The effect of thermocyclic aging on color stability of high translucency monolithic lithium disilicate and zirconia ceramics luted with different resin cements: an in vitro study

The impact of Streptococcus mutans biofilms on the color stability and topographical features of three lithium disilicate ceramics

PURPOSE

Secondary caries around ceramic restorations is the most common reason for the replacement of fixed dental prostheses (FDPs). Therefore, it is important to examine the susceptibility of different ceramic materials to biofilm formation. This study aimed to evaluate biofilm development and associated roughness and color alterations in three lithium disilicate ceramics: Emax CAD (EC), Emax Press (EP), and LiSi Press (LP).

MATERIALS AND METHODS

Streptococcus mutans biofilms were grown on the three ceramics (n = 10 per group) for 7 days. Surface roughness values and color alteration were assessed before and after the biofilm using a non-contact profilometer and spectrophotometer, respectively. Biofilm growth was evaluated using colony-forming units (CFUs) and scanning electron microscope (SEM) images. The data were analyzed using one-way ANOVA and Tukey tests.

RESULTS

There was a significant (p ≤ 0.001) growth of S. mutans colonies on EC (6.75 ± 0.56) and EP (6.72 ± 0.54) specimens compared to LP, which showed no biofilm growth. The change in average surface roughness (∆Ra, nm) was significantly lower (p < 0.001) in the EC specimens (0.029 ± 0.003) compared to the EP (0.055 ± 0.012) and LP (0.041 ± 0.010). When the changes in the Rv and Rt values were investigated, no significant difference was observed among the groups. Following the biofilm challenge, the change in color (∆E00) was significantly lower (p = 0.005) in the LP group (1.68 ± 1.45) compared to the EC group (3.89 ± 1.50) and no significant difference was observed between the EP group (2.74 ± 1.01) and the other two ceramics (p ≥ 0.05).

CONCLUSION

LP ceramics exhibited superior resistance to S. mutans biofilm formation and associated changes in surface roughness and color compared to the Emax CAD and Emax Press ceramics. These findings suggest that the LiSi Press material may be more favorable to mitigate the risk of secondary caries.

The effects of cement thickness and cement shade on the final color of lithium disilicate crowns

PURPOSE

The aim of this study is to evaluate the effect of resin cement color, cement thickness, and thermocycling on the final color of monolithic lithium disilicate crowns.

MATERIALS AND METHODS

A total of ninety prepared central incisors of typodont teeth were restored with lithium disilicate crowns which have different cement thicknesses (40 µm, 80 µm, and 120 µm) and cement shades (clear, yellow, and white). Color parameters of restorations were measured with a spectrophotometer in three different steps 1) before cementing 2) after cementing and 3) after thermocycling with 10000 cycles. Color differences (ΔE₀₀) were calculated with the CIEDE2000 formula and evaluated according to perceptibility (0.8) and acceptability (1.8) thresholds. The ΔE₀₀ data were analyzed by using two-way ANOVA before and after thermocycling (α = .05).

RESULTS

There was no interaction between the cement shade and the cement thickness factors. After cementation, the mean ΔE₀₀ was under the perceptibility threshold in the group of 40 µm cement thickness and clear cement while it was between the perceptibility and acceptability thresholds (0.8 < ΔE₀₀ < 1.8) for all other groups. After thermocycling, the ΔE₀₀ values were between the perceptibility and acceptability thresholds for all experimental groups. Although there were no significant differences among the groups, thermocycling increased the color difference values.

CONCLUSION

The cementation of restorations with clear, yellow, and white resin cements resulted in color differences with uncemented restorations except for the group cemented with clear cement in 40 µm cement thickness. All study groups revealed perceptible color change after thermocycling.

Effect of Simulated Mastication on Structural Stability of Prosthetic Zirconia Material after Thermocycling Aging

Recent trends to improve the aesthetic properties-tooth-like color and translucency-of ceramic dental crowns have led to the development of yttria-stabilized zirconia (Y-TZP) materials with higher stabilizer content. These 5Y-TZP materials contain more cubic or t' phase, which boosts translucency. The tradeoff as a consequence of a less transformable tetragonal phase is a significant reduction of strength and toughness compared to the standard 3Y-TZP composition. This study aims at determining the durability of such 5Y-TZP crowns under lab conditions simulating the conditions in the oral cavity during mastication and consumption of different nutrients. The test included up to 10,000 thermal cycles from 5 °C to 55 °C "from ice cream to coffee" and a chewing simulation representing 5 years of use applying typical loads. The investigation of the stress-affected zone at the surface indicates only a very moderate phase transformation from tetragonal to monoclinic after different varieties of testing cycles. The surface showed no indication of crack formation after testing. It can, therefore, be assumed that over the simulated period, dental crowns of 5Y-TZP are not prone to fatigue failure.

Color Stability of Resin Cements after Water Aging

The color stability of resin cements plays a key role in the achievement of esthetically-pleasant restorations. Resin luting materials can be mainly divided into two main classes: adhesive (relying on previous application of adhesive systems) or self-adhesive (also known as one-step cements). The different chemical compositions determine their physio-mechanical characteristics which, in turns, influence their color stability. To evaluate the color variations of different dual-cured resin cements after water aging, 80 disc-shaped specimens (15 mm in diameter and 1.2 mm thick) were obtained from the following resin cements (n = 10): (1) Maxcem Elite Universal, MCU (Kerr); (2) RelyX Universal, RXU (3M); (3) Calibra Ceram, CAL (Dentsply); (4) Multilink, MUL (Ivoclar-Vivadent); (5) Panavia V5, PAN (Kuraray); (6) Calibra Universal, CUN (Dentsply); (7) SpeedCEM Plus, SCP (Ivoclar); and (8) Panavia SA, PSA (Kuraray). After light-polymerization, the specimens were measured with a spectrophotometer and CIELab* values were recorded. The specimens were then placed in a digitally controlled thermostatic water bath at 60° for 30 days and afterwards the color measurements were repeated. Color differences were calculated for each specimen before and after water-aging procedures with ΔEab formula and the data were statistically analyzed (p < 0.05). The type of cement statistically influenced the ΔEab (p < 0.05), with MCU showing the lowest color variations (4.3 ± 0.7) whereas RXU and PSA the highest (16.9 ± 1.6 and 16.8 ± 1.2, respectively). No differences were observed between CAL, CUN and SCP (p = 0.05). Color stability is related to the chemical composition of the resinous luting materials, thus material dependent.

Effect of Different Shading Techniques on the Color of Zirconia Ceramic Restoration (An In vivo Study)

BACKGROUND: The color of all ceramic restorations has a significant effect on the final appearance of the restoration. AIM: This study aimed to evaluate the effect of different shading techniques on the color stability of monolithic zirconia crowns cemented on the upper anterior teeth. METHODS: In this study, there were nine patients. Each patient has undergone a reduction for the upper six anterior teeth. Fifty-four zirconia jacket crowns were constructed using CAD/CAM technique. According to the shading technique, the crowns were categorized into two groups (pre-shaded and liquid shaded), where the upper right reduced teeth received pre-shaded zirconia crowns while the upper left reduced teeth received liquid-shaded zirconia crowns according to the selected shade. The color was assessed using easy shade after cementation and 1 year follow-up period. Data were collected, tabulated, and statistically analyzed. RESULTS: Color change (ΔE) of the cemented pre-shaded zirconia crowns on the upper right central incisors, lateral incisors, and canines was 2.37, 2.84, and 1.92, respectively, while color change (ΔE) of the cemented liquid-shaded zirconia crowns on the upper left central incisors, lateral incisors, and canines was 2.52, 2.88, and 2.77, respectively. Color change of both pre-shaded and liquid-shaded zirconia crowns after 1 year follow-up was within the clinically acceptable range 1>E>3.7, and there was no significant difference between them. CONCLUSIONS: The aging and technique of shading had no significant effect on the color of zirconia ceramic.