Abstract
Statement of problem
The debonding of zirconia cantilevered resin-bonded fixed dental prostheses remains
a technical complication because zirconia’s chemical inertness impedes adequate surface
preparation for bonding. Limited clinical evidence on the performance of various pretreatment
methods for the bonding surface of zirconia resin-bonded fixed dental prostheses is
available.
Purpose
The present prospective, randomized, controlled clinical trial aimed at evaluating
the performance of zirconia resin-bonded fixed dental prostheses prepared with nanostructured
alumina coating.
Material and methods
The study adopted a prospective, randomized, controlled, double-blind (patients, operator)
design to compare the performance of nanostructured alumina coating with that of conventional
airborne-particle abrasion. Twenty-seven healthy patients needing a replacement of
a missing maxillary or mandibular central or lateral incisor were screened and rated
to be eligible, and 31 zirconia cantilevered resin-bonded fixed dental prostheses
were randomly allocated into 1 of 2 groups. The first group (n=15), where the restoration
bonding surface was airborne-particle abraded with 50-μm alumina, served as a control
group. In the second group (n=16), the restorations were pretreated with nanostructured
alumina coating. Treatment and data collection were standardized. The primary outcome
evaluated was the survival of the RBFDPs as defined by the restoration not debonding.
The Kaplan-Meier analysis of cumulative survival was performed, and nonparametric
tests were used to determine patient-specific differences between both study groups
(age, sex, restored arch, tooth replaced, bonding surface area) (α=.05). Retainer
wing surfaces of debonded resin-bonded fixed dental prostheses were inspected under
a scanning electron microscope.
Results
Within a mean ±standard deviation observation period of 22.4 ±7.7 months (minimum,
8.3; maximum, 37.9 months), 3 debondings occurred, and the survival rate was 90.3%.
The survival rate was 93.8% for the nanostructured alumina coating and 86.7% for the
control group, with no statistically significant differences (log-rank, P=.54). No patient-specific differences were found between study groups (P>.05). As per the scanning electron micrographs, the majority of the nanostructured
alumina-coated surfaces had large areas of nanostructured alumina residue, whereas
the airborne-particle abraded surfaces exhibited predominantly adhesive failure with
less cement residue.
Conclusions
Over a mean observation period of 2 years, both zirconia pretreatments showed promising
and comparable clinical results; therefore, nanostructured alumina coating could be
regarded as a viable alternative pretreatment method to airborne-particle abrasion.
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Article info
Publication history
Published online: August 19, 2021
Footnotes
Supported by the Slovenian Research Agency funding through research project Toward reliable implementation of monolithic zirconia dental restorations (J2-9222) and research program Ceramics and complementary materials for advanced engineering and biomedical applications (P2-0087).
Identification
Copyright
© 2021 by the Editorial Council for the Journal of Prosthetic Dentistry.
