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Effect of Different Impression Methods and Ceramic Materials On Ciência Odontológica Brasileira UNIVERSIDADE ESTADUAL PAULISTA “JÚLIO DE MESQUITA FILHO” Instituto de Ciência e Tecnologia Campus de São José dos Campos ORIGINAL ARTICLE doi: 10.14295/bds.2018.v21i3.1543 Effect of different impression methods and ceramic materials on adaptation of inlays Efeito de diferentes métodos de moldagem e materiais cerâmicos na adaptação de inlays Marília Pivetta RIPPE1, Elen GUERRA2, ArianneVallim Pinto COELHO2, Lilian Costa ANAMI2, Renata Marques de Melo MARINHO2, Marco Antonio BOTTINO2, Luiz Felipe VALANDRO1 1 - Federal University of Santa Maria - Prosthodontics Unit - Faculty of Odontology - Santa Maria – RS - Brazil. 2 - São Paulo State University (Unesp) – Institute of Science and Technology – São José dos Campos – Department of Dental Materials and Prosthodontics - São José dos Campos – SP - Brazil. ABSTRACT RESUMO Objective: The aim of this study was to evaluate the Objetivo: O objetivo deste estudo foi avaliar a internal and marginal adaptation of inlays fabricated adaptação interna e marginal de inlays confeccionadas from different types of impressions (conventional a partir de diferentes tipos de moldagens (convencional and digital) and different ceramics (feldspathic e digital) e diferentes materiais cerâmicos (feldspática and lithium disilicate). Material and Methods: e dissilicato de lítio). Materiais e Métodos: Quarenta Forty premolars were prepared for all-ceramic pré-molares foram preparados para inlay totalmente inlay restoration and assigned to 4 groups (n=10), cerâmica e distribuídos em 4 grupos (n = 10) segundo according to the impression method (conventional o método de moldagem (convencional com silicone de with addition silicone and digital impression) and adição e moldagem digital) e tipo cerâmica (dissilicato ceramic type (lithium disilicate and feldspathic de lítio e blocos de cerâmica feldspática). Para cada ceramic blocks). For each type of impression, 10 tipo de moldagem, 10 inlays foram confeccionadas a inlays were milled from lithium disilicate blocks partir de pastilhas de dissilicato de lítio e as outras 10 and the other 10 from feldspathic ceramic blocks de blocos de cerâmica feldspática, por meio do sistema in a CAD-CAM facility. The internal adaptation was CAD-CAM. A adaptação interna foi analisada pela analyzed by the replica technique. The marginal fit técnica da réplica. O ajuste marginal foi analisado com was analyzed under a stereo microscope by directly estéreo microscópio medindo diretamente o espaço measuring the gap formed between the inlay and the entre a inlay e o dente nas regiões proximal e oclusal. tooth in the proximal and occlusal regions. Results: Resultados: As adaptações marginais e internas não The marginal or internal adaptations were not foram afetadas pelo tipo de moldagem (convencional affected by type of impression (conventional = digital = impressão digital), independentemente do tipo de impression), irrespective of the ceramic type. Only cerâmica. Somente a adaptação interna foi afetada pelo the internal adaptation was affected by the material material, sendo que a cerâmica feldspática apresentou type, i.e., feldspathic ceramic had lower values than menores valores que a cerâmica de dissilicato, lithium dissilicate ceramic, when considering the considerando a moldagem digital. Conclusão: As digital impression. Conclusion: The conventional moldagens convencional e digital promoveram and digital impressions promoted similar marginal adaptação marginal e interna semelhante de inlays and internal adaptation for feldspathic and disilicate de cerâmica feldspática e dissilicato testadas. Para ceramic inlays. For the digital impression the moldagem digital, a cerâmica feldspática mostrou feldspathic inlays showed better internal adaptation melhor adaptação interna do que a dissilicato de lítio. than lithium dissilicate inlays . PALAVRAS-CHAVE KEYWORDS Cerâmica; Adaptação interna dentária; Adaptação Ceramics; Dental internal adaptation; Dental marginal marginal dentária; Técnica de moldagem dentária. adaptation; Dental impression technique. 296247 Braz Dent Sci 2018 Jul/Sep;21(3) Rippe MP et al. Effect of different impression methods and ceramic materials on adaptation of inlays INTRODUCTION As regards the accuracy of the impression type, Syrek et al. [10] and Pradíes et al. [11] showed that the digital impression he preservation of healthy tooth structure promoted better marginal adaptation of all- should be always encouraged by using T ceramic crowns when compared with minimally invasive preparations, when conventional two-step impression-taking. possible, such as inlays and onlays. For However, Almeida e Silva et al. [12] found no maximum longevity of these restorations, the difference between the types of impressions. bond between the tooth structure and all- Moreover, Hamza et al. [13] showed that ceramic inlays should be reliable, since this type the type of ceramic might also influence the of restoration is retained in the preparation marginal adaptation of restorations. However, up mainly by the bond between different substrates to now no studies have compared the methods (dentin / enamel and restorative material) [1] of conventional and digital impression of inlay and the low mechanical friction that takes preparations in terms of marginal and internal place. [2] Thus, the ceramic type should be adaptation. taken into account for a proper cementation. Both, feldspathic and lithium disilicate ceramic Therefore, the aim of this study was to have shown to be suitable for inlay restorations. evaluate the effect of the impression method (conventional or digital) and ceramic type (lithium In order to achieve greater longevity of disilicate and feldspathic) inlay restorations inlay restorations, in addition to durable bond on the internal and marginal adaptation. The strength, the marginal accuracy is most important. hypotheses were: 1) The method of impression [3,4] Poor marginal fit increases the plaque would not influence the internal and marginal retention sites and induces periodontal disease; adaptation, irrespective of the ceramic material [5] leads to microleakage of the oral cavity fluids, used; 2) The type of material would not influence capable of resulting in endodontic inflammation the internal e marginal adaptation, irrespective [6] and secondary caries at restoration margins. of the method of impression. [7] However, it is difficult to establish an acceptable marginal fit for inlay restorations, due to faults occurring during impression-taking MATERIAL & METHODS and processing of the restorations. Furthermore This study was approved by the Committee the inherent limitations of adhesives should be of Ethics in Research and the teeth were donated considered, such as relatively high polymerization by the Human Teeth Bank. shrinkage; low resistance to degradation; and Forty human maxillary premolars were high thermal expansion coefficient. [8] selected, according to the inclusion criteria of Therefore, good marginal adaptation is no visible cracks or decay. The specimens were only possible if, firstly ,a good impression is randomly assigned into four groups (http:// taken. The accuracy of the impression is critical www.randomizer.org), according to table 1. to the success of the restoration. Nowadays, in Table 1 - Experimental Design addition to the conventional polyvinyl siloxane impression materials, digital impression can be Impressiontechnique Material Groups (n=10) used for clinical procedures: it is faster because Feldspathic ConFel Conventionalimpression it reduces the number of clinical steps and is Disilicate ConDis more comfortable for the patient. In addition, Feldspathic DigFel the digital model can be sent to the lab by Digital impression e-mail, without the need to fabricate a die and Disilicate DigDis performing occlusal registration. [9] 248297 Braz Dent Sci 2018 Jul/Sep;21(3) Rippe MP et al. Effect of different impression methods and ceramic materials on adaptation of inlays The teeth were embedded in a cylinder CAD, Ivoclar-Vivadent,Schaan, Liechtenstein). (h=14 mm,Ø=25 mm) containing acrylic resin Lithium disilicate inlays were sintered (Dencrilay, Dencril, Caieiras, Brazil) up to 3 mm according to manufacturer’s recommendation. below the cemento-enamel junction, with the The design of the inlays was standardized for occlusal surface parallel to the horizontal plane. all groups (space for the cement wasof 80µm). Preparation Internal adaptation Standardized cavity preparations (inlay Internal adaptation was measured type) were prepared in the teeth using a conical by using the replica technique. The tooth trunk diamond bur with rounded angles (KG preparation was filled with a thin layer of Sorensen 3131, Barueri, Brazil). The burs were light-body addition silicone (Elite, Zhermack), mounted in a high-speed hand piece fixed to a and the inlay was seated using a load of 750 modified optical microscope. The preparation g. After the impression material set, the inlay dimensions were as follows: buccal-lingual was removed, leaving a thin film of silicone width, 3 mm; occlusal box depth, 3 mm; and adhering to the preparation, representing the rounded internal line angles. Each diamond space between the inlay and the tooth cavity. bur was used for the preparation of five teeth. For the purpose of stabilization, a putty material Afterwards, all preparations were polished with was placed in the space previously occupied by diamond burs with the same shape and lower the inlay, which adhered to the light-body film. grit
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