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PubMed1997

A clinical trial of all-ceramic crown restorations: status, fall 1995.

Although porcelain-fused-to-metal (PFM) restorations are the most widely used full-coverage crown restoration systems, their inherent properties make the achievement of natural aesthetic restorations an elusive task. In contrast, the all-ceramic system (IPS Empress, Ivoclar North America, Amherst, NY) offers excellent translucency and vitality, without the opacity associated with PFM restorations. Its vitality is further enhanced by an adhesive resin cementation method that conducts the color of the underlying tooth structure. This article reports the status of a 5-year investigation, initiated in 1992, of the clinical performance of the IPS Empress all-ceramic system and the resin cementation system used with it.

Adolescent↗

PubMedDate not supplied

An intraindividual clinical comparison of 2 metal-ceramic systems.

PURPOSE: It has been questioned whether the surface and color of the ceramic and the metal-ceramic bond strength of a titanium-ceramic system are comparable to those of a conventional noble alloy-ceramic system. It was therefore the aim of this study to carry out an intraindividual clinical comparison between crowns fabricated according to the Procera system (titanium copings veneered with a low-fusing ceramic) and noble-alloy copings veneered with a medium-fusing ceramic. MATERIALS AND METHODS: Twenty-one crown pairs were fabricated for eighteen patients; three of the patients were each provided with two crown pairs. After 2 years nineteen crown pairs in sixteen patients could be compared. Clinical examinations were performed by two calibrated dentists who are long experienced in prosthetic dentistry. The crowns were rated according to the California Dental Association system. In addition, Bleeding Index and Margin Index were evaluated. RESULTS: After 2 years the quality of surface and color of the ceramic material seemed to have deteriorated more in titanium-ceramic crowns than in conventional metal-ceramic crowns, although the difference was not statistically significant. Regarding anatomic form, margin integrity, Bleeding Index, and Margin Index the differences between the two crown systems were small. CONCLUSION: The low-fusing ceramics have been subject to improvements during the last few years. Their bond strength to titanium seems to be comparable to that of conventional metal-ceramic systems. However, in the long run one problem may be the surface and color stability of low-fusing ceramics. To make extended long-term comparisons between the two metal-ceramic systems possible the present patient material will be followed for a longer period than the current 2 years.

Adult↗

PubMed1996

Direct tooth-colored materials for noncarious lesions: a 3-year clinical report.

One hundred fifty-nine noncarious cervical lesions were restored with glass-ionomer cement, resin composite used with a dentinal bonding agent, or the laminate (sandwich) restoration, which combines both these materials. These restorations were evaluated at baseline, 1 year, and 3 years for color match, cavosurface marginal discoloration, anatomic form, marginal adaptation, and retention. There was a general deterioration of the restorations with time. Lesions restored with resin composite and a dentinal bonding agent exhibited the highest percentage of lost restorations.

Adult↗

PubMed1994

Color communication, laboratory fabrication, and cementation.

Once considered to be revolutionary, porcelain veneers are now the foundation of most aesthetic dental practices. Requiring only conservative preparations, porcelain veneers can dramatically change a smile. This article discusses the technique necessary to prepare and place porcelain veneers, using a new pressed-ceramic system. Close and thorough cooperation and communication between the clinician and the laboratory are essential throughout the procedure, and this article is coauthored by a dentist and a ceramist.

Aluminum Silicates↗

PubMed1997

Effect of 10 percent carbamide peroxide on color of provisional restoration materials.

To improve esthetic results, nightguard vital bleaching of teeth using 10 percent carbamide peroxide, or CP, may be indicated when an anterior tooth is restored with a provisional crown. This study evaluated the effect of NGVB solutions containing 10 percent CP on the color stability of provisional restoration materials. Disks were fabricated from six representative provisional restoration materials and were tested in five different 10 percent CP bleaching agents. An orange discoloration occurred with provisional materials that contained methacrylate when they were exposed to 10 percent CP bleaching solutions.

Carbamide Peroxide↗

PubMed1997

Effect of adding opaque porcelain on the final color of porcelain laminates.

STATEMENT OF PROBLEM: Increasing the opacity of porcelain laminates is one of the techniques most commonly used to mask the color of darkly stained teeth. PURPOSE OF STUDY: Two different brands of porcelain (Fortune and Optec) disks that contained various amounts of modifying porcelains to alter opacity were cemented with untinted resin cement to a dark colored substrate. MATERIAL AND METHODS: The color of the substrate was measured before and after cementation and the change in color was calculated. RESULTS: Fortune porcelain showed a progressive increase in the amount of change produced as the modifying porcelain was increased, whereas Optec porcelain showed a decrease in the amount of change as modifying porcelain was increased. CONCLUSION: A progressive increase of yellow was exhibited in the samples as the amount of opacity is increased.

Analysis of Variance↗

PubMed1998

Yttrium-partially stabilized zirconium dioxide posts: an approach to restoring coronally compromised nonvital teeth.

In the pursuit of esthetic restorations for nonvital teeth, the introduction of a tooth-colored intraradicular post system is described. Conventional metallic posts can corrode and may cause inflammatory reactions and discoloration of the periodontium. Zirconium dioxide is a chemically stable ceramic with physical and optical properties that make it an ideal choice for the construction of esthetic, life-like restorations. The purpose of this study was to describe the composition, properties, and practical applications of zirconia posts in clinical practice.

Ceramics↗

PubMed2006

Clinical evaluation of an all-ceramic restorative system: 24-month report.

PURPOSE: To clinically evaluate an all-ceramic restorative system (Finesse All-Ceramic) when used in conjunction with an ultra-low fusing porcelain (Finesse) using bonded esthetic resin cements (Enforce & Calibra). METHODS: 40 posterior and anterior crowns, 20 all-ceramic inlays and onlays, and 26 veneers were placed in 43 patients. Standard ceramic preparations were performed followed by conventional polyvinylsiloxane (Aquasil) impression techniques using cord retraction. The bonded resin cement was used to place the restorations following manufacturer's instructions. A majority of restorations (95-100%) were evaluated to be optimal at baseline (B), 6, 12, and 24 months using a modified Ryge criteria for the following categories: color match, marginal adaptation, porcelain staining, secondary caries, postoperative sensitivity, and retention. RESULTS: There were sufficient shades available to obtain desired esthetic result with 98% of all restorations being rated Alfa for shade match to Vita Lumin shade guide. The overall 2-year success rate (inlay/onlays, crowns, and veneers) was 98.75%.

Dental Marginal Adaptation↗

PubMedDate not supplied

Tooth-colored inlays: new cementation technique.

A new technique for tooth-colored inlay cementation is introduced. Dual-cure fully filled restorative resin Sono-Cem (ESPE America, Norristown, PA) was used to cement tooth-colored restoration. A specially designed wooden tip in the gently vibrating Profin handpiece (Dentatus USA, New York) may be considered an excellent instrument for cementing porcelain and composite inlays with Sono-Cem cement. Also, a wide variety of diamond/tungsten plated abrasive Lamineer tips in a Profin Handpiece may be used for tooth preparation as well as for finishing restorations.

Adult↗

PubMed1994

Tooth-colored posterior restorations using Cerec Method (CAD/CAM)-generated ceramic inlays.

The ability to provide patients with esthetic tooth-colored posterior restorations produced from "factory-standardized" ceramics in a single visit is a unique feature of CAD/CAM technology. Recent improvements in the hardware and computer software of the Siemens CEREC CAD/CAM System have improved its ease of use and the quality of the restoration produced. Attention to tooth preparation requirements and care in the cementing and finishing procedures remain requirements for the production of these restorations.

Bicuspid↗

PubMed1997

IPS Empress veneers. Color communication, laboratory fabrication, and cementation.

Adult↗

PubMed1998

Replacement and initial placement of tooth colored restorations: a review and discussion.

Disagreement exists among dentists concerning reasons for initial placement and replacement of composite restorations, although specific criteria have been established by several reports. According to numerous studies, the longevity of composite restorations appears to be lower than for amalgam restorations; however, with advances in dental materials, composite resin longevity should increase. Inadequate operator technique and poor patient compliance are contributing factors for restoration failure. Research regarding enamel and dentin bonding systems will produce better quality and more durable results for composite restorations.

Composite Resins↗

PubMed1999

Predicting porcelain thickness required for dental shade matches.

STATEMENT OF PROBLEM: Production of a ceramic dental restoration that matches a target shade is dependent on porcelain thickness. Even when adequate porcelain thickness exists, clinical shade matches are difficult to achieve. PURPOSE: This study predicted the thickness of dentin porcelain required to obtain a clinical shade match (</=3 DeltaE units) for a variety of dental porcelain systems and shades. MATERIALS AND METHODS: Three all-ceramic crown systems (Empress, Inceram-Alumina, Inceram-Spinell) and 2 metal ceramic systems (Vintage, VMK-95) were evaluated, each in shades A1, A3, and C2. Five specimens of each porcelain, of each shade, were fabricated at thicknesses of 1.0, 1.2, 1.5, and 2.0 mm. CIE-LAB coordinates were recorded for each specimen, and for the midgingival third of corresponding shade tabs with a Minolta CR-321 colorimeter. RESULTS: Seventy percent of the color difference between specimen and shade tab was due to high L* (Munsell value) in the specimens. At thicknesses of </=2.0 mm of dentin porcelain, the all-ceramic systems exhibited more shade matches than the metal ceramic systems. CONCLUSIONS: Specimens made from semi-translucent all-ceramic systems exhibited clinical shade matches that were superior to those made with the metal ceramic systems. Increasing thickness of the semi-translucent systems from 1.0 to 2.0 mm did not improve shade matching.

Aluminum Oxide↗

PubMed1997

Achieving functional restorations utilizing a new Ceromer system.

The advent of pressed ceramic restorations (IPS Empress, Ivoclar Williams, Amherst, NY) has driven dental therapy to continuously strive for more aesthetic and functional materials. The dental profession requires restorations to exhibit strength, natural color, wear resistance, marginal integrity, and ease of fabrication in the restorative therapies selected. With the introduction of a new ceromer and fiber-reinforced composite (FRC) system (Targis System, Ivoclar Williams, Amherst, NY), the replacement of a single tooth or multiple teeth with a FRC, metal-free bridge is now a suitable alternative to conventional dental therapy. This presentation will review the clinical protocol, material properties, and aesthetic characteristics of this new generation of restorative material.

Adult↗

PubMed1995

[Neon-colored plastics for orthodontic appliances. Biocompatibility studies].

Public concern and issues of liability have made product safety a major concern throughout the medical field including orthodontics. The purpose of this study was to test the biocompatibility of the new neon colored plastic materials to be used for removable orthodontic appliances before they reach the market and are used in patient treatment. In addition, eight modifications of this synthetic material, which has been used in appliances for many years, were examined without neon color. The procedures established tested for: 1. mutagenicity, 2. toxicity, and 3. irritation of the mucous membrane. As alternatives to using animals the Ames Test, the Agar Overlay Assay, and the HET-CAM Test were employed to test for these properties. The tests revealed that, when the manufacturer's instructions are followed, neither the polymerized materials as used in patient appliances nor the shavings resulting from the orthodontist or the technician grinding the appliance exhibit mutagenic, toxic, or irritating properties.

Animals↗

PubMed1998

Six-year follow-up with Empress veneers.

This study reports on 6 years experience with IPS Empress laminate veneers. A total of 83 anterior veneers were positioned in 21 patients from January 1991 to December 1996 in the author's private practice. Final evaluation was carried out in May and June 1997. Color match, marginal discoloration, recurrent caries, contour, and marginal integrity were evaluated using the modified U.S. Public Health Service criteria at baseline and subsequent recall appointments. On the basis of the criteria used, a large percentage of veneers were rated Alfa. Only one failure was recorded, resulting in a success rate of 98.8%. A thorough description of clinical procedures and laboratory techniques through which anterior teeth can be successfully treated with ceramic veneers is supplied. A clinical case is presented to demonstrate the satisfactory esthetic results obtained using this very conservative restorative technique.

Aluminum Silicates↗

PubMed1996

The direct/indirect composite resin veneers: a case report.

Veneer restorations are well suited for conservative and aesthetic improvement of the anterior dentition. Laboratory fabricated porcelain and composite resin veneers present optimal aesthetics and durability. Although there are disadvantages associated with direct bonding, it provides control of color and contour for the operator, particularly in the case of a single anterior central incisor. Direct/indirect composite resin veneers utilize the advantages of both direct and indirect techniques in reconstruction of restorations with improved physical properties. The learning objective of this article is to review the available composite resins, opaquers, and tints, and present a step-by-step protocol for predictable restoration of discolored anterior dentition with direct/indirect heat-treated composite resin veneers in a single appointment. Patient evaluation, preoperative aesthetic considerations, selection of the restorative composite resins, and the clinical procedure are discussed.

Adolescent↗

PubMed1997

Six years of clinical experience with an all-ceramic system.

The search for tooth-colored and metal-free restorations is one of the major challenges in dental research. For several decades, ceramic has been used as a restorative material because of its aesthetics and stability. Unfortunately, the survival rate of most all-ceramic systems seems unsatisfactory; due to the natural brittleness of ceramic, fractures have been the primary reason for the high failure rate. Since 1988, the University of Zurich Dental School, Switzerland, has been working with the IPS Empress all-ceramic system (Ivoclar/Williams, Amherst, NY). This article reports the clinical and research data from approximately 3,000 all-ceramic restorations.

Aluminum Silicates↗