Publications by authors named "Vinni Thavakkara"

2 Publications

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Influence of collar height of definitive restoration and type of luting cement on the amount of residual cement in implant restorations: A clinical study.

J Prosthet Dent 2021 Jun 8. Epub 2021 Jun 8.

Senior Resident, Department of Prosthodontics, Government Dental College, Kozhikode, Kerala, India.

Statement Of Problem: Residual cement in the peri-implant sulcus may cause peri-implant mucositis, which can lead to peri-implantitis. Clinical studies comparing the role of the collar height of the definitive restoration and the type of cement used for luting the prosthesis in the amount of residual cement are lacking.

Purpose: The purpose of this clinical study was to determine the volume of residual cement left undetected in the peri-implant sulcus by an implant prosthesis with 3 different collar heights and 3 luting cements.

Material And Methods: Participants with single implants in the premolar region were divided into 3 groups of 10 according to the distance from the peri-implant soft tissue crest to the implant platform: group low collar (sulcus depth <2 mm), group medium collar (2-4 mm), and group high collar (>4 mm). A metal-ceramic crown with an occlusal opening was fabricated on a straight titanium abutment, which facilitated removal of the crown along with the abutment after cementation. The implant luting cements used were composite resin cement (RelyX U200), Type I glass ionomer cement (GC Gold Label 1), and zinc oxide noneugenol interim luting cement (RelyX Temp NE). The modified crown was cemented with 1 cement each during the impression, bisque evaluation, and definitive crown cementation appointments. The crown was retrieved, and the residual cement collected during each appointment. The measurements obtained were statistically analyzed with general linear model analysis followed by post hoc testing using the Bonferroni test (α=.05).

Results: Mean volume of the residual excess cement (mm) formed in group low collar was 0.33 ±0.17, 0.26 ±0.17, and 0.08 ±0.08 for subgroups Resin, GIC, and ZNE, respectively. In group medium collar, it was 1.18 ±0.31, 1.08 ±0.3, and 0.61 ±0.32; and in group high collar, it was 2.33 ±0.31, 2.1 ±0.74, and 1.31 ±0.56 for the same subgroup, respectively. There was a statistically significant difference in the formation of REC between the collar height groups (P<.001). Among the luting cements, zinc oxide noneugenol cement produced significantly lower residual cement compared with the other 2 cements, and there was no statistically significant difference between the glass ionomer and resin cements (P>.05).

Conclusions: The collar height of the definitive restoration and the type of luting cement play significant roles in the formation of residual cement in fixed implant-supported restorations.
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http://dx.doi.org/10.1016/j.prosdent.2021.03.032DOI Listing
June 2021

Randomized clinical trial of zirconia and polyetheretherketone implant abutments for single-tooth implant restorations: A 5-year evaluation.

J Prosthet Dent 2021 Apr 28. Epub 2021 Apr 28.

Assistant Professor, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia.

Statement Of Problem: Titanium-supported polyetheretherketone (PEEK) abutments provide an economic alternative to zirconia abutments in esthetically important areas. Research comparing the performance regarding esthetics, longevity, and biologic parameters of PEEK abutments is lacking.

Purpose: The purpose of this clinical study was to determine whether PEEK implant abutments provide similar esthetic and biologic parameters and survival rates as zirconia implant abutments.

Material And Methods: Forty participants (age 20 to 50 years) receiving maxillary anterior and premolar implants were enrolled in the study and randomly assigned into 1 of 2 groups: Group PEEK (20 titanium-supported PEEK abutments) and group ZIR (20 zirconia abutments). Both groups were restored with pressed lithium disilicate ceramic crowns. Technical, biologic, and esthetic evaluation was performed at baseline and at 1, 3, and 5 years. The probing pocket depth, plaque control record, and bleeding on probing were recorded at the abutments (test) and compared with those at the corresponding contralateral teeth (control) and also between the 2 test groups. Standardized digital radiographs of the implants were made, and the bone level was recorded with the implant shoulder as the reference on the mesial and distal sides. The color difference between the peri-implant mucosa and control teeth gingiva and the discoloration of the implant crowns were determined with a spectrophotometer. The Student unpaired t test and repeated-measure ANOVA were used to statistically analyze the data (α=.05).

Results: From the 5-year evaluation, both PEEK and zirconia abutments with ceramic crowns showed 100% survival rate without any fracture or restoration loss. Differences in the biologic parameters of zirconia and PEEK abutments were statistically similar: mean probing pocket depth (group ZIR: 2.32 ±0.50 mm, group PEEK: 2.13 ±0.60 mm); mean plaque control record (group ZIR: 0.19 ±0.19, group PEEK: 0.15 ±0.17); and mean bleeding on probing (group ZIR: 0.12 ±0.11, group PEEK: 0.08 ±0.12). The mean marginal bone loss at 5 years was similar for implants supporting zirconia and PEEK abutments: mean mesial bone level (group ZIR: 1.8 ±0.5 mm; group PEEK: 1.9 ±0.6 mm), and mean distal bone level (group ZIR: 1.7 ±0.6 mm, group PEEK: 1.8 ±0.3 mm). The initial color difference (ΔE) between the peri-implant mucosa and gingiva of the analogous contralateral teeth diminished over time. No discoloration of the definitive restoration supported by PEEK or zirconia was detected over 5 years.

Conclusions: At the 5-year evaluation, zirconia and PEEK abutments exhibited the same survival rate with similar biologic and esthetic outcomes.
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http://dx.doi.org/10.1016/j.prosdent.2021.02.037DOI Listing
April 2021