Comparison of access-hole filling materials for screw retained implant prostheses: 12-month in vivo study

BACKGROUND: Screw retained implant prostheses seem to be an efficient restorative method to prevent peri-implantitis caused by cement excess around the abutment. The drawback of the screw-retained prostheses is the difficulty to realize an efficient access-hole filling functionally and aesthetically. Up to now, few in vitro and in vivo studies were reported in the literature. The aim of this study was to evaluate clinical performances of two direct filling materials through a period of 12 months. METHODS: To pursue a previous in vitro evaluation, this in vivo 12 months prospective study followed up and compared the access-hole filling integrity of a modified 4-META (4-methacryloxyethyl trimellitate anhydride)/MMA-TBB (methyl methacrylate-tri-n-butyl borane) – based resin (M4M) and a photo-polymerizing nano-hybrid composite resin (CR). Twenty-eight access-holes were filled with both materials respectively, then impressions and intra-oral photographs were taken at T = 0, T = 1 M (month), 3, 6, and 12 M. The access-hole surface measurement and the margin analysis (depth and angle) were carried out. The VAS (visual analogue scale) value on marginal discoloration and integrity at the baseline T = 0 and T = 12 M was recorded. RESULTS: The mean values of the surface areas changes from T = 1 to T = 12 M were 83.3 ± 11.5% for group CR and 77.1 ± 13.1% for group M4M, respectively. (Mann-Whitney test p < 0.05, p = 0.046). The mean marginal depth at T = 12 M for group CR were 141.2 ± 125.5 μm and 132.1 ± 107.8 μm for the group M4M, respectively. (Mann-Whitney test p > 0.05, p = 0.58). The mean values of the angle formed at the margin (T = 12 M) were for group CR 39.5 ± 19.4° and 28.2 ± 17.2° for group M4M, respectively (Mann-Whitney test p < 0.0001). The photographical analysis by VAS values showed no significant difference between CR and M4M groups (Mann-Whitney test p > 0.05, p = 0.848). CONCLUSIONS: Based on intra- and extra-oral evaluations with the limitation, both CR and M4M combined with a ceramic primer are indicated as promising materials to fill the access-hole. Further long-term investigation is necessary to confirm this finding.