All-ceramic restorations have become an attractive alternative to porcelain-fused-to-metal crowns. In-Ceram, and more recently IPS Empress 2 were introduced as a new all-ceramic system for single crowns and 3-unit fixed partial dentures. But their strength and marginal fit are still an important issue. This study evaluated the fracture resistance and marginal fit of three systems of 3 unit all-ceramic bridge fabricated on prepared maxillary anterior resin teeth in vitro. The 3 all-ceramic bridge systems were: (1) a glass-infiltrated, sintered alumina system (In-Ceram) fabricated conventionally, (2) the same system with copy-milled alumina cores (copy-milled In-Ceram), (3) a heat pressed, lithium disilicate reinforced glass-ceramic system (IPS Empress 2). Ten bridges of each system with standardized design of framework were fabricated. All specimens of each system were compressed at $55^{\circ}$ at the palatal surface of pontic until catastrophic fracture occurred. Another seven bridges of each system were fabricated with standard method. All of the bridge-die complexes were embedded in epoxy resin and sectioned buccolingually and mesiodistally. The absolute marginal discrepancy was measured with stereomicroscope at ${\times}50$ power. The following results were obtained: 1. There was no significant difference in the fracture strength among the 3 systems studied. 2. The Weibull modulus of copy-milled In-Ceram was higher than that of In-Ceram and IPS Empress 2 bridges. 3. Copy-milled In-Ceram($112{\mu}m$) exhibited significantly greater marginal discrepancy than In Ceram ($97{\mu}m$), and IPS Empress 2 ($94{\mu}m$) at P=0.05. 4. The lingual surfaces of the ceramic crowns showed smaller marginal discrepancies than mesial and distal points. There was no significant difference between teeth (incisor, canine) at P=0.05. 5. All-ceramic bridges of three systems appeared to exhibit sufficient initial strength and accept able marginal fit values to allow clinical application.
Journal of the Korea Academia-Industrial cooperation Society
/
v.18
no.10
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pp.448-453
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2017
The purpose of this study was to compare the marginal discrepancy of coping crowns according to manufacturing method and materials by using the CAD/CAM system to compare the optimum manufacturing method and materials. The coping crowns were fabricated by using manufacturing methods and materials, and marginal fit was measured using the replica technique. For comparative analysis of manufacturing methods and materials, analysis of variance was performed. One-way ANOVA was performed to compare and analyze different mean values. For the milling method of the alloy, 114.6 was obtained for the MM group, 111.4 for the MS group, 67.2 for the MSC group, and 50.9 for the MSS group, respectively, using the milling/sintering method. In the milling/sintering method of ceramic, 35.6 and 36.3, respectively, were obtained for the SLME group and SLMR group, respectively. However,there was a significant difference according to the material. The milling/sintering method of the ceramic material gave the lowest value, and it was verified by the optimal method. However, marginal discrepancy of coping crowns fabricated using the CAD/CAM system is applicable to the clinic since it corresponds to acceptable numerical values in clinical practice.
In an effort to facilitate fabrication procedure of all ceramic crowns, a novel preparation method for all ceramic crown using alumina tape was developed. The alumina tape having a uniform thickness was cast by using Doctor blade method. The physical properties of newly introduced alumina tape has biaxial flexure strength of $500\sim600MPa$. The value of toughness is $3.18\sim3,28MPa.m^{1/2}$ which corelates with fracture and the linear shrinkage rate of the alumina tape is 0.44% during core production. The marginal fitness of the alumina tape all-ceramic restoration with $90{!`}$shoulder margin had average marginal discrepancy at $78.3{\S}$ > and average marginal gap at $44.4{\S}$ >. At the marginal preparation of $135{!`}$deep chamfer, the average marginal discrepancy at $82.1{\S}$ > and the average marginal gap at $40.2{\S}$ > had been reported. This fabrication procedure of all ceramic crowns with alumina tapes is easier and less technical sensitive for dental technicians. After restoration with new all ceramic crowns we followed the patients 2 years later, there were no complications as porcelain fractures or periodontal disease. We had good esthetic clinical results with new all ceramic crowns.
There have been many studies about marginal discrepancy of single restorations made by various systems and materials. But many of statistical inferences are not definite because of sample size, measurement number, measuring instruments. etc. The purpose of this study was to compare the marginal adaptations of the anterior single restorations made by different systems and to consider more desirable statistical methods in analysing the marginal fit. The in vitro marginal discrepancies of three different all-ceramic crown systems (Celay In-Ceram. Conventional In-Ceram. IPS Empress 2 layering technique) and one control group (PFM) were evaluated and compared. The crowns were made from one extracted maxillary central incisor prepared with a 1mm shoulder margin and $6^{\circ}$ taper walls by milling machine. 10 crowns per each system were fabricated. Measurements or a crown were recorded at 50 points that were randomly selected for marginal gap evaluation. Non-parametric statistical analysis was performed for the results. Within the limits of this study, the following conclusions were drawn: 1 Mean gap dimensions and standard deviations at the marginal opening for the maxillary incisor crowns were $98.2{\pm}40.6{\mu}m$ for PFM, $83.5{\pm}18.7{\mu}m$ for Celay In-Ceram, $104.9{\pm}44.1{\mu}m$ for conventional In-Ceram, and $45.5{\pm}11.5{\mu}m$ for IPS Empress 2 layering technique. The IPS Empress 2 system showed the smallest marginal gap (P<0.05). The marginal openings of the other three groups were not significantly different (P<0.05). 2 The marginal discrepancies found in this study were all within clinically acceptable standards ($100\sim150{\mu}m$). 3. When the variable is so controlled that the system may be the only one, mean value is interpreted to be the marginal discrepancy of a restoration which is made by each system and standard deviation is to be technique-sensitivity of each one. 4. From the standard deviations. the copy-milling technique (Celay/In-Ceram) was not considered to be technique-sensitive in comparison with other methods. 5. Parametric analysis is more reliable than non-parametric one in interpretation of the mean and standard deviation. The sample size of each group has to be more than 30 to use parametric statistics. The level of clinically acceptable marginal fit has not been established. Further studies are needed.
Statement of problem: The use of zirconia prostheses fabricated with CAD/CAM system is on an increasing trend in dentistry. However, evaluation of the fit related to internal relief and marginal reproducibility of zirconia has not been reported. Purpose : This study was to evaluate the fit related to internal relief and marginal reproducibility of zirconia core fabricated with CAD/CAM system. Materials and methods: The evaluation was based on 30 zirconia cores and 5 IPS-Empress2 cores. Zirconia cores were fabricated in different conditions of internal relief(0, 10, 20, 30, 40 and $50{\mu}m$), and IPS-Empress2 cores were fabricated in accordance with the manufacturer's instructions. Before cementation, the marginal discrepancies or cores were measured on metal die. And then, each core was cemented to stone die, embedded in an acrylic resin and sectioned in two planes(mesiodistally and labiopalatally). The internal gaps were measured at the margin and axial surface. Measurements for the marginal discrepancies, the internal marginal gaps and the internal axial gaps were performed under a measuring microscope(Compact measuring microscope STM5; Olympus, Japan) at a magnification of ${\times}100$. In addition, the marginal conagurations of metal die, zirconia core and IPS-Empress2 core were examined with SEM(S-2700, Hitachi, Japan). Results : Within the limits of this study the results were as follows. 1. Compared with IPS-Empress2 cores, the marginal discrepancies of zirconia cores had no significant differences. the internal marginal gaps were statistically smaller and the internal axial gaps were statistically larger in each condition of internal relief. 2. The marginal discrepancies and the internal marginal gaps of zirconia cores had no significant differences related to the conditions of internal relief(P>0.05). 3. The internal axial gaps of zirconia cores with $0{\sim}20{\mu}$m for internal relief were significantly larger than that with $50{\mu}m$ (P<(0.0001). 4. SEM micrographs showed favorable marginal reproducibility of zirconia core and smooth texture on the milling surface. Conclusion: The marginal discrepancy and the internal gaps of zirconia core were clinically acceptable and the milling surface was showed smooth texture. For fabrication of the durable esthetic restoration, further investigations on complex design of core, milling accuracy, compatability of enamel porcelain and porcelain firing seems to be needed.
von Maltzahn, Nadine Freifrau;Bernhard, Florian;Kohorst, Philipp
The Journal of Advanced Prosthodontics
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v.12
no.2
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pp.100-106
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2020
PURPOSE. The purpose of this in vitro study was to evaluate the fitting accuracy of single crowns made from a novel presintered Co-Cr alloy prepared with a computer-aided design and computer-aided manufacturing (CAD/CAM) technique, as compared with crowns manufactured by other digital and the conventional casting technique. Additionally, the influence of oxide layer on the fitting accuracy of specimens was tested. MATERIALS AND METHODS. A total of 40 test specimens made from Co-Cr alloy were investigated according to the fitting accuracy using a replica technique. Four different methods processing different materials were used for the manufacture of the crown copings (milling of presintered (Ceramill Sintron-group_cer_sin) or rigid alloy (Tizian NEM-group_ti_nem), selective laser melting (Ceramill NPL-group_cer_npl), and casting (Girobond NB-group_gir_nb)). The specimens were adapted to a resin model and the outer surfaces were airborne-particle abraded with aluminum oxide. After the veneering process, the fitting accuracy (absolute marginal discrepancy and internal gap) was evaluated by the replica technique in 2 steps, before removing the oxide layer from the intaglio surface of the crowns, and after removing the layer with aluminum oxide airborne-particle abrasion. Statistical analysis was performed by multifactorial analysis of variance (ANOVA) (α=.05). RESULTS. Mean absolute marginal discrepancy ranged between 20 ㎛ (group_cer_npl for specimens of Ceramill NPL) and 43 ㎛ (group_cer_sin for crowns of Ceramill Sintron) with the oxide layer and between 19 ㎛ and 28 ㎛ without the oxide layer. The internal gap varied between 33 ㎛ (group_ti_nem for test samples of Tizian NEM) and 75 ㎛ (group_gir_nb for the base material Girobond NB) with the oxide layer and between 30 ㎛ and 76 ㎛ without the oxide layer. The absolute marginal discrepancy and the internal gap were significantly influenced by the fabrication method used (P<.05). CONCLUSION. Different manufacturing techniques had a significant influence on the fitting accuracy of single crowns made from Co-Cr alloys. However, all tested crowns showed a clinically acceptable absolute marginal discrepancy and internal gap with and without oxide layer and could be recommended under clinical considerations. Especially, the new system Ceramill Sintron showed acceptable values of fitting accuracy so it can be suggested in routine clinical work.
Statement of problem. In-Ceram system is one of the all-ceramic crowns that can be used in anterior 3 unit fixed partial dentures and posterior single crowns. The alumina core used in In-Ceram system is manufactured using slip-casting technique. The slip-casting technique is difficult and technique sensitive. To improve this problem, tape-casting method was introduced into dentistry. There were no studies to examine the effect of margin design on the margin fitness of all-ceramic crowns fabricated from alumina tape. Purpose. The purpose of this study was to compare the marginal fitness of glass infiltrated alumina core fabricated from aqueous-based alumina tape according to different margin types ($90^{\circ},\;110^{\circ},\;135^{\circ}$ shoulder margin). Material and method. Three upper central resin incisors were prepared with $90^{\circ},\;110^{\circ}$, and $135^{\circ}$ shoulder margins for all-ceramic crowns, respectively. The resin teeth were duplicated and master die and special plaster die were made as usual. After alumina cores were fabricated from aqueous-based alumina tape, cores were cemented to each 15 epoxy dies replicated from three resin teeth with resin cement. These cemented cores were embedded in epoxy resin. Specimens were cut mesiodistally and buccolingually. Marginal gap and discrepancy were measured under microscope. Results. The marginal gap and discrepancy of $90^{\circ}$ marginal angle was $75.1{\mu}m,\;86.6{\mu}m,\;110^{\circ}$ marginal angle was $41.5{\mu}m,\;50.7{\mu}m$ and $135^{\circ}$ marginal angle was $51.7{\mu}m,\;54.2{\mu}m$, respectively. The smallest value was seen in 110 (angle, which was statistically significant compared to that of $90^{\circ}$ angle (p<0.05). Conclusion. Marginal fitness of alumina cores made of alumina tape with $110^{\circ}$ shoulder margin was best and others were clinically acceptable.
STATEMENT OF PROBLEM: Recently, various all-ceramic crowns fabricated with CAD/CAM systems have come into wide use in dental clinic. However, there are only few domestic studies on CAD/CAM restorations. PURPOSE: Purpose of this study was to compare the fidelity (absolute marginal discrepancy and internal gap) between various cores fabricated with different CAD/CAM systems (Procera system, Lava system, Cerec inLab system) and conventional metal cast core. MATERIALS AND METHODS: 10 cores per each system were fabricated. The absolute marginal discrepancies were measured using measuring microscope and digital counter. The internal gaps were calculated using a silicone paste. The results were statistically analyzed using the one-way ANOVA test and Tukey's HSD test. RESULTS: Within the limits of this study the results were as follows. 1. The absolute marginal discrepancies were $32.5{\pm}3.7\;{\mu}m$ for metal cast core, $72.2{\pm}7.0\;{\mu}m$ for Procera core, $40.8{\pm}5.4\;{\mu}m$ for Lava core, and $55.3{\pm}8.7\;{\mu}m$ for Cerec inLab core. The internal gaps were $38.4{\pm}5.7\;{\mu}m$ for metal cast core, $71.4{\pm}5.3\;{\mu}m$ for Procera core, $45.9{\pm}7.3\;{\mu}m$ for Lava core, and $51.8{\pm}6.2\;{\mu}m$ for Cerec inLab core. 2. The fidelity of metal cast core showed the smallest gaps, followed by Lava core, Cerec inLab core, and Procera core. CONCLUSION: The fidelities of 4 core groups were all within the clinically acceptable range ($120\;{\mu}m$).
Purpose: The purpose of this in vitro study was to compare the marginal fit of POM restorations with 3 different thickness of metal coping. Methods: 2.0mm Occlusal reduction, 1.0mm preparation of axial wall with 6degree taper, and chamfer margin was prepared a maxillary first premolar on dentiform. Duplicate prepared die and, make 30 individual dies with Ni-Cr metal. Make 3 groups of 30 press ceramic on Metal crown with different thickness of metal coping; 10 of 0.1mm, 10 of 0.3mm, 10 of 0.5mm thickness metal coping. The marginal fit of the crowns was evaluated 50 points per 1 crown, around the crown margin circumference under a optical microscope at original magnification ${\times}100$. A 1-way analysis of variance (ANOVA) was used to compare data. Results: The mean marginal discrepancy for POM with 0.1mm metal copings was $72.56{\mu}m$, $67.83{\mu}m$ for 0.3mm metal coping POMs, and $72.56{\mu}m$ for 0.5mm metal coping POM. The 1-way ANOVA showed significant difference among 3 groups. Conclusion: The marginal fit of pressed-on-metal (POMs) was best with 0.3mm thickness of metal coping, fallowing by 0.1mm, and 0.5mm in the order.
Purpose: The purpose of this study was to evaluate the fit of zirconia core using MAD/MAM system comparing to that of conventional metal-ceramic and CAD/CAM system. Materials and methods: Duplicating the prepared resin tooth, 50 improved stone dies were fabricated. These dies are classified as a group of 5 to create the core. The groups were composed of metal-ceramic, $Cercon^{(R)}$, $Ceramill^{(R)}$, $Rainbow^{TM}$, and $Zirkonzhan^{(R)}$. Each core was cemented to stone die, and then, absolute marginal discrepancy was measured with microscope at a magnification of ${\times}50$. Statistical analysis was done with one-way ANOVA test and Tukey's HSD test. Results: The mean absolute marginal discrepancy for metal-ceramic was $51.97{\pm}23.38{\mu}m$, for $Cercon^{(R)}$ was $62.16{\pm}25.88{\mu}m$, for $Ceramill^{(R)}$ was $67.64{\pm}40.38{\mu}m$, for $Rainbow^{TM}$ was $125.07{\pm}42.19{\mu}m$, and for $Zirkonzhan^{(R)}$ was $105{\pm}44.61{\mu}m$. Conclusion: 1. Fit of margin was identified as in the order of metal-ceramic, $Cercon^{(R)}$, $Ceramill^{(R)}$, $Zirkonzhan^{(R)}$, and $Rainbow^{TM}$. 2. Absolute marginal discrepancy of the zirconia core that designed by MAD/MAM system had significant differences in order of $Ceramill^{(R)}$, $Zirkonzhan^{(R)}$, and $Rainbow^{TM}$. 3. The mean absolute marginal discrepancy between $Cercon^{(R)}$ and $Ceramill^{(R)}$ did not show significant differences.
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