The Effect of Luting Cement and Titanium Base on the Final Color of Zirconium Oxide Core Material

Effect of cement type on vertical marginal discrepancy and residual excess cement in screwmentable and cementable implant-supported monolithic zirconia crowns

The purpose of this study was to investigate the vertical marginal discrepancy (VMD) and residual excess cement (REC) of cementable and screwmentable monolithic zirconia crowns cemented with different types of cement. Abutments were attached to 40 implant analogues. Crowns were created using computer-aided design/computer-aided manufacturing technology from monolithic zirconia blocks, either with or without a screw access hole (SAC). Crowns created both ways were split into two groups and cemented with resin and zinc polycarboxylate cement under a 5-kg weight. VMD and REC values were evaluated using an X20 zoom stereomicroscope. Data were analysed using two-way ANOVA and the Bonferroni test. According to the two-way ANOVA results, REC measurements differed significantly in the crown design and cement groups. However, whilst VMD values were significantly different in both crown design groups, there was no significant difference in the cement groups. According to the Bonferroni test results, the highest REC (157.241 ± 44.29 µm) and VMD (68.052 ± 16.19 µm) values were found in the crowns without SAC and cemented with zinc polycarboxylate. Screwmentable crowns are more effective than cementable crowns in reducing REC and VMD. Whilst polycarboxylate cement reduces VMD in screwmentable crowns, resin cement is more suitable for cementable crowns.

The effects of provisional resin cements on the color and retentive strength of all-ceramic restorations cemented on customized zirconia abutments

This study aimed to evaluate the effects of two types of provisional resin cements on the color and retentive strength of two different all-ceramic restorations cemented onto customized zirconia abutments. Forty-two crowns were made of monolithic zirconia and lithium disilicate ceramics (n = 21 per group) and cemented on customized zirconia abutments by using two provisional resin cements of TempBond Clear and Implantlink Semi, and TempBond serving as the control (n = 7 per cement subgroup). The specimens’ color was measured before and after cementation and after thermocycling. The color difference was calculated by using CIEDE2000 formula (ΔE₀₀). The tensile force was applied to assess the retentive strength. Kruskal-Wallis, Dunn’s post-hoc, and Mann-Whitney non-parametric tests were used to compare ΔE₀₀(1) and ΔE₀₀(2) and two-way ANOVA followed by one-way ANOVA and Tukey’s HSD post hoc test and T-test were used to compare retentive strength between subgroups. In the lithium disilicate group, ΔE₀₀ of the control subgroup (TempBond) was significantly higher than that of Implantlink Semi cements subgroup (P = 0.001). But, in the monolithic zirconia group, ΔE₀₀ of the control subgroup (TempBond) was significantly higher than that of Implantlink Semi (P = 0.020) and TempBond Clear cements (P = 0.007). In the monolithic zirconia group, the control subgroup (TempBond) was significantly more retentive than TempBond Clear (P = 0.003) and Implantlink Semi cement (P = 0.001). However, in the lithium disilicate group, Implantlink Semi cement was significantly more retentive than TempBond Clear (P = 0.019) and TempBond (control) (P = 0.001). The final color of both restorations was significantly affected by the provisional resin cement type. The retentive strength was influenced by both the type of cement and ceramic.

Effects of surface treatments and abutment shades on the final color of high-translucency self-glazed zirconia crowns

STATEMENT OF PROBLEM

Achieving excellent esthetics with monolithic self-glazed zirconia crowns in anterior teeth is challenging, and the impact of different surface treatments and abutment shades on the final color is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of different external surface treatments (self-glazed, milled, polished, and glazed), different intaglio surface treatments (milled and airborne-particle abraded), and different abutment shades on the color difference of high-translucency self-glazed zirconia crowns.

MATERIAL AND METHODS

Sixty shade A1 and 60 shade A3 crowns were fabricated with a thickness of 0.80 ±0.02 mm and randomly divided into 12 groups (n=10). Different external and intaglio surface treatments were applied. Shade A1 and A3 abutments were made with composite resin. Color was measured with a spectrophotometer and expressed in CIELab coordinates, and color differences (ΔE₀₀) between specimens and references were calculated. The data were analyzed with ANOVA and the Tukey post hoc test. The impact of different surface treatments and abutment shades on the color difference were compared by using multiple linear regression (α=.05).

RESULTS

The effects of external surface treatments, intaglio airborne-particle abrasion, and abutment shades on the L∗, a∗, b∗ and ΔE₀₀ values of the final color of the crowns were significantly different (P<.001). Polishing resulted in the greatest ΔE₀₀ value among all external surface treatments (P<.001). The average ΔE₀₀ values of all crowns on the A3 abutment were higher than those of all crowns on the A1 abutment (P<.001). The influence on the color difference was abutment>external surface treatment>intaglio surface treatment.

CONCLUSIONS

Different surface treatments affected the final color of zirconia crowns, and a greater impact was seen with external surface treatments than with intaglio surface treatments. External polishing resulted in the greatest color difference. The abutment shade had the most effect on the color difference, as the darker the abutment color, the greater the color difference.

Monolithic Zirconia FPD on Modified Titanium Bonding Bases in Limited Interocclusal Distance: A Case Report

A 62-year-old male patient sought treatment for missing maxillary teeth. A diagnostic cast demonstrated that the interocclusal distance was insufficient. A 5-unit screw-retained implant-supported fixed partial denture (FPD) was used to restore missing maxillary teeth. The restoration of multiple missing teeth using an implant-supported FPD is challenging when the interocclusal distance is limited due to lack of retention and inadequate esthetics. In this case, a hexagonal, screw-retained, and subgingivally located titanium-based zirconia implant-supported FPD with a conical abutment base was used for restoration to overcome the limited interocclusal distance. This implant-supported FPD, consisting of CAD/CAM-designed monolithic zirconia cemented to a titanium bonding base in the laboratory, is expected to facilitate predictable retention and adequate esthetics as well as provide ease of retrieval.

Effects of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations

Background. Effects of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations are unclear. The aim of this study was to evaluate the impacts of veneering porcelain thickness and background shade on the shade match of zirconia-based restorations.

Methods. Forty A2 shade veneered zirconia disk specimens (10 mm in diameter) were fabricated, with veneering porcelain thicknesses of 1.6, 1.8, 2.0 and 2.2 mm. Three backgrounds were made of A2 shade composite resin (A2), nickel-chromium alloy (NC) and amalgam (AM). The veneered zirconia specimens were placed on the backgrounds. CIELab values were measured with a spectrophotometer. ΔE values were measured to determine color differences between the specimens and the A2 VITA classical shade (target shade). ΔE values were compared with an acceptability threshold (ΔE=3.7). Repeated measures ANOVA, Bonferroni, and 1-sample t-test were used to analyze data (P<0.05).

Results. Mean ΔE values ranged between 1.9 and 5.0. The veneering porcelain thickness, the background shade and their interaction affected the ΔE (P<0.0001). The minimum veneering porcelain thickness for the shade match was 2 mm for NC and 1.8 mm for AM.

Conclusion. Veneering porcelain thickness and background shade affected the shade match of zirconia-based restorations. With dark-shaded backgrounds, the amount of veneering porcelain thickness needed for the shade match might be beyond acceptable clinical limits. Tooth-shaded backgrounds are esthetically advocated rather than dark-shaded backgrounds in zirconia-based restorations.