective clinical observational study of fixed implant-supported restorations using a methacrylate cement.
        Clin Oral Implants Res. 2014; 25: 797-802
        • Burbano M.
        • Wilson T.G.
        • Valderrama P.
        • Blansett J.
        • Wadhwani C.P.K.
        • Choudhary P.K.
        • et al.
        Characterization of cement particles found in peri-implantitis-affected human biopsy specimens.
        Int J Oral Maxillofac Implants. 2015; 30: 1168-1173
        • Wilson T.G.
        • Valderrama P.
        • Burbano M.
        • Blansett J.
        • Levine R.
        • Kessler H.
        • et al.
        Foreign bodies associated with peri-implantitis human biopsies.
        J Periodontol. 2015; 86: 9-15
        • Linkevicius T.
        • Vindasiute E.
        • Puisys A.
        • Peciuliene V.
        The influence of margin location on the amount of undetected cement excess after delivery of cement-retained implant restorations.
        Clin Oral Implants Res. 2011; 22: 1379-1384
        • Shah K.C.
        • Seo Y.R.
        • Wu B.M.
        Clinical application of a shape memory implant abutment system.
        J Prosthet Dent. 2017; 117: 8-12
        • Shabalovskaya S.
        • Anderegg J.
        • Van Humbeeck J.
        Critical overview of Nitinol surfaces and their modifications for medical applications.
        Acta Biomater. 2008; 4: 447-467
        • El Medawar L.
        • Rocher P.
        • Hornez J.C.
        • Traisnel M.
        • Breme J.
        • Hildebrand H.F.
        Electrochemical and cytocompatibility assessment of NiTiNOL memory shape alloy for orthodontic use.
        Biomol Eng. 2002; 19: 153-160
        • Thompson S.A.
        An overview of nickel-titanium alloys used in dentistry.
        Int Endod J. 2000; 33: 297-310
        • Wen J.C.
        • McCannel C.A.
        • Mochon A.B.
        • Garner O.B.
        Bacterial dispersal associated with speech in the setting of intravitreous injections.
        Arch Ophthalmol. 2011; 129: 1551-1554
        • Michalakis K.X.
        • Hirayama H.
        • Garefis P.D.
        Cement-retained versus screw-retained implant restorations: a critical review.
        Int J Oral Maxillofac Implants. 2003; 18: 719-728
        • Cano-Batalla J.
        • Soliva-Garriga J.
        • Campillo-Funollet M.
        • Munoz-Viveros C.A.
        • Giner-Tarrida L.
        Influence of abutment height and surface roughness on in vitro retention of three luting agents.
        Int J Oral Maxillofac Implants. 2012; 27: 36-41
        • Bernal G.
        • Okamura M.
        • Muñoz C.A.
        The effects of abutment taper, length and cement type on resistance to dislodgement of cement-retained, implant-supported restorations.
        J Prosthodont. 2003; 12: 111-115
        • Bresciano M.
        • Schierano G.
        • Manzella C.
        • Screti A.
        • Bignardi C.
        • Preti G.
        Retention of luting agents on implant abutments of different height and taper.
        Clin Oral Implants Res. 2005; 16: 594-598
        • Breeding L.C.
        • Dixon D.L.
        • Bogacki M.T.
        • Tietge J.D.
        Use of luting agents with an implant system.
        J Prosthet Dent. 1992; 68: 737-741
        • Taylor T.D.
        • Agar J.R.
        • Vogiatzi T.
        Implant prosthodontics: current perspectives and future directions.
        Int J Oral Maxillofac Implants. 2000; 15: 66-75
        • Pan Y.H.
        • Ramp L.C.
        • Lin C.K.
        • Liu P.R.
        Comparison of 7 luting protocols and their effect on the retention and marginal leakage of a cement-retained dental implant restoration.
        Int J Oral Maxillofac Implants. 2006; 21: 587-592
        • Krishnan V.
        • Thomas C.T.
        • Sabu I.
        Management of abutment screw loosening: review of literature and report of a case.
        J Indian Prosthodont Soc. 2014; 14: 208-214
        • Wittneben J.G.
        • Joda T.
        • Weber H.P.
        • Bragger U.
        Screw retained vs. cement retained implant-supported fixed dental prosthesis.
        Periodontol 2000. 2017; 73: 141-151
        • Vigolo P.
        • Mutinelli S.
        • Givani A.
        • Stellini E.
        Cemented versus screw-retained implant-supported single-tooth crowns: a 10-year randomised controlled trial.
        Eur J Oral Implantol. 2012; 5: 355-364
        • Ekfeldt A.
        • Oilo G.
        Occlusal contact wear of prosthodontic materials. An in vivo study.
        Acta Odontol Scand. 1988; 46: 159-169
        • Chee W.
        • Felton D.A.
        • Johnson P.F.
        • Sullivan D.Y.
        Cemented versus screw-retained implant prostheses: which is better?.
        Int J Oral Maxillofac Implants. 1999; 14: 137-141
        • Zarone F.
        • Sorrentino R.
        • Traini T.
        • Di Lorio D.
        • Caputi S.
        Fracture resistance of implant-supported screw- versus cement-retained porcelain fused to metal single crowns: SEM fractographic analysis.
        Dent Mater. 2007; 23: 296-301
        • Limmer B.
        • Sanders A.E.
        • Reside G.
        • Cooper L.F.
        Complications and patient-centered outcomes with an implant-supported monolithic zirconia fixed dental prosthesis: 1 year results.
        J Prosthodont. 2014; 23: 267-275
        • Vizcaya F.R.
        Retrospective 2-to 7-year follow-up study of 20 double full-arch implant-supported monolithic zirconia fixed prostheses: measurements and recommendations for optimal design.
        J Prosthodont. 2018; 27: 501-508
        • Duda S.H.
        • Bosiers M.
        • Lammer J.
        • Scheinert D.
        • Zeller T.
        • Oliva V.
        • et al.
        Drug-eluting and bare nitinol stents for the treatment of atherosclerotic lesions in the superficial femoral artery: long-term results from the SIROCCO trial.
        J Endovasc Ther. 2006; 13: 701-710
        • Ghazal A.R.A.
        • Hajeer M.Y.
        • Al-Sabbagh R.
        • Alghoraibi I.
        • Aldiry A.
        An evaluation of two types of nickel-titanium wires in terms of micromorphology and nickel ions' release following oral environment exposure.
        Prog Orthod. 2015; 16: 9
        • Mikulewicz M.
        • Chojnacka K.
        • Wozniak B.
        • Downarowicz P.
        Release of metal ions from orthodontic appliances: an in vitro study.
        Biol Trace Elem Res. 2012; 146: 272-280
        • Shabalovskaya S.A.
        Surface, corrosion and biocompatibility aspects of Nitinol as an implant material.
        Biomed Mater Eng. 2002; 12: 69-109