Restoring strength of incisors with veneers and full ceramic crowns. 2010

Yong-Hee P Chun, and Constanze Raffelt, and Hanjo Pfeiffer, and Mozhgan Bizhang, and Gunnar Saul, and Uwe Blunck, and Jean-François Roulet
Biologic and Materials Sciences, University of Michigan, Ann Arbor, MI 48108, USA. ychun@umich.edu

OBJECTIVE The aim was to determine the in vitro fracture resistance of incisors restored with veneers and full ceramic crowns compared to unrestored teeth. METHODS Seventy intact, extracted human maxillary central incisors were randomized and assigned to 7 groups (n = 10). The teeth in group 1 remained intact (control). The teeth in groups 2 to 6 were prepared and IPS Empress restorations were conditioned and bonded using an adhesive luting cement, Variolink II/Syntac (group 2: labial veneer with incisal overlap, group 3: 3/4 veneer with margin in enamel, group 4: 3/4 veneer with margin in dentin, group 5: crown with margin in enamel, group 6: crown with margin in dentin group 7: veneer on worn tooth. After finishing and polishing, specimens were stored in water and thermocycled for 2000 cycles between 5 degrees C and 55 degrees C. The maximal fracture load of the specimens (40-degree inclination) was determined using the universal testing machine (Zwick) at a constant crosshead speed (0.5 mm/min). The statistical analysis was performed using the Kruskal-Wallis test with Bonferroni correction (p < 0.05). Fracture surfaces were qualitatively analyzed by SEM. RESULTS All restored teeth with cervical preparation margins in enamel showed a fracture load not significantly different from the intact teeth (control). Restored teeth with cervical preparation margins in dentin showed a significantly lower fracture load. All restorations showed a fracture load far above 400 N, serving as functional reference for anterior teeth. The failures were predominantly cohesive. CONCLUSIONS For the restoration of tooth strength, defining the finishing lines of veneers and crowns in enamel is recommended. Restorations with finishing lines in dentin resulted in significant loss of strength. Three-quarter veneers with finishing lines in enamel are functionally equal to crowns with the advantage of conserving tooth structure.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D001840 Dental Bonding An adhesion procedure for orthodontic attachments, such as plastic DENTAL CROWNS. This process usually includes the application of an adhesive material (DENTAL CEMENTS) and letting it harden in-place by light or chemical curing. Bonding, Dental,Cure of Orthodontic Adhesives,Curing, Dental Cement,Dental Cement Curing,Orthodontic Adhesives Cure
D003442 Crowns A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. Dental Crowns,Crown, Dental,Crowns, Dental,Dental Crown,Crown
D003776 Dental Porcelain A type of porcelain used in dental restorations, either jacket crowns or inlays, artificial teeth, or metal-ceramic crowns. It is essentially a mixture of particles of feldspar and quartz, the feldspar melting first and providing a glass matrix for the quartz. Dental porcelain is produced by mixing ceramic powder (a mixture of quartz, kaolin, pigments, opacifiers, a suitable flux, and other substances) with distilled water. (From Jablonski's Dictionary of Dentistry, 1992) Porcelain,Porcelain, Dental,Dental Porcelains,Porcelains,Porcelains, Dental
D003793 Dental Restoration, Permanent A restoration designed to remain in service for not less than 20 to 30 years, usually made of gold casting, cohesive gold, or amalgam. (Jablonski, Dictionary of Dentistry, 1992) Dental Fillings, Permanent,Dental Filling, Permanent,Dental Permanent Filling,Dental Permanent Fillings,Dental Restorations, Permanent,Filling, Dental Permanent,Filling, Permanent Dental,Fillings, Dental Permanent,Fillings, Permanent Dental,Permanent Dental Filling,Permanent Dental Fillings,Permanent Dental Restoration,Permanent Dental Restorations,Permanent Filling, Dental,Permanent Fillings, Dental,Restoration, Permanent Dental,Restorations, Permanent Dental
D003799 Dental Stress Analysis The description and measurement of the various factors that produce physical stress upon dental restorations, prostheses, or appliances, materials associated with them, or the natural oral structures. Analyses, Dental Stress,Analysis, Dental Stress,Stress Analyses, Dental,Stress Analysis, Dental,Dental Stress Analyses
D003801 Dental Veneers The use of a layer of tooth-colored material, usually porcelain or acrylic resin, applied to the surface of natural teeth, crowns, or pontics by fusion, cementation, or mechanical retention. Dental Laminates,Dental Laminate,Dental Veneer,Laminate, Dental,Laminates, Dental,Veneer, Dental,Veneers, Dental
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000134 Acid Etching, Dental Preparation of TOOTH surfaces and DENTAL MATERIALS with etching agents, usually phosphoric acid, to roughen the surface to increase adhesion or osteointegration. Dental Acid Etching,Etching, Dental Acid
D014082 Tooth Fractures Break or rupture of a tooth or tooth root. Fracture, Tooth,Fractures, Tooth,Tooth Fracture

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