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The Effect of Finish Line Form and Luting Agent on the Breaking

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The Effect of Finish Line Form and Luting Agent on the Breaking Guillermo Bernai. DDS, MSD Bogota, Colombia Rose Marie /lines, DOS. MSD' David T. Brown, DDS. MS' The Effect of Finish Line Carlos A. Munoz, DDS, MSD* Form and Luting Agent on the Breaking Strength of Charles /, Coodacre, ODS, MSD" Dicor Crowns Indiana University School of Dentistry Molar teeth were prepared to a standardized cylindric form using a lathe. Dicor crowns were lufed on these preparations using zinc phosphate, glass-ionomer, and resin cements. The crowns were thermocycled and subjected to fracture loading fo compare the effect of fhe different luting agents on fracture strength. Five finishing lines were used to determine if resin cement and associated bonding procedures could counteract the negative effect certain finish lines produce on all-ceramic crowns. When resin cement was used in conjunction with restoration and tooth precementation bonding treatments, the crowns were significantly stronger than when glass-ionomer or zinc phosphate cements were used. No difference in strength was found between the five finish lines when the crowns were cemented with resin and associated bonding procedures. Int I Proslhodont 1993;6:286-290. everal investigations have been reported'"^ con- The selection of a luting agent and/or restoration S cerning the effect of tooth preparation design and tooth precementation bonding procedures on the breaking strength of Dicor (Dentsply, York, have been shown to affect the strength of all- PA) complete crowns. The following tooth prepara- ceramic restorations. Grossman and Nelson' fabri- tion designs were found to enhance all-ceramic cated 50 Dicor crowns to fit identically prepared restoration strength: (1) a total occlusal conver- extracted human teeth and found that crowns luted gence of 10 degrees; (21 a shoulder finish line with a using zinc phosphate cement had significantly sharp axiogingival line angle; (3) a finish line with lower crushing strengths than crowns luted using minimal cervical slope; and (4) a finish line with Dicor light-activated resin cement. minimal variation in its occlusocervical location Mclnnes-Ledoux et al' determined that surface around the circumference of the tooth. FHowever, treatment of enamei and dentin increased the these studies did not determine if the use of resin bond strength of glass-ionomer cement and that cement and associated bonding procedures could Dicor iight-activated resin cement produced higher counteract the weakening effect of certain finish bond strengths than three different glass-ionomer line forms. cements. Duffin et al" tested the fracture resistance of Dicor crowns of varying thicknesses that had been luted using different agents on extracted third mo- lars. The highest overall fracture resistance oc- curred when resin cement was used in combination 'Associate Professor, Department of Proslhodootics. with etched enamel and the ceramic thickness was "Professor and Chairman, Department of Prosthodontics. 0.5 mm. Malament and Grossman- evaluated the clinical Reprint requests: Dr Rose Marie Iones, Iridiaría University, School of Dentistry, 1121 West Michigan Street, Indianapolis, Indiana performance of Dicor crowns luted using a light- 46202. activated resin cement and bonding procedures. The International lournal ÜI Prosthodortk 286 nal et al Finish Line Form and Luting Agents Fig 1 Finishing line forms: A, shouider with a 0.5-mm round- ing of the axiogingival line angle: B, shoulder witii a 0 3-mm round- ing of the axiogingivai line angle: C, shoulder with a 90-degree ax- iogingival line angle; D, shoulder with a 135-degree cervical slope and sharp axiogingivai line angle: E, shoulder with a 0,4-mm-wide axiogingivai groove. 0,5 mm 0,\n3 mm 0,4 mm A B E One practitioner placed 397 crowns over 33 months. The overall success rate for bonded Dicor crowns was 98,7% and was significantly higher than previously reported values for nonbonded tech- niques. The restorations had a mean axial wall thickness of 1,82 mm and a mean posterior occlusal thickness of 1,74 mm, Thepurposesof fhis study were to determine: (1) if different luting agenfs produce variations in all- ceramic restoration strength and (2) if the use of resin cement and associated bonding procedures would counteract the negative effect of certain finishing line designs. Materials and Methods One hundred five intact, extracted human maxil- lary first molars were cleaned and continuously Fig Z Left, schematic diagram of ex- stored in distilled water to maintain their integrity. tracted tooth and iufed restoration with The teeth were prepared using five different finish load being appiied through a bail bearing line forms (Fig 1), To uniformly prepare each tooth, attached to Ihe moving head of an instron testing machine Right, occlusal view of fhe rotational center was determined using a restoration showing three triangular custom-made centering device (Tiber Industries, ndges that were brougiit mto simuitane- Bogota, Colombia) and then the teeth were ous contact with the bali bearing prior to mounfed in a cylindric acrylic resin (Formafray, Kerr testing. Mfg, Romulus, Ml) base. Uniform cylindric tooth preparations were made using a lathe and diamond rotary instruments by reducing the external surface Impressions of the prepared teeth were made of the tooth into a cylindric form, then creating fhe using a poly(vinyl siloxane) impression material finish lines shown in Fig 1, Finish line E was pre- (Reprosil, Caulk Dentsply, Milford, DE], and 105 pared using two different diamond instruments, stone dies (Prima Rock, Whip Mix Corp, Louisville, A total occlusal convergence angle of 10 degrees KY) were made, was used in conjunction with a finish line depth of A complete contour master wax pattern with 1,2 mm for all tooth preparations. Dimensional uni- three cusps was formed with an occlusal thickness formity was verified using digital calipers (Mitutoyo of 1.5 mm in the depth of the occlusal grooves and Digimatic Caliper 0,01-100 mm, Code No, 500-350, 2,3 mm at the cusp tips. The axial wall thickness was Mitutoyo Corp, Japan) and a Boley gauge machined 1,2 mm cervicaily and increased to 1,6 mm at the so Ihat the calipers possessed a 10-degree conver- occiusal surface. The triangular ridges were formed gence angle. The mean variation in tooth prepara- so that a 6-mm-diamefer stainless sleel ball bearing tion diameter and height were found to be 0,09 mm would make simultaneous contact with the three and 0,07 mm, respectively. ridges of the crowns during fracture testing (Fig 2), 287 The Internationai Iournal oí Prosihodoiitics Finish Line Form and Luting Agents A 4-mm-long, 10-gauge Y-shaped wax sprue form (Fleck's Mizzy Inc, Cherry Hill, Nj]; I2) glass- was aftached to the wax pattern, and a polytvinyl ionomer cement (Fuji Glass lonomer 1 Luting Ce- siloxanel mold was fabricated to permit the forma- ment, Scottsdale, AZ); or (3] visible light-activated tion of duplicate wax patterns using the wax injec- resin cement IDicor, Dentsplyl. The rounded inter- tion technique described by Friedlander et al.^ nal finish line was selected to facilitate fabrication Tbe axial and occlusal walls of each stone die of the specimens. werecoatedwith two layers of Dicor die spacer that To determine if resin cement could counteract were found to range between 35 and 50 ixm.' Die the negative effect of certain finish line characteris- lubricant (Slaycris Products, Portland, OR] was ap- tics, 15 additional restorations were luted using plied, and the die was placed in the previously resin cement on teeth prepared with each of the fabricated siiicone mold that was supported by a other finishing lines shown in Fig 1. Dicor visible stone matrix secured in position with an elastic light-activated resin cement was used in conjunc- band. Inlay wax (Kerr Mfg] was heated to ZSO^F in a tion with the enamel, dentin, and restoration pre- wax-injection apparatus lAutrol, Pro-Craft, GFC, cementation treatments listed in Table 1. The ce- Carlstadt, N)], and 105 identical patterns were made. mented crowns were placed in a humidor at 37°C for 7 days and then subjected to 2,500 thermal The wax patterns were recovered from the mold, cycles between 7°C and 47°C with adwell timeof 30 the margins were refined on each die, and Dicor seconds at each temperature. The crowns were crowns were fabricated according to the manufac- then stored for 1 week at 37^ and 100% humidity turer's recommendations. Two layers of Dicor and then tested to fracture. shading porcelain (D-C3] were applied and fired. To verify that differences in restoration strength Each crown was placed in a testing jig specially could be detected when different luting agents fabricated for this study. With the use of 0.04-mm- were used with this tooth-restoration experimental thick articulating paper (Bausch Articulating Paper, model, 15 crowns Imade for dies with a shoulder Dentrade Internat, San Francisco, CA], the crowns finish line and 0.3 mm of axiogingival rounding; Fig were aligned so the three triangular ridges were 1, finish line B) were luted using each of the follow- brought into simultaneous contact with the 6-mm ing three materials: 11) zinc phosphate cement stainless steel ball bearing fitted into the moving Table 1 Restoration and Tooth Pretreatment and Cementation Procedures Using Dicor Visible Li g ht-Activated Resin Cement Restoration pretreatment Tooth pretreatment Crown dried with Tooth cieaned witti oil-free Base and oataiyst mixed in compressed air nontluoride prophylaxis equal portions tor 30 paste, rinsed with water tor seconds 15
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