CORRELATION BETWEEN MARGIN FIT AND MICROLEAKAGE IN COMPLETE CROWNS CEMENTED WITH THREE LUTING AGENTS

Microleakage can be related to margin misfit. Also, traditional microleakage techniques are time-consuming. This study evaluated the existence of correlation between in vitro margin fit and a new microleakage technique for complete crowns cemented with 3 different luting agents. Thirty human premolars were prepared for full-coverage crowns with a convergence angle of 6 degrees, chamfer margin of 1.2 mm circumferentially, and occlusal reduction of 1.5 mm. Ni-Cr cast crowns were cemented with either zinc phosphate (ZP) (S.S. White), resin-modified glass-ionomer (RMGI) (Rely X Luting Cement) or a resin-based luting agent (RC) (Enforce). Margin fit (seating discrepancy and margin gap) was evaluated according to criteria in the literature under microscope with 0.001 mm accuracy. After thermal cycling, crowns were longitudinally sectioned and microleakage scores at tooth-cement interface were obtained and recorded at x100 magnification. Margin fit parameters were compared with the one-way ANOVA test and microleakage scores with Kruskal-Wallis and Dunn''s tests (α=0.05). Correlation between margin fit and microleakage was analyzed with the Spearman''s test (α=0.05). Seating discrepancy and marginal gap values ranged from 81.82 μm to 137.22 μm (p=0.117), and from 75.42 μm to 78.49 μm (p=0.940), respectively. Marginal microleakage scores were ZP=3.02, RMGI=0.35 and RC=0.12 (p<0.001), with no differences between RMGI and RC scores. The correlation coefficient values ranged from -0.27 to 0.30 (p>0.05). Conclusion: Margin fit parameters and microleakage showed no strong correlations; cast crowns cemented with RMGI and RC had lower microleakage scores than ZP cement.     

Microleakage of crowns cemented with glass ionomer cement: effects of preparation finish and conditioning with polyacrylic acid.

This study compared the marginal leakage of cast gold complete crowns cemented with glass ionomer and with zinc phosphate cement. The effect of polishing the preparations and conditioning with polyacrylic acid was also evaluated for glass ionomer cement. The cast gold crowns cemented with glass ionomer cement demonstrated significantly lower marginal leakage than did those with zinc phosphate cement. The extent of microleakage was not substantially different between crowns when the preparations were polished and conditioned with polyacrylic acid.     

桩核修复体的微漏研究

本文的桩核修复体微漏研究采用染色法,选28个完整的离体上中切牙分成4组.实验结果表明:铸造Ni-Cr合金桩核报漏值最小,简单桩附自凝甲基丙烯酸甲脂核、螺纹桩附光敏树脂核微漏值较大,临床上应用后两种桩核材料修复时应谨慎.     

Combined effects of thermocycling and load-cycling on microleakage of computer-aided design/computer-assisted manufacture molar crowns

This study evaluated the combined effects of thermocycling and compressive load-cycling on microleakage of computer-aided design/computer-assisted manufacture molar crowns. Sixteen ceramic (Vita Mark-II) and 16 composite resin (Paradigm MZ-100) crowns were milled using the CEREC 3D system. Eight crowns of each group were cemented to prepared molars using Panavia F 2.0, and 8 were cemented using RelyX Unicem Clicker. Specimens were thermocycled for 500 cycles and subjected to load-cycling for 1,000,000 cycles (60 to 600 N). Specimens were then tested for microleakage. Data were analyzed statistically using the Tukey post hoc test. All composite resin crowns survived load and thermal fatigue, while 6 ceramic crowns developed cracks. There were no statistically significant differences among groups regarding microleakage scores. Paradigm MZ-100 crowns were more crack-resistant to combined load and thermal fatigue than those composed to Vita Mark-II. However, microleakage scores of both types of crowns were similar. Int J Prosthodont 2011;24:376-378.     

Microleakage of core materials for complete cast gold crowns

This study evaluated the microleakage patterns of complete cast-gold crowns cemented onto teeth rebuilt with pin-retained cores made from cast gold, amalgam, composite resin, and silver-reinforced glass ionomer by using three different cements (zinc phosphate, glass ionomer, and resin cement). Crowns cemented onto unrebuilt tooth preparations with zinc phosphate cement served as controls. The cemented specimens were thermocycled between 4 degrees and 50 degrees C in waterbaths. They were then embedded in epoxy resin and sectioned. The extent of marginal microleakage was evaluated with a stereomicroscope and scored. The findings indicated that the type of luting agent used appeared to affect microleakage more than the core material. No significant differences in the degree of microleakage were found under crowns cemented onto teeth rebuilt with the four core materials when cemented with the same luting cement.     

The in vitro effect of pulpal pressure and luting agent on tensile bond strength of complete cast crowns

STATEMENT OF PROBLEM: The degree to which pulpal pressure may affect bond strength of complete cast crowns is unknown. PURPOSE: The aim of this in vitro study was to evaluate the effect of simulated pulpal pressure on the tensile bond strength of complete cast crowns luted with 2 different cements. MATERIAL AND METHODS: Forty-eight human mandibular canine teeth were cleaned and stored in saline solution. The crowns were prepared by 1 investigator, and standardization of the preparation was accomplished by fixing a dental handpiece in a parallelometer. Uniform grooves, 0.5 mm in depth, were prepared with burs with depth guides. The complete crowns were prepared with a 0.5-mm shoulder margin. Teeth were randomly divided into 2 groups of 24 teeth each (Group I and Group II). In Group I, bonding and tensile test procedures of the teeth were carried out under simulated pulpal pressure (15 cm of saline solution). In Group II, simulated pulpal pressure was not used. The roots were removed 1 mm below the cementoenamel junction to create direct communication with the pulp chamber. The remaining pulpal tissues were carefully removed, and crowns were embedded in acrylic resin. The acrylic resin was then penetrated by a stainless steel tube that connected the pulp chamber and the barrel of a disposable plastic 5-ml syringe. The pulp chambers were filled with physiological saline solution under elevated pressure to locate the area of greatest permeability on the dentinal surface. Crowns were cast (Co-Cr alloy) with a 20-mm bar to allow testing of the bond strength. Each of the 2 groups were further divided into 2 luting cement groups of 12 each (Group I, A and B, and Group II, A and B). Group IA/IIA and Group IB/IIB specimens were luted with a polycarboxylate luting cement (Poly-F Plus) and an adhesive luting cement (Superbond C&B), respectively. After storage in distilled water for 24 hours, all specimens were subjected to a tensile bond test in a universal testing machine at a crosshead speed of 0.5 mm/min until failure. The maximum load at fracture (Newton) was recorded. The results were then evaluated with 2-way analysis of variance and Tukey's honestly significant difference tests (alpha=.05). RESULTS: Simulated pulpal pressure increased the bond strength of cast complete crowns cemented with an adhesive luting agent (P=.01). No significant difference was found in the bond strength of complete cast crowns cemented with polycarboxylate cement with or without pulpal pressure. Superbond C&B adhesive luting agent showed significantly higher bond strength values for Group I (388.9+/-32.7) and Group II (300.9+/-66.8), when compared with polycarboxylate cement for Group I (221.3+/-17.3) and Group II (186.8+/-38.5) (P=.001). CONCLUSION: Simulated pulpal pressure had a positive effect on the retention of complete cast crowns when cemented with Superbond C&B adhesive luting agent. Superbond C&B significantly increased the retention of crowns in either the presence or absence of pulpal pressure.     

Retention,marginal leakage,and cement solubility of provisional crowns cemented with temporary cement containing stannous fluoride

PURPOSE: This in vitro study investigated the (1) retention and microleakage of provisional crowns cemented with temporary cements to which stannous fluoride (SnF2) was added, and (2) solubility of these cements. MATERIALS AND METHODS: Provisional crowns were constructed of acrylic resin with shoulder preparations for 12 molars. The crowns were luted with Tempbond, Tempbond NE, and Freegenol temporary cements, and also with SnF2 added to these cements. Specimens were thermocycled 100 times, stored for 6 days, and immersed in 0.5% basic fuschin. Seven days after cementation, crown removal (retention) tests were conducted. Marginal leakage was assessed using a five-level scale to score dye penetration. Solubility in water of the cements with and without SnF2 was assessed using cement disks. RESULTS: Freegenol was more retentive than the other cements. The incorporation of SnF2 significantly increased the retention capacity of Freegenol and Tempbond NE but had no effect on Tempbond. Tempbond showed significantly higher dye penetration than Freegenol. The addition of SnF2 did not alter the dye penetration of the cements. There were no significant differences in the solubility of the cements. However, the incorporation of SnF2 increased the solubility of Freegenol and Tempbond NE (P < .001) and Tempbond (P < .01). CONCLUSION: The addition of SnF2 increased the retention of temporary crowns cemented with Tempbond NE and Freegenol but did not affect the retention of those cemented with Tempbond. The marginal leakage of crowns cemented with the tested temporary cements with and without the incorporation of SnF2 was similar. However, the addition of SnF2 increased the solubility of the cements.     

Microleakage of four core materials under complete cast crowns

This study evaluated the microleakage patterns of complete cast-metal crowns cemented onto teeth that were rebuilt with pin-retained cores made from cast metal, composite resin, acrylic resin and amalgam by using four different cements. One hundred extracted human teeth were used to compare the microleakage of composite resin core, metal core, acrylic resin core and amalgam core, and regular crown preparations under a complete cast metal crown cemented with different cements as determined by 2% methylene blue dye solution. Specimens were compared with and without aging after cementation in a thermal bath by cycling some of them between 4 degrees C and 50 degrees C in a 2% methylene blue bath and others in a similar bath held at 37 degrees C. The extent of marginal microleakage was evaluated with a stereomicroscope and scored. It was determined through variance analysis that the type of core used in the substructure, the cement used for cementing and the thermocycling process were all important in microleakage. No significant differences in the degree of microleakage were found under crowns cemented onto teeth rebuilt with the four core materials when cemented with the same luting cement.     

Comparison of microleakage of three acid-base luting cements versus one resin-bonded cement for Class V direct composite inlays

STATEMENT OF PROBLEM: Demineralized dentin beneath set cement may adversely affect microleakage under fixed restorations. PURPOSE: Microleakage of direct composite inlays cemented with acid-base cements and a methyl methacrylate resin cement were evaluated to determine their effect on the integrity of the underlying hybridized dentin. MATERIALS AND METHODS: Sixty Class V box preparations (3 mm x 3 mm x 1.5 mm) were precisely prepared in previously frozen bovine teeth with one margin in enamel and another margin in dentin. Direct composite inlays (EPIC-TMPT) for each preparation were divided into 4 groups of 15 specimens each and cemented with 3 acid-base cements (control group): Elite, Ketac-Cem, Hy-Bond Carbo-Cem, and 1 adhesive resin cement: C&B Metabond. All specimens were stored in distilled water for 24 hours at 37 degrees C before immersion in 0.5% basic fuchsin for 24 hours. The dye penetration was measured on the sectioned specimens at the tooth-cement interface of enamel and cementum margins and recorded with graded criteria under light microscopy (Olympus Vanox-T) at original magnification x 50, 100, and 200. A Kruskal-Wallis and the Mann-Whitney test at P<.05 were used to analyze leakage score. RESULTS: All cementum margins of the 3 acid-base cements tested demonstrated significantly higher leakage scores than cementum margins for inlays cemented with the resin cement tested(P<.01). No leakage along the tooth-cement interface was found for inlays retained with the adhesive resin cement. CONCLUSIONS: Within the limitations of this study, the 3 acid-base cements tested exhibited greater microleakage at the cementum margins than did the adhesive resin cement that was tested.     

Marginal discrepancies and leakage of all-ceramic crowns: influence of luting agents and aging conditions

PURPOSE: This study evaluated the marginal discrepancies and leakage of all-ceramic crowns cemented with different luting agents after fatigue tests. MATERIALS AND METHODS: Forty-eight all-ceramic crowns were cemented onto natural molars. Zinc-phosphate cement, compomer cement, and an adhesive composite resin luting system were used in 16 specimens each. Sixteen metal-ceramic crowns were cemented with zinc-phosphate cement as a control. Half of the specimens in each group were fatigued in a chewing simulator for 600,000 loading cycles with 3,500 thermocycles. The others received the 3,500 thermocycles only. An impression-replica technique and SEM were used for evaluation of the marginal discrepancies. Leakage of the specimens was microscopically assessed. RESULTS: There were no significant differences between marginal discrepancies of the groups, with the exception of porcelain shoulder margins in the metal-ceramic group, which had significantly larger discrepancies (P < .01). There was no significant effect of the fatigue tests on marginal discrepancies. However, significant differences of leakage were found between the groups cemented with the different luting agents after both fatigue tests. The adhesive composite resin luting system demonstrated the least leakage. The compomer cement showed an intermediate level of leakage, and the zinc-phosphate cement showed severe leakage that extended through the dentinal tubules to the pulp chambers. No significantly different effect of the two fatigue tests on the leakage was found. CONCLUSION: The adhesive composite resin luting system showed clinically acceptable marginal discrepancies and an excellent ability to minimize leakage of all-ceramic crowns.     

An In Vitro Evaluation of the Microleakage under Complete Metal Crowns Using Three Adhesive Luting Cements

Despite the material advancements and precise laboratory techniques, cement lines are inevitable in fixed prosthodontics which leads to increased dependence on the integrity of the cement to maintain the marginal seal. The material class of luting agent is known to influence microleakage. Studies of cement dissolution and disintegration have produced varying results. Hence, this study was done to evaluate marginal leakage under complete metal crowns using three adhesive cements, two resin cements (one self cure, one dual cure) and a glass ionomer cement. Metal crowns were prepared on sixty intact extracted premolars and were randomly divided into three groups of twenty each, with each group using a different cement for luting. All the samples were then subjected to thermocycling and were sectioned using a diamond saw. Reflected Binocular Stereomicroscope at 100× magnification was used to study the extent of microleakage at both metal cement (MC) and tooth cement (TC) interface, at two opposite margins of each sectioned specimen. Data was analyzed with a one way analysis of variance. For comparison among the groups multiple comparison Bonferroni test was done. Within group data was analysed with independent student t test. Between three groups, metal crowns cemented with multilink cement showed significantly less microleakage at both the interfaces. Glass ionomer cement recorded maximum combined microleakage amongst three cements irrespective of the interfaces. Within group, glass ionomer and multilink cement showed more microleakage at MC interfaces than at TC interface. A complex interaction between variables related to dental restoration, luting agent and tooth structure probably influence microleakage. In vitro studies must always be followed by in vivo studies before definite conclusion can be drawn.     

An evaluation of a glass ionomer luting agent: pulpal histological response

Pulpal histological response after crown cementation with a glass ionomer luting agent was evaluated and compared with the response to a polycarboxylate cement or a varnish plus zinc phosphate cement. Pulpal histological response was evaluated on teeth that had full crowns cemented with the test luting agents 3, 10, and 56 days after cementation. No statistically significant differences were found in pulpal histological response between the materials tested during all periods. These findings suggest that factors other than pulpal inflammation are contributing to the reported hypersensitivity after cementation associated with glass ionomer luting agents.     

Microleakage in full-crown all-ceramic restorations: influence of internal surface treatment, silane application, alumina system, and substrate

This study investigated the influence of internal surface treatment and margin location on the microleakage of 2 alumina-reinforced ceramic crown systems: In-Ceram (VITA Zahnfabrik) and Procera (Nobel Biocare). Full crowns were produced for each of the 2 systems (n = 24) in human premolars, with margins located in enamel and dentin, and luted with Single Bond and RelyX ARC (3M ESPE). Four internal ceramic treatments were tested: (1) aluminum oxide blasting (AO), (2) AO plus silane, (3) hydrofluoric acid etching (HF), and (4) HF plus silane. After thermal cycling, leakage was measured quantitatively. Statistical analysis (P < .05) showed higher leakage in dentin margins compared to enamel. In enamel, Procera showed greater leakage compared to In-Ceram. Generally, lower microleakage was observed for the AO plus silane treatment.     

Effect of auxiliary grooves on molar crown preparations lacking resistance form: a laboratory study.

PURPOSE: To investigate the effect of auxiliary grooves on resistance to dislodgment of crowns on compromised molar preparations lacking resistance form. MATERIALS AND METHODS: Thirty human molar teeth were randomly assigned to three groups of ten, and prepared to a height-to-width ratio of 0.3 with a total convergence of 50 degrees , and 1-mm shoulder margin. Base metal alloy copings were constructed with a 45 degrees loading platform and cemented with zinc phosphate cement under a 50 N load. Initially, resistance testing was conducted using a Universal Testing Machine (Instron) at 1 mm/min for all 30 specimens. Following crown dislodgment, Group 1 copings were recemented and retested, Group 2 had one axial groove added, and Group 3 had two axial grooves added. New copings for Groups 2 and 3 were made, cemented, and again tested for resistance. Standardized radiographs were taken prior to initial cementation and scanned into digital images. The percentage of area occupied by the pulpal chamber above the acrylic mounting (PS), and the closest distance to pulp from the preparation surface (CD) were measured. RESULTS: Recementation or the addition of one groove did not affect the dislodgment values (p > 0.05), but addition of two grooves caused a highly significant increase in resistance (p < 0.001). Regression analysis showed an inverse relationship between initial resistance values and pulpal space area. Lower resistance values were observed when the pulpal space area was large (p= 0.004). CONCLUSIONS: Crowns can be recemented without affecting resistance to dislodgment. Two grooves should be incorporated into compromised molar crown preparations to increase resistance form. Teeth with large pulps and therefore less coronal dentine have poorer resistance form, and therefore would benefit from placement of auxiliary grooves.     

Microleakage and marginal gap of adhesive cements for noble alloy full cast crowns

Very limited comparative information about the microleakage in noble alloy full cast crowns luted with different types of adhesive resin cements is available. The purpose of this study was to evaluate the microleakage and marginal gap of two self-adhesive resin cements with that of other types of adhesive luting cements for noble alloy full cast crowns. Fifty noncarious human premolars and molars were prepared in a standardized manner for full cast crown restorations. Crowns were made from a noble alloy using a standardized technique and randomly cemented with five cementing agents as follows: 1) GC Fuji Plus resin-modified glass ionomer cement, 2) Panavia F 2.0 resin cement, 3) Multilink Sprint self-adhesive resin cement, 4), Rely X Unicem self-adhesive resin cement with pretreatment, and 5) Rely X Unicem with no pretreatment. The specimens were stored in distilled water at 37°C for two weeks and then subjected to thermocycling. They were then placed in a silver nitrate solution, vertically cut in a mesiodistal direction and evaluated for microleakage and marginal gap using a stereomicroscope. Data were analyzed using a nonparametric Kruskal-Wallis test followed by Dunn multiple range test at a p<0.05 level of significance. The Rely X Unicem (with or with no pretreatment) exhibited the smallest degree of microleakage at both tooth-cement and cement-crown interfaces. The greatest amount of microleakage was found for Panavia F 2.0 resin cement followed by GC Fuji Plus at both interfaces. No statistically significant difference in the marginal gap values was found between the cementing agents evaluated (p>0.05). The self-adhesive resin cements provided a much better marginal seal for the noble alloy full cast crowns compared with the resin-modified glass ionomer or dual-cured resin-based cements.     

Influence of finish-line form on crown cementation.

Studies reporting the influence of finish-line configuration on the fit of cemented crowns have had conflicting conclusions. This study examined the effect of finish-line configuration on the fit of cemented complete crowns. Three identical tooth preparations were made, each with a different facial finish line: shoulder, shoulder-bevel, and chamber. The prepared teeth were replicated to produce 45 epoxy resin teeth, 15 for each finish-line design. Thirty cast crowns were fabricated and seated on their respective epoxy resin teeth--fifteen without cement and fifteen with zinc phosphate cement. An additional set of fifteen castings, seated on their working dies, was used for control measurements. All specimens were embedded, sectioned, and measured at predetermined sites. Results showed that finish-line form does not affect the fit of cemented crowns.     

表面处理对全瓷冠修复体微渗漏的影响

目的：评估不同的表面处理方法以及两种不同的瓷系统对微渗漏的影响.方法：取48颗正畸拔出的前磨牙,分2组（每组24个）,一组用于制作procera瓷全冠,另一组制作In-Ceram瓷全冠.每一组又分为4小组（每小组各6例）,①.50μm氧化铝喷砂;②.氧化铝喷砂加硅烷;.③.氢氟酸酸蚀;④.氢氟酸酸蚀加硅烷.比较各组的微渗漏情况,数据进行t检验和三元方差分析组问差异.结果：在牙釉质内,4种方法中氧化铝喷砂并硅烷处理对两种瓷而言都显著减少了微渗漏（p＜0.01）,但procera瓷表现了更多的微渗漏（p＜0.05）;在牙本质中,4种表面处理方法中氧化铝喷砂并硅烷处理可减少微渗漏,两种瓷表现相似.结论：牙本质表现了较高的微渗漏;在不同的表面处理方法中,氧化铝喷砂并硅烷处理微渗漏表现最少.     

Cement thickness and microleakage under metal-ceramic restorations with a facial butted margin: an in vivo investigation.

Ten metal-ceramic restorations with buccal porcelain butt margins and palatal metal beveled margins were fabricated for periodontally hopeless teeth. After cementation, the experimental crowns remained in the oral environment for 3 to 6 months; the teeth were then extracted and used for microscopic and microleakage evaluation. All ten crowns showed at least a small amount of microleakage, but adaptation of beveled margins proved to be superior to that of shoulder porcelain margins.     

Microleakage of all-ceramic crowns using self-etching resin luting agents

Self-etching adhesive systems are a new generation of materials that possess acidic methacrylates that can generate self-adhesion. There is limited data reported on the marginal leakage of ceramic restorations bonded with self-etching adhesive materials. This study assessed and compared the amount of microleakage of bonded ceramic crowns using three different types of self-etching adhesive systems with and without a die spacer. Eighteen human molars were prepared for all-ceramic IPS Empress crowns and the teeth were randomly assigned to each experimental group. The buccal side had the preparation finish line 1.5 mm below the CEJ, and the lingual finish line was 1.5 mm above the CEJ, creating margins in enamel and dentin. Two die-spacing techniques were used (three layers or no layer of die spacer). Each crown restoration was cemented with one of three self-etching resin luting agents (Panavia F 2.0, Multilink and RelyX Unicem). The specimens were thermally cycled for 1000 cycles, then immersed in a 5% methylene blue dye solution for 24 hours. The teeth were then rinsed, embedded in clear epoxy resin and sectioned. A total of 60 sections were evaluated for each type of resin luting agent using digital image analysis at 70x magnification. A novel formula, using mean percentage of microleakage, was developed by dividing the extent of dye penetration along the tooth/resin luting cement interphase and the total perimeter of the tooth crown surface. The data were analyzed using three-way analysis of variance at the 0.05 level of significance. Fisher's PLSD intervals were calculated for comparing significant means. Panavia F 2.0 showed a lower degree of microleakage than RelyX Unicem and Multilink at both the enamel and dentin margins. Interactions of the main effects (cement, margin and die spacer technique) were all highly significant (p< or =0.004). The degree of microleakage was higher on the dentin margins than on the enamel margins (p<0.0001). The degree of microleakage for the die spacer group was not significantly different from the group with no die spacer technique (p>0.1). Overall, Panavia F 2.0 showed the least microleakage, followed by RelyX Unicem and Multilink, respectively.     

An evaluation of a glass ionomer luting agent: bacterial leakage

This study quantitatively evaluates the bacterial leakage beneath crowns cemented with a glass ionomer cement compared with those cemented with a polycarboxylate cement or a varnish plus zinc phosphate cement. Bacterial samples were taken from beneath full crowns cemented with the test luting agents 3, 10, and 56 days after cementation. Two-way analysis of variance of the resultant data showed a significant increase in bacterial counts for zinc phosphate, a significant decrease for polycarboxylate, and no change for glass ionomer. These findings suggest that bacterial leakage may not be the reason for the reported poor clinical response associated with glass ionomer luting agents.