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Comparing the Efficacy of Preventing Submarginal Cement: Chamfer Margin System versus the Reverse Margin System


Authors:

Emil Svoboda, DDS, PhD, FAAID, DABOI/ID – In Private Practice

Abstract:

Purpose of the Study: This in vitro study compares the use of a custom abutment-crown complex with a chamfer margin connection with that of an inflected margin complex connection called the Reverse Margin. The two systems are compared regarding their ability to prevent submarginal cement.

Methods: A printed acrylic model and milled Chamfer (1) and Reverse Margin (2) zirconia crowns with 80 µ cement space were made to fit complimentary abutments. A simulated gingiva was made from a pink silicone that had been shaped by a custom healing abutment (3) retained by a 5.7 mm implant analogue base (BioHorizons). The abutments were designed to be 1 mm below the silicone gingival margin.(4) Abutment screw access channel was packed with pink Teflon tape and the crowns were cemented into place (RelyX™ Unicem, 3M) while the dental model was on a weigh scale. (5) Crown seating pressure ranged from 38 to 42 NCm. The cement was light cured and the implant analogue-abutment-crown complex was pulled out of the model, disassembled and photographed for analyses. The submarginal cement was made more apparent by rubbing it with blue articulating paper. The process was repeated 10 times for each condition; CM 6 & RM 7

Results: All the chamfer margin cases showed evidence of one or more areas where excess cement had extended beyond the margin of the crown after its cementation. None of the inflected margin cases allowed excess cement to extend beyond the margin.

Conclusion: The Reverse Margin Complex was superior to the Chamfer Margin Complex at preventing submarginal cement. This may have great significance to the long-term safety and stability implant fixed restorations. The Reverse Margin System has been specifically designed to mitigate the two root causes of implant treatment complications identified by the author.

Articles: 1 Korsch M, Obst U, Walther W. Cement‐associated peri‐implantitis: a retrospective clinical observational study of fixed implant‐supported restorations using a methacrylate cement. Volume 25, Issue 7, July 2014, pgs 797-802 2 Wilson TG. The Positive Relationship Between Excess Cement and Peri-implant Disease: A Prospective Clinical Endoscopic Study. J. Periodont 2009;1388-1392 3 Svoboda ELA. Controlling Excess Cement During The Process of Intra-oral Prosthesis Cementation: Overcoming the Gingival Effects. OralHealth Oct 2015;52-66 4 Svoboda ELA. Stock Abutments Cause Problems Preventable by a Well-Designed Prosthesis Installation System. Aug 12, 2019, In Press OralHealth.

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