Within the limitations of the study, the following conclusions can be derived.
1) Zirconia type and thickness made significant difference in translucency of high translucency monolithic zirconia product.
2) Color of the high-translucency zirconia products was changed by the core material.
The amount of color change in the final restoration was in the order of blue> metal>
white> A3 dentin
3) Final color of a high-translucency zirconia restoration was changed by combination of certain core materials and resin cements. Opaque white cement showed high
masking ability, but not to the extent to which it could completely cover a dark core.
Acknowledgement There are no conflicts of interest
References
Al-Amleh B, Lyons K, Swain M: Clinical trials in zirconia: a systematic review. J Oral Rehabil 37(8): 641-652, 2010.
Al Hamad KQ, Obaidat, II, Baba NZ: The Effect of Ceramic Type and Background Color on Shade Reproducibility of All-Ceramic Restorations. J Prosthodont, 2018.
Alqahtani MQ, Aljurais RM, Alshaafi MM: The effects of different shades of resin luting cement
３１
on the color of ceramic veneers. Dent Mater J 31(3): 354-361, 2012.
Azer SS, Ayash GM, Johnston WM, Khalil MF, Rosenstiel SF: Effect of esthetic core shades on the final color of IPS Empress all-ceramic crowns. J Prosthet Dent 96(6): 397-401, 2006.
Bagis B, Turgut S: Optical properties of current ceramics systems for laminate veneers. J Dent 41 Suppl 3: e24-30, 2013.
Bjorn Theelke PF, Michael Jahns, Rainer Dittmann: Flexural strength of a novel esthetic full-contour zirconia compared to other ceramics. In: IADR, San Francisco, Calif., USA 2017.
p. 97.
Blatz MB, Alvarez M, Sawyer K, Brindis M: How to Bond Zirconia: The APC Concept. Compend Contin Educ Dent 37(9): 611-617; quiz 618, 2016.
Bressan E, Paniz G, Lops D, Corazza B, Romeo E, Favero G: Influence of abutment material on the gingival color of implant-supported all-ceramic restorations: a prospective multicenter study. Clin Oral Implants Res 22(6): 631-637, 2011.
Chaiyabutr Y, Kois JC, LeBeau D, Nunokawa G: Effect of abutment tooth color, cement color, and ceramic thickness on the resulting optical color of a CAD/CAM glass-ceramic lithium disilicate-reinforced crown. The Journal of prosthetic dentistry 105(2): 83-90, 2011.
Chaiyabutr Y, Kois JC, Lebeau D, Nunokawa G: Effect of abutment tooth color, cement color, and ceramic thickness on the resulting optical color of a CAD/CAM glass-ceramic lithium disilicate-reinforced crown. J Prosthet Dent 105(2): 83-90, 2011.
Chang J, Da Silva JD, Sakai M, Kristiansen J, Ishikawa-Nagai S: The optical effect of composite luting cement on all ceramic crowns. J Dent 37(12): 937-943, 2009.
Chu SJ, Trushkowsky RD, Paravina RD: Dental color matching instruments and systems. Review of clinical and research aspects. J Dent 38 Suppl 2: e2-16, 2010.
Church TD, Jessup JP, Guillory VL, Vandewalle KS: Translucency and strength of high-translucency monolithic zirconium oxide materials. Gen Dent 65(1): 48-52, 2017.
Conrad HJ, Seong WJ, Pesun IJ: Current ceramic materials and systems with clinical recommendations: a systematic review. J Prosthet Dent 98(5): 389-404, 2007.
Dede DO, Armaganci A, Ceylan G, Cankaya S, Celik E: Influence of abutment material and luting cements color on the final color of all ceramics. Acta Odontol Scand 71(6): 1570-1578, 2013.
３２
Dede DO, Ceylan G, Yilmaz B: Effect of brand and shade of resin cements on the final color of lithium disilicate ceramic. J Prosthet Dent 117(4): 539-544, 2017a.
Dede DO, Sahin O, Ozdemir OS, Yilmaz B, Celik E, Koroglu A: Influence of the color of composite resin foundation and luting cement on the final color of lithium disilicate ceramic systems. J Prosthet Dent 117(1): 138-143, 2017b.
Della Bona A, Pecho OE, Ghinea R, Cardona JC, Perez MM: Colour parameters and shade correspondence of CAD-CAM ceramic systems. J Dent 43(6): 726-734, 2015.
Douglas RD, Steinhauer TJ, Wee AG: Intraoral determination of the tolerance of dentists for perceptibility and acceptability of shade mismatch. J Prosthet Dent 97(4): 200-208, 2007.
Dozic A, Voit NF, Zwartser R, Khashayar G, Aartman I: Color coverage of a newly developed system for color determination and reproduction in dentistry. J Dent 38 Suppl 2: e50-56, 2010.
Fathy SM, El-Fallal AA, El-Negoly SA, El Bedawy AB: Translucency of monolithic and core zirconia after hydrothermal aging. Acta Biomater Odontol Scand 1(2-4): 86-92, 2015.
Guncu MB, Cakan U, Muhtarogullari M, Canay S: Zirconia-based crowns up to 5 years in function: a retrospective clinical study and evaluation of prosthetic restorations and failures. Int J Prosthodont 28(2): 152-157, 2015.
Hannink RH, Kelly PM, Muddle BC: Transformation toughening in zirconia‐containing ceramics.
Journal of the American Ceramic Society 83(3): 461-487, 2000.
Heffernan MJ, Aquilino SA, Diaz-Arnold AM, Haselton DR, Stanford CM, Vargas MA: Relative translucency of six all-ceramic systems. Part I: core materials. J Prosthet Dent 88(1): 4-9, 2002.
Hofmann N, Hofmann N, Papsthart G, Hugo B, Klaiber B: Comparison of photo-activation versus chemical or dual-curing of resin-based luting cements regarding flexural strength, modulus and surface hardness. Journal of oral rehabilitation 28(11): 1022-1028, 2001.
Ilie N, Stawarczyk B: Quantification of the amount of light passing through zirconia: the effect of material shade, thickness, and curing conditions. J Dent 42(6): 684-690, 2014.
Jankar AS, Kale Y, Pustake S, Bijjaragi S, Pustake B: Spectrophotometric Study of the Effect of Luting Agents on the Resultant Shade of Ceramic Veneers: An Invitro Study. J Clin Diagn Res 9(9): ZC56-60, 2015.
３３
Jiang L, Liao Y, Wan Q, Li W: Effects of sintering temperature and particle size on the translucency of zirconium dioxide dental ceramic. J Mater Sci Mater Med 22(11): 2429-2435, 2011.
Johnston WM, Ma T, Kienle BH: Translucency parameter of colorants for maxillofacial prostheses.
Int J Prosthodont 8(1): 79-86, 1995.
Kanchanavasita W, Triwatana P, Suputtamongkol K, Thanapitak A, Chatchaiganan M: Contrast ratio of six zirconia-based dental ceramics. J Prosthodont 23(6): 456-461, 2014.
Kelly JR, Nishimura I, Campbell SD: Ceramics in dentistry: historical roots and current perspectives. J Prosthet Dent 75(1): 18-32, 1996.
Kilinc E, Antonson SA, Hardigan PC, Kesercioglu A: Resin cement color stability and its influence on the final shade of all-ceramics. J Dent 39 Suppl 1: e30-36, 2011.
Kim HK, Kim SH: Optical properties of pre-colored dental monolithic zirconia ceramics. J Dent 55: 75-81, 2016.
Kohal RJ, Att W, Bachle M, Butz F: Ceramic abutments and ceramic oral implants. An update.
Periodontol 2000 47: 224-243, 2008.
Lawson NC, Burgess JO: Dental ceramics: a current review. Compend Contin Educ Dent 35(3):
161-166; quiz 168, 2014.
Lee YK: Influence of scattering/absorption characteristics on the color of resin composites. Dent Mater 23(1): 124-131, 2007.
Leinfelder KF, Isenberg BP, Essig ME: A new method for generating ceramic restorations: a CAD-CAM system. J Am Dent Assoc 118(6): 703-707, 1989.
Linden JJ, Swift EJ, Boyer DB, Davis BK: PHOTO-ACTIVATION OF RESIN CEMENTS THROUGH PORCELAIN VENEERS. Journal of Dental Research 70(2): 154-157, 1991.
Materials CoD, Devices: Revised American national standards institute/American dental association specification no. 8 for zinc phosphate cement. Elsevier. 1978.
Matsuzaki F, Sekine H, Honma S, Takanashi T, Furuya K, Yajima Y, et al.: Translucency and flexural strength of monolithic translucent zirconia and porcelain-layered zirconia. Dent Mater J 34(6): 910-917, 2015.
Rosenstiel SF, Land MF, Crispin BJ: Dental luting agents: A review of the current literature. J Prosthet Dent 80(3): 280-301, 1998.
３４
Ruyter IE, Nilner K, Moller B: Color stability of dental composite resin materials for crown and bridge veneers. Dent Mater 3(5): 246-251, 1987.
Shokry TE, Shen C, Elhosary MM, Elkhodary AM: Effect of core and veneer thicknesses on the color parameters of two all-ceramic systems. J Prosthet Dent 95(2): 124-129, 2006.
Sulaiman TA, Abdulmajeed AA, Donovan TE, Ritter AV, Vallittu PK, Narhi TO, et al.: Optical properties and light irradiance of monolithic zirconia at variable thicknesses. Dent Mater 31(10): 1180-1187, 2015.
Sunico-Segarra M, Segarra A: Resin Cements: Factors Affecting Clinical Performance. 2015. p. 9-22.
Tabatabaian F: Color Aspect of Monolithic Zirconia Restorations: A Review of the Literature. J Prosthodont, 2018.
Tabatabaian F, Bakhshaei D, Namdari M: Effect of Resin Cement Brand on the Color of Zirconia-Based Restorations. J Prosthodont, 2018a.
Tabatabaian F, Habib Khodaei M, Namdari M, Mahshid M: Effect of cement type on the color attributes of a zirconia ceramic. J Adv Prosthodont 8(6): 449-456, 2016.
Tabatabaian F, Javadi Sharif M, Massoumi F, Namdari M: The color masking ability of a zirconia ceramic on the substrates with different values. J Dent Res Dent Clin Dent Prospects 11(1): 7-13, 2017.
Tabatabaian F, Motamedi E, Sahabi M, Torabzadeh H, Namdari M: Effect of thickness of monolithic zirconia ceramic on final color. J Prosthet Dent 120(2): 257-262, 2018b.
Tabatabaian F, Taghizade F, Namdari M: Effect of coping thickness and background type on the masking ability of a zirconia ceramic. J Prosthet Dent 119(1): 159-165, 2018c.
Turgut S, Bagis B: Effect of resin cement and ceramic thickness on final color of laminate veneers:
an in vitro study. J Prosthet Dent 109(3): 179-186, 2013.
Uzun G, Uzun G, Uzun G, Keyf F, Keyf F: Effect of different cement colors on the final color of IPS empress ceramic restorations. Biotechnology, biotechnological equipment 21(4): 501-505, 2007.
Vagkopoulou T, Koutayas SO, Koidis P, Strub JR: Zirconia in dentistry: Part 1. Discovering the nature of an upcoming bioceramic. Eur J Esthet Dent 4(2): 130-151, 2009.
Vichi A, Ferrari M, Davidson CL: Influence of ceramic and cement thickness on the masking of
３５
various types of opaque posts. J Prosthet Dent 83(4): 412-417, 2000.
Vichi A, Ferrari M, Davidson CL: Color and opacity variations in three different resin-based composite products after water aging. Dent Mater 20(6): 530-534, 2004.
Vichi A, Louca C, Corciolani G, Ferrari M: Color related to ceramic and zirconia restorations: a review. Dent Mater 27(1): 97-108, 2011.
Wang F, Takahashi H, Iwasaki N: Translucency of dental ceramics with different thicknesses. The Journal of prosthetic dentistry 110(1): 14-20, 2013.
Wang F, Takahashi H, Iwasaki N: Translucency of dental ceramics with different thicknesses. J Prosthet Dent 110(1): 14-20, 2013.
Xing W, Jiang T, Ma X, Liang S, Wang Z, Sa Y, et al.: Evaluation of the esthetic effect of resin cements and try-in pastes on ceromer veneers. J Dent 38 Suppl 2: e87-94, 2010.
Yaman P, Qazi SR, Dennison JB, Razzoog ME: Effect of adding opaque porcelain on the final color of porcelain laminates. J Prosthet Dent 77(2): 136-140, 1997.
Yu B, Ahn JS, Lee YK: Measurement of translucency of tooth enamel and dentin. Acta Odontol Scand 67(1): 57-64, 2009.
Zhang H, Li Z, Kim B-N, Morita K, Yoshida H, Hiraga K, et al.: Effect of Alumina Dopant on Transparency of Tetragonal Zirconia. Journal of Nanomaterials 2012: 5, 2012.
Zhang Y: Making yttria-stabilized tetragonal zirconia translucent. Dent Mater 30(10): 1195-1203, 2014.
Zhang Y, Lawn BR: Novel Zirconia Materials in Dentistry. J Dent Res 97(2): 140-147, 2018.
３６ Abstract (In Korean)
다양한 코어 재료에 대한 지르코니아 수복물의 최종 색상 결정에 대한 레진 시멘트의 영향
정 지 희 연세대학교 대학원
치의학과 (지도교수 신 유 석)
I. 목적
본 연구의 목적은 high translucency monolithic zirconia의 translucency를 비교하고, resin cement가 수복물의 최종 색조에 미치는 영향을 알기 위함이다.
II. 방법 및 재료
육십개의 A2 shade high translucency monolithic zirconia 디스크가 지름 10mm, 두께는 0.5mm와 1.0mm로 제작되어 4개의군으로 나눠졌다. (n=15, Lava Plus 0.5(LP 0.5), Lava Plus 1.0(LP 1.0), Lava Esthetic 0.5(LE 0.5), Lava Esthetic 1.0(LE 1.0)) Core는 blue, white shade의 dual cure resin, A3 dentin shade의 composite resin, 그리고 titanium block을 이용 하였고 지름은 10mm, 두께는 5mm로 제작하였다. Cement는 5종류의 self adhesive resin cement로, 두께는 25 마이크로 미터로 제작하였다.
색조의 측정은 spectrophotometer를 사용하여 L*, a*, 그리고 b*값을 측정하였다. 통
３７
계학적 유의차 알기 위해 tukey HSD test와 one-way ANOVA가 시행되었다.
III. 결과
지르코니아 투과도 측면에서는 LE 0.5>LP 0.5> LE 1.0> LP 1.0순으로 나타났고, 각 군 간의 유의차 존재하였다. LE 0.5에 core를 다르게 하여 색변화를 관찰하였을 때, blue, metal, white, A3 shade resin 순으로 색변화 크게 나타났다. 각 군 간에 모두 유 의차 존재하였다. core를 blue로 하였을 때, 각 지르코니아 종류별 색변화를 관찰 하였다. 이때 색 변화는 LP 0.5, LE 0.5, LP 1.0, 그리고 LE 1.0 순으로 가장 큰 색 변화가 나타났다. 이때 LE 0.5와 LP 1.0간에는 유의차 존재하지 않았고 나머지 군 간에는 모두 유의차 존재하였다. LE 0.5에 core를 A3 dentin shade resin을 사용하였을 때, cement로 인한 색 변화는, 가장 큰 것은 Gcem white였고, Theracem, U200A2, U200TR, GcemA2 순이었다. LE 0.5에 blue core를 사용했을 때 cement로 인한 색 변 화를 관찰하였다. 이때 가장 큰 색 변화는 Gcem white였고, 그 다음으로 theracem, U200A2, Gcem A2, U200TR순으로 나타났다. 모든 군 간에 유의차 존재하였다.
IV. 결론
지르코니아 두께가 두꺼울수록, 투과도는 감소하였다. Zirconia 최종 수복물의 색
은 특정한 core재료와 cement의 조합에 의해 영향을 받았다. core 재료를 다르게 했을 때, blue>metal> white> A3 dentin순으로 최종 수복물에서의 색 변화가 더욱 큰 값으로 나타났다. 비교적 opaque 계열의 cement가 masking능력이 더욱 컸다.
핵심되는 단어: monolithic zirconia; color; translucency; cement; spectrophotometer