In vitro marginal fit of three all-ceramic crown systems before and after cementation

Marginal adaptation of different monolithic zirconia crowns with horizontal and vertical finish lines: A comparative in vitro study

Background

This study evaluated the influence of different tooth preparation techniques and zirconia materials on marginal adaptation.

Methods

Forty-eight healthy human maxillary first premolars were divided into two primary groups based on preparation design: group A (chamfer) and group B (vertical). Within each main group, there were three subgroups, comprising eight teeth each, distinguished by the type of zirconia material employed (Zircad LT, MT, and Prime by Ivoclar Vivadent). All the samples were prepared by the same operator using a dental surveyor. Intraoral scanning was performed on the prepared teeth. SironaInLab CAD 20.0 software was used to design crowns, which were subsequently generated using a 5-axis milling machine. The crowns were cemented to their respective teeth with self-adhesive resin cement. Marginal gap measurements were taken in micrometers (μm) before and after cementation at 16 sites per sample using a digital microscope at×230 magnification. The collected data were evaluated using statistical analysis using the independent t-test, paired t-test, and ANOVA at an 0.05 significance level.

Results

The vertical preparation group exhibited the smallest marginal gap, while the chamfer group displayed the largest. This disparity was statistically significant (P<0.05) for pre- and post-cementation measurements across all materials. There were no significant differences between the different monolithic zirconia crowns.

Conclusion

The vertical preparation design illustrated significantly better marginal adaptation than the chamfer preparation design. Comparisons between materials showed comparable marginal gaps. The mean values of the marginal gaps in all groups increased significantly after cementation.

Evaluation of the marginal adaptation and debonding strength of two types of CAD-CAM implant-supported cement-retained crowns

BACKGROUND

In-vitro data from a clinically well-known lithium disilicate ceramic reference was used to assess the expected performance of resin-based materials in implant dentistry. The purpose of the study was to compare the bond strength and marginal adaptation of nano-ceramic hybrid composite crowns cemented to stock cement-retained abutments to lithium disilicate crowns.

METHODS

Twenty abutment analogs were embedded into auto-polymerizing acrylic resin blocks. The blocks were divided into 2 groups according to the restorative crown material. The 2 groups were divided as follows: Resin nano-ceramic group and lithium disilicate group. Abutment analogs in both groups were scanned using a laboratory scanner, and the restorations were designed, manufactured, and cemented with resin cement over the corresponding group. All samples were tested for marginal adaptation and bond strength after storage for 24 hours at 37 °C in 100% humidity. Data were collected, tabulated, and statistically analysed using the appropriate tests. Normality was checked using Shapiro Wilk test and Q-Q plots. Data were normally distributed. Variables were presented using mean, 95% Confidence Interval (CI) and standard deviation in addition to median and Inter Quartile Range (IQR). Differences between groups regarding debonding forces was assessed using independent t test. Two Way ANOVA was performed to assess the effect of material and bonding on marginal gap. All tests were two tailed and p value was set at < 0.05.

RESULTS

Marginal gap and debonding force values were significantly different according to the type of material used (P < .05). Resin nano-ceramic crowns presented lower marginal gap values before (20.80 ± 8.87 μm) and after (52.11 ± 22.92 μm) bonding than lithium disilicate crowns. The debonding force value for resin nano-ceramic crowns (284.30 ± 26.44 N) was significantly higher than that for lithium disilicate crowns (253.30 ± 33.26 N). Adhesive failure mode was detected in all the specimens in both groups.

CONCLUSIONS

The type of material used for implant-supported cement-retained crowns had a statistically significant effect on marginal adaptation and bond strength. Resin nano-ceramic implant-supported cement-retained crowns had better marginal adaptation and higher bond strength than those manufactured using lithium disilicate.

Fracture strength and three-dimensional marginal evaluation of biocompatible high-performance polymer versus pressed lithium disilicate crowns

STATEMENT OF PROBLEM

Despite the acceptable physical properties of biocompatible high-performance polymer (BioHPP), little is known about the marginal accuracy and fracture strength of restorations made from this material.

PURPOSE

This in vitro study assessed the marginal and internal adaptation and fracture strength of teeth restored with lithium disilicate (LD) ceramics and BioHPP monolithic crowns.

MATERIAL AND METHODS

Twenty-four extracted premolars were prepared for complete coverage crowns and divided into 2 groups to receive pressed IPS e.max LD, or computer-aided design and computer-aided manufacturing (CAD-CAM) BioHPP monolithic crowns. After adhesive cementation, the marginal and internal adaptations of the restorations were evaluated by microcomputed tomography at 18 points for each crown. Specimens were subjected to 6000 thermal cycles at 5 °C and 55 °C and 200 000 load cycles of 100 N at a frequency of 1.2 Hz. The fracture strength of the restorations was then measured in a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed via an independent-sample t-test (α=.05).

RESULTS

The mean ±standard deviation of marginal gap was 138.8 ±43.6 μm for LD and 242.1 ±70.7 μm for BioHPP groups (P=.001). The mean ±standard deviation value of absolute marginal discrepancy was 193.8 ±60.8 μm for LD and 263.5 ±97.6 μm for BioHPP groups (P=.06). The internal occlusal and axial gap measurements were 547.5 ±253.1 μm and 197.3 ±54.8 μm for LD (P=.03) and 360 ±62.9 μm and 152.8 ±44.8 μm for BioHPP (P=.04). The mean ±standard deviation of internal space volume was 15.3 ±11.8 μm³ for LD and 24.1 ±10.7 μm³ for BioHPP (P=.08). The mean ±standard deviation of fracture strength was 2509.8 ±680 N for BioHPP and 1090.4 ±454.2 MPa for LD groups (P<.05).

CONCLUSIONS

The marginal adaptation of pressed lithium disilicate crowns was better, while BioHPP crowns displayed greater fracture strength. Marginal gap width was not correlated with fracture strength in either group.

The Effect of a Digital Manufacturing Technique, Preparation Taper, and Finish Line Design on the Marginal Fit of Temporary Molar Crowns: An In-Vitro Study

The aim of this study is to investigate the combined effect of a digital manufacturing technique (subtractive vs. additive), preparation taper (10° vs. 20° TOC), and finish line (chamfer vs. shoulder) on the marginal adaptation of temporary crowns following cementation with a compatible temporary cement. Four mandibular first molar typodont teeth were prepared for full coverage crowns with standard 4 mm preparation height as follows: 10° TOC with the chamfer finish line, 10° TOC with the shoulder finish line, 20° TOC with the chamfer finish line and 20° TOC with the shoulder finish line. Each of the four preparation designs were subdivided into two subgroups to receive CAD/CAM milled and 3D-printed crowns (n = 10). A total of 80 temporary crowns (40 CAD/CAM milled and 40 3D-printed) were cemented to their respective die using clear temporary recement in the standard cementation technique. The samples were examined under a stereomicroscope at ×100 magnification following calibration. Linear measurements were performed at seven equidistant points on each axial surface and five equidistant points on each proximal surface. One-way ANOVA analysis and Tukey HSD (Honestly Significance Difference) were performed. The best marginal fit was seen in group 8, while the poorest fit was noted in group 2. Shoulder finish lines and 10° TOC resulted in higher marginal gaps, especially in CAD/CAM milled group. The selection of 3D-printed crowns may provide a better marginal fit within the range of clinical acceptability. Marginal gaps were within clinical acceptability (50 and 120 µm) in all groups except group 2.

The Effect of Various Cementing Agents on Occlusal Discrepancy Using an Intra-Oral Scanner: An In Vivo Study

A marginal fit of all-ceramic crowns is a prerequisite for the long-term clinical success of a dental restoration. Few in vivo studies have investigated the effect of the film thickness of various luting agents on vertical discrepancy. This in vivo study evaluated the influence of three luting cements on the occlusal vertical discrepancy of milled crowns using a complete digital workflow. Forty-three patients treated in a students’ clinic in Tel-Aviv University with 45 single posterior digitally prepared monolithic crowns were included in the study. The crowns were randomly divided into three groups using different resin luting agents: self-adhesive resin cement, resin-modified glass ionomer cement and adhesive resin cement. The crowns were intra-orally scanned before and after cementation. The two standard tessellation language (STL) files for each crown were superimposed using digital software, and between four and six measurements were made at the occlusal surface to demonstrate the occlusal and marginal discrepancies. One-way ANOVA (α = 0.05) was used. The vertical occlusal discrepancy ranged from 2 to 38 μm. The mean vertical discrepancy values were (µm): self-adhesive resin = 12.93 ± 4.74, resin-modified glass ionomer = 19.05 ± 4.60 and adhesive resin = 13.69 ± 5.17. There were significant differences between resin-modified and self-adhesive cement groups (p = 0.004), and between resin-modified and adhesive resin cement groups (p = 0.013). Distal marginal ridge measurements were significantly different between resin-modified glass ionomer cement and self-adhesive resin cement group (p < 0.001) and the adhesive resin cement group (p = 0.021). There were no significant differences between the discrepancy values at the two measurement points in the self-adhesive cement group (p = 0.377), nor the resin-modified glass ionomer group (p = 0.388), or the adhesive resin cement group (p = 0.905). The cementation procedure with various resin cements results in occlusal vertical discrepancies within standard clinical acceptability. Resin-modified glass ionomer cement produced more vertical discrepancy than adhesive and self-adhesive resin cements did.

Does Resin Cement Type and Cement Preheating Influence the Marginal and Internal Fit of Lithium Disilicate Single Crowns?

This paper assesses the effect of cement type and cement preheating on the marginal and internal fit of lithium disilicate single crown. Methods: 40 maxillary premolars were selected, restored with lithium disilicate single crowns. Teeth were randomly assigned into four groups (n = 10) based on cement type (Panavia SA or LinkForce) and preheating temperature (25 °C or 54 °C). After fabrication of the restoration, cements were incubated at 25 °C or 54 °C for 24 h, and each crown was cemented to its corresponding tooth. After 24 h, all specimens were thermally aged to (10,000 thermal cycles between 5 °C and 55 °C), then load cycled for 240,000 cycles. Each specimen was then sectioned in bucco-palatal direction and inspected under a stereomicroscope at x45 magnification for marginal and internal fit evaluation. The data were statistically analyzed (significance at p ≤ 0.05 level). Results: At the mid-buccal finish line, mid-buccal wall, palatal cusp, mid-palatal wall, mid-palatal finish line, and palatal margin measuring points, there was a significant difference (p ≤ 0.05) between the lithium disilicate group cemented with Panavia SA at 25 °C and the group cemented with LinkForce at 25 °C, while there was no significant difference (p > 0.05) at the other points. At all measuring points, except at the palatal cusp tip (p = 0.948) and palatal margin (p = 0.103), there was a statistically significant difference (p ≤ 0.05) between the lithium disilicate group cemented with Panavia SA at 54 °C and the group cemented with LinkForce at 54 °C. Regardless of cement preheating, statistically significant differences were found in the buccal cusp tip, central groove, palatal cusp tip, and mid-palatal wall (p ≤ 0.05) in the lithium disilicate group cemented with Panavia SA at 25 °C and 54 °C, as well as the mid-palatal chamfer finish line and palatal margin in the LinkForce group cemented with Panavia SA at 25 °C and 54 °C. At the other measurement points, however, there was no significant difference (p > 0.05). Conclusions: The type of resin cement affects the internal and marginal fit of lithium disilicate crowns. At most measuring points, the cement preheating does not improve the internal and marginal fit of all lithium disilicate crowns.

Effect of cement space on marginal discrepancy and retention of CAD/CAM crown

This research aimed to evaluate the effect of cement space on the marginal discrepancy and retention of computer-aided design/computer-aided manufacturing (CAD/CAM) crowns. A total of 30 premolar Frasaco teeth were machined to receive crowns with cement spaces of 70, 90, and 110 μm. The marginal discrepancy measurements were done before and after cementation. Pull-off test was conducted using universal testing machine (UTM). Data was analyzed using two-way mixed ANOVA with post-hoc Bonferroni test and Kruskal-Wallis test. The crowns with cement space of 70 μm showed a significantly higher absolute marginal discrepancy than those with 90 and 110 μm. No significant effect on the crown retention was found. Within the limitations of this study, modifying cement space to 90 μm and 110 μm may improve the marginal adaptation of CAD/CAM crown, whereas adjusting cement space from 70 to 110 μm did not significantly affect the crown retention.

X-ray microtomographic evaluation of the absolute marginal fit of fixed prostheses made from soft Co-Cr and zirconia

STATEMENT OF PROBLEM

The absolute marginal fit of CAD-CAM presintered fixed partial dentures has been poorly documented.

PURPOSE

The purpose of this in vitro study was to evaluate the marginal fit of presintered cobalt-chromium (Co-Cr) and zirconia 3-unit fixed partial dentures by using X-ray microcomputed tomography (μCT).

MATERIAL AND METHODS

A metal model was prepared from a typodont to receive fixed partial dentures (N=12). The maxillary first premolar and first molar were prepared with a circumferential 1.2-mm chamfer and 2-mm occlusal reduction. The dies were scanned and assigned to 1 of 2 groups to receive the prostheses made of presintered Co-Cr or presintered zirconia (n=6). Each framework was seated on its model without load application. The abutments were scanned by using μCT. A circle with 10 diameters, with a step of 18 degrees, was projected at the center of the obtained image. Absolute marginal discrepancy and marginal gap mean values were measured, and overextended and underextended margins determined. The data were analyzed by using the Levene t test and ANOVA (α=.05).

RESULTS

No statistically significant difference was found in the marginal fit between the materials tested (P=.939). The mean values were 66 ±14 μm for Co-Cr and 61 ±12 μm for zirconia. The absolute marginal discrepancy mean value for the premolar was 69 ±12 μm and 41 ±9 μm for the molar (P<.001). Overextension was predominant for both materials tested, with a higher percentage reported for the zirconia group.

CONCLUSIONS

Presintered alloys presented clinically acceptable adaptation with a predominance of marginal overextensions.

Adaptation accuracy of milled lithium disilicate crowns: A 2D and 3D microCT analysis

OBJECTIVE

Evaluate the effects of the scanning techniques and the crystallization in the internal and marginal adaptation of milled lithium disilicate crowns by two techniques computer microtomography analysis.

MATERIALS AND METHODS

Sixteen polyurethane teeth prepared for a complete crown were divided into two groups according to the scanner method (n = 8): indirect (IND), dental stone models were scanned with laser-surface scanner, and direct (DIR), digital typodont creates with an intraoral scanner. Internal and marginal gap were evaluated by micro-computed tomography (microCT). The replica technique (RT) was applied for analysis of total volume (TV) and marginal volume (MV) gap in microCT. The data showed normal distribution (Shapiro-Wilk test). One-way ANOVA (scanner techniques) with repeated measures (crystallization) was performed. Multiple comparisons were performed with Bonferroni adjustment (α = .05).

RESULTS

The axial gap showed a significant difference between the times (P = .017) for lower values after crystallization. The vertical marginal gap presented a significant difference in times for higher value after crystallization (P = .001). The marginal horizontal gap IND was greater than DIR after crystallization (P = .001) and IND before lower than after crystallization. For TV was not significant difference and MV in DIR was reduction (P = .002) after crystallization.

CONCLUSION

Crystallization changes the relationship between the crown and tooth, reducing internal gap and preventing the adequate fit in indirect and direct scanning.

CLINICAL SIGNIFICANCE

The measure gap under technological methodology is useful for adjust clinical parameters prosthetic in the CAD/CAM and the applicability of the new possibilities of analysis.

Marginal and internal fit evaluation of conventional metal-ceramic versus zirconia CAD/CAM crowns

Background

The purpose of this in vivo study was to compare the marginal and internal gap widths of monolithic zirconia crowns fabricated by CAD/CAM technique and metal-ceramic crowns fabricated by conventional technique.

Material and Methods

10 participants needing a single restoration were selected. Zirconia crowns using CAD/CAM technology (Group A) (n=10) and metal-ceramic crowns (Group B) (n=10) using lost wax casting technique were fabricated for each selected tooth. The marginal and internal gaps of crowns were recorded using a replica technique with light body silicone material stabilized with a regular set putty. Each replica was sectioned buccolingually and mesiodistally and then evaluated at five pre-determined sites. The points measured were PM for marginal gap, PA for axial gap, PAO for axio-occlusal transition gap and PO and PCO for occlusal gaps using a stereomicroscope at 30× magnification. The Paired Sample (t) test was used to detect significant differences between the two groups in terms of marginal and internal fit (α= 0.05).

Results

The mean for the marginal gap was 77.42μm (±39.5μm) for Group A compared with 95.86μm (±55.12μm) for Group B. Mean values for internal gap was 87.24 (±21.7 µm) for Group A and 132.91 µm (± 50.63 µm) for Group B. Significant differences were observed between both the groups for marginal (p=.010) and internal (p=.000) fit.

Conclusions

The CAD/CAM fabricated zirconia crowns demonstrated a better accuracy of fit when compared to metal-ceramic crowns fabricated by conventional technology. Key words:Marginal fit, Internal fit, Computer-aided design/computer-aided manufacturing (CAD/CAM).

Influence of two different cement space settings and three different cement types on the fit of polymer-infiltrated ceramic network material crowns manufactured using a complete digital workflow

OBJECTIVES

The study evaluates the influence of two spacer settings and three resin luting materials on the marginal and internal fit of polymer-infiltrated ceramic network (PICN) material crowns manufactured using a complete digital workflow.

METHODS

Optical impressions of fifty identical dies were performed using the 3M scanner (software version 5.0.2). Twenty crowns were designed using Ceramill Mind (version 3.4.10.1163), from which ten with spacer setting of 50 μm (G1) and ten with 80 μm (G2). Thirty crowns (spacer setting of 50 μm) were divided into three groups corresponding to the resin materials used as follows: RelyX Unicem (RX), Variolink Esthetic (VLE), and Nexus 3 (NX3). All crowns were milled from Vita Enamic blocks. After micro-CT scanning, absolute marginal discrepancy (AMD), internal gap (IG), total cement space volume (TCV), and marginal porosities (VP) were measured.

RESULTS

Significant difference was detected on the VP between the RX and NX3 group (p = 0.033). The mean values of all parameters were the following: AMD (μm): G1 182.6, G2 253.7, RX 210.8, VLE 195.5, NX3 186.6; IG (μm): G1 215.6, G2 173.1, RX 171.1, VLE 198.6, NX3 203; TCV (mm³): G1 22.9, G2 20.49, RX 17.57, VLE 17.49, NX3 20.59; VP (mm³): G1 0.26, G2 0.34, RX 0.32, VLE 0.46, NX3 0.54.

CONCLUSIONS

Fit of PICN material crowns was not significantly influenced by increasing the spacer settings and cementation with different resin materials. Additionally, RelyX Unicem showed significantly less porosities as compared with Nexus3.

CLINICAL RELEVANCE

Both 50 μm and 80 μm virtual spacer settings can be suggested for the manufacture of PICN crowns when Ceramill Mind (version 3.4.10.1163) is used. Furthermore, a self-adhesive system can be recommended for the cementation.

An in vitro evaluation of marginal fit zirconia crowns fabricated by a CAD-CAM dental laboratory and a milling center

BACKGROUND

Marginal fit is critical for the success and longevity of a dental restoration. Zirconia crowns can be fabricated either chair-side, in a dental laboratory or in a milling center; each can give different marginal fits results. However, discussion of the marginal fit of zirconia crowns when different fabrication methods are compared is lacking in the literature.

PURPOSE

To compare the marginal discrepancy (MD) and absolute marginal discrepancy (AMD) of computer-aided design, and computer-aided manufacturing (CAD-CAM) used in a dental laboratory and a milling center for producing monolithic zirconia crowns.

METHODS

The marginal fit of 30 zirconia crowns cemented to typodont teeth was evaluated by means of a sectioning technique. Fifteen crowns were fabricated with a CEREC inLAB MC X5 from IPS e.max ZirCAD blocks. Fifteen crowns were fabricated using a LAVA milling center from LAVA Plus Zirconia Blocks. The 30 crowns were sectioned with a precision saw, and MD and AMD were subsequently measured using a light microscope. Data were analyzed using the one-way ANOVA technique to investigate significant differences in the marginal fit between the two fabrication systems (α = .05).

RESULTS

The AMD dimension of the CEREC inLAB system was significantly smaller (P < .05). Mean AMD values for zirconia crowns fabricated by the CEREC inLAB were 85 μm, and for the LAVA milling center 133 μm. There was no significant difference between the two systems regarding the MD dimensions. The MD values for zirconia crowns fabricated by the CEREC inLAB were 53 μm and for the LAVA milling center 61 μm.

CONCLUSIONS

The CEREC inLAB system demonstrated significantly better marginal fit in relation to the AMD. However, no difference between the systems was found in the MD. Monolithic zirconia crowns fabricated by the CAD-CAM CEREC inLAB system and the LAVA system milling center showed MD values of less than 120 μm, which is within the clinically acceptable range.

Influence of Material Selection on the Marginal Accuracy of CAD/CAM-Fabricated Metal- and All-Ceramic Single Crown Copings

This study evaluated the marginal accuracy of CAD/CAM-fabricated crown copings from four different materials within the same processing route. Twenty stone replicas of a metallic master die (prepared upper premolar) were scanned and divided into two groups. Group 1 (n = 10) was used for a pilot test to determine the design parameters for best marginal accuracy. Group 2 (n = 10) was used to fabricate 10 specimens from the following materials with one identical CAD/CAM system (GAMMA 202, Wissner GmbH, Goettingen, Germany): A = commercially pure (cp) titanium, B = cobalt-chromium alloy, C = yttria-stabilized zirconia (YSZ), and D = leucite-reinforced glass-ceramics. Copings from group 2 were evaluated for the mean marginal gap size (MeanMG) and average maximum marginal gap size (AMaxMG) with a light microscope in the “as-machined” state. The effect of the material on the marginal accuracy was analyzed by multiple pairwise comparisons (Mann–Whitney, U-test, α = 0.05, adjusted by Bonferroni-Holmes method). MeanMG values were as follows: A: 46.92 ± 23.12 μm, B: 48.37 ± 29.72 μm, C: 68.25 ± 28.54 μm, and D: 58.73 ± 21.15 μm. The differences in the MeanMG values proved to be significant for groups A/C (p = 0.0024), A/D (p = 0.008), and B/C (p = 0.0332). AMaxMG values (A: 91.54 ± 23.39 μm, B: 96.86 ± 24.19 μm, C: 120.66 ± 32.75 μm, and D: 100.22 ± 10.83 μm) revealed no significant differences. The material had a significant impact on the marginal accuracy of CAD/CAM-fabricated copings.

Influence of light activation of simplified adhesives on the shear bond strength of resin cements to a leucite-reinforced ceramic

Objective

This study aims to evaluate the influence of the light activation of simplified adhesives on the shear bond strength of resin cements to a glass-ceramic. Three factors were evaluated: (1) cement in two levels (light cured and dual cured); (2) adhesive in two levels (Single Bond 2 and Single Bond Universal), and (3) light activation in two levels (yes or no).

Materials and Methods

Thirty-two 1-mm thick slices of a leucite-reinforced glass-ceramic (IPS Empress CAD) were divided into eight groups according to adhesive (Single Bond 2 or Single Bond Universal), cement (AllCem Veneer or AllCem), and light activation of the adhesive before application of the cement (yes or no). Ceramic surfaces were etched for 60 s with 5% hydrofluoric acid, and adhesives were applied. Four cement cylinders were made over each ceramic slice (n = 16) and then submitted to shear bond strength tests.

Statistical Analysis

Data were analyzed with three-way ANOVA and Tukey (α = 0.05).

Results

There were significant differences between adhesives (P < 0.0001) and no differences between cements (P = 0.0763) and light activation (P = 0.4385). No interaction effect occurred (P = 0.05). Single Bond 2 showed higher bond strength than Single Bond Universal.

Conclusions

The light activation of the adhesive before the application of the resin cement did not influence the bond strength.

Marginal adaptation of lithium disilicate ceramic crowns cemented with three different resin cements

OBJECTIVES

The cementation process and cementation materials have an influence on the marginal adaptation of restorations. The gap could be affected by thermal and mechanical loading (TCML). The computerized x-ray microtomography (μCT) method offers the possibility of measuring the marginal gap without destruction of the restoration. The aim of this study was to evaluate the marginal gap (MG) and the absolute marginal discrepancy (AMD) before and after TCML.

MATERIALS AND METHODS

Thirty-nine human premolars were prepared for full ceramic crowns made of lithium disilicate. The crowns were cemented by three different resins-Panavia F 2.0, Variolink II, and Relyx Unicem. The MG and AMD were evaluated by μCT before and after TCML.

RESULTS

Panavia F 2.0 had the lowest MG (before 118 μm-after TMCL 124 μm) and AMD (before 145 μm-after TMCL 154 μm), followed by Relyx Unicem (MG: before 164 μm-after TCML 155 μm; AMD: before 213 μm-after TMCL 209 μm) and Variolink II (MG: before 317 μm-after TMCL 320 μm; AMD: before 412 μm-after TMCL 406 μm). The differences were statistically significant before and after TCML. Rather than TCML, it appeared the resin cement was responsible for differences between the MG and AMD before and after TCML.

CONCLUSIONS

μCT is an accurate technique for assessing cemented restorations. Panavia F 2.0 has the lowest MG and AMD before and after TCML.

CLINICAL RELEVANCE

The resin material that features a three-step protocol (Variolink II) produced higher MG and AMG values than the Panavia or Relyx Unicem varieties with less or no intermediate steps at all.

Marginal Adaptation and Quality of Interfaces in Lithium Disilicate Crowns — Influence of Manufacturing and Cementation Techniques

Purpose: To evaluate the cement line thickness and the interface quality in milled or injected lithium disilicate ceramic restorations and their influence on marginal adaptation using different cement types and different adhesive cementation techniques.

Methods and Materials: Sixty-four bovine teeth were prepared for full crown restoration (7.0±0.5 mm in height, 8.0 mm in cervical diameter, and 4.2 mm in incisal diameter) and were divided into two groups: CAD/CAM automation technology, IPS e.max CAD (CAD), and isostatic injection by heat technology, IPS e.max Press (PRESS). RelyX ARC (ARC) and RelyX U200 resin cements were used as luting agents in two activation methods: initial self-activation and light pre-activation for one second (tack-cure). Next, the specimens were stored in distilled water at 23°C ± 2°C for 72 hours. The cement line thickness was measured in micrometers, and the interface quality received scores according to the characteristics and sealing aspects. The evaluations were performed with an optical microscope, and scanning electron microscope images were presented to demonstrate the various features found in the cement line. For the cement line thickness, data were analyzed with three-way analysis of variance (ANOVA) and the Games-Howell test (α=0.05). For the variable interface quality, the data were analyzed with the Mann-Whitney U-test, the Kruskal-Wallis test, and multiple comparisons nonparametric Dunn test (α=0.05).

Results: The ANOVA presented statistical differences among the ceramic restoration manufacturing methods as well as a significant interaction between the manufacturing methods and types of cement (p&lt;0.05). The U200 presented lower cement line thickness values when compared to the ARC with both cementation techniques (p&lt;0.05). With regard to the interface quality, the Mann-Whitney U-test and the Kruskal-Wallis test demonstrated statistical differences between the ceramic restoration manufacturing methods and cementation techniques. The PRESS ceramics obtained lower scores than did the CAD ceramics when using ARC cement (p&lt;0.05).

Conclusions: Milled restorations cemented with self-adhesive resin cement resulted in a thinner cement line that is statistically different from that of CAD or pressed ceramics cemented with resin cement with adhesive application. No difference between one-second tack-cure and self-activation was noted.

Effect of Resin Bonded Luting Agents Influencing Marginal Discrepancy in All Ceramic Complete Veneer Crowns

INTRODUCTION

Marginal discrepancy severely affects the long term success of All ceramic complete veneer crowns. The precise role of resin luting agents influencing this phenomenon needs to be explored further.

AIM

To estimate and compare the marginal discrepancy in CAD/CAM processed All ceramic complete veneer crowns prior and following luting with resin bonded luting agents.

MATERIALS AND METHODS

Extracted human maxillary first premolars were randomly allocated into four groups of 27 samples each Viz., Group I-Resin Modified Glass Ionomer Cement (GIC) (RelyX), Group II-Bis-GMA based dual cure resin cement (Variolink II), Group III-PMMA based resin cement (Superbond), Group IV- Urethane Dimethacrylate resin cement (Calibra). Following tooth preparation, CAD/CAM All ceramic complete veneer crowns were fabricated and sectioned and marginal discrepancy was evaluated using a scanning electron microscope (TESCAN, Magnification power-1,00,000x) prior and after luting with the experimental resin cements.

RESULTS

The vertical and horizontal discrepancy before and after cementation with Group I [270.08±103.10μm, 165.3±53.00μm and 270.86±102.70μm, 166.62±54.96μm respectively]; Group II [254.21±79.20μm, 117.75±24.29μm and 234.81±79μm, 116.89±18.22μm respectively]; Group III [272.47±86.25μm, 142.08±50.83μm and 251.82±62.69μm, 136.07±44.95μm respectively]; Group IV were [260.28±64.81μm, 116.98±17.71μm and 233.08±69.44μm, 116.58±21.13μm respectively]. ANOVA inferred a statistically significant difference between the four test specimen with regards to vertical and horizontal marginal discrepancy after cementation (F=9.092, p<0.001), (F=10.97, p<0.001). Tukey HSD Post-hoc test observed significant differences in vertical and horizontal marginal discrepancies between the resin modified glass ionomer and resin cements (p<0.05).

CONCLUSION

Resin cements exhibited a greater reduction in the marginal discrepancy than the resin modified glass ionomer following luting in All ceramic complete veneer crowns. Hence resin cements are more preferable to GIC for luting All ceramic complete veneer crowns.

Cervical and Incisal Marginal Discrepancy in Ceramic Laminate Veneering Materials: A SEM Analysis

CONTEXT

Marginal discrepancy influenced by the choice of processing material used for the ceramic laminate veneers needs to be explored further for better clinical application.

AIMS

This study aimed to evaluate the amount of cervical and incisal marginal discrepancy associated with different ceramic laminate veneering materials.

SETTINGS AND DESIGN

This was an experimental, single-blinded, in vitro trial.

SUBJECTS AND METHODS

Ten central incisors were prepared for laminate veneers with 2 mm uniform reduction and heavy chamfer finish line. Ceramic laminate veneers fabricated over the prepared teeth using four different processing materials were categorized into four groups as Group I - aluminous porcelain veneers, Group II - lithium disilicate ceramic veneers, Group III - lithium disilicate-leucite-based veneers, Group IV - zirconia-based ceramic veneers. The cervical and incisal marginal discrepancy was measured using a scanning electron microscope.

STATISTICAL ANALYSIS USED

ANOVA and post hoc Tukey honest significant difference (HSD) tests were used for statistical analysis.

RESULTS

The cervical and incisal marginal discrepancy for four groups was Group I - 114.6 ± 4.3 μm, 132.5 ± 6.5 μm, Group II - 86.1 ± 6.3 μm, 105.4 ± 5.3 μm, Group III - 71.4 ± 4.4 μm, 91.3 ± 4.7 μm, and Group IV - 123.1 ± 4.1 μm, 142.0 ± 5.4 μm. ANOVA and post hoc Tukey HSD tests observed a statistically significant difference between the four test specimens with regard to cervical marginal discrepancy. The cervical and incisal marginal discrepancy scored F = 243.408, P < 0.001 and F = 180.844, P < 0.001, respectively.

CONCLUSION

This study concluded veneers fabricated using leucite reinforced lithium disilicate exhibited the least marginal discrepancy followed by lithium disilicate ceramic, aluminous porcelain, and zirconia-based ceramics. The marginal discrepancy was more in the incisal region than in the cervical region in all the groups.

The marginal fit of E.max Press and E.max CAD lithium disilicate restorations: A critical review

This critical review aimed to assess the vertical marginal gap that was present when E.max lithium disilicate-based restoration (Press and CAD) are fabricated in-vitro. Published articles reporting vertical marginal gap measurements of in-vitro restorations that had been fabricated from E.Max lithium disilicate were sought with an electronic search of MEDLINE (PubMed) and hand search of selected dental journals. The outcomes were reviewed qualitatively. The majority of studies that compared the marginal fit of E.max press and E.max CAD restorations, found that the E.max lithium disilicate restorations fabricated with the press technique had significantly smaller marginal gaps than those fabricated with CAD technique. This research indicates that E.max lithium disilicate restorations fabricated with the press technique have measurably smaller marginal gaps when compared with those fabricated with CAD techniques within in-vitro environments. The marginal gaps achieved by the restorations across all groups were within a clinically acceptable range.

Evaluation of the marginal fit of full ceramic crowns by the microcomputed tomography (micro-CT) technique

Objective:

To evaluate the marginal gap (MG) and absolute marginal discrepancy (MD) of full ceramic crowns with two finish line designs, shoulder and chamfer, using microcomputed tomography (micro-CT) before and after cementation.

Materials and Methods:

Sixty extracted human maxillary premolar teeth were divided into two groups based on the finish line design: Group I: 90° shoulder and Group II: 135° chamfer. The specimens were further grouped based on the type of full ceramic crown they received: Group A: Feldspathic Cerec inLab ceramic system, Group B: Cerec inLab aluminum oxide ceramic system and Group C: Lithium disilicate press ceramic system. Before cementation, five crowns from each group were scanned using micro-CT in two sections, sagittal and coronal, to determine the MG and MD values for four regions of the crown (sagittal buccal, sagittal lingual, coronal mesial and coronal distal). After cementation and thermal cycling, the scanning was repeated. Measurements were obtained from 10 points for each region, 80 points totally, to evaluate the MG and MD values. Files were processed using NRecon and CTAn software. Results were statistically analyzed using one- and two-way ANOVA and Tukey HSD tests (P = 0.05).

Results:

Full ceramic systems showed clinically acceptable marginal adaptation values. The Feldspathic Cerec inLab ceramic system generally presented the lowest variance, except in the MG values of the coronal mesial region. The MG and MD values of all ceramics increased significantly after cementation, except in the shoulder preparation design (sagittal buccal region) for MG and in the chamfer preparation design (sagittal lingual region) for MD values.

Conclusions:

Full-ceramic crowns showed clinically acceptable marginal adaptation values. The Feldspathic Cerec inLab ceramic system (Vitablocs Mark II) generally presented the lowest variance when compared with the other ceramics, except for the MG values on the mesial surface of the coronal section.