Contrast ratios and masking ability of three types of ceramic veneers

Effect of milling procedures in CAD-CAM systems on the color changes of CAD-CAM polymethyl methacrylate resin material as interim material

PURPOSE

This study aimed to investigate the effects of new and used burs on CAD-CAM PMMA resin color changes following thermocycling.

MATERIALS AND METHODS

Twenty disk-shaped specimens (10 × 2 mm) were made using a single brand of CAD-CAM polymethyl methacrylate resin (Polident) for the color test. Group N consisted of half of the specimens that were machined using the new tungsten carbide bur set, and Group U consisted of the specimens that were milled using the used bur set (500 machining time). A color test was performed on the specimens both before and after thermocycling. For the statistical analysis, the Kruskal-Wallis and Dunn Pairwise Comparison tests were employed.

RESULTS

The ∆E* value of specimens (2.057) milled with the used bur was higher than those of specimens milled with the new bur (0.340), but this value is within clinically acceptable limits. After thermocycling, specimens milled with the utilized burs had the greatest L* (93.850) and b* (5.000) values. After thermocycling, statistically significant differences were discovered between Group N and Group U as well as between specimens milled with the utilized bur before and after thermocycling.

CONCLUSION

Thermocycling process have an effect on the mean ∆E values of specimens milled with the used carbide bur, but these ∆E* values were not statistically significant.

CLINICAL SIGNIFICANCE

The color and clinical performance of CAD-CAM restorations may be affected by variations in CAD-CAM milling bur properties, particularly those related to their frequent use.

A comparative evaluation of the variations on the shades of pressable ceramic system with the layering technique after different number of firing cycles: An in vitro study

AIM

The main aim of the present study was to compare and evaluate the effect of repetitive firings on different shades of a pressable all ceramic system layered with veneering porcelain.

SETTING AND DESIGN

In-vitro comparative study.

MATERIALS AND METHODS

An in vitro comparative study was conducted, and a total of 60 disc shaped specimens (15 mm in diameter and 0.8 mm in thickness) were made of heat pressed ceramic of shades A2, A3, and B2 (20 discs of each shade) grouped as Group I, II, and III, respectively, using the lost wax technique. The discs were subsequently layered with veneering porcelain followed by glazing and overglazing and underwent a firing cycle at each step until six times combined. CIE L*a*b* measurements were noted on each sample after the third, fourth, fifth, and sixth firing using VITA Easyshade Advance 4.0 spectrophotometer.

STATISTICAL ANALYSIS USED

Statistical Analysis was done by SPSS 17.0 software. One way analysis of variance, multiple comparisons using the Tukey test, and descriptive statistical analysis were done for all the groups in the study. P <0.05 was statistically significant.

RESULTS

The mean color differences for the repeated firings were imperceptible (ΔE <1.67) to the human eye for all ceramic samples tested except between the fourth and fifth firing of Group II (shade A3).

CONCLUSION

The analysis revealed that although repeated firings lead to changes in L*, a*, and b* values, the mean color difference was below the clinically acceptable color change (ΔE <3.7).

Investigating the effect of solid loading on microstructure, mechanical properties, and translucency of highly translucent zirconia ceramics prepared via stereolithography-based additive manufacturing

A study was conducted to explore the potential of 5 mol% yttria-partially stabilized zirconia (5Y-PSZ) ceramics for dental restorations, using stereolithography (SLA) printing technique. Four different solid loadings were established in the ceramic paste systems to study their effects on microstructure, mechanical properties, and translucency. The study examined the rheological behavior and photopolymerization performance of the ceramic pastes with varying solid loadings. Results showed that, an increase in powder concentration resulted in a decrease in cure depth (Cd) and penetration depth (Dp). A narrower pore size distribution was observed in the green bodies with a high solid loading, facilitating the achievement of final densification. The green and sintered densities were highest at 52 vol%, with values of 3.46 ± 0.01 g/cm3 and 6.01 ± 0.02 g/cm3, respectively. Additionally, all of the green strengths exceeded 30 MPa, with a maximum of 35.09 ± 2.02 MPa obtained at 44 vol%. The maximum flexural strength and minimum contrast ratio (CR) value of 746 ± 75 MPa and 0.40 ± 0.01 were achieved at 52 vol% after sintering. No significant differences were observed in the phase composition and hardness of the as-sintered ceramics. Though significant differences were observed in photopolymerization performance, four materials showed similar structural reliability considering Weibull modulus and characteristic strength.

Effects of background color and thickness on the optical properties of CAD-CAM resin-matrix ceramics

STATEMENT OF PROBLEM

Information regarding the masking ability of computer-aided design and computer-aided manufacture (CAD-CAM) resin-matrix ceramic materials with different compositions is scarce.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of background color and thickness on the optical properties (color and translucency) of CAD-CAM resin-matrix ceramics.

MATERIAL AND METHODS

Twelve rectangular specimens were fabricated at a different thickness (1, 1.5, and 2 mm) (n=12) from each of the resin-matrix ceramic materials: Shofu block (SB), Lava Ultimate (LU), CERASMART (CS), VITA ENAMIC (VE), Crystal Ultra (CU), and the VITABLOCS Mark II feldspathic ceramic (VB). The color of the specimens over amalgam, titanium, enamel, and dentin backgrounds was measured with a spectrophotometer, and the color differences (ΔE∗ab) were calculated by using the Commission Internationale de l'Eclairage (CIE) 76 formula. The difference in color of the specimen over the black and white backgrounds was used to calculate the translucency parameter (TP). ANOVA was used to statistically test whether material, background, and thicknesses influenced ΔE∗ab and TP values. Post hoc comparisons were performed to determine the significant difference among the groups (α=.05).

RESULTS

The interaction with 2 between factors demonstrated that the material was a factor that significantly influenced ΔE∗ab (P<.001). The highest mean ±standard deviation of ΔE∗ab was recorded in the combination of VB material and 2-mm thickness (1.84 ±0.37), and the lowest with CS material with 1.5-mm thickness (0.47 ±0.24). The type of material and specimen thickness significantly influenced TP (P<.001). The highest and lowest mean ±standard deviation of TP were recorded for the 1-mm-thick CS (14.20 ±0.90) and 2-mm-thick SB (4.91 ±0.42) specimens, respectively.

CONCLUSIONS

CERASMART resin-matrix ceramic and VITABLOCS Mark II feldspathic ceramic exhibited high and low masking abilities over the investigated background substrates, respectively. However, irrespective of the thickness, all study materials exhibited acceptable masking abilities.

Effects of surface treatment and shade on the color, translucency, and surface roughness of high-translucency self-glazed zirconia materials

STATEMENT OF PROBLEM

The impact of different surface treatments and shades on the color, translucency, and surface roughness of high-translucency self-glazed zirconia materials is unclear.

PURPOSE

The purpose of this in vitro study was to investigate the effects of different external surface treatments (self-glazed, milled, polished, and glazed), intaglio surface treatments (milled and airborne-particle abraded), and shades (A1 and A3 shades) on the color, translucency, and surface roughness of high-translucency self-glazed zirconia materials, as well as the correlations among optical parameters, translucency, and surface roughness.

MATERIAL AND METHODS

Eighty shade A1 and 80 shade A3 disks were fabricated with a thickness of 0.80 ±0.02 mm and divided into 16 groups (n=10). Different external and intaglio surface treatments were applied to the specimens. CIELab values were measured with a spectrophotometer, and color differences (ΔE₀₀) and relative translucency parameter (RTP) were calculated. Total transmittance (Tt%) and reflectance (R%) were tested with a spectrophotometer equipped with an integrating sphere. Surface roughness (Ra and Rz) (μm) was measured with a noncontact 3-dimensional laser scanning microscope. One specimen from each group was subjected to scanning electron microscope (SEM) examination. Data were analyzed with ANOVA and the Tukey post hoc test. The correlation among optical parameters, translucency, and surface roughness was investigated by using Pearson correlation analysis (α=.05).

RESULTS

The effects of external surface treatments, intaglio airborne-particle abrasion, and shades on ΔE₀₀, RTP, and Ra values of the disks were significantly different (P<.001). The smoothest external polishing surface had the greatest RTP and color difference (P<.001). Shade A3 disks had lower RTP and Tt% values than shade A1 disks (P<.001). ΔE₀₀ had a highly positive relationship with the RTP (A1: r=0.884, P<.001; A3: r=0.859, P<.001). SEM images demonstrated that surface treatments affected the surface texture of monolithic zirconia ceramics.

CONCLUSIONS

Different surface treatments affected the surface roughness, translucency, and final color of zirconia materials. The smoothest external polishing surface had the greatest RTP and color difference. Different shades influenced the translucency, as the darker the disk shade, the lower the translucency. The RTP was appropriate as an auxiliary indicator for evaluating the color of a dental ceramic.

Effects of Substrate and Cement Shade on the Translucency and Color of CAD/CAM Lithium-Disilicate and Zirconia Ceramic Materials

The aim of this in vitro study was to evaluate the effects of substrate and cement shades on the translucency and color of lithium-disilicate and zirconia CAD/CAM materials. Two light-cured resin cements (RelyX Veneer Cement; 3M; Choice 2 Veneer Cement; Bisco Dental) with a standardized thickness (0.1 mm) were tested in combination with two different monolithic CAD/CAM materials (E-Max CAD (LI2SI2O5); Ivoclar Vivadent; Katana (ZrO2); Kuraray-Noritake Dental) on two different colored composite substrates used as a dentin (Filtek Supreme XTE; 3M); for a total of 12 combinations (n = 10). The specimens’ color was measured with a spectrophotometer (Spectroshade; MHT). Measurements were taken using the CIELAB color coordinate system (L*a*b*) against black and white backgrounds. L*a*b* values were statistically analyzed for the variables Substrate, Ceramic, and Cement by applying a Three-Way ANOVA followed by the Tukey Test for post-hoc comparison (p < 0.05). Translucency Parameter (TP) and Constant Ratio (CR) were assessed to evaluate translucency; acceptability and perceptibility thresholds (ΔE00 1.8 and 0.8) were used. Statistically significant influence was found for factors ceramic material, cement shade, and substrate color (p < 0.05). Unacceptable color differences were reported for Li2Si2O5. Opacity was significantly higher when white opaque cement shade was employed. Ceramic type and cement shade significantly influenced L*a*b* color coordinates. The final translucency and color of ceramic restorations can, therefore, be influenced by ceramic material, cement shade, and substrate color.

Masking ability of different ceramics upon various underlying structures

OBJECTIVE

To evaluate masking ability of different types and thicknesses of ceramics upon various substructures.

MATERIALS AND METHODS

Discs (Ø 12 mm, thickness 0.4, 0.6, 0.8, 1.0, 1.2, 1.4, 1.6, 1.8, and 2.0 mm) were prepared from Bruxzir-Anterior® (Bc), Celtra-DUO® (Cc), and Vita-Suprinity® (Vc) (n = 15/group). Substructures (2 mm thickness) were prepared from natural dentine (Ds), tetracycline-stained dentine (Ts), zirconia (Zs), resin composite (Rs), and cast metal (Ms). A spectrophotometer was used to measure the CIE L*a*b* color coordinates of a specimen. Masking ability was determined from the color difference (∆E₀₀ ) of ceramics between before- and after combining with substructure using ANOVA and Bonferroni test (α = 0.05). ∆E₀₀ value was compared with acceptable clinical threshold (∆E₀₀  = 1.8) and an ideal threshold (∆E₀₀  = 0.8).

RESULTS

Type-thickness of ceramics and substructures were significantly affected ∆E₀₀ . Ts significantly influenced ∆E₀₀ more than Rs, Ms, Zs, and Ds. No significant ∆E₀₀ upon Ms and Zs was indicated. Bc completely masked Ts and Rs if thickness was ≥0.6 mm, and Zs, Ms, and Ds if ≥0.4 mm. Cc completely masked Ts and Rs if thickness was >1.6 mm, and Zs, Ms, and Ds if >1.4 mm. Vc completely masked Ts if thickness was >1.4 mm, Rs and Ms if >1.2 mm, and Zs and Ds if >1 mm.

CONCLUSION

Ts is the most influential substructure impact on color appearance, requiring a minimum thickness of 0.6 mm Bc, 1.2 mm Vc, or 1.6 mm Cc to be perfectly masked.

CLINICAL SIGNIFICANCE

Masking ability was significantly influenced by the type and thickness of ceramic material and underlying structure. Monolithic zirconia had a significantly higher masking ability than lithium silicate/phosphate glass ceramic. Ts indicated the most influencial substructure impacting the color appearance of ceramic restoration, which require a minimum thickness of 0.6 mm Bc, 1.2 mm Vc, or 1.6 mm Cc to achieve ideal masking capability.

Optical properties of a novel glass-ceramic restorative material

OBJECTIVE

To examine the optical properties of a dental restorative material manufactured from lithium aluminosilicate ceramic and reinforced with lithium disilicate. Translucency and the optical effects of various supporting materials on color were the primary focus.

METHODS

Five 10 × 10 mm samples were prepared in thicknesses of 0.5, 1.0, 1.5, and 2.0 mm of both high translucency (HT) and low translucency (LT) versions of the material in shade A3. A spectrophotometer was used to measure the illuminance of the samples with black and white backings in order to calculate contrast ratio (CR) and relative translucency parameter (RTP). A baseline relationship between translucency and material thickness was examined and the effects of composite, titanium, and zirconia abutments on color change were studied.

RESULTS

No significant findings were identified for RTP or CR between the HT and LT material, regardless of the material thickness (p = 0.39, p = 0.14, respectively). Regardless of material thickness (HT vs. LT), translucencies (RTP and CR) were significantly different with composite, titanium, and zirconia backings compared to baseline values (p < 0.0001). Titanium had the most significant decrease in translucency compared to composite and zirconia. There was no difference in ΔE00 between the HT and LT materials (p > 0.05) regardless of the backing. Titanium had the most significant effect on color of both materials followed by composite then zirconia (p < 0.0001).

CONCLUSIONS

There is not a clinically significant difference in translucency between the high translucency and low translucency materials. Only zirconia supporting structures produced changes in color that are clinically acceptable.

CLINICAL SIGNIFICANCE

Understanding the optical properties of glass-ceramic restorative materials aids providers in selecting appropriate materials for optimum esthetic outcomes. The lithium-aluminosilicate reinforced with lithium disilicate material does a poor job masking supporting structures and resisting color change.

Effect of additional pressing on the color and translucency of pressable ceramic materials: An in vitro study

STATEMENT OF PROBLEM

Whether reusing the buttons of pressable ceramic materials affects their color or translucency is unclear.

PURPOSE

The purpose of this in vitro study was to investigate the effect of additional pressing on the color and translucency of 3 different lithium disilicate ceramic brands.

MATERIAL AND METHODS

Seventy-two disk-shaped ceramic specimens (Ø14×1.5 mm) were divided into 2 groups: pressed group and additionally pressed group, each containing 36 specimens. These groups were further divided into 3 subgroups: lithium disilicate (LDS), lithium disilicate with high-density micronization technology (LDS-HDM), and zirconia-reinforced lithium silicate (ZLS). Pressing was performed in the press group yielding 36 pressed specimens. Additional pressing was performed by using the buttons resulting from the press group, yielding 36 additionally pressed specimens. Color differences and translucency between pressed and additionally pressed groups were measured with a portable spectrophotometer (VITA Easyshade Compact). The translucency parameter (TP) was measured on black and white backgrounds. Color differences between the 2 groups were analyzed statistically by using the Kruskal-Wallis nonparametric test followed by the Dunn-Sidek method for individual comparison among means of all groups (α=.05).

RESULTS

A statistically significant difference was found in color after additional pressing among the 3 tested materials (P=.005). After additional pressing, color difference (ΔE) values were found between the LDS group (3.78 ±1.11) and the ZLS group (3.03 ±1.44). These ΔE values were beyond the selected clinical perceptible threshold (ΔE=2.6). However, the LDS-HDM group had a ΔE value of 1.80 ±1.22, which is considered clinically not perceivable. Furthermore, LDS showed a statistically significant decrease in translucency after additional pressing (P=.002). However, after additional pressing, ZLS and LDS-HDM showed no statistically significant differences in translucency (P>.05).

CONCLUSIONS

The colors of the 3 tested materials were affected by additional pressing. Only LDS-HDM showed color changes below the selected clinically perceptible threshold (ΔE=2.6). Furthermore, only LDS showed a significant decrease in translucency.

Experimental methodologies to evaluate the masking ability of dental materials: A systematic review

OBJECTIVE

To conduct a systematic review on the masking ability of discolored substrates, analyzing the capacity and quality of the response produced by the different methodologies and techniques applied to overcome this clinical challenge.

MATERIALS AND METHODS

The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The electronic search was conducted in MEDLINE/PubMed, Scopus and Web of Science databases, without date restriction. In vitro studies, written in English, applying different methodologies to evaluate masking ability were included. The variables of interest were: type, color and thickness of the restorative and/or cement material; use of pigments in the restorative material and/or cement; color of the substrate; and background color used for the evaluations.

RESULTS

Database search retrieved 307 eligible papers with a final inclusion of 47 published papers. Approximately 98% of the studies used ΔE, 36% used TP, and only 6% used CR to evaluate the masking ability of restorative materials.

CONCLUSIONS

The most appropriate methodology to evaluate the masking ability is using color difference equations (ΔE) associated with the perceptibility and acceptability thresholds.

CLINICAL SIGNIFICANCE

As different methodologies have been used to evaluate the masking ability of esthetic restorative materials on colored substrates, there is an urgent need to reach a consensus and propose a method, which is suggested by the present systematic review.

Optical effect of resin cement, abutment material, and ceramic thickness on the final shade of CAD-CAM ceramic restorations

STATEMENT OF PROBLEM

High-translucency ceramics can be influenced by the underlying structure, altering the restoration shade. How this affects color matching is unclear.

PURPOSE

The purpose of this in vitro study was to investigate the optical effects of cement shade, ceramic type, ceramic thickness, and abutment material on the final color of computer-aided design and computer-aided manufacturing (CAD-CAM) ceramic restorations.

MATERIAL AND METHODS

Two shades of resin cement (yellow, translucent), 3 types of background (titanium, white zirconia, yellow zirconia), and 3 types of high-translucent ceramic (each type shade A1 and A3) were used in this study. For the experimental groups, a total of 72 ceramic specimens were produced across 4 groups based on ceramic thickness (1.0 mm, 1.5 mm, and 2.0 mm). For the control groups, each ceramic type and shade was prepared at a thickness of 4 mm. A total of 8 resin cement specimens were produced in 4 groups based on shade by using a plastic mold (12×12×0.2 mm). To demonstrate the effect of implant abutment materials, 3 types of background were fabricated with a thickness of 2 mm. For the experimental groups, 3 specimens (ceramic, cement, and background) were sequentially placed with glycerin in the center of each background specimen. Color measurements of the experimental groups were made with a spectrophotometer and recorded in the Commission Internationale de l'Eclairage Lab coordinate system. The color differences (ΔE) between experimental and control groups were then calculated. The Kruskal-Wallis test (α=.05) was used to analyze the multiple comparisons of ceramic thickness, ceramic type, and abutment material. The Mann-Whitney U test (α=.05) was used to analyze cement shade.

RESULTS

Significant differences were found for different ceramic thicknesses, ceramics types, and abutment materials (P≤.001). A clinically acceptable shade (ΔE≤3) was found in 1.5- and 2.0-mm ceramics with the titanium and 2.0-mm ceramics with the yellow zirconia background. However, the color between the experimental group and the control group was similar when using the 2 cement shades (P>.05).

CONCLUSIONS

An increase in ceramic thickness could minimize alteration of the final shade. High-translucency ceramics, together with a resin cement, were able to successfully mask titanium with a ceramic thickness of at least 1.5 mm. However, only a ceramic with a thickness of 2.0 mm was able to mask the yellow zirconia background.

Translucency parameter of conventional restorative glass-ionomer cements

OBJECTIVE

To evaluate the translucency parameter (TP) and contrast ratio (CR) of different conventional restorative glass-ionomer cements (GICs).

MATERIALS AND METHODS

Eighteen brands of GICs were evaluated. Five disks of each material were made following ISO 9917-1. The luminous reflectance and Central Bureau of the International Commission on Illumination parameters of disks were evaluated using a colorimeter, against backings of white and black, to obtain the translucent parameter and contrast ratio of different brands of glass-ionomer cements. The correlation between translucency parameter and contrast ratio was assessed with the Pearson correlation test. The translucent and contrast ratio parameters values were submitted to the one-way ANOVA and Tukey test for multiple comparisons (p < 0.05).

RESULTS

There was a strong inverse relationship between CR and TP (r²  = 0.94, p < 0.001). The contrast ratio decreased as translucency increased. There were significant differences in TP and CR among brands (p < 0.001).

CONLUSIONS

GICs exhibit different translucency and contrast ratio behavior. Some brands of GICs presented very low TP and this condition would be unacceptable for areas with esthetic demands. In addition, TP and CR showed a strong linear relationship.

CLINICAL SIGNIFICANCE

The results found in this study demonstrated that the knowledge of the translucency and CR of different conventional restorative GICs is important in order to guide clinicians in the selection of restorative GICs for anterior teeth.

Shade reproduction and the ability of lithium disilicate ceramics to mask dark substrates

Objectives

This study aimed to evaluate the ability of lithium disilicate ceramics to reproduce the A2 shade and to mask A4 substrates.

Materials and Methods

Twenty-four discs (8 mm in diameter, shade A2) of high translucency (groups 1–3) and low translucency (groups 4–6) of IPS e.max ceramic with different thicknesses (0.5, 0.75, and 1 mm) were fabricated as monolithic structures. In addition, discs of medium opacity (group 7–8) with different core/veneer combinations (0.3 mm/0.7 mm and 0.5 mm/0.5 mm) were fabricated as bilayer structures. Specimens were superimposed on an A4 substrate (complex). The color changes of the complex were measured using a spectrophotometer on a black background, and the ΔE values of the complex were compared with either the A4 substrate or the A2 shade tab. One-way analysis of variance, the Tukey honest significant difference test, and the Fisher test were used to analyze the data (p < 0.05).

Results

Significant between-group differences were found for comparisons to both the A4 substrate and the A2 shade (p < 0.05). When compared with the A4 substrate, the ΔE values in all groups were in the non-acceptable range. When compared with the A2 shade, the ΔE values in all groups, except groups 2 and 3, were in the clinically acceptable range.

Conclusions

All translucencies and thicknesses masked the underlying dark substrate. However, the low-translucency IPS e.max Press better reproduced the A2 shade.

Structural, chemical and optical characterizations of an experimental SiO2-Y-TZP ceramic produced by the uniaxial/isostatic pressing technique

This study aimed to produce a new SiO₂+Y-TZP ceramic via uniaxial/isostatic compression that was structurally and chemically characterized relating to its translucency and flexural strength. SiO₂ and Y-TZP were mixed using a ball mill, pressed and sintered at 1150 °C. The optical and mechanical properties of the specimens were compared to lithium disilicate (LD) and zirconia-reinforced lithium silicate (ZLS) (Kruskal-Wallis, α = 0.05). The Fourier Transform Infrared Spectroscopy bands suggested an interaction between Si, O and Zr. Contrast ratio and translucency parameter of the experimental ceramic were higher and lower, (p = 0.000001) respectively, than those of the LD and ZLS. The experimental ceramic presented similar flexural strength to ZLS, but lower than LD (p < 0.0001). It can be concluded that this processing method is efficient to obtain a SiO₂+Y-TZP ceramic and 1150 °C crystallizes SiO₂ without inducing t-m transformation. The SiO₂+Y-TZP ceramic presented lower translucency and higher masking ability than the commercially available glass-ceramics, but similar flexural strength to one glass-ceramics.

Effects of number of firings and veneer thickness on the color and translucency of 2 different zirconia-based ceramic systems

STATEMENT OF PROBLEM

Color matching between a zirconia-based ceramic restoration and a natural tooth is a common clinical challenge.

PURPOSE

The purpose of this in vitro study was to investigate the effects of the number of firings, veneer thickness, and zirconia core translucency on the final color and translucency of zirconia-based ceramic restorations.

MATERIAL AND METHODS

Sixty disk-shaped zirconia specimens (10×1 mm) were prepared in high and low translucencies (n=30 per translucency group). Each zirconia group was subdivided into 3 subgroups (n=10) veneered with ceramic layers of 0.5-, 1-, and 1.5-mm thicknesses. The specimens were then subjected to 1, 3, 5, and 7 firing times. Color and translucency parameters were measured by using a spectrophotometer. Data were analyzed by using multifactorial repeated measures ANOVA and subgroup analysis (α=.05).

RESULTS

The number of firings affected the L*, a*, and b* values and translucency parameter in both zirconia-based systems with different veneer thicknesses (P<.05). Increasing the veneer thickness decreased the translucency parameter and increased the L*, a*, and b* values in both zirconia-based systems (P<.05). The color difference values (ΔE) were the highest between 1 and 3, 1 and 5, and 1 and 7 firings, and the lowest between 5 and 7 firings in both zirconia systems.

CONCLUSIONS

Repeated firings and porcelain veneer thickness affected the final color and translucency of both zirconia systems and, consequently, adversely influenced the esthetic outcomes. Thus, these factors should be considered in the tooth preparation and laboratory phase.

Comparação estética entre sistemas cerâmicos sobre substrato escurecido

Objetivo: O objetivo deste trabalho foi avaliar visualmente a possível influência de um substrato escurecido no resultado estético de coroas com infraestruturas de dissilicato de lítio ou zircônia. Metodologia: O delineamento foi observacional, transversal e descritivo. Para o experimento, foi selecionado um paciente com necessidade de coroas totais no 11 e 21, onde um dos dois elementos deveria ser escurecido. Uma coroa de dissilicato de lítio foi confeccionada sobre o substrato sem alteração de cor. Para o elemento escurecido foram confeccionadas uma coroa de dissilicato de lítio e uma de zircônia, criando-se duas situações clínicas. Sem conhecimento de qual material foi usado, os avaliadores responderam a um questionário que comparava o resultado estético das coroas de dissilicato de lítio ou zircônia com a coroa de dissilicato de lítio sobre o substrato normal, assim como as duas situações clínicas entre si. No total, 20 cirurgiões-dentistas participaram como avaliadores. Os avaliadores julgaram as restaurações como excelentes, aceitáveis ou inaceitáveis e, após, foi realizada uma análise descritiva das avaliações. Resultados: Os resultados demonstraram que houve diferença estética entre as restaurações de dissilicato de lítio e de zircônia, sendo que o dissilicato de lítio não conseguiu bloquear a cor do substrato, mesmo sendo utilizada uma pastilha opaca (MO). Conclusão: Concluiu-se que em casos de substrato escurecido está indicada a utilização de uma infraestrutura com opacidade suficiente, como a zircônia, podendo ocorrer diferenças visualmente perceptíveis e inaceitáveis caso seja utilizado um material translúcido como o dissilicato de lítio.

Color changes of ceramic veneers following glazing with respect to their composition

PURPOSE

The purpose of this study was to compare the translucency and color changes of ceramic laminate veneers of different composition following glazing process.

MATERIALS AND METHODS

10 mm × 10 mm square specimens of 0.6 mm and 1.0 mm thicknesses were fabricated with IPS e.max Press (EM) and IPS e.max ZirPress (ZP) (n=10 per group). The color coordinates (CIE L^* a^* b^*) of the specimens were recorded with a colorimeter before and after glazing. The color changes and translucency parameter (TP) were calculated. For the comparisons with the composition and thicknesses between the ‘not glazed’ and ‘glazed’ groups, statistical analyses were done through paired T-test, independent two-sample T-test, and multiple regression analysis using SPSS 18.0 (P<.05).

RESULTS

The TP of 0.6 mm EM was higher than that of 0.6 mm ZP. Total color difference (ΔE^*) between bare and glazed specimens of 1.0 mm EM was greater than that of 1.0 mm ZP with statistical significance. Following glazing, specimens from all groups showed statistically significant amount of decrease in L^* and a^*, and statistically significant increase in b^*. The result of multiple regression analysis of EM and ZP showed that ΔL^* improved ΔE^*.

CONCLUSION

Within the limitations of present study, we conclude that translucency and color of ceramic laminate veneers change significantly after glazing process, and the nature and amount of changes vary with different compositions.

The Effect of Ceramic Type and Background Color on Shade Reproducibility of All-Ceramic Restorations

PURPOSE

To investigate the effects of background color on shade reproduction using CAD/CAM zirconia and lithium disilicate ceramics.

MATERIALS AND METHODS

A plastic tooth was prepared for an all-ceramic crown and scanned. Tooth-shaped light background dies were manufactured. Full-contour crowns were milled from translucent zirconia (ZT) and low translucency lithium disilicates (E [LT]). Copings from opaque zirconia (Z) and medium opacity lithium disilicate (E[MO]) ceramics were milled and layered with veneering porcelain to full contour. Metal copings were used to produce a dark background. Specimens were divided into 8 groups with 3 variables: background color, ceramic type, and translucency. Crowns were cemented using composite resin cement. Color was measured with a spectrophotometer. Color difference (∆E) was calculated using the CIEDE2000 formula between the specimens and the target shade, A1. Statistical analysis was performed using a nested design 3-way ANOVA and Tukey multiple comparisons.

RESULTS

The closest ∆E to target shade was produced by E (LT) (2.13 ± 0.19) on the dark background. This increased significantly to 2.90 ± 0.19 on the light background (p = 0.03). The e.max (MO) groups significantly increased (p = 0.001) to 4.40 ± 0.22 and 4.47 ± 0.4, (p = 1.00) for the dark and light backgrounds, respectively. ∆E for the zirconia groups were higher and ranged from 4.85 ± 0.48 to 5.60 ± 0.48 in the ZT groups (p = 0.04) and 6.5 ± 0.82 to 7.75 ± 0.53 (p = 0.001) for Z groups from dark to light backgrounds. There was an overall lack of chromaticity between the specimens and the target shade A1 CONCLUSIONS: Ceramic color was affected by ceramic type, background, and translucency. Lithium disilicate appeared to be better than zirconia in shade reproduction. Less-opaque materials matched the target shade better, while opaque materials and low translucencies were more suitable for dark backgrounds.

Effect of priming agents on shear bond strengths of resin-based luting agents to a translucent zirconia material

PURPOSE

The purpose of the present study was to evaluate the effect of priming agents and artificial aging with thermocycling on shear bond strengths of two resin-based luting agents to a translucent zirconia material.

METHODS

A total of 308 pairs of translucent zirconia disk specimens were divided into seven treatment groups: Alloy Primer (ALP), Clearfil Ceramic Primer Plus (CCP), Meta Fast Bonding Liner (MFB), MR. bond (MRB), Super-Bond PZ Primer Liquid B (PZB), V-Primer (VPR), and an unprimed group (UP). The specimens in each group were bonded with Panavia V5 Universal (UNI) and Opaque shade (OPA). Shear bond strengths (n=11 each) were tested before and after 5000 thermocycles. The data were analyzed with the Kruskal-Wallis test and the Steel-Dwass test.

RESULTS

For both 0 and 5000 thermocycles, the ALP (47.8 and 41.5MPa, respectively) and CCP (45.8 and 42.3MPa, respectively) groups showed significantly higher bond strengths than other groups in the UNI luting agent. For the OPA luting agent, CCP group (45.8MPa) exhibited the highest pre-thermocycling bond strength in all groups. The ALP (32.4MPa) and CCP (36.5MPa) groups had significantly higher post-thermocycling shear bond strengths than other groups. In several groups, the shear bond strengths of the UNI luting agent were significantly higher than those of the OPA luting agent before and after thermocycling.

CONCLUSIONS

Application of priming agents containing hydrophobic phosphate monomer (MDP) yielded the durable bond strengths of resin-based luting agents to a translucent zirconia material.

Masking properties of ceramics for veneer restorations

STATEMENT OF PROBLEM

The translucency and opacity of ceramics play a significant role in emulating the natural color of teeth, but studies of the masking properties and limitations of dental ceramics when used as monolayer restorations are lacking.

PURPOSE

The purpose of this in vitro study was to determine the translucency of 6 materials used for veneer restorations by assessing their translucency parameters (TPs), contrast ratios (CRs), and potential to mask dark tooth colors.

MATERIAL AND METHODS

Ten square- or disk-shaped specimens (0.5-mm thickness, shade A2) were fabricated from Vitablocks Mark II (VMII; Vita Zahnfabrik), IPS e.max CAD LT (EMXC LT; Ivoclar Vivadent AG), IPS e.max CAD HT (EMXC HT; Ivoclar Vivadent AG), IPS Empress CAD LT (EMP LT; Ivoclar Vivadent AG), IPS e.max Press LT (EMXP LT; Ivoclar Vivadent AG), and CZR (CZR; Kuraray Noritake Dental Inc). Their luminance (Y) values over black and over white tiles were measured, followed by their color (CIELab) over black tiles and white tiles and shaded A2 (control group), A3.5, A4, and B4 acrylic resin blocks. All measurements were performed using a spectrophotometer in 2 different areas on each specimen. Then CRs, TPs, and color differences (over shaded backgrounds) were determined. Data were subjected to 1-way and 2-way ANOVA (α=.05) for analysis.

RESULTS

Mean CR values of EMXP LT were significantly higher than those of the other tested materials, whereas VMII and EMXC HT had the lowest values (P<.001). Mean TP values over black and over white backgrounds of VMII and EMXC HT were significantly higher than those of the other tested materials, while EMXP LT and EMXC LT revealed the lowest values (P<.001). Background shade A4 displayed the highest mean effect (expressed in ΔE* values) on the color of the ceramic materials, whereas shade B4 demonstrated the lowest mean background effect (P<.001).

CONCLUSIONS

Significant differences in translucency among the tested ceramics were revealed (P<.001). The EMXC LT and EMXP LT groups were the least translucent under the conditions of this study (P<.001). All tested ceramics exhibited poor masking properties against the A4 background. The color differences of most tested ceramics were more acceptable when tested against the B4 background (ΔE*≤3.3).

The color masking ability of a zirconia ceramic on the substrates with different values

Background. The color masking ability of a restoration plays a significant role in coveringa discolored substructure; however, this optical property of zirconia ceramics has not been clearly determined yet. The aim of this in vitro study was to evaluate the color masking ability of a zirconia ceramic on substrates with different values.

Methods. Ten zirconia disk specimens,0.5 mm in thickness and 10 mm in diameter, were fabricated by a CAD/CAM system. Four substrates with different values were prepared, including: white (control), light grey, dark grey, and black. The disk specimens were placed over the substratesfor spectrophotometric measurements. A spectrophotometer measured the L^*, a^*, and b^* color attributes of the specimens. Additionally, ΔE values were calculated to determine the color differences between each group and the control,and were then compared with the perceptional threshold of ΔE=2.6. Repeated-measures ANOVA, Bonferroni, and one-sample t-test were used to analyze data. All the tests were carried out at 0.05 level of significance.

Results. The means and standard deviations of ΔE values for the three groups of light grey, dark grey and black were 9.94±2.11, 10.40±2.09, and 13.34±1.77 units, respectively.Significant differences were detected between the groups in the ΔE values (P<0.0001).The ΔE values in all the groups were more than the predetermined perceptional threshold(ΔE>2.6) (P<0.0001).

Conclusion. Within the limitations of this study, it was concluded that the tested zirconia ceramic did not exhibit sufficient color masking ability to hide the grey and black substrates.

Influence of resin cement shade on the color and translucency of ceramic veneers

Objective

This in vitro study evaluated the effect of two different shades of resin cement (RC- A1 and A3) layer on color change, translucency parameter (TP), and chroma of low (LT) and high (HT) translucent reinforced lithium disilicate ceramic laminates.

Material and Methods

One dual-cured RC (Variolink II, A1- and A3-shade, Ivoclar Vivadent) was applied to 1-mm thick ceramic discs to create thin RC films (100 µm thick) under the ceramics. The RC was exposed to light from a LED curing unit. Color change (ΔE) of ceramic discs was measured according to CIEL*a*b* system with a standard illuminant D65 in reflectance mode in a spectrophotometer, operating in the light range of 360-740 nm, equipped with an integrating sphere. The color difference between black (B) and white (W) background readings was used for TP analysis, while chroma was calculated by the formula C^*_ab=(a^*2+b^*2)^½. ΔE of 3.3 was set as the threshold of clinically unacceptable. The results were evaluated by two-way ANOVA followed by Tukey's post hoc test.

Results

HT ceramics showed higher ΔE and higher TP than LT ceramics. A3-shade RC promoted higher ΔE than A1-shade cement, regardless of the ceramic translucency. No significant difference in TP was noted between ceramic discs with A1- and those with A3-shade cement. Ceramic with underlying RC showed lower TP than discs without RC. HT ceramics showed lower chroma than LT ceramics, regardless of the resin cement shade. The presence of A3-shade RC resulted in higher chroma than the presence of A1-shade RC.

Conclusions

Darker underlying RC layer promoted more pronounced changes in ceramic translucency, chroma, and shade of high translucent ceramic veneers. These differences may not be clinically differentiable.

Analysis of Translucency Parameter of Glass-Ceramics Fabricated by Different Techniques

THE PURPOSE

of the study was to analyse translucency parameter (TP values) of glass-ceramics fabricated by different techniques and investigate the effect of the corrosive medium on TP values.

MATERIALS AND METHODS

Three specimens of each type of IPS e.max ceramics (Ivoclar Vivadent, Schaan, Liechtenstein) were made in three colours (A2, C2 and B3) by three fabrication techniques (layering - e.max Ceram Dentin; heat-pressing - e.max Press; CAD/CAM - e.max CAD). Specimens were made in the form of plates (10 mm x 12 mm x 0.8 mm). CIE L*a*b* values were measured by a spectrophotometer (X-Rite DTP 20 Pulse, Neu Isenburg, Germany) before and after exposure to 4% acetic acid at 80 °C for 16 hours (ISO 6872) to calculate translucency parameter (TP values). Statistical data were analysed using the IBM SPSS 22 software.

RESULTS

IPS e.max Ceram Dentin had significantly the lowest TP values, and IPS e.max Press the highest TP values of all colours (A2, C2, B3), both prior and after exposure to acid (p<0.001). The difference in TP values among colours was evident in the IPS e.max Ceram Dentin material, both before and after exposure to acid with a great effect size (p<0.001; η2 = 0.702 and 0.741), and in the IPS e.max Press material (p<0.001, effect size 0.547 and 0.576). CAD/CAD specimens showed uniform TP values between three colours. Further, exposure to a corrosive medium did not result in a statistically significant change of TP values in any of the materials tested.

CONCLUSIONS

Different types of glass-ceramics showed significant difference in TP values both with respect to the fabrication technique and colour. Exposure to a corrosive medium did not result in a statistically significant change of TP values.

Spectrophotometric evaluation of shade reproduction of pressable all-ceramic system on un-stained and stained tooth: An in vitro study

Purpose:

To evaluate the shade reproduction of a pressable all-ceramic system placed on unstained and stained extracted maxillary central incisor using a color measurement spectrophotometer. In addition, to compare shade reproduction of this material with low translucency and medium opacity on unstained tooth and medium and high opacity on stained tooth.

Materials and Methods:

Total 45 discs, with difference in the opacity of core, were used. After spectrophotometric evaluation, shade reproduction of the discs was compared and calculated by formula: Δ E* = ([Δ L*]²+ [Δ a*]²+ [Δ b*]²)^1/2.

Results:

Student's t-test showed that in a sample of 15, the values of Δ E* for Group I - LT (Us.T.) lie between 0 and l, for Group II - MO (for Us. as well as S.T.) between l and 2, for Group III - HO (S.T.) are all above 5. Comparison among groups after t-test showed that mean Δ E* values of Group I - LT is less than Group II - MO for the unstained tooth, Δ E* for Group II - MO is less than average Δ E* value of Group III - HO for stained tooth.

Conclusion:

All-ceramic with low translucency can be used for the fabrication of restoration on the unstained tooth as it gives the best shade reproduction. The medium opacity material may be used on the unstained as well as on stained tooth. However, the clinical implication of high opacity is limited when applied over the stained tooth as it is giving a shade reproduction, which is not within acceptable limits.

Effectiveness of Combination of Dentin and Enamel Layers on the Masking Ability of Porcelain

This study evaluated the masking ability of different porcelain thicknesses and combination of enamel and/or dentin porcelain layers over simulated background dental substrates with higher (A2) and lower (C4) color values. Combination of the enamel (E) and dentin (D) monolayer porcelain disks with different thicknesses (0.5 mm, 0.8 mm, and 1 mm) resulted in the following bilayer groups (n=10): D1E1, D1E0.8; D1E0.5; D0.8E0.8; D0.8E0.5, and D0.5E0.5. CIELAB color coordinates were measured with a spectrophotometer. The translucency parameter of mono and bilayer specimens and the masking ability estimated by color variation (ΔE*ab) of bilayer specimens over simulated dental substrates were evaluated. Linear regression analysis was used to investigate the relationships translucency parameter × ΔE*, translucency parameter × porcelain thickness, and ΔE* × porcelain thickness. Data were analyzed statistically (α= 0.05). Thinner porcelain disks were associated with higher translucency. Porcelain monolayers were considerably more translucent than bilayers (enamel + dentin). Dentin porcelain was less translucent than enamel porcelain with same thickness. ΔE* was always lower when measured over A2 background. Higher ΔE* was observed for the C4 background, indicating poorer masking ability. Increased ΔE* was significantly associated with increased translucency for both backgrounds. Decreased translucency and ΔE* were associated with increased total porcelain thickness or increased dentin thickness for both backgrounds. In conclusion, increased porcelain thickness (particularly increased dentin layer) and increased porcelain opacity resulted in better masking ability of the dental backgrounds.

The influence of resin cements on the final color of ceramic veneers

PURPOSE

To evaluate the effect of three brands of resin cement on the final color of ceramic veneers.

METHODS

50 disk-shaped ceramic specimens (IPS e.Max, 0.6mm×8.0mm diameter) and disk-shaped composite resin background specimens (4.0mm×8.0mm diameter) were prepared and divided into 10 groups (n=5). These paired specimens were bonded using ten shades of resin cement (Variolink Veneer, shades LV-3, LV-2, MV, HV+2, HV+3; Panavia F, shades light and brown; and RelyX™ Veneer, shades WO, TR, A3). A spectrophotometer (VITA Easyshade) was used to measure the color parameters (CIE L*a*b* values) of the paired disks before and after cementation. The color differences (ΔE values) after cementation were calculated and statistically analyzed by the One-way ANOVA (at the significant level p<0.05).

RESULTS

The color parameters of the ceramic disks were measured in terms of the increase in L* value, and the decrease in Cab(*) value after bonding with the resin cement. The ΔE values of ceramic disks after cementation ranged from 1.38 to 7.16. The ΔE values were more than 3.3 when the ceramic disks were cemented with resin cements in shade HV+3 (4.90) and shade WO (7.16). One-way ANOVA of ΔE values revealed significant differences in the resin cement shades.

CONCLUSIONS

Resin cements can affect the final color of ceramic veneer restorations, and the extent of this effect varies according to the resin cement shades.

Comparison of Shade of Ceramic with Three Different Zirconia Substructures using Spectrophotometer

OBJECTIVE

This study assessed how changing the Zirconia (Zr) substructure affected the color samples after they have been overlaid by the same shade of veneering ceramic.

MATERIALS AND METHODS

Three commercial Zr materials were tested in this study: Prettau(®) Zirconia (ZirKonZahn, Italy), Cercon (Dentsply, Germany) and InCoris ZI (Sirona, Germany). For each system, 15 disk-shaped specimens (10 × 1 mm) were fabricated. Three shades of A1, A2 and A3.5 of porcelain (IPS e.MaxCeram, IvoclarVivadent, USA) were used for layering the specimens. Five specimens from each type of Zr were layered with same shade of ceramic. Color measurements were recorderd by a spectrophotometer Color-Eye(®) 7000A (X-Rite, Grand Rapids, MI). Mean values of L, a, b color coordinates and ΔE were recorded and comparisons were made.

RESULTS

Differences in the ΔE were recorded for the same porcelain shade with different Zr substructures and affected the color of the specimens (p < 0.01, ANOVA). The maximum difference between the ΔE values for the A1, A2 and A3.5 shades with three types of Zr substructures was found to be 1.59, 1.69 and 1.45 respectively. Multiple comparisons of the ΔE with PostHoc Tukey test revealed a statistically significant difference (p < 0.05) between the three types of Zr, except between Type 2 Zr and Type 3 Zr for the Shade A1. The mean values of L, a, b and ΔE for the Prettau(®) Zirconia substructure were found to be the least among the three types.

CONCLUSIONS

The brand of Zr used influences the final color of the all ceramic Zr based restorations and this has clinical significance.

Effect of changes in sintering parameters on monolithic translucent zirconia

OBJECTIVES

Aim of this study was to evaluate the effect of different sintering parameters on color reproduction, translucency and biaxial flexural strength of monolithic zirconia.

METHODS

Translucent zirconia discs having 15mm diameter, 1mm thickness, and shade A3 were milled and divided according to the sintering temperatures (1460°C, 1530°C, and 1600°C) into three groups (n=30). Each group was later divided into three subgroups (n=10) according to the sintering holding time (1, 2, and 4h). Easyshade spectrophotometer (Vita, Bad Säckingen, Germany) was used to obtain the ΔE between the specimens and the shade A3. Mean ΔE values below 3.0 were considered "clinically imperceptible", ΔE values between 3.0 and 5.0 were considered "clinically acceptable" and ΔE values above 5.0 were considered "clinically unacceptable". Contrast ratio (CR) was obtained after comparing the reflectance of light through the specimens over black and white background. Biaxial flexural strength was tested using the piston-on-three balls technique in a universal testing machine.

RESULTS

Mean ΔE results ranged from 4.4 to 2.2. Statistically significant decrease in the Delta E was observed as the sintering time and temperature increased. CR decreased from 0.75 to 0.68 as the sintering time and temperature increased. No significant change in the biaxial flexural strength was observed.

SIGNIFICANCE

Sintering zirconia using long cycles and high temperatures will result in reduction of ΔE and CR. Biaxial flexural strength is not affected by changes in the evaluated sintering parameters.

Ceramic materials for porcelain veneers: part II. Effect of material, shade, and thickness on translucency

STATEMENT OF PROBLEM

Information regarding the differences in translucency among new ceramic systems is lacking.

PURPOSE

The purpose of this study was to compare the relative translucency of the different types of ceramic systems indicated for porcelain veneers and to evaluate the effect of shade and thickness on translucency.

MATERIAL AND METHODS

Disk specimens 13 mm in diameter and 0.7-mm thick were fabricated for the following 9 materials (n=5): VITA VM9, IPS Empress Esthetic, VITA PM9, Vitablocks Mark II, Kavo Everest G-Blank, IPS Empress CAD, IPS e.max CAD, IPS e.maxPress, and Lava Zirconia. VITA VM9 served as the positive control and Lava as the negative control. The disks were fabricated with the shade that corresponds to A1. For IPS e.maxPress, additional disks were made with different shades (BL2, BL4, A1, B1, O1, O2, V1, V2, V3), thickness (0.3 mm), and translucencies (high translucency, low translucency). Color coordinates (CIE L∗ a∗ b∗) were measured with a tristimulus colorimeter. The translucency parameter was calculated from the color difference of the material on a black versus a white background. One-way ANOVA, the post hoc Tukey honestly significant difference, and the Ryan-Einot-Gabriel-Welsch multiple range tests were used to analyze the data (α=.05).

RESULTS

Statistically significant differences in the translucency parameter were found among porcelains (P<.001) according to the following rank: VM9>PM9, Empress Esthetic>Empress CAD>Mark II, Everest, e.max CAD>e.max Press>Lava. Significant differences also were noted when different shades and thickness were compared (P<.001).

CONCLUSIONS

Different ceramic systems designed for porcelain veneers present varying degrees of translucency. The thickness and shade of lithium disilicate ceramic affect its translucency. Shade affects translucency parameter less than thickness.

Effect of Ceramic Thickness and Luting Agent Shade on the Color Masking Ability of Laminate Veneers

The main objective of the study was to recognize the effect of ceramic thickness and luting agent on the extent to which the restoration masks color variations that may be present in the underlying dental structure. Two pressable ceramics were used: Lithium disilicate reinforced (IPS e.max- Ivoclar Vivadent) and Leucite reinforced (Cergo- Dentsply). Fifteen ceramic discs were manufactured from each ceramic and divided into three groups, according to the thickness (0.5, 1, 1.5 mm). To simulate the color of a dark underlying dental structure, background discs, color C3, with 20 mm diameter, were made using resin composite. The ceramic discs with varying thicknesses were seated on the dark background of the resin composite with either resinous opaque cement or resinous cement. The color parameters were determined by the CIE Lab system of colors using a spectrophotometer and color differences (ΔE) were calculated. The results were then statistically analyzed, using ANOVA test and Tukey HSD test. The ΔE values of both ceramic systems were affected by both the luting agent and the ceramic thickness (P < 0.05). The use of an opaque luting agent resulted in an increase of the ΔE* values for all ceramics tested, regardless of the thickness. For the 1.5-mm thick veneers, higher values in the color parameters were obtained for both ceramic materials. The color masking ability of ceramics used for laminate veneers is significantly affected by the thickness of the ceramic and the shade of the luting agent used.

Translucency of dental ceramics with different thicknesses

STATEMENT OF PROBLEM

The increased use of esthetic restorations requires an improved understanding of the translucent characteristics of ceramic materials. Ceramic translucency has been considered to be dependent on composition and thickness, but less information is available about the translucent characteristics of these materials, especially at different thicknesses.

PURPOSE

The purpose of this study was to investigate the relationship between translucency and the thickness of different dental ceramics.

MATERIAL AND METHODS

Six disk-shaped specimens of 8 glass ceramics (IPS e.max Press HO, MO, LT, HT, IPS e.max CAD LT, MO, AvanteZ Dentin, and Trans) and 5 specimens of 5 zirconia ceramics (Cercon Base, Zenotec Zr Bridge, Lava Standard, Lava Standard FS3, and Lava Plus High Translucency) were prepared following the manufacturers' instructions and ground to a predetermined thickness with a grinding machine. A spectrophotometer was used to measure the translucency parameters (TP) of the glass ceramics, which ranged from 2.0 to 0.6 mm, and of the zirconia ceramics, which ranged from 1.0 to 0.4 mm. The relationship between the thickness and TP of each material was evaluated using a regression analysis (α=.05).

RESULTS

The TP values of the glass ceramics ranged from 2.2 to 25.3 and the zirconia ceramics from 5.5 to 15.1. There was an increase in the TP with a decrease in thickness, but the amount of change was material dependent. An exponential relationship with statistical significance (P<.05) between the TP and thickness was found for both glass ceramics and zirconia ceramics.

CONCLUSIONS

The translucency of dental ceramics was significantly influenced by both material and thickness. The translucency of all materials increased exponentially as the thickness decreased. All of the zirconia ceramics evaluated in the present study showed some degree of translucency, which was less sensitive to thickness compared to that of the glass ceramics.

How will surface treatments affect the translucency of porcelain laminate veneers?

PURPOSE

The purpose of this study was to evaluate whether surface treatments affect the translucency of laminate veneers with different shades and thicknesses.

MATERIALS AND METHODS

A total of 224 disc-shaped ceramic veneers were prepared from A1, A3, HT (High Translucent) and HO (High Opaque) shades of IPS e.max Press (Ivoclar Vivadent) with 0.5 mm and 1.0 mm thicknesses. The ceramics were divided into four groups for surface treatments. Group C: no surface treatments; Group HF: etched with hydrofluoric acid; Group SB: sandblasted with 50-µm Al₂O₃; and Group L; irradiated with an Er;YAG laser. A translucent shade of resin cement (Rely X Veneer, 3M ESPE) was chosen for cementation. The color values of the veneers were measured with a colorimeter and translucency parameter (TP) values were calculated. A three-way ANOVA with interactions for TP values was performed and Bonferroni tests were used when appropriate (α=0.05).

RESULTS

There were significant interactions between the surface treatments, ceramic shades and thicknesses (P=.001). For the 0.5-mm-thick specimens there were significant differences after the SB and L treatments. There was no significant difference between the HF and C treatments for any shades or thicknesses (P>.05). For the 1-mm-thick ceramics, there was only a significant difference between the L and C treatments for the HT shade ceramics (P=.01). There were also significant differences between the SB and C treatments except not for the HO shades (P=.768).

CONCLUSION

The SB and L treatments caused laminate veneers to become more opaque; however, HF treatment did not affect the TP values. When the laminate veneers were thinner, both the shade of the ceramic and the SB and laser treatments had a greater effect on the TP values.

Achieving the desired colour in discoloured teeth, using leucite-based CAD-CAM laminate systems

OBJECTIVES

To evaluate the cumulative effect of the abutment tooth and resin cement colour on the resultant optical properties of porcelain laminate veneers (PLVs) fabricated with leucite-based CAD/CAM blocks with different shades and thicknesses.

METHODS

A total of 224 ceramic specimens were prepared from the IPS Empress CAD with four different shades of HT-A1, LT-A1, MT-A1 and Bl-1. Resin composite discs were prepared with shade A3.5. For the cementation, 4 different shades of light-cure resin cements were chosen. L*, a*, and b* values, as well as the chroma (C) and hue (h) values of each cemented ceramic and the A1 shade table, were recorded.

RESULTS

L*, Cab* and hab* values of the cemented ceramics were influenced by ceramic shade, ceramic thickness, cement shade, and interaction terms of the three variables. There were significant differences between the 1-mm-thick ceramic veneers that exhibited higher L* and lower Cab* values compared with veneers that were 0.5mm in thickness. Using the Tr shade cement resulted in lower L* and higher Cab* values for all thicknesses and ceramic shades, whereas the WO shade cement resulted in higher values.

CONCLUSIONS

The selected colour of a laminate restoration is significantly affected by the ceramic shade, ceramic thickness and resin cement shade. Using the WO shade resin cement seems to be more effective in masking the discoloured abutment tooth. Clinicians should also select the translucency level of the ceramic block with the shade when a leucite-based CAD/CAM system is chosen to treat a discoloured tooth.

Effect of resin cement and ceramic thickness on final color of laminate veneers: an in vitro study

STATEMENT OF PROBLEM

Different shades of resin cements may adversely affect the final color of translucent restorations, especially thin laminates.

PURPOSE

The purpose of this study was to determine the effect of different types and shades of resin cement and different thicknesses and shades of IPS Empress Esthetic ceramics on the final color of laminate restorations.

MATERIAL AND METHODS

A total of 392 disks were made with A1, A3, EO, and ET shades of IPS Empress Esthetic with 0.5-mm and 1-mm thicknesses. Two dual-polymerizable and 2 light-polymerizable resin cement systems from different manufacturers (a total of 13 shades) were selected for cementation (n=7). Similarly, with porcelain ingot shades A1 and A3, opaque and translucent shades were selected from the Rely X Veneer and Maxcem Elite cement systems. For the opaque and translucent shades of the Variolink II resin cement system, the highest and lowest (+3 and -3) and medium (0) shades of Variolink Veneer cement were included in the study. Color changes in the porcelain substructures after cementation were examined with a colorimeter, and color differences (ΔE) were calculated. The results were analyzed with Wilcoxon signed-ranks and Kruskal-Wallis tests (α=.05).

RESULTS

The results indicated that the color of porcelain disks changed significantly after cementation (P<.001). Most of the color changes appeared after cementation with Variolink-3 Veneer in all porcelain shades. The smallest color change was obtained from Variolink II Tr in the EO shade of porcelain. The colors of the same shades of different resin cement systems were found at different coordinates in the CIE L*a*b* system. The final color difference (ΔE) of cemented veneers decreased when ceramic thickness increased.

CONCLUSIONS

The type and shade of resin cement and the thickness and shade of the ceramic all influenced the resulting optical color of laminate restorations.