Pengaruh Ukuran Partikel Alumunium Oksida dan Tekanan Intraoral Abrasion terhadap Kekuatan Lekat Geser Semen Resin pada Gigi Tiruan Jembatan Adhesif

Abstract

Adhesive bridge dentures are fixed dentures with minimal preparation of the abutment tooth enamel which are attached using adhesive resin cement micromechanically. The adhesion resistance of this type of denture relies heavily on the bond between the resin cement both with the tooth and metal surfaces. Adhesive bridge dentures consist of a pontic that is anchored to the abutment teeth using a metallic wing retainer made of metal. The disadvantages of this denture are the low success rate due to debonding due to errors in the cementation procedure, contamination of the enamel surface of the abutment teeth, and contamination of the wing retainer of the adhesive bridge during try-in. The success of these dentures can be increased by mechanical pre-treatment in the oral cavity known as the intraoral abrasion technique. Intraoral abrasion is a micromechanical treatment using water and air sprays to form roughness and increase the surface area of tooth attachment without causing dentin hypersensitivity. The determination of Al2O3 particle size and optimal pressure in intraoral abrasion to increase the shear bond strength of resin cement in adhesive bridge dentures is not yet known clearly. The aim of this study was to determine the effect of Al2O3 particle size and intraoral abrasion pressure with self-adhesive resin cement on the shear bond strength of resin cement on adhesive bridge dentures.This type of research is laboratory experimental. The number of samples consisted of 30 metal Nickel Chromium (Ni-Cr) cylinders and 30 maxillary premolars. Samples were made at the USU FKG Dental Industrial Service Unit where the Ni-Cr metal had a diameter of 5 mm and a height of 3 mm. The Ni-Cr metal was then cemented on the prepared tooth surface and embedded into an acrylic block measuring 20 x 20 x 20 mm. The metal sample group was divided into 2 intraoral abrasion treatment groups with Al2O3 particle sizes of 29 and 53 μm. After that, each group was divided into 3 groups based on the intraoral abrasion pressure used, namely 1, 3, and 5 bar. Measurement of shear bond strength valueson adhesive bridge dentures was carried out using a universal testing machine. The results of the unpaired t test showed the effect of particle size Al2O3 29-53μm and intraoral abrasion pressure of 1, 3 and 5 bar on the shear bond strength of resin cement on adhesive bridge dentures with a significance level of p=0,0014; p=0,0076 and p=0,00003(p<0,05). The results of the one-way anova test showed that there was an effect of 1, 3 and 5 bar intraoral abrasion pressure with a particle size of 29 and 53 μm Al2O3 on the shear bond strength of resin cement on adhesive bridge dentures with a significance level of p=0,0001 (p<0,05). LSD post hoc test results from intraoral abrasion pressure of 1, 3 and 5 bar with Al2O3 particle sizes of 29 and 53 μm showed that there was a significant difference between all treatment groups with a value of p=0,0001 (p<0,05). The results of shear bond strength and failure of attachment using SEM (Scanning Electron Microscope) and digital camera show the failure type are cohesive and mixed of adhesive-cohesive. Based on the results of this study, it was concluded that the best parameters in the intraoral abrasion procedure were an Al2O3 particle size of 53 μm and a pressure of 1 bar. The resulting chemical, physical and geometric properties can influence surface roughness of enamel and increase shear bond strength of the adhesive bridge without causing dentin hypersensitivity. The use of Al2O3 particle size parameters of 53 μm and intraoral abrasion pressure of 1 bar as pre-treatment on tooth surface before adhesive bridge cementation procedures can be suggested for long-term clinical applications.