Comparative evaluation of bonding strength of computer aided machined ceramic, pressable ceramic, and milled metal implant abutment copings and effect of surface conditioning on bonding strength: An in vitro study
Identifieur interne : 000710 ( Pmc/Corpus ); précédent : 000709; suivant : 000711Comparative evaluation of bonding strength of computer aided machined ceramic, pressable ceramic, and milled metal implant abutment copings and effect of surface conditioning on bonding strength: An in vitro study
Auteurs : Sapna Rani ; Mahesh Verma ; Shubhra Gill ; Rekha GuptaSource :
- The Journal of the Indian Prosthodontic Society [ 0972-4052 ] ; 2016.
Abstract
The aim of this study was to compare the shear bond strength of computer aided design/computer aided machined ceramic (CAD/CAM), pressable ceramic, and milled metal implant copings on abutment and the effect of surface conditioning on bonding strength.
A total of 90 test samples were fabricated on three titanium abutments. Among 90 test samples, 30 copings were fabricated by CAD/CAM, 30 by pressable, and 30 by milling of titanium metal. These 30 test samples in each group were further subdivided equally for surface treatment. Fifteen out of 30 test samples in each group were surface conditioned with airborne particle abrasion. All the 90 test samples were luted on abutment with glass ionomer cement. Bonding strength was evaluated for all the samples using universal testing machine at a crosshead speed of 5 mm/min. The results obtained were compared and evaluated using one-way ANOVA with
The mean difference for CAD/CAM surface conditioned subgroup was 1.28 ± 0.12, for nonconditioned subgroup was 1.20 ± 0.11. The mean difference for pressable surface conditioned subgroup was 1.18 ± 0.04, and for nonconditioned subgroup was 0.75 ± 0.28. The mean difference for milled metal surface conditioned subgroup was 2.57 ± 0.58, and for nonconditioned subgroup was 1.49 ± 0.15.
On comparison of bonding strength, milled metal copings had an edge over the other two materials, and surface conditioning increased the bond strength.
Url:
DOI: 10.4103/0972-4052.176517
PubMed: 27141163
PubMed Central: 4837770
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparative evaluation of bonding strength of computer aided machined ceramic, pressable ceramic, and milled metal implant abutment copings and effect of surface conditioning on bonding strength: An <italic>in vitro</italic> study</title><author><name sortKey="Rani, Sapna" sort="Rani, Sapna" uniqKey="Rani S" first="Sapna" last="Rani">Sapna Rani</name><affiliation><nlm:aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Verma, Mahesh" sort="Verma, Mahesh" uniqKey="Verma M" first="Mahesh" last="Verma">Mahesh Verma</name><affiliation><nlm:aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Gill, Shubhra" sort="Gill, Shubhra" uniqKey="Gill S" first="Shubhra" last="Gill">Shubhra Gill</name><affiliation><nlm:aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Gupta, Rekha" sort="Gupta, Rekha" uniqKey="Gupta R" first="Rekha" last="Gupta">Rekha Gupta</name><affiliation><nlm:aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27141163</idno><idno type="pmc">4837770</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837770</idno><idno type="RBID">PMC:4837770</idno><idno type="doi">10.4103/0972-4052.176517</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000710</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000710</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Comparative evaluation of bonding strength of computer aided machined ceramic, pressable ceramic, and milled metal implant abutment copings and effect of surface conditioning on bonding strength: An <italic>in vitro</italic> study</title><author><name sortKey="Rani, Sapna" sort="Rani, Sapna" uniqKey="Rani S" first="Sapna" last="Rani">Sapna Rani</name><affiliation><nlm:aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Verma, Mahesh" sort="Verma, Mahesh" uniqKey="Verma M" first="Mahesh" last="Verma">Mahesh Verma</name><affiliation><nlm:aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Gill, Shubhra" sort="Gill, Shubhra" uniqKey="Gill S" first="Shubhra" last="Gill">Shubhra Gill</name><affiliation><nlm:aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</nlm:aff></affiliation></author><author><name sortKey="Gupta, Rekha" sort="Gupta, Rekha" uniqKey="Gupta R" first="Rekha" last="Gupta">Rekha Gupta</name><affiliation><nlm:aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</nlm:aff></affiliation></author></analytic><series><title level="j">The Journal of the Indian Prosthodontic Society</title><idno type="ISSN">0972-4052</idno><idno type="eISSN">1998-4057</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background/Purpose:</title><p>The aim of this study was to compare the shear bond strength of computer aided design/computer aided machined ceramic (CAD/CAM), pressable ceramic, and milled metal implant copings on abutment and the effect of surface conditioning on bonding strength.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>A total of 90 test samples were fabricated on three titanium abutments. Among 90 test samples, 30 copings were fabricated by CAD/CAM, 30 by pressable, and 30 by milling of titanium metal. These 30 test samples in each group were further subdivided equally for surface treatment. Fifteen out of 30 test samples in each group were surface conditioned with airborne particle abrasion. All the 90 test samples were luted on abutment with glass ionomer cement. Bonding strength was evaluated for all the samples using universal testing machine at a crosshead speed of 5 mm/min. The results obtained were compared and evaluated using one-way ANOVA with <italic>post-hoc</italic> and unpaired <italic>t</italic>-test at a significance level of 0.05.</p></sec><sec id="st3"><title>Results:</title><p>The mean difference for CAD/CAM surface conditioned subgroup was 1.28 ± 0.12, for nonconditioned subgroup was 1.20 ± 0.11. The mean difference for pressable surface conditioned subgroup was 1.18 ± 0.04, and for nonconditioned subgroup was 0.75 ± 0.28. The mean difference for milled metal surface conditioned subgroup was 2.57 ± 0.58, and for nonconditioned subgroup was 1.49 ± 0.15.</p></sec><sec id="st4"><title>Conclusions:</title><p>On comparison of bonding strength, milled metal copings had an edge over the other two materials, and surface conditioning increased the bond strength.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Kim, Jt" uniqKey="Kim J">JT Kim</name></author><author><name sortKey="Cho, Sa" uniqKey="Cho S">SA Cho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ehrenkranz, H" uniqKey="Ehrenkranz H">H Ehrenkranz</name></author><author><name sortKey="Langer, B" uniqKey="Langer B">B Langer</name></author><author><name sortKey="Marotta, L" uniqKey="Marotta L">L Marotta</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abbo, B" uniqKey="Abbo B">B Abbo</name></author><author><name 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Indian Prosthodont Soc</journal-id><journal-id journal-id-type="iso-abbrev">J Indian Prosthodont Soc</journal-id><journal-id journal-id-type="publisher-id">JIPS</journal-id><journal-title-group><journal-title>The Journal of the Indian Prosthodontic Society</journal-title></journal-title-group><issn pub-type="ppub">0972-4052</issn><issn pub-type="epub">1998-4057</issn><publisher><publisher-name>Medknow Publications & Media Pvt Ltd</publisher-name><publisher-loc>India</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27141163</article-id><article-id pub-id-type="pmc">4837770</article-id><article-id pub-id-type="publisher-id">JIPS-16-142</article-id><article-id pub-id-type="doi">10.4103/0972-4052.176517</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Comparative evaluation of bonding strength of computer aided machined ceramic, pressable ceramic, and milled metal implant abutment copings and effect of surface conditioning on bonding strength: An <italic>in vitro</italic> study</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Rani</surname><given-names>Sapna</given-names></name><xref ref-type="aff" rid="aff1"></xref><xref ref-type="corresp" rid="cor1"></xref></contrib><contrib contrib-type="author"><name><surname>Verma</surname><given-names>Mahesh</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Gill</surname><given-names>Shubhra</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib><contrib contrib-type="author"><name><surname>Gupta</surname><given-names>Rekha</given-names></name><xref ref-type="aff" rid="aff1"></xref></contrib></contrib-group><aff id="aff1">Department of Prosthodontics, MAIDS, New Delhi, India</aff><author-notes><corresp id="cor1"><bold>Address for correspondence:</bold> Dr. Sapna Rani, House No. 2062, Sector 7/d, Faridabad - 121 006, Haryana, India. E-mail: <email xlink:href="drsapnadaksh@gmail.com">drsapnadaksh@gmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><season>Apr-Jun</season><year>2016</year></pub-date><volume>16</volume><issue>2</issue><fpage>142</fpage><lpage>147</lpage><history><date date-type="received"><day>25</day><month>4</month><year>2015</year></date><date date-type="accepted"><day>19</day><month>10</month><year>2015</year></date></history><permissions><copyright-statement>Copyright: © The Journal of Indian Prosthodontic Society</copyright-statement><copyright-year>2016</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/3.0"><license-p>This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.</license-p></license></permissions><abstract><sec id="st1"><title>Background/Purpose:</title><p>The aim of this study was to compare the shear bond strength of computer aided design/computer aided machined ceramic (CAD/CAM), pressable ceramic, and milled metal implant copings on abutment and the effect of surface conditioning on bonding strength.</p></sec><sec id="st2"><title>Materials and Methods:</title><p>A total of 90 test samples were fabricated on three titanium abutments. Among 90 test samples, 30 copings were fabricated by CAD/CAM, 30 by pressable, and 30 by milling of titanium metal. These 30 test samples in each group were further subdivided equally for surface treatment. Fifteen out of 30 test samples in each group were surface conditioned with airborne particle abrasion. All the 90 test samples were luted on abutment with glass ionomer cement. Bonding strength was evaluated for all the samples using universal testing machine at a crosshead speed of 5 mm/min. The results obtained were compared and evaluated using one-way ANOVA with <italic>post-hoc</italic> and unpaired <italic>t</italic>-test at a significance level of 0.05.</p></sec><sec id="st3"><title>Results:</title><p>The mean difference for CAD/CAM surface conditioned subgroup was 1.28 ± 0.12, for nonconditioned subgroup was 1.20 ± 0.11. The mean difference for pressable surface conditioned subgroup was 1.18 ± 0.04, and for nonconditioned subgroup was 0.75 ± 0.28. The mean difference for milled metal surface conditioned subgroup was 2.57 ± 0.58, and for nonconditioned subgroup was 1.49 ± 0.15.</p></sec><sec id="st4"><title>Conclusions:</title><p>On comparison of bonding strength, milled metal copings had an edge over the other two materials, and surface conditioning increased the bond strength.</p></sec></abstract><kwd-group><kwd>Bonding strength</kwd><kwd>computer aided design/computer aided machined</kwd><kwd>metal milling</kwd><kwd>pressable ceramic</kwd><kwd>surface conditioning</kwd></kwd-group></article-meta></front><body><sec sec-type="intro" id="sec1-1"><title>INTRODUCTION</title><p>At present, implants have become a standard means of replacing missing teeth since they have the advantage of allowing preservation of the integrity of sound teeth adjacent to the edentulous area. The most widely used material for dental implants is titanium owing to its superior properties such as biocompatibility and corrosion resistant.[<xref rid="ref1" ref-type="bibr">1</xref>]</p><p>After placement and osseointegration of implants, it is the responsibility of the dentist to maintain properly designed and fitted prosthesis.[<xref rid="ref2" ref-type="bibr">2</xref>] Clinical decisions are not limited to the selection of the type of implant but are also dependent on the material of prosthesis. Regardless of the implant system used, a restoration is selected to emerge from the tissues to imitate a natural tooth.[<xref rid="ref3" ref-type="bibr">3</xref>] The quest for predictable long-term results has raised several questions concerning the materials used as well as the techniques followed in clinical practice. Implant supported restorations can be fabricated by nonprecious alloys or all ceramic materials. In the recent scenario of advanced technology, recent progress in casting techniques as well as the introduction of computer aided design/computer aided machined (CAD/CAM) has made it possible to make the prostheses using titanium also. Titanium is particularly suitable for patients who are allergic to other metal alloys.[<xref rid="ref4" ref-type="bibr">4</xref>]</p><p>CAD/CAM technology, all ceramic systems, and high strength ceramic materials have become integral parts of modern dentistry. Optimal esthetics and characteristics such as color stability, high wear resistance, and low thermal conductivity make all ceramic materials ideal for the fabrication of dental prostheses.[<xref rid="ref5" ref-type="bibr">5</xref>] The main advantage of all ceramic systems lies in the absence of metal, especially in cases with very thin tissue thickness and shallow implant depths allowing a more esthetically pleasing restoration.</p><p>Dental implant restorations can be cement retained, screw retained or a combination of both. Because it is difficult to achieve passive fit with screw-retained implant restorations, some dentists prefer cemented prosthesis.[<xref rid="ref6" ref-type="bibr">6</xref>] On the other hand, cement retained prosthesis has the disadvantage of compromised stability in case of less interocclusal distance, as the abutment lacks the height and taper for cement retention.[<xref rid="ref7" ref-type="bibr">7</xref>] Retention should be considered for cement retained prostheses for its removal for future maintenance. Retrievability also serves as the safety mechanism to allow the prosthesis to be removed without causing harm to underlying implant superstructures.[<xref rid="ref8" ref-type="bibr">8</xref>]</p><p>Retention certainly influences the lack of complications as well as the longevity of implant prostheses. Over the years, those engaged in implant supported restorations have debated as to which type of mechanism is preferable for increase bonding of cemented restorations.[<xref rid="ref9" ref-type="bibr">9</xref>] The success of implant-supported restorations depends on the success of bonding between prosthesis and metal interface. Retention of crown depends on cement used, surface preparation of the implant abutment, and other variables such as internal surface characteristics of coping and the height and taper of implant abutment.[<xref rid="ref8" ref-type="bibr">8</xref>] For better simulation of clinical conditions, investigation of the bonding or retentive strength should be studied using axial dislodgment forces.[<xref rid="ref10" ref-type="bibr">10</xref>] Numerous studies investigating the bonding strength of different luting agents on retention of cement-retained prosthesis and also effect of airborne-particle abrasion on zirconia copings are available, but there is a paucity of studies having direct comparison of different copings to the best of our knowledge.</p><p>Due to the above concerns, there is a need for comparing the shear bond strength of abutment copings of different materials, made by different techniques as well as effect of surface conditioning on bonding. The null hypothesis was that there was no difference in bond strength of abutment copings made of different materials and also no effect of surface conditioning on bonding. The alternate hypothesis states that there was difference in bond strength of abutment copings, and also surface conditioning affected the bonding strength.</p></sec><sec sec-type="materials|methods" id="sec1-2"><title>MATERIALS AND METHODS</title><sec id="sec2-1"><title>Fabrication of copings</title><p>The present research is a cross-sectional <italic>in vitro</italic> study aimed to compare the shear bond strength of different copings and effect of surface conditioning on shear bond strength of three different types of abutment copings made on titanium implant abutment (Indident Dental Implant System, DRDO Inmas, New Delhi, India).</p><p>In the present study, three different types of abutment copings were fabricated on titanium implant abutment (Indident Dental Implant System, DRDO Inmas, New Delhi, India). The sample size was estimated to be 30 in each group based on previous studies.[<xref rid="ref11" ref-type="bibr">11</xref>]</p><p>For Group A, 30 CAD/CAM zirconia copings were fabricated on one implant abutment [<xref ref-type="fig" rid="F1">Figure 1a</xref>] using cercon CAD/CAM system (Dentsply, Germany). Scan spray containing silver particles was sprinkled on abutment. Optical scanning was done with cercon eye. Once the scanning was completed with cercon eye, cement gap, wall thickness, and occlusal geometry were adjusted for the coping with the help of cercon art program. A luting gap of 30 μm and wall thickness of 0.8 mm were chosen for the coping fabrication. Presintered zirconia blank of 38 size was inserted in cercon brain to complete the milling. After milling was completed, the frameworks of the coping were separated from the blank with the help of micromotor and sintered in furnace, according to manufacturer's instructions. Dimensions of CAD/CAM coping was measured with digital caliper (Shenzhen YKS Technology Ltd., China).</p><fig id="F1" position="float"><label>Figure 1</label><caption><p>(a-c) Abutment copings made of computer aided design/computer aided machined (left), pressable ceramic (middle), and milled metal (right)</p></caption><graphic xlink:href="JIPS-16-142-g001"></graphic></fig><p>For Group B, 30 pressable ceramic copings of similar dimensions as that of CAD/CAM copings were fabricated on implant abutment [<xref ref-type="fig" rid="F1">Figure 1b</xref>]. (IPS E-max, Ivoclar Vivadent, Liechtenstein). Implant abutment was screwed on implant analog, and two coatings of die spacer (Durolan, DFS) were applied on implant abutment to attain the same cement space. To attain the similar dimension as CAD/CAM coping, silicon index was fabricated of CAD/CAM coping extending on the predetermined groove on implant analog. Molten inlay wax (Geo-dip, Renfert, Germany) was poured in silicon index, and mounted abutment was inserted in that index to the level of predetermined groove. Investment of wax pattern was done in silicone ring with the phosphate bonded investment material (IPS PressVEST Speed). The IPS E-max press ingot was inserted in hot investment ring. Investment ring was inserted in the center of hot press furnace (Multimat 2 touch + press) using investment tongs; selected program was started. After cooling of the ring, the sprue and reaction layer on the copings were removed, and copings were retrieved. Dimensions of pressable ceramic coping were verified with a digital caliper.</p><p>For Group C, 30 milled metal copings of similar dimensions as that of CAD/CAM copings were fabricated on implant abutment [<xref ref-type="fig" rid="F1">Figure 1c</xref>]. The wax pattern was fabricated in the same manner as for pressable copings. Wax pattern was scanned in the computer true definition scanner (TDS). The CAD volume data was transferred to the multi-axis metal milling machine (TDS cutter, Turbodent system, Taiwan). Copings were milled from titanium blank using the existing data [<xref ref-type="fig" rid="F2">Figure 2</xref>]. Copings were separated from the blank. Again, dimensions were verified using digital caliper.</p><fig id="F2" position="float"><label>Figure 2</label><caption><p>Metal milling of titanium blank for abutment copings</p></caption><graphic xlink:href="JIPS-16-142-g002"></graphic></fig></sec><sec id="sec2-2"><title>Surface conditioning</title><p>Copings of CAD/CAM, pressable ceramic and metal millings were divided into two halves. To maintain standardization, same surface treatment was applied for copings. One-half (15 out of 30 samples in each group) was surface conditioned by air-abrasion with 50 μm Al<sub>2</sub>O<sub>3</sub> at 2.5 bars pressure for 20 s at a distance of 10 mm in the sandblaster [<xref ref-type="fig" rid="F3">Figure 3</xref>],[<xref rid="ref9" ref-type="bibr">9</xref>] and other half were left nonconditioned. Thus, three groups with two subgroups of each of the copings were prepared:</p><fig id="F3" position="float"><label>Figure 3</label><caption><p>Surface conditioning done by air-abrasion with 50 μm Al<sub>2</sub>O<sub>3</sub> at 2.5 bars pressure for 20 s</p></caption><graphic xlink:href="JIPS-16-142-g003"></graphic></fig><p><list list-type="bullet"><list-item><p>Group A (<italic>n</italic> = 30): Copings made by computer-aided technique</p><p><list list-type="bullet"><list-item><p>Subgroup A1 (<italic>n</italic> = 15): Copings made by computer-aided technique that were surface conditioned</p></list-item><list-item><p>Subgroup A2 (<italic>n</italic> = 15): Copings made by computer-aided technique that were nonconditioned</p></list-item></list></p></list-item><list-item><p>Group B (<italic>n</italic> = 30): Copings made by pressable ceramic technique <list list-type="bullet"><list-item><p>Subgroup B1 (<italic>n</italic> = 15): Copings made by pressable ceramic technique that were surface conditioned</p></list-item><list-item><p>Subgroup B2 (<italic>n</italic> = 15): Copings made by pressable ceramic technique that were nonconditioned</p></list-item></list></p></list-item><list-item><p>Group C (<italic>n</italic> = 30): Copings made by metal milling</p></list-item></list></p><p><list list-type="simple"><list-item><p>Subgroup C1 (<italic>n</italic> = 15): Milled metal copings that were surface conditioned</p></list-item><list-item><p>Subgroup C2 (<italic>n</italic> = 15): Milled metal copings that were nonconditioned.</p></list-item></list></p></sec><sec id="sec2-3"><title>Cementation of copings</title><p>All specimens were cemented to titanium abutment using glass ionomer cement (GIC) (Meron, VOCO GmbH, Germany) to make standardization, which was mixed according to manufacturers’ recommendations. An alignment apparatus [<xref ref-type="fig" rid="F4">Figure 4</xref>] was used that applied a weight of 750 g to the bonded specimens. Extra cement was scraped out,[<xref rid="ref9" ref-type="bibr">9</xref>] and after initial set (8 min), specimens were stored in distilled water for 24 h to simulate the moist oral environment.</p><fig id="F4" position="float"><label>Figure 4</label><caption><p>Alignment apparatus applying a weight of 750 g to the bonded specimens</p></caption><graphic xlink:href="JIPS-16-142-g004"></graphic></fig></sec><sec id="sec2-4"><title>Determination of bonding strength</title><p>In the present study, shear bond strength was evaluated by universal testing machine [<xref ref-type="fig" rid="F5">Figure 5</xref>] (22.5 K Instron, model 4482). Forces were applied axially on coping cemented on abutment at a cross-head speed of 1.0 mm/min. A computer connected with the Instron machine recorded the result of each test. The nonadhesive chemical bond strength (∂) values (expressed in effects of MPa) were calculated using the formula: ∂ = L/A.[<xref rid="ref9" ref-type="bibr">9</xref>] Where L is load (in N) and A is the adhesive area (in m<sup>2</sup>).[<xref rid="ref12" ref-type="bibr">12</xref>]</p><fig id="F5" position="float"><label>Figure 5</label><caption><p>Pull-off test for determination of bonding strength</p></caption><graphic xlink:href="JIPS-16-142-g005"></graphic></fig></sec><sec id="sec2-5"><title>Data analysis</title><p>The shear bond strength was evaluated by pull-off test for all the abutment copings. All calculations were performed using the SPSS (version 16) for windows (SPSS Inc., Chicago, IL, USA).</p></sec></sec><sec sec-type="results" id="sec1-3"><title>RESULTS</title><p>A one-way analysis of variance was computed for statistical significance at <italic>P</italic> = 0.05 for individual groups with <italic>post-hoc</italic> (Tukey's Honest Significant Difference) and intragroup comparison was done by unpaired <italic>t</italic>-test.</p><p>The mean difference for CAD/CAM surface conditioned group was 1.28 ± 0.12, for nonconditioned group was 1.20 ± 0.11. The mean difference for pressable surface conditioned group was 1.18 ± 0.04, and for nonconditioned group was 0.75 ± 0.28. The mean difference for milled metal surface conditioned group was 2.57 ± 0.58, and for nonconditioned group was 1.49 ± 0.15 [<xref ref-type="fig" rid="F6">Graph 1</xref> and <xref ref-type="table" rid="T1">Table 1</xref>].</p><fig id="F6" position="float"><label>Graph 1</label><caption><p>Mean and standard deviation of bonding strength (in MPa) between surface conditioned (C) and nonconditioned specimens (NC)</p></caption><graphic xlink:href="JIPS-16-142-g006"></graphic></fig><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Mean bonding strength (in MPa) of different specimens</p></caption><graphic xlink:href="JIPS-16-142-g007"></graphic></table-wrap><p>On intragroup comparison, results showed that pressable ceramic and milled metal group had the statistically significant difference (<italic>P</italic> = 0.05) in conditioned and nonconditioned specimens [<xref ref-type="table" rid="T2">Table 2</xref>]. Bonding strength was highest for milled metal surface conditioned group. The least bonding strength was found for pressable nonconditioned group. The mean bond strength value with air abrasion specimens was higher. On intergroup comparisons, CAD/CAM, pressable, and milled metal surface conditioned specimens had statistically significant difference, and similar results were found for nonconditioned specimens [<xref ref-type="table" rid="T3">Table 3</xref>].</p><table-wrap id="T2" position="float"><label>Table 2</label><caption><p>Mean comparison and standard deviation of bonding strength(in MPa) between different abutment copings</p></caption><graphic xlink:href="JIPS-16-142-g008"></graphic></table-wrap><table-wrap id="T3" position="float"><label>Table 3</label><caption><p>Mean comparison of bonding strength (in MPa) between surface conditioned and nonconditioned specimens</p></caption><graphic xlink:href="JIPS-16-142-g009"></graphic></table-wrap></sec><sec sec-type="discussion" id="sec1-4"><title>DISCUSSION</title><p>This study assessed the bonding strength of copings made out of different materials and also evaluated the effect of surface conditioning on bonding strength. The results of this study led to the rejection of null hypothesis that there was no significant difference in the bond strength of tested groups. Metal copings fabricated by milling technique provided much stronger retention as compared to other materials and also surface conditioning increases the bonding strength.</p><p>Two all ceramic materials and titanium metal were used in this study, and titanium metal was not casted because milling of titanium metal overcomes the problem of production of reactive surface layer on its surface when cast in thin and fragile sections.[<xref rid="ref13" ref-type="bibr">13</xref>]</p><p>Over the years, questions have been put on bonding of implant supported restorations.[<xref rid="ref3" ref-type="bibr">3</xref>] In order to improve bonding, the internal surface of restoration may be modified chemically or mechanically. This helps to promote surface roughness of restoration and reactivity to the luting agent. Chemical surface treatments include the use of various reactive agents while mechanical procedures include airborne-particle abrasion with alumina particles and abrasion with a mounted stone.[<xref rid="ref14" ref-type="bibr">14</xref>]</p><p>Cornelia Schiessl <italic>et al</italic>.[<xref rid="ref15" ref-type="bibr">15</xref>] investigated the factors which determine the retentiveness of copings made out of Co-Cr alloy and zirconia luted with permanent and provisional luting cements. The conclusion of this study was that copings made of metal alloy and zirconia showed no different level of retentiveness when set onto titanium abutments fixed with permanent or provisional cements. As concluded in this study, surface conditioning with airborne particle abrasion enhances the bonding of metallic as well as ceramic-based restorations. Tashkandi[<xref rid="ref11" ref-type="bibr">11</xref>] evaluated the effect of surface treatment on micro-shear bond strength of zirconia frameworks. He concluded a better bond strength in combination with air-abrasion. This was in agreement with other studies (Bottino <italic>et al</italic>. 2005).[<xref rid="ref16" ref-type="bibr">16</xref>]</p><p>Ebert <italic>et al</italic>. in 2007[<xref rid="ref9" ref-type="bibr">9</xref>] found similar results when evaluating the effect of two surface conditioning methods and two luting gap sizes on the bonding of zirconia copings. He found that air-abraded copings increased the retention. Airborne-particle abrasion has also been recommended as the best method of pretreatment in previous studies to improve the bond strength to oxide ceramics. Sadig and Al Harbi[<xref rid="ref17" ref-type="bibr">17</xref>] compared the effect of different surface conditions on the retentiveness of titanium crowns cemented abutments using two types of cement. Results showed that sandblasted castings and pretreatment of abutment exhibited the greatest retentive strength. Shahin and Kern[<xref rid="ref18" ref-type="bibr">18</xref>] in 2010 also concluded that air-abrasion significantly increases crown retention.</p><p>In the present study, GIC was used to cement milled metal and all ceramic copings. Although resin cements has got the maximum retention for all ceramic restorations, previous studies assessed that GIC has also got the adequate retention.[<xref rid="ref19" ref-type="bibr">19</xref>] Maeyama <italic>et al</italic>.[<xref rid="ref20" ref-type="bibr">20</xref>] compared the retentive strength of metal copings on prefabricated abutments with five different luting agents. GIC has got the sufficient retentive strength for luting cement retained superstructures.</p><p>GIC was used for luting all the specimens to make standardization, and moreover different resin cements require different pretreatment which could alter results. GIC show high water solubility and require sufficient time for complete setting reaction to maximize their retention. Manufacturer of GIC states that the material will reach its full set in 4–7 min so 8 min setting period that was allowed in the previous study should prove satisfactory.</p><p>The limitations of this study include that all copings were produced and tested under ideal conditions, which may not reflect conditions in daily clinical practice. Thermal cycling and long-term water storage are the factors that can have effects on the durability of bond strength,[<xref rid="ref10" ref-type="bibr">10</xref>] and they are important parameters to simulate the oral conditions. In terms of <italic>in vivo</italic> loading, the masticatory cycle consists of combination of vertical and lateral forces, subjecting the restoration to a variety of off-axis loading. In the current investigation, the cemented copings were subjected to only axial forces. No single <italic>in vitro</italic> test provides an accurate indication of the intraoral environment.[<xref rid="ref3" ref-type="bibr">3</xref>] Hence, future studies should attempt to simulate intraoral conditions, as well as utilize additional mechanical tests, which can provide a more reliable assessment of retention.</p></sec><sec sec-type="conclusions" id="sec1-5"><title>CONCLUSIONS</title><p>Within the conditions and limitations of this <italic>in vitro</italic> study, milled metal copings had the highest bond strength as compared to CAD/CAM and pressable ceramic copings. Surface conditioning with air-abrasion achieved better bond strength of all type of copings. 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