Precision of fit: the Procera AllCeram crown

STATEMENT OF PROBLEM: Strength, color stability, and precision of fit are requirements for all-ceramic restorations. The Procera AllCeram crown system, composed of a densely sintered high-purity alumina core combined with a low fusing surface porcelain, appears to satisfy most of these requirements. However, evaluation of marginal fit has not been reported. PURPOSE: This study measured the precision of fit of the Procera AllCeram crown fabricated with Procera CAD/CAM technology for the premolar and molar teeth fit to a die. MATERIAL AND METHODS: Five ivorine maxillary first premolars and first molars were prepared for full-coverage crowns. Preparations were standardized with a convergence angle of 10 degrees, chamfer margins of 1.3 to 1.5 mm circumferentially, and occlusal reduction of 2.0 mm. AllCeram crowns were fabricated for the dies, and the fit of the crown to the die was determined by using a standardized procedure with a silicone impression material that served a dual role: (1) as a retrievable luting agent, and (2) to replicate the internal aspects of the crown. Laser videography was used to measure the gap dimension between the crowns and the dies at the marginal opening, the axial wall, the cusp tip, and the occlusal adaptation measurement locations. Mean gap dimensions and standard deviations (SDs) were calculated for marginal opening, internal adaptation, and precision of fit. RESULTS: Mean gap dimensions and standard deviations at the marginal opening for the premolar and molar crowns were 56.0 microns SD +/- 21 and 63.0 microns SD +/- 13 microns, respectively. The mean gap dimensions and SDs of the internal adaptation were 69.0 microns SD +/- 17 microns for axial wall, 48.0 microns SD +/- 12 microns for cusp tip, and 36.0 microns SD +/- 7 microns for occlusal adaptation for the premolar crowns; and 49.0 microns SD +/- 3 microns axial wall, 67.0 microns SD +/- 21 microns cusp tip, and 74.0 microns SD +/- 29 microns occlusal adaptation for molar crowns. Precision of fit and SDs for premolar and molar crowns were 52.0 microns SD +/- 19 microns and 63.0 microns SD +/- 20 microns, respectively. Mean marginal openings and precision of fit gap dimensions for the crown groups were not significantly different at the .05 level. However, gap dimensions that defined the internal adaptation at the measurement locations were different (P < or = .05). CONCLUSION: Mean gap dimensions for marginal openings, internal adaptation, and precision of fit for the crown groups were below 70 microns. These findings show that the crowns studied can be prescribed with confidence knowing that the precision of fit will consistently be less than 70 microns.     

Procera: a new way to achieve an all-ceramic crown

The Procera System embraces the concept of computer-assisted design and computer-assisted machining to fabricate an all-ceramic crown composed of a densely sintered, high-purity aluminum oxide coping combined with a compatible veneering porcelain. Strength, precision of fit, color stability, cementation, and wear characteristics are among the many factors that concern clinicians when fabricating all-ceramic restorations with this new crown system. This article presents, in summary form, the data from the many studies on Procera AllCeram crowns that have been conducted at clinical and laboratory centers around the world. The evidence reported in these studies clearly demonstrates that the Procera AllCeram crown represents a combination of computer technology and creativity for which a positive prognosis can be made. Today its application is restricted to single crowns; however, with continued development, multiple unit all-ceramic anterior and posterior fixed partial dentures are clearly in the future.     

Blood transfusion practices in Mwanza Region, Tanzania. Bugando Medical Centre

Uncertainty exists about the forces applied by dentists during dental crown cementation. A measuring system was developed based around a commercially available miniature (3.8 mm high and 12.7 mm diameter) load cell. The load cell was mounted in a finger stall and the applied force measured. Experimental results suggest that dentists typically apply a force to metal crowns of about 60 N for a few seconds, followed by the application of a steady force of about 20 to 30 N. Lower forces are applied to porcelain crowns.     

New players and puzzles in the Hedgehog signaling pathway

STATEMENT OF PROBLEM: Esthetic demands of patients and practitioners for an all-ceramic crown in both anterior and posterior regions of the dental arches has prompted the development of the Procera AllCeram crown. Long-term clinical trials that evaluate the strength and naturalness of the Procera AllCeram crown are lacking. PURPOSE: This prospective study was initiated to evaluate the clinical performance of 100 Procera AllCeram crowns after 5 years in service. MATERIAL AND METHODS: One hundred Procera AllCeram crowns were fabricated for 58 patients (20 men and 38 women). Patients were treated by 4 general dental practitioners. Crown placement involved both the anterior and posterior regions of the dental arches. Crowns were examined at baseline and once a year during the 5 years that followed and evaluated at each appointment with the California Dental Association's quality assessment system. RESULTS: Of the 97 crowns remaining in the study after 5 years, only 3 crowns had experienced a fracture through the veneering porcelain and the aluminum oxide coping material. Two additional crowns were replaced as a result of fractures of only the veneering porcelain. One crown was replaced as a result of recurrent caries. All remaining crowns were ranked as either excellent or acceptable for surface/color, anatomic form, and marginal integrity. CONCLUSION: The 5-year clinical observations and ranking with the California Dental Association's quality assessment criteria supported the conclusion that Procera AllCeram crowns may be used in all areas of the mouth.     

The effect of adhesive luting agent-dentinal surface interactions on compressive strength of two types of all-ceramic crowns

This research compared the compressive strength of two types of all-ceramic crown (Hi-Ceram and Duceram) as affected by selected luting cements (Zn phosphate, glass ionomer and composite resin cement). Thirty crowns of similar size and shape were constructed (15 crowns of each tested material) to fit a standard posterior tooth preparation. Five crowns from each material were cemented by one of the tested cements. The cemented crowns were loaded until catastrophic failure. A two-way analysis of variance was performed and showed that the type of utilized cement had a significant effect on the compressive strength being that Panevia Ex. resin cement the most effective one followed by glass ionomer and then finally zn phosphate cement. Statistical analysis also showed that Hi-Ceram crowns were more resistant to occlusal load than Duceram.     

Functional recovery and timing of hospital discharge after primary total hip arthroplasty

BACKGROUND: Dental porcelain has found an increased number of applications in recent years with the development of new methods for the construction of porcelain veneers and intracoronal restorations. In addition, it is used in metal-ceramic and all-porcelain crowns and bridges for the restoration of anterior and posterior teeth. METHODS: This paper presents a review of a number of studies that have examined the visual and microscopic appearance and roughness of glazed, unglazed and polished porcelain surfaces using techniques such as, scanning electron microscopy and surface profilometry. FINDINGS: All have agreed that glazed porcelain provides a smooth and dense surface. Many have shown that polishing can produce an equally smooth surface, which may even be esthetically better. Some studies supported the use of polishing as an alternative to glazing. However, reports have shown that unglazed porcelain is more abrasive than glazed. CLINICAL SIGNIFICANCE: This paper aims to guide general practitioners in the proper polishing of adjusted porcelain in the dental office. The recommendations of various authors are summarized in Table I.     

Replacing posterior teeth with freestanding implants: four-year prosthodontic results of a prospective study

This article presents prospective four-year prosthetic results of the placement of 432 posterior freestanding, conventionally cemented prosthetic tooth implants in posterior edentulous spaces using the Bicon Dental Implants system (Bicon Dental Implants). Over four years, 0.74 percent of the abutments loosened, 0.5 percent of the abutments fractured, and 2.47 percent of the crowns experienced porcelain fracture, (all porcelain fractures occurred at time of placement). This low rate of problems appears to make free-standing single-tooth implant restorations a reliable solution to treating posterior edentulism.     

Fabrication of a fixed partial denture in the Class II partial edentulous mandible using the UCLA abutment: a clinical report

Several methods are currently available to restore the partially edentulous patient with osseointegrated implants. The UCLA abutment eliminates the unesthetic, traditional transmucosal abutment and can provide esthetic crowns, fixed prostheses, and subgingival porcelain margins without the need for excessive instrumentation and components. A clinical report for the fabrication of a direct, implant-borne fixed prosthesis using the UCLA abutment is presented.     

The use of resin-bonded porcelain crowns for primary molars in infra-occlusion

Infra-occluded primary molars without permanent successors may require restorative treatment to maintain occlusal stability and periodontal health in addition to creating an aesthetic result. This paper describes the use of two resin-bonded porcelain crowns to provide a simple, minimally invasive technique using a material with good wear resistance and high strength to create an aesthetic and functional occlusion.     

24-hour shear bond strength of metal orthodontic brackets bonded to porcelain using various adhesion promoters

Clinically, orthodontists are often faced with the difficulties of bonding to porcelain crowns, veneers, or bridges. Traditional methods of dealing with this are often time-consuming and generally esthetically unacceptable to patients. Current interest involves the use of organosilane primers with or without NTG-GMA and BPDM resins to aid in chemically bonding porcelain with traditional orthodontic adhesives. This study compared the bond strength of three types of adhesion promoters: Ormco Porcelain Primer (OR) (Ormco Corp., Glendora, Calif.), All-Bond2 (AB2) (Bisco Dental Products, Inc., Itasca, Ill.), and Scotchprime Ceramic Primer (SP) (3M, St. Paul, Minn.) with two orthodontic adhesives: Phase II (Reliance, Inc., Itasca, Ill.) and Rely-a-bond (Reliance, Inc., Itasca, Ill.). Eighty ceramometal samples were fabricated and hydrated for 1 week in distilled water before bonding. Next, the samples were etched with 2.5 % HF acid for 90 seconds, rinsed and upper central incisor metal orthodontic brackets were bonded with the various primers and adhesives. After 24 hours they were sheared off with an MTS machine at at rate of 0.5 mm/min, and the bond strength was measured. The mean shear bond strengths (MPa) with Phase II were as follows; Control 0.44 (sigma = 0.22), AB2 8.40 (sigma = 3.61), OR 13.31 (sigma = 5.79), SP 13.53 (sigma = 3.34). With Rely-a-bond, the shear bond strengths were Control 0.41 (sigma = 0.67), AB2 4.34 (sigma = 1.88), OR 9.73 (sigma = 4.58), and SP 12.40 (sigma = 3.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Synergism of capillary isotachophoresis and capillary zone electrophoresis

Commercially pure titanium (CPT) substrate was subjected to porcelain firing and bond strengths under three-point bending mode (span length: 15 mm; crosshead speed: 0.5 mm/min) were evaluated. Experimental variables included surface treatments of CPT and porcelain firing schedules. Variables for the surface treatments were (1) sandblasting, (2) mono- and triple-layered nitridation, and (3) mono-layered chrome-doped nitridation. Variables for the porcelain firing schedule included (4) bonding agent application, (5) bonding agent plus gold bonding agent application, and (6) Procera porcelain application. All together eleven sample groups were prepared with different combination of aforementioned experimental variables. Statistically all of them exhibited no significant differences. Hence, we employed two further criteria; (I) the minimum bond strength should exceed the maximum porcelain strength per se, and (II) the CPT substrate should not be heated close to the beta-transus temperature. After applying these criteria, it was concluded that mono-layered nitridation and mono-layered application of chrome-doped nitridation on both (with and without) sandblasted and non-sandblasted surfaces were the most promising conditions for a successful Titanium-Porcelain System.     

Effect of restoration composition, shade, and thickness on the cure of a photoactivated resin cement

PURPOSE: This study investigates the effect of selected properties of a restorative material (type, shade, and thickness) on the cure of a photoactivated resin cement. MATERIALS AND METHODS: Disks of ceramic and resin-based restorative materials of two extreme shades were made to provide thicknesses of 0.5 to 3.0 mm in 0.5-mm intervals. Light transmission was measured through various thicknesses and shades of each restorative material type. The effect of light transmission, as influenced by restorative material type, shade, and thickness on resin cement cure was also determined. RESULTS: Thickness and shade of restorative material had the greatest influence on light transmission. For simulated restoration thicknesses 1.5 mm and greater, Dicor (Dentsply International Inc, York, PA) had greater transmission of light than the other materials, regardless of shade. At equal restorative material thickness, light transmission was similar for identical shades of the other three materials. Restoration shade and thickness also had the greatest influence on resin cement cure. Material type, although significant, had only a minor influence. At thicknesses of 1 to 2 mm, Dicor consistently yielded greater resin cement cure values than any other material tested. CONCLUSIONS: When considering the ability of restorative materials to transmit light for curing of photo-activated resin cements, the thickness of the restoration and its shade are much more influential than the choice of restorative material. Dicor provides greater light transmission that results in the ability to photobond restorations of greater thicknesses than the other materials. For restorations greater than 1 mm in thickness, a dual cure or chemical cure resin cement should be used to provide maximal cement properties.     

Use of plastic bar molded casting in the modification of variably expanding investment to compensate for casting shrinkage of nickel-chromium alloy

Trial plastic bar molded castings were compared for accuracy with cast crowns by means of a nickel-chromium alloy, which was used to establish the liquid density of variably expanding investments. The plastic bars were invested to evaluate the change of expansion rate in a wide range of six liquid densities from 0% to 100%, and the distances between the sections were measured before and after casting. Wax crowns were cast to obtain a more detailed relation around 0% expansion at seven liquid densities, and the gaps between the base of the die and the margin of the crown were measured before and after casting. The expansion rates of both castings were calculated and thus were proportional to the liquid density; both regression curves indicated high correlation coefficients. As a result of the statistics of the Student's t-test, the difference between the two methods was not significant. The trial plastic bar was useful in establishing the variably expanding investment for precise casting of artificial crowns.     

In vitro milling accuracy and fit of 'natural inlays'

OBJECTIVE: This study aimed to investigate the milling behaviour of natural inlays (NI) dental restorations constructed from sound extracted teeth. This was done by comparing the milling accuracy and fit of NI to those of industrial porcelain inlays (PI), milled in the same way. METHODS: A calibration pro-inlay was used to mill three NI and three PI. These were cemented in six acrylic cavities reproduced from the calibration mould, using composite luting cement. No etching and bonding were done. After storage for 24 h in water at room temperature the specimens were sliced buccolingually in a standardised way. For each specimen, two sections were photographed under a light-microscope, resulting in enlarged pictures of the sections. An acetate matrix with the measurement points was placed over each picture in a standardised way. The interfaces between inlays and moulds were measured at 13 fixed points per section using computerised image analysis software. The mean vertical- and floor-interfaces were calculated for each picture, and the overall means were found for each group. Confidence intervals were used for comparison of the differences. The profiles of the milled materials were examined using scanning electron microscopy. RESULTS: There were no differences between NI and PI in the mean interfaces (NI, 102 +/- 8 micrometers; PI, 107 +/- 8 micrometers). Electron microscopy revealed no apparent differences in the profiles of the milled surfaces. CONCLUSION: These findings indicate that the milling accuracy and the fit of natural inlays and milled porcelain inlays are comparable.     

Marginal fit consistency of copy-milled all-ceramic crowns during fabrication by light and scanning electron microscopic analysis in vitro

The aim of this study was to evaluate the marginal fit of copy-milled Celay In-Ceram crowns after different fabrication steps and to compare light-microscopic with scanning-electron-microscopic data. A master steel die of an upper middle incisor with a shoulder preparation and a rounded inner line angle was used. Impressions were taken to produce 10 working stone dies. One crown per working die was manufactured. The evaluation of the external marginal gap was performed on the master steel die by using a light microscope and a computerized video image analysis system after copy milling (A), glass infiltration (B), and veneering (C). Approximately 3900 readings were taken. In a final series the veneered crowns were measured by using a scanning electron microscope (Cs), yielding approximately 1000 readings. The results obtained were: A mean, 25.1 microm; s.d., 5.1 microm; range, 2.5-76.8 microm: B mean, 20.6 microm; s.d., 2.3 microm; range, 2.5-76.1 microm: C mean, 18.3 microm; s.d., 4.1 microm; range, 2.5-87.2 microm: Cs mean, 23.0 microm; s.d., 7.6 microm; range, 0.0-94.5 microm. The results were statistically evaluated using the t-test. The differences found between the series did not show practical relevance. Therefore, it is concluded that the manufacturing steps after copy milling have no obvious influence on the external marginal gap width. Scanning electron microscopic data seem to confirm the light-microscopic results. Hence, we expect that the Celay In-Ceram method yields a clinically acceptable marginal fit.     

Porcelain veneers for primary incisors: a case report

A 4-year-old boy with severely discolored primary maxillary incisors was treated with bonded porcelain veneer restorations. Two years previously, the child had been treated with topical application of sodium fluoride-silver nitrate solution to arrest dental caries associated with a nursing bottle habit. With minimal chair time, the incisors were restored with laboratory-processed porcelain veneer restorations that were bonded with resin cement. This is perhaps the only report to date of the use of porcelain veneer restorations for primary anterior teeth.     

相场法在金属凝固过程的应用现状

相场法是在计算材料学中发展最快的一种强大的计算方法,以基本的热力学和动力学为输入,可用于模拟和预测材料的介观尺度形貌和微观结构的演变。首先总结了相场模型的历史发展、物理基础、数学表达及其数值求解,其次分析了相场法在纯物质、二元合金、多组分系统以及定向凝固、增材制造等领域中的应用情况,最后对相场法进行了总结及展望,并指出相场法发展应趋向于超大尺度相场模拟技术,更高效算法的开发,相场模型与热力学、动力学数据库的结合,工业应用的探索以及与实验观察技术的进一步结合。     

Microleakage of oral microflora for porcelain and some porcelain repair materials--in vitro study

Repairing porcelain fractures has become of interest to the dentist. The intra oral fracture of metal-ceramic restorations may be due to inadequate metal support, excessive porcelain thickness, technical flaws, and occlusal forces. Various techniques for intra oral porcelain repair have been suggested. The resin-porcelain junction has been in question since the advent of the porcelain veneer for cast metal restorations. To enhance this, several intermediary products and techniques have been developed to increase the chemical bond between the fractured porcelain and the repair materials. Clinical procedures for porcelain repair has required roughening of porcelain surface with a rotary abrasives, application of silane followed by composite to replace the contour of the restoration (2, 13, 14). Laboratory data suggested that the strong bond of the repair materials was developed.     

Antenatal sonographic diagnosis of club foot with particular attention to the implications and outcomes of isolated club foot

OBJECTIVE: This study assessed the clinical performance of dentin-bonded crowns, in which ceramic crowns are bonded to underlying dentin with a resin composite-based luting material and a dentin bonding agent. METHOD AND MATERIALS: Twenty-five patients who had received such restorations more than 1 year previously were recalled for evaluation of their crowns. RESULTS: Sixty dentin-bonded complete-coverage restorations were assessed. Forty-one of the crowns had been placed on incisor teeth. The mean time since placement of the restorations was 2.43 years. Fifty-seven of the 60 restorations were intact. The three failures had resulted from cracks in the restorations, which had not clinically debonded. No secondary caries was detected at the crown margins, and anatomic form was assessed as excellent for 56 crowns. Root canal treatment had been required in one case. Color match was rated very good for 47 crowns. All 25 patients were satisfied with their restorations. CONCLUSION: Dentin-bonded crowns may be found to have a low rate of failure and to provide a high level of patient satisfaction.     

The effect of fluoride treatments on glazed and polished ceramic surfaces

A scanning electron microscope (SEM) Study was conducted to evaluate the micromorphology of glazed and polished ceramic restoration surfaces after treatment with different types of fluorides with different concentrations and acidity. This study showed that glazed ceramic surfaces appeared to be smoother and more resistant to fluoride agents than polished ceramic surfaces. Fluoride agents with a lower pH (more acidic) and higher in fluoride concentration caused more surface damage to porcelain. Therefore, it is recommended to use a neutral fluoride agent with low fluoride concentration. If the ceramic restoration is to be polished after glazing due to clinical adjustment, it is advisable to reglaze it particularly before fluoride application.