G Sterzenbach1, G Karajouli, R Tunjan, T Spintig, K Bitter, M Naumann. 1. Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, CharitéCentrum 3, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany, guido.sterzenbach@charite.de.
Abstract
OBJECTIVES: This in vitro study aimed to predict the potential of fracture initiation after long-term incubation (LTI) of lithium-disilicate restorations due to a hygroscopic expansion of self-adhesive resin cement (SARC) used as core build-up material. METHODS: Human maxillary central incisors were divided into four groups (n = 10). Teeth were endodontically treated and decoronated. Specimens were restored in a one-stage post-and-core procedure using experimental dual-curing SARC. Three application protocols to build up the core were compared as follows: I, auto-polymerisation; II, dual curing including 40 s light-initiated polymerisation; and III, an open matrix technique in a dual-curing mode. In group IV, a chemical-curing composite core build-up material served as control. For all specimens, a 2-mm ferrule design was ensured. Full anatomic lithium-disilicate crowns were adhesively luted. One-year LTI in 0.5 % chloramine solution at 37 °C was performed. Restorations were examined after 3, 6, 9 and 12 month of storage. Survival rates were calculated using log-rank statistics (p = 0.05). RESULTS: Fifty per cent of lithium-disilicate crowns of groups I and II showed visible crack propagation after 9 months of incubation, while one crown failed in group III. No failure was observed in group IV. The survival rates differed significantly (p = 0.017). CONCLUSION: SARC used to build up the core of severely damaged endodontically treated teeth does have the potential to cause fracture of lithium-disilicate crown restorations. CLINICAL RELEVANCE: Hygroscopic expansion of self-adhesive resin cements used as a core build-up material might have an adverse impact on longevity of glass-ceramic crowns.
OBJECTIVES: This in vitro study aimed to predict the potential of fracture initiation after long-term incubation (LTI) of lithium-disilicate restorations due to a hygroscopic expansion of self-adhesive resin cement (SARC) used as core build-up material. METHODS:Human maxillary central incisors were divided into four groups (n = 10). Teeth were endodontically treated and decoronated. Specimens were restored in a one-stage post-and-core procedure using experimental dual-curing SARC. Three application protocols to build up the core were compared as follows: I, auto-polymerisation; II, dual curing including 40 s light-initiated polymerisation; and III, an open matrix technique in a dual-curing mode. In group IV, a chemical-curing composite core build-up material served as control. For all specimens, a 2-mm ferrule design was ensured. Full anatomic lithium-disilicate crowns were adhesively luted. One-year LTI in 0.5 % chloramine solution at 37 °C was performed. Restorations were examined after 3, 6, 9 and 12 month of storage. Survival rates were calculated using log-rank statistics (p = 0.05). RESULTS: Fifty per cent of lithium-disilicate crowns of groups I and II showed visible crack propagation after 9 months of incubation, while one crown failed in group III. No failure was observed in group IV. The survival rates differed significantly (p = 0.017). CONCLUSION: SARC used to build up the core of severely damaged endodontically treated teeth does have the potential to cause fracture of lithium-disilicate crown restorations. CLINICAL RELEVANCE: Hygroscopic expansion of self-adhesive resin cements used as a core build-up material might have an adverse impact on longevity of glass-ceramic crowns.