Journal of Dental Medicine

Statement of Problem: Nowadays economical issues on high gold alloys have changed the practice of metal-ceramic restorations toward base-metal alloys. Minalux is one of the base-metal alloys produced in Iran. Marginal fitness is of high importance to be evaluated in dental alloys.
Purpose: The aim of the present study was to compare the marginal adaptation of two base-metal alloys, Minalux (Mavadkaran Co. Iran) and VeraBond2 (Aibadent Co. USA ) during firing cycles of porcelain.

 Materials and Methods: In an experimental study 24 standard brass dies, with 135° chamfer finishing line were fabricated by Computer Numeric Controlled (CNC) milling machine. The samples were randomly divided in two groups, A and B, 12 in each. Following wax-up, the samples were equally cast with two mentioned alloys. In each group, there were 4 controlled samples, which proceeded to firing cycle without veneering porcelain. Scanning electron microscope (SEM) measurements of marginal gap from buccal and lingual aspects were performed after 4 stages of casting, degassing, porcelain application and glazing. The data were analyzed using Four-way ANOVA and multiple comparative test based on Tukey criteria.

 Results: The findings of this study revealed that there was no significant difference in the marginal gap of Minalux (31.10±7.8u.m) and VeraBond2 (30.27±6.96u.m) with confidence level at 0.95 (P=0.43). For both alloys the greatest gap was observed after degassing stage (P<0.05). Porcelain and porcelain veneering proximity caused significant changes in the marginal gap of Minalux castings (P<0.05), however, such changes did not occur in VeraBond2 (PO.05).
Conclusion: Based on the findings of this study, the marginal gaps of two base metal alloys, Minalux and VeraBond2, were proved to be identical and that of the Minalux alloy existed in the range of acceptable clinical application. It was also concluded that Minalux dental alloys could provide proper marginal adaptation.

Statement of Problem: Dental porcelain is one of the best materials ever used in dentistry. Excellent tissue compatibility, esthetics, very low solubility in oral fluids, high compressive strength, and the lowest bacterial plaque accumulation on the glazed porcelain are some of its advantages. Porcelain brittleness due to its low tensile strength, impact strength and the occlusal attrition of opposing teeth enamel are some of its disadvantages. The most important mechanical properties of dental porcelains are their flexural strength that is the ability of a porcelain to resist fracture when loaded from above. Different ways have been proposed to eliminate porcelain brittleness and develop its flexural strength, among which baking porcelain on a metal framework is more commonly used.
Purpose: Considering that restoration and replacement of teeth by porcelain fused to metal restorations is still the most commonly used technique, the aim of the present study was to measure the flexural strength of a porcelain bonded to metal powder, D4 Dentin, and to compare it with Vita Dentin powder.
Materials and Methods: In this experimental study, a stainless steel box, 25x5x2mm was made according to ISO 6872: 1995 (E) Standard and filled with D4 Dentin powder and Vita Dentin (VMK 68N) and baked in Vita furnace. Then 10 blocks of D^ Dentin and 10 of Vita Dentin were made. Samples were placed on the three point bending test machine and force was applied the middle of each block. To analyze the data, t- student test and co-variance analysis were used.
Results: Mean flexural strength of D4 Dentin was 53.40±1.35 MPa and that of Vita Dentin was 53.86+7.38 MPa. The difference was not statistically significant.

Conclusion: According to ISO 6872: 1995 (E) standard, the flexural strength of all D4 Dentin samples were greater than 50 Mpa.

Statement of Problem: In order to eliminate the esthetic problem of metal collar in porcelain fused to metal crowns various techniques, such as shoulder porcelain, have been suggested.

Purpose: The aim of this study was to investigate the effects of repeated porcelain firing cycles on the marginal integrity of shoulder in porcelain fused to metal crowns, made of two kinds of alloys: noble and base-metal.

Materials and Methods: In this experimental study, four groups of ten brazen models (Die) were used. Metal crowns of groups A&B were made of a noble alloy and those of C&D of a base-metal alloy. Groups A&C had the shoulder width of 1mm and groups B&D had the shoulder width of 1.5mm. After degassing and opaqing, shoulder porcelain was completed in the area of shoulder. At this stage, the average vertical gap of margin was measured by a reflective microscope (400). Data were analyzed using ANOVA and Duncan tests.

Results: No simoltaneouse interaction between the type of alloy and the shoulder width was found (P=0.709). The type of alloy had a significant effect on marginal integrity (P=0.021) attributing the best marginal integrity of shoulder porcelain to base-metal alloys. Shoulder width played also a significant role on marginal integrity (P=0.00) indicating that the reduction of shoulder width would increase the marginal integrity.

Conclusion: According to these findings, the best marginal integrity of shoulder porcelain is achieved through shoulder width of 1mm along with base-metal alloys.

Statement of Problem: Porcelain restorations are susceptible to fracture and a common method for repairing is the use of silane and composite on etched porcelain. Although HF is very effective in porcelain etching but has detrimental effects on tissues.

Purpose: In this study, the effect of APF and PHA was compared with HF in porcelain etching. Also the role of silane, unfilled resin and dentin bonding in bond strength of composite- porcelain was evaluated.

Methods and Materials: In this experimental in-vitro study, one-hundred twenty porcelain square blocks (552 mm) were prepared and bonding surfaces of each sandblasted. Samples were divided into three groups. The first group (n=40) were etched with buffered HF 9.5% (Ultradent) for 1 min., the second group (n=40) were etched with Iranian APF 1.23% (Kimia) for 10 minutes and the third group (n=40) were etched with Iranian PHA 37% (Kimia) for 1 min. Ultradent silane was applied on the surfaces of half of cases in each group. On the surfaces of half of silane-treated samples unfilled resin was applied and dentin bonding was used on the surfaces of the remaining. Samples without silane were treated in a similar manner. Composite cylinder with 4mm diameter and 2 mm height was bonded to porcelain. Specimens were stored in 37°C distilled water for 24 hours and subjected to 500 cycles. Shear bond strength was measured with an Instron machine and type of fracture was evaluated using a stereomicroscope. Results were analyzed using 3 way ANOVA, Kaplan- Maier and Tukey HSD tests.

Results: Findings showed that PHA and APF roughened the porcelain surface without creating retentive micro undercuts but HF etches porcelain and creates retentive microundercuts. Ultradent silane had no significant effect on bond strength of porcelain- composite. Unfilled resin with Ultradent silane compared with dentin bonding with the same silane is more effective in bond strength of composite- porcelain.

Conclusion: Based on present study, application of Ultradent silane on sandblasted and etched porcelain with PHA or APF cannot be used as an alternative to this silane on sandblasted and etched porcelain with HF.

Statement of Problem: One of the greatest problems in metal –ceramic restorations is debonding of porcelain from dental alloys. Production of dental alloys by Iranian companies necessitates the evaluation of physical and handling properties of these products.

Purpose: In this study the bond strength between porcelain and two types of base metal alloys, Supercast (with beryllium) and Minalux (without beryllium) was investigated.

Materials and Methods: In this experimental study 10 cylindric bars from each base metal alloy were prepared. The bars were degassed and porcelain was applied around them in a disc form (8 mm diameter and 2 mm thickness). The bond strength of porcelain to metal bars was tested with the shear strength test by Instron. Data were analyzed with student t-test and P<0.05 was considered as the limit of significance.

Results: The mean failure load was 71.58±6.4 KgF for Supercast and 67.34±5.48 for Minalux alloy. The bond strength of Supercast and Minalux were 55.85±4.99 MPa and 52.54±4.27 MPa respectively. The difference was statistically significant (P0.001).

Conclusions: This study showed that nickel-chromium-beryllium alloy (Supercast) produced significantly better ceramometal bonding than nickel chromium alloy without beryllium (Minalux).

Statement of Problem: Ceramic restorations are popular because they can provide the most natural replacement for teeth. However, the brittleness of ceramics is a primary disadvantage. There are various methods for strengthening ceramics such as metal framework, ceramic cores, and surface strengthening mechanisms through glazing, work hardening and ion exchange.

Purpose: The purpose of this study was to evaluate the effect of polish on flexural strength of feldspathic porcelain and to compare it with overglaze and autoglaze.

Materials and Methods: In this experimental study, one brand of feldspathic porcelain (colorlogic, Ceramco) was used and forty bars (25×6×3 mm) were prepared according to ISO 6872 and ADA No. 69. The specimens were randomly divided into four groups: overglazed, auto glazed, fine polish and coarse polish (clinic polish). Flexural strength of each specimen was determined by three point bending test (Universal Testing Machine, Zwick 1494, Germany). Collected data was analyzed by ANOVA and post-hoc test with P<0.05 as the limit of significance.

Results: A significant difference was observed among the studied groups (P<0.0001). According to post-hoc test, flexural strength in overglaze and fine polish group were significantly stronger than clinic polish and autoglaze group (P<0.001). Although the mean value for overglazed group was higher than fine polish group, this was not statistically significant (P=0.9). Also no statistical difference was seen between autoglazed and coarse polish group (P=0.2).

Conclusion: Based on the findings of this study, flexural strength achieved by fine polish (used in this study) can compete with overglazing the feldespathic porcelains. It also can be concluded that a final finishing procedure that involves fine polishing may be preferred to simple staining followed by self-glazing.

Background and Aim: With the introduction of porcelain veneers to fulfill patients’ esthetic needs, question raises about the ability of the veneers to cover the substructure discoloration. It seems that using shade modifiers under the porcelain veneers can neutralize the discoloration. The goal of this study was to determine the efficacy of shade modifiers in correcting tooth discoloration, when used with resin cements under porcelain veneers.

Materials and Methods: In this experimental study, 60 porcelain discs with two thicknesses of 0.7 mm and 2 mm (30 porcelain of each thickness) were made from ceramco porcelain powder. 40 of them were in A2 shade and 20 were made by the mixture of A2 shade porcelain powder and porcelain stain to represent tooth discoloration. Then all the laminate discs (0.7 mm) were cemented over the 2 mm thick discs to make groups of 10 samples as followed: 1- The first group: laminate discs + resin cement + 2mm thick discs with A2 shade. 2- The second group: laminate discs + resin cement + 2mm thick discolored discs. 3- The third group: laminate discs+ resin cement+ shade modifier+ 2mm thick discolored discs. The color of 30 specimens was measured by spectrophotometer in 2 conditions. 1- To include the specular reflection (SCI). 2- To exclude specular reflection (SCE). In each condition the specimens were measured on both a white background (W) and a black one (B). The mean color differences (E) of each specimen in the second and third group with the specimens of the first group were calculated. Data were analyzed using Paired sample t-test and P<0.05 of significance.

Results: Color measurements showed that in SCIW condition L was significantly different among the three groups except the first and the third. In SCEW condition all the parameters showed significant differences. In SCIB condition, E was not significantly different between the second and the third groups. Hue (h) parameter wasn’t different between groups one and three neither was chroma (c) among the three groups. In SCEB condition, E was not statistically different between groups two and three.

Conclusion: Considering the statistical results, shade modifier couldn’t completely match the color of the specimens in the third group with the first one. But, the lower E for the third group comparing to the second one means that shade modifier was successful in reducing the effect of substructure discoloration.

Background and Aim: Replacing fractured ceramometal restorations may be the best treatment option, but it is costly. Many different bonding systems are currently available to repair the fractured ceramometal restorations. This study compared the shear bond strength of composite to a base metal alloy using 4 bonding systems.

Materials and Methods: In this experimental in vitro study, fifty discs, casted in a Ni-Cr-Be base metal alloy (Silvercast, Fulldent),were ground with 120, 400 and 600 grit sandpaper and divided equally into 5 groups receiving 5 treatments for veneering. Conventional feldspathic porcelain (Ceramco2, Dentsply Ceramco) was applied on control group (PFM or group1) and the remaining metal discs were air- abraded for 15 seconds with 50 mm aluminum oxide at 45 psi and washed for 5 seconds under tap water.Then the specimens were dried by compressed air and the  groups were treated with one of the bonding systems as follows: All-Bond 2 (AB), Ceramic Primer (CP), Metal Primer II (MP) and Panavia F2 (PF). An opaque composite (Foundation opaque) followed by a hybrid composite (Gradia Direct) was placed on the treated metal surface and light cured separately. Specimens were stored in distilled water at 37⁰C and thermocycled prior to shear strength testing. Fractured specimens were evaluated under a stereomicroscope. Statistical analysis was performed with one way ANOVA and Tukey HSD tests. P<0.05 was considered as the level of significance.

Results: Mean shear bond strengths of the groups in MPa were as follows: PFM group 38.6±2, All-Bond 2 17.06±2.85, Ceramic Primer 14.72±1.2, Metal Primer II 19.04±2.2 and Panavia F2 21.37±2.1. PFM group exhibited the highest mean shear bond strength and Ceramic Primer showed the lowest. Tukey's HSD test revealed the mean bond strength of the PFM group to be significantly higher than the other groups (P<0.001). The data for the PF group was significantly higher than AB and CP groups (P<0.05) and the shear bond strength of the MP group was higher than CP group, but was not significantly different from AB (P>0.05).

Conclusion: Based on the results of this study, the most reliable treatment for fractured metal-ceramic restorations would be the replacement of the restoration. If this is not possible, adhesive resin cements containing filler and phosphate-based monomers (especially MDP) such as Panavia F2 could be recommended for bonding composite to base metal alloys.

Background and Aim: Because of stable aesthetic and minimum destructive technique, Porcelain laminate veneer has an important role in aesthetic dentistry. But main reason of failure in this treatment is restoration fracture. Therefore tooth preparation have an important role in fracture resistance of porcelain laminate veneer. The aim of this in vitro study was to evaluate the fracture resistance of porcelain laminate veneer dependent on tooth preparation after exposure to dynamic loading.

Materials and Methods: In this study, 30 caries free mandibular incisors were devided into 3 groups. First group (Control group) remained unprepared. In second group (Window preparation) facial surface was prepared with 0.3, 0.5, 0.7 mm in cervical, middle and incisal, respectively. In third group (Incisal lap preparation) the preparation was like second group and included 2 mm of incisal edge. 20 feldespatic ceramic veneer were bonded adhesively with dual-cure luting cement (Rely X). All specimens were subjected to cyclic mechanical loading (720000 cycles, 1.3Hz, 30N) and thermal cycling (5-55 C, dwell time 60seconds, 500 cycles). The specimens were exposed to Universal testing machine until failure occurred with a constant crosshead speed of 1mm/min.

Results: Five specimens of first group, one specimen of second group and two specimens of third group fractured during cyclic loading. The mean failure loads(MPa) after exposure to continues load were as follows: First group: 168/96 (561.01-1115.08), second group: 394.10 (248.92- 641.33) and third group: 273.47 (135.45 - 479.80). Data analysis was performed by ANOVA, LSD and chi Square test.

Conclusion: Significant difference between 3 groups were found. Fracture resistance of control group was significantly higher than other groups and window group preparation was significantly higher than incisal lap group. The samples were under the cyclic loads before they put under the continuous pressures of universal testing machine. It was clear that incisal lap preparation is more resistance against fatigue failure compared to window preparation.

Background and Aims: The aim of this in vitro study was to compare shear bond strength of metal brackets bonded to dental porcelain on the basis of presence or absence of silane, type of acid [hydrofluoric acid (HF) or phosphoric acid (H3PO4)] and roughness of porcelain surface (glazed or deglazed) within mouth-like environment.
Materials and Methods: Eighty glazed ceramic disks were randomly divided into 8 groups of 10 disks: group 1 [HF+silane], group 2 [deglazed+HF+silane], group 3 [HF], group 4 [deglazed+HF], group 5 [H3PO4+silane], group 6 [deglazed+H3PO4+silane], group 7 [H3PO4], group 8 [deglazed+H3PO4]. Then the brackets were bonded and thermocycled. After that, shear bond strength test was done using the Zwick device and the type of bond failure was determined under stereomicroscope at 4X magnification. 3-way ANOVA and Kruskal-Wallis were used for statistical analyses.
Results: The shear bond strength for the test groups were as follows: group (1):13.05±7.7 MPa , group (2):25.16±10.66 MPa, group (3):6.7±5.86 MPa, group (4):15.39±8.97 MPa, group (5):12.76±7.91 MPa, group (6):13.57±7.85 MPa, group (7):0.54±0.67 MPa, group (8): 9.34±6.52 MPa. The type of bond failure in all groups was adhesive failure except for group 2. No significant difference in the interaction between (glazed or deglazed), (presence or absence of silane), and type of acid was found (P>0.05).
Conclusion: Under the conditions of this study, the best clinical method was the use of 37% phosphoric acid and silane that resulted in the optimal clinical strength and adhesive bond failure.

Background and Aims: The bond strength between veneer ceramics and zirconia frameworks is the weakest component in the layered ceramics. Due to the possible effect of adding pigments to the core materials on the bond strength between core and veneer as well as the introduction of new ceramic materials in dentistry, the aim of this study was to compare the zirconia core-veneer microtensile bond strength using two ceramic veneers with or without coloring the core.
Materials and Methods: In this experimental study, 12 disc-shaped specimens were fabricated using a manually aided design- manually aided manufactured (MAD/MAM) zirconia core (Zirkonzahn). Two veneering ceramics of Ceram Kiss and Zirkonzahn ICE were also used to veneer the specimens. Half of the Zirkonzahn discs were remained white and the others were colored by shade A2.Then, the discs were cut into microbars (30 for each group) and the microtensile bond strength of the core-veneer was calculated. The specimens were assessed using scanning electron microscopy (SEM) and the data were analyzed using two-way ANOVA and Student's t-test.
Results: Significant differences with respect to veneer layer were found (P<0.001). No significant differences were seen among colored and uncolored cores (P=0.69).
Conclusion: According to the apparent effect of veneering ceramics on the core-veneer bond strength, careful selection of these agents is essential to achieve adequate bond strength between core and veneer to prevent delaminating and chipping failures of zirconia veneered restorations.

Background and Aims: The aim of this study was to evaluate the quality of an experimental hydrofluoric acid (HF) for preparation of porcelain and to compare it with two commercial hydrofluoric acids in Iranian trademark.

Materials and Methods: A- Evaluation of etch pattern of experimental HF using scanning electron microscope (SEM): 6 feldespathic discs were divided into 3 groups. Each group was etched with related HF (experimental, Ultradent and Kimia) for 1 minute. SEM images were recorded at 3 magnifications. B- Bond strength test: 18 feldespathic discs were considered for each acidic group. Then the porcelain surfaces were etched and bonded to composite with unfilled resin. Consequently, the microshear test was done. C- Microleakage test: 54 discs were divided into 3 groups (n=18). Then the porcelain surfaces were etched and bonded to composite with unfilled resin and finally observed under stereomicroscope. The data were analyzed with one-way ANOVA and Smirnov tests.

Results: SEM analysis showed no difference between groups in terms of etch pattern. Microshear bond strength values for experimental, Kimia, and Ultradent HF were 28.53 (±4.92), 28.21 (±6.61), and 26.14 (±7.61) MPa, respectively. There was no significant difference between the bond strength of test groups (P<0.05). Furthermore, no significant difference was found between the microleakage of test groups (P>0.05).

Conclusion: Quality of experimental HF in terms of etch pattern, microshear bond strength and microleakage of composite/porcelain interface was similar to that of two commercial hydrofluoric acids.

  Background and Aims: Porcelain restorations are often ground for clinical adjustment and this removes the surface glaze layer and introduces flaws that can grow in wet environments due to stress-corrosion, reduce the strength of porcelain and limit restoration lifetime. The aim of this study was to introduce some surface treatment methods to control the flaws of ceramic restorations external surface and improve their strength.

  Materials and Methods: 40 feldspathic discs were prepared and divided into 4 groups (n=10): not indented (group 1) and others indented by vickers with 29.4 N and received different treatments: no treatment (group 2), polished (group 3) and polished-silane-resin (group 4). Biaxial flexural strength of discs was tested after water storage. Data were analyzed using one-way ANOVA .

  Results: The mean flexural strength of specimens in group 1 (134.49±12.60), 2 (94.81±15.41), 3 (89.20±16.22) and 4 (80.67±12.01) were measured. Group 1 (not indented) revealed significantly higher strength (P<0.001) than that of indented groups (2, 3 and 4) . There was no significant difference between group 2 (no treatment) and 3 or 4 (treated) and between treatment methods (3 and 4) (P=0.136).

  Conclusion: The strength of porcelains is dependent on presence of cracks. With the limitations of this study, none of the treatment methods could strengthen the cracked ceramic.