Filler content and gap width after luting of ceramic inlays, using the ultrasonic insertion technique and composite resin cements. An in vitro study

Influence of preparation design on fit and ceramic thickness of CEREC 3 partial ceramic crowns after cementation

OBJECTIVE

This study investigated the influence of preparation design on the marginal and internal gap and ceramic thickness of partial ceramic crowns (PCCs) fabricated with the CEREC 3 system.

MATERIALS AND METHODS

Sixteen extracted human mandibular molars were prepared according to two different preparation designs (n = 8): a retentive preparation design with traditional cusp capping (Group I) and a non-retentive preparation design with horizontal reduction of cusps (Group II). PCCs were fabricated from IPS Empress CAD with the CEREC 3 system. The parameters for luting space and minimum occlusal ceramic thickness were set to 30 μm and 1.5 mm, respectively. The fabricated PCCs were cemented to their corresponding teeth with self-adhesive resin cement and were then scanned by micro-computed tomography. The marginal and internal gaps were measured at pre-determined measuring points in five bucco-lingual and three mesio-distal cross-sectional images. The ceramic thicknesses of the PCCs were measured at the measuring points for cusp capping areas.

RESULTS

Group II (167.4 ± 76.4 μm) had a smaller overall mean gap, which included the marginal and internal gap measurements, than that of Group I (184.8 ± 89.0 μm). The internal gaps were larger than the marginal gaps, regardless of preparation design. Group I presented a thinner ceramic thickness in the cusp capping areas than the minimum occlusal ceramic thickness parameter of 1.5 mm. CONCLUSION. Preparation design had an influence on fit, particularly the internal gap of the PCCs. Ceramic thickness could be thinner than the minimum ceramic thickness parameter.

Effect of Ultrasonic Versus Manual Cementation on the Fracture Strength of Resin Composite Laminates

Indirect composite laminates, when cemented ultrasonically, resulted in repairable failures as opposed to indirect composite laminates cemented under hand pressure.

In vivo and in vitro evaluation of marginal fit of class II ceromer inlays

The aim of this study was to evaluate the marginal adaptation of class II ceromer (Targis, Vivadent) indirect inlay restorations under both in vivo and in vitro conditions. Twenty Targis inlays were produced for class II inlay cavities (13 mandibular and seven maxillary teeth) in 20 patients. The in vivo adaptation of the inlay to the tooth cavity was evaluated by means of silicone replica technique. For in vitro evaluation, 20 mesio-occluso-distal (MOD) Targis inlays were made in extracted upper molars. Half of the inlays were cemented with Variolink high-viscosity resin cement while the other half was cemented with Variolink Ultra. The replica specimens and in vitro samples were sectioned buccolingually and mesiodistally, and marginal adaptation was evaluated at both proximal and occlusal margins at 200x magnification under a light microscope. The data was analyzed with anova (P < 0.05). The in vivo mean film thickness values for occlusal and proximal locations were recorded as 73 and 132 microm respectively. In vitro mean marginal fit values were observed as 48 and 67 microm for occlusal and proximal margins of inlays luted with Variolink II high viscosity. The marginal fit values recorded under in vivo conditions were higher in magnitude than the measurements obtained under in vitro conditions. The use of a highly filled resin luting agent with an ultrasonic insertion technique did not cause an increase in marginal gap width of the inlay.

Interface evaluation after manual and ultrasonic insertion of standardized class I inlays using composite resin materials of different viscosity

OBJECTIVE

The aim of the present study was to investigate the effect of manual and ultrasonic insertion of standardized class I inlays (Cerana) using three composite resin materials of different viscosity (Tetric Flow, Tetric, and Tetric Ceram) on time to seat inlays, film thickness, and filler distribution within the materials.

METHODS

In a preliminary test, mean loads for manual and ultrasonic insertion were measured using the high viscosity composite resin material (Tetric Ceram). These loads were then applied with all composite resin materials to evaluate the times required to seat the inlays. In addition, film thickness was assessed using scanning electron microscopy, and filler distribution (wt% silicon, barium, ytterbium) was monitored using energy-dispersive spectroscopy.

RESULTS

Ultrasonic insertion significantly reduced mean load applied to seat inlays (6.4+/-1.4 N; mean+/-SD) as compared to manual insertion (18.9+/-3.1 N; p < 0.001). Using an ultrasonic device, times for insertion values were significantly lower in the high and medium viscosity composite resin material groups compared to manual insertion (p < 0.05). The widest film thickness was recorded for the high viscosity composite resin material in combination with manual insertion (p < 0.05). However, when ultrasound was applied, there was no difference in film thickness between the three materials at any levels. Furthermore, the analysis of filler distribution revealed no significant differences between groups.

CONCLUSION

Highly filled viscous composite resin materials may be used in combination with the ultrasonic insertion technique without untoward effects on film thickness or filler distribution.

Effect of the silicone disclosing procedure on the shear bond strength of composite cements to ceramic restorations

STATEMENT OF PROBLEM

There is no evidence-based information on how ceramic restorations with an adhesive bond between restoration material and composite cement may be influenced by a silicone disclosing agent.

PURPOSE

The aim of this study was to determine the effects of the silicone disclosing procedure on the shear bond strength of composite cements in the luting of industrial sintered and laboratory sintered ceramic restorations.

MATERIAL AND METHODS

Thirty standardized (15 x 10 x 9 mm) prefabricated ceramic specimens (Groups 1, 3, 5) and 30 standardized (15 x10 x 9 mm) conventionally sintered ceramic specimens (Groups 2, 4, 6) were roughened with sandpaper (800-grit). Each group contained 10 specimens. Groups 3 and 4 were conditioned with hydrofluoric acid and primed with silane solution after the use of a silicone disclosing procedure. Groups 1 and 2 served as the control groups, where no silicone disclosing procedure was performed. Groups 5 and 6 were insulated with glycerine before the silicone disclosing procedure. A glass tube (4.5 mm in diameter) was used to apply a cylinder of dual-polymerized composite cement to the conditioned surfaces. All specimens were submitted to 5000 thermocycles (5 degrees to 55 degrees C) to simulate the in vivo situation. The specimens were subjected to a shear-pull test at a constant crosshead speed of 5 mm/min with a universal testing machine. The comparative shear bond strengths were analyzed by use of Duncan's test (alpha=0.05).

RESULTS

Shear bond strength values for Groups 1 (9.86 +/- 4.97 MPa) and 2 (9.56 +/- 4.47 Mpa) were obtained with no significant differences. Lower but significantly undifferent values were obtained for Groups 3 (7.49 +/- 4.67 MPa) and 4 (7.62 +/- 3.49 MPa) after the use of a silicone disclosing procedure. In Groups 5 (8.21 +/- 4.75 MPa) and 6 (8.22 +/- 3.59 MPa), including insulation with glycerine before the silicone disclosing procedure, no significant differences were obtained.

CONCLUSION

Within the limitations of this study, the use of silicone disclosing procedures before conditioning the ceramic surface did not lead to a significant reduction of the shear bond strength between ceramic and composite cement. The ceramic materials used (industrial-sintered versus laboratory-sintered ceramic) had no significant influence on adhesion.

Interface gap size of manually and CAD/CAM-manufactured ceramic inlays/onlays in vitro

OBJECTIVES

To determine the fit of ceramic inlays manufactured using a recently introduced CAD/CAM-system (Decim) and of two types of laboratory-made heat-pressed ceramics (IPS Empress and Opc).

MATERIALS AND METHODS

Extracted human premolars were prepared to receive mesio-occlusodistal (MOD) ceramic inlays, for which 10 Denzir, 10 IPS Empress, and 10 Opc were fabricated. The Denzir restorations were produced by the manufacturer of the CAD/CAM-system, and the IPS Empress and Opc by student dental technicians. Before luting the internal fit on the diestone models and on the premolars was determined using replicas. After luting on the premolars with a resin composite the marginal and internal fit were measured. The values were analyzed statistically using ANOVA and Scheffe's test at a significance level of p<0.05.

RESULTS

Before luting there were no significant differences (p>0.05) in the internal gap width between the three systems studied when placed on their matching diestone models. When placed on the premolars a significant difference (p<0.01) in the internal fit was seen between Empress and Opc before luting, whereas there were no significant differences (p>0.05) between Empress and Denzir and between Opc and Denzir. Between the diestone models and the premolars there were significant differences (p<0.01) in the internal fit, except for IPS Empress. After luting there were no significant differences (p>0.05) between IPS Empress and Denzir, whereas the marginal gap width was significantly wider (p<0.001) for Opc than for IPS Empress and Denzir. The internal fit was significantly (p<0.001) wider for Opc than for IPS Empress, whereas there were no significant differences (p>0.05) between IPS Empress and Denzir or between Opc and Denzir.

CONCLUSION

After luting there were only slight differences in the fit between the restorations fabricated using the three different manufacturing techniques and ceramics. Therefore, long-term follow-up studies are needed to assess the clinical significance of the slight differences between the three systems.