Microleakage of luting cements in CAD/CAM pediatric zirconia crowns: an in vitro study

The durability of pediatric zirconia crowns for primary teeth is influenced by the choice of luting cement, with the effectiveness of the cement being directly correlated to its ability to reduce microleakage. This in vitro study aimed to assess and compare the microleakage of custom-made zirconia crowns (CZCs) and prefabricated zirconia crowns (PZCs) on primary maxillary incisors when luted with self-adhesive resin cement, resin-modified glass ionomer cement (RMGIC), and bioactive cement. Sixty primary maxillary incisors were prepared and allocated into two groups, each corresponding to the two types of crowns. These groups were further divided into three subgroups each to test the different luting cements. Following the cementation process and thermocycling, the specimens were immersed in a 2% methylene blue solution for microleakage evaluation. The analysis involved sectioning the teeth and examining them under a stereomicroscope. Statistical analysis, using two-way ANOVA and post hoc Dunnett T3 tests (p < 0.05), revealed significant differences in microleakage among the cements. The study found that PZCs luted with RMGIC showed the highest level of microleakage, whereas those luted with bioactive cement exhibited the lowest, positioning bioactive cement as the preferable choice for minimizing microleakage. This finding illustrates the critical importance of selecting appropriate luting cements to optimize the clinical outcomes of zirconia crown restorations in pediatric dentistry, focusing on reducing microleakage to ensure the restoration's durability and success.