Search

PURPOSE To determine the fracture resistance of chairside computer-aided design and computer-assisted manufacturing (CAD/CAM) lithium disilicate full coverage crowns and two different designs of overlay restorations for premolars. MATERIALS AND METHODS CAD/CAM lithium disilicate (IPS e.max CAD for CEREC/HT A1 C14, Ivoclar Vivadent) restorations (15 specimens/group) with 1.5 mm occlusal thickness and 1.0 mm chamfer were designed and fabricated with a chairside CAD/CAM system (CEREC, Dentsply Sirona). The restorations were prepared in three different designs: (1) full coverage crowns, (2) overlays with the margin located 2 mm above the gingiva, and (3) overlays with the margin located 4 mm above the gingiva. Restorations were cemented using conventional resin luting cement (Multilink, Ivoclar Vivadent) with primer system (Monobond Plus, Ivoclar Vivadent) to resin printed dies, load cycled (2,000,000 load cycles at 1 Hz with 275 N force), and then finally loaded with a steel indenter until failure. Scanning electron microscopy observations of fractured surfaces were also conducted. Group results were analyzed with one-way analysis of variance, and the medians were evaluated independently with Kruskal-Wallis. RESULTS The fracture force of CAD/CAM lithium disilicate restorations was significantly different (p < 0.001) depending on the design of the restoration. Full coverage crowns showed significantly higher force to fracture (1018.8 N) than both types of overlays (p = 0.002 for overlay 2.0 mm and p < 0.001 for overlay 4.0 mm above gingiva). Among the two overlays, the restoration with the margin located 2 mm above the gingiva showed significantly higher fracture force (813.8 N) than the overlay with margin at 4 mm above the gingiva (436.1 N; p < 0.001). The fracture appearance of the crowns was much more complex than that of the overlay restorations. CONCLUSIONS Full coverage chairside CAD/CAM lithium disilicate premolar crown showed higher fracture resistance than overlay restorations. Overlays with the margin located 2 mm above the margin demonstrated higher resistance than those with the margin located 4 mm above the gingiva.

Purpose Zirconia crowns often crack at the margin. This study determined the loads and the times at which cracks are initiated in high-translucency monolithic zirconia crowns with different margin designs. Materials and methods A total of 90 crowns were fabricated from Zirconia blanks. The fabricated crowns had different margin thicknesses (light-chamfer, CL and heavy-chamfer, CH ) and collar heights (no-collar, NC ; low-collar, LC ; high-collar, HC ). They were grouped as CL NC , CL LC , CL HC , CH NC , CH LC , and CH HC (15 crowns/group). The crowns were seated on a metal model and loaded vertically through round end punch (Φ = 10 mm) at 0.2 mm/min crosshead speed until cracks began to be seen. Videos of the crack initiation were recorded at the rate of 50 frames/second. Load-initiated cracks and durability time were compared for significant differences using analysis of variance. Results The mean ± standard deviation values of load (N) and time (s) taken to initiate cracks were 3190 ±775, 212 ±47 for CL NC ; 2754 ±1109, 180 ±42 for CL LC ; 2887±832, 191±27 for CL HC ; 4082 ±896, 241 ±36 for CH NC ; 4180 ±1029, 220 ±28 for CH LC ; 4119 ±1124, 222 ±39 for CH HC . This indicates that the thickness of the margin has a significant influence on load-withstanding crack initiation capacity and durability time (p 0.05). No interaction was observed among these factors. Conclusion Heavy chamfer margin provided a stronger zirconia crown than the light chamfer margin, but both of them were capable of withstanding crack-initiated load higher than the theoretical maximum masticatory force. The presence or absence of a collar did not have any impact on the crack initiation. Fabrication of zirconia crowns with either a heavy or light chamfer margin and with or without the presence of a collar should be generated by considering the relevant emergence profile.

PURPOSE The marginal fit is an essential component for the clinical success of prosthodontic restorations. The aim of this study was to investigate the influence of different abutment finish line widths and crown thicknesses on the marginal fit of zirconia crowns fabricated using either standard or fast sintering protocols. MATERIALS AND METHODS Six titanium abutments were fabricated for receiving zirconia molar crowns. Crowns were designed virtually and milled from partially sintered zirconia blanks and divided into 12 groups (n = 10/group). Crowns in groups 1 to 6 were sintered by standard sintering, while those in groups 7 to 12 were sintered by fast sintering. Groups were further categorized according to abutment finish line and crown thickness: G1/G7 (0.5 mm chamfer, 0.8 mm thick); G2/G8 (0.5 mm chamfer, 1.5 mm thick); G3/G9 (1.0 mm chamfer, 0.8 mm thick); G4/10 (1.0 mm chamfer, 1.5 mm thick); G5/G11 (1.2 mm chamfer, 0.8 mm thick); G6/G12 (1.2 mm chamfer, 1.5 mm thick). The marginal gaps were assessed at 8 locations using digital microscopy. The linear mixed effect model analysis was performed at a significance level of 0.05. RESULTS All vertical marginal gaps were within the clinically acceptable range (∼11-52 μm). G8 (FS, 0.5 mm chamfer, 1.5 mm thick) demonstrated the largest gaps (47.95 μm, 95% CI: 44.57-51.23), whereas G3 (SS, 1.0 mm chamfer, 0.8 thick) had the smallest marginal gap (14.43 μm, 95% CI: 11.15-17.71). A linear mixed effect models showed significant differences for the interaction between finish line × crown thickness × sintering (F = 18.96, p < 0.001). The lingual surfaces showed the largest gaps in both sintering protocols, while the mesial and mesiobuccal surfaces demonstrated the smallest gaps. CONCLUSIONS There was a significant interaction between finish line widths, crown thickness, and sintering protocol on the marginal gaps in both sintering protocols; 1.0 mm finish line preparations with either 0.8 mm or 1.5 mm occlusal reduction had better marginal fit in both sintering protocols compared to 0.5 mm or 1.2 mm finish lines. Smaller marginal discrepancies were observed for standard sintering crowns with a 0.5 mm finish line and 1.5 mm occlusal reduction. Conservative occlusal reduction should be accompanied with a 1.2 mm finish line to obtain better marginal fit for full-contoured zirconia crowns.

PURPOSE To: (1) determine which preparation techniques clinicians use in routine clinical practice for single-unit crown restorations; (2) test whether certain practice, dentist, and patient characteristics are significantly associated with these techniques. MATERIALS AND METHODS Dentists in the National Dental Practice-Based Research Network participated in a questionnaire regarding preparation techniques, dental equipment used for single-unit crown preparations, scheduled chair time, occlusal clearance determination, location of finish lines, magnification during preparation, supplemental lighting, shade selection, use of intraoral photographs, and trimming dies. Survey responses were compared by dentist and practice characteristics using ANOVA. RESULTS Of the 2132 eligible dentists, 1777 (83%) responded to the survey. The top two margin configuration choices for single-unit crown preparation for posterior crowns were chamfer/heavy chamfer (65%) and shoulder (23%). For anterior crowns, the most prevalent choices were the chamfer (54%) and the shoulder (37%) configurations. Regarding shade selection, a combination of dentist, assistant, and patient input was used to select anterior shades 59% of the time. Photographs are used to communicate shade selection with the laboratory in about half of esthetically demanding cases. The ideal finish line was located at the crest of gingival tissue for 49% of respondents; 29% preferred 1 mm below the crest; and 22% preferred the finish line above the crest of tissue. Average chair time scheduled for a crown preparation appointment was 76 ± 21 minutes. Practice and dentist characteristics were significantly associated with margin choice including practice type (p < 0.001), region (p < 0.001), and years since graduation (p < 0.001). CONCLUSIONS Network dentists prefer chamfer/heavy chamfer margin designs, followed by shoulder preparations. These choices were related to practice and dentist characteristics.

Purpose This in vitro study evaluated and compared the vertical marginal gap of cast and milled full coverage gold copings using two margin designs (chamfer and chamfer bevel) before and after fitting adjustments. Materials and Methods Ten impressions were made of two metal master dies (one chamfer margin, one chamfer-bevel margin) and poured twice in Type IV stone. The 20 subsequent casts with 40 dies were split into four groups (n = 10); cast gold bevel, cast gold chamfer, milled gold bevel, and milled gold chamfer groups. The cast specimens received approximately 40 μm die relief no closer than 1 mm from the finish line. Cast copings were hand waxed, cast in a high noble gold alloy, chemically divested, and the sprues were removed. For milled gold copings, casts were scanned and copings designed using 3shape D900 scanner and software. Parameters were set to approximate analog fabrication (cement gap = 0.01 mm; extra cement gap = 0.04 mm, drill radius = 0.65 mm). Copings were milled from the same high noble alloy. All copings were seated on their respective master die in a custom scanning jig and measured using a measuring microscope at 90× (60 measurements per specimen, 15 per surface). Following initial measurements, all copings were adjusted on stone dies. The number of adjustment cycles was recorded and post-adjustment measurements were made using the same method. Data were analyzed using independent and paired t-tests. Results Milled gold copings with a beveled margin (11.7 ± 20.4 μm) had a significantly (p < 0.05) smaller marginal gap than cast gold copings with a beveled margin (43.6 ± 46.8 μm) after adjustment. Cast gold copings with a chamfer margin (22.7 ± 24.7 μm) had a significantly (p < 0.05) smaller marginal gap than milled gold copings with a chamfer margin (27.9 ± 31.6 μm) following adjustments. Adjustments significantly decreased marginal gap for both cast groups (p < 0.05) and the milled chamfer bevel group (p < 0.05) but had no significant effect on the milled chamfer group. Conclusions Within the limitations of this study, results indicate that gold restorations milled with the tested parameters provide a vertical marginal gap that is an acceptable alternative to traditional gold crown casting techniques.

Purpose To evaluate the fracture load of 3-unit zirconia-based posterior fixed dental prostheses (FDPs) before and after veneering the frameworks. Materials and Methods Forty standardized stainless-steel master dies were fabricated (height: 5 mm, convergence: 6o, chamfer: 1 mm) and randomly screwed in pairs onto metal bases. The bases were randomly divided into two groups (n = 20 each) according to the zirconia CAD/CAM system used for constructing 3-unit structures for FDPs: group 1 (L): Lava All-ceramic, group 2 (Z): IPS e.max ZirCAD. Half of the zirconia structures per group were randomly selected and veneered, while the remaining half was left unveneered. The specimens were luted in standard fashion onto the stainless steel master dies using conventional glass ionomer cement. All specimens were tested for fracture load (FL). Specimens were subjected to a three-point bending test until fracture by applying an axial compressive load at the central fossa of the pontics with a universal testing machine at a 0.5 mm/min crosshead speed. Wilcoxon's rank-sum test and Weibull statistics were used for statistical analysis (α = 0.05). Results L structures recorded significantly higher values of load to fracture than the Z group both before and after veneering. Within each ceramic group, no differences were found between unveneered and veneered frameworks. Conclusions Although further studies are necessary to corroborate these findings, both zirconia systems could be recommended for restoring posterior teeth on the basis of the fracture load values recorded in this experiment (>1000 N). The veneering procedure did not affect the overall load to fracture in any group.

Purpose The purpose of the study was to find out how light-body impression material thickness influences the horizontal dimensional accuracy of casts examined on a scanned model. Materials and Methods Customized manikin mandibles were used for impression taking with a dual-phase impression method. These mandibles were prepared in a way that allowed the control of light-bodied impression material thickness. First premolars were prepared for a full crown by supragingival chamfer on both sides in all mandibles. For the measurements, buccal and lingual reference points were made at the preparation margin. Impressions were taken at nine thickness levels and a control level (TTotal = 10; 0–1.2 mm), and the reference points’ average distance was compared across thickness levels on both the left and right side. We carried out three measures for each specimen and used three specimens per thickness level. Total sample size was N = 180, creating a sizable database to understand the influence. Results The results indicated that light-body impression material thickness had no influence on the horizontal dimension of a die measured on scanned dies in these specific circumstances. Conclusions The thickness of light-body impression material in the dual-phase impression taking technique did not have a significant influence on the horizontal accuracy of scanned dies, which makes the technique safe and reliable for single crown restorations without having to take extra precautions for the thickness of light-body impression material.

PURPOSE The aim of this study was to evaluate the durability of lithium disilicate crowns bonded on abutments prepared with two types of finish lines after long-term cyclic loading. MATERIALS AND METHODS Pressed lithium disilicate all-ceramic molar crowns were bonded (Variolink II) to epoxy abutments (height: 5.5 mm, O: 7.5 mm, conicity: 6°) (N = 20) with either knife-edge (KE) or large chamfer (LC) finish lines. Each assembly was submitted to cyclic loading (1,200,000×; 200 N; 1 Hz) in water and then tested until fracture in a universal testing machine (1 mm/min). Failure types were classified and further evaluated under stereomicroscope and SEM. The data (N) were analyzed using one-way ANOVA. Weibull distribution values including the Weibull modulus (m), characteristic strength (0), probability of failure at 5% (0.05), 1% (0.01), and correlation coefficient were calculated. RESULTS Type of finish line did not significantly influence the mean fracture strength of pressed ceramic crowns (KE: 1655 ± 353 N; LC: 1618 ± 263 N) (p = 0.7898). Weibull distribution presented lower shape value (m) of KE (m = 5.48; CI: 3.5 to 8.6) compared to LC (m = 7.68; CI: 5.2 to 11.3). Characteristic strengths (0) (KE: 1784.9 N; LC: 1712.1 N) were higher than probability of failure at 5% (0.05) (KE: 1038.1 N; LC: 1163.4 N) followed by 1% (0.01) (KE: 771 N; LC: 941.1 N), with a correlation coefficient of 0.966 for KE and 0.924 for LC. Type V failures (severe fracture of the crown and/or tooth) were more common in both groups. SEM findings showed that fractures occurred mainly from the cement/ceramic interface at the occlusal side of the crowns. CONCLUSION Lithium disilicate ceramic crowns bonded onto abutment teeth with KE preparation resulted in similar fracture strength to those bonded on abutments with LC finish line. CLINICAL SIGNIFICANCE Pressed lithium disilicate ceramic crowns may not require invasive finish line preparations since finish line type did not impair the strength after aging conditions.

Purpose The aim of this study was to evaluate the fracture resistance (FR) and shear bond strength (SBS) via finite element analysis (FEA) of zirconia framework veneered with different methods. Materials and Methods Zirconia frameworks were prepared as crowns for FR and cubic blocks for SBS (N = 60, n = 10). The specimens were veneered with one of the following veneering methods: (a) overcemented file-splitting (OCF), (b) layering (L), or (c) overpressing (P). For crowns, stainless steel dies (N = 30; chamfer: 1 mm) were scanned using a contrast spray. Bilayered design for OCF and reduced design (1 mm) for both L and P were performed by computer-aided design and manufacturing. For the SBS test, zirconia blocks were sectioned (4 × 4 × 4 mm3) under water cooling and sintered. Frameworks were veneered with compatible ceramics for each veneering method and subjected to mechanical tests. The milled suprastructures were bonded to zirconia frameworks using a resin composite in Group OCF and photopolymerized. Crowns were cemented to the metal dies with resin modified glass-ionomer cement. All specimens were stored at 37°C, 100% humidity for 48 hours prior to mechanical tests. Data were statistically analyzed (ANOVA, Bonferroni tests, α = 0.05). Fractured specimens were examined under scanning electron microscopy (SEM), and FEA modeling of the crowns was performed. Results Mean FR values (N) were significantly higher with L (6102 ± 1519) and P (4117 ± 1083) than with of OCF (1900 ± 254) (p = 0.01). The mean SBS (MPa) in OCF (24 ± 4) was significantly lower (p 0.05). For crown restorations, while only adhesive failures were found in OCF, cohesive failures within veneering ceramic were more frequent in P and L. FEA verified these findings. Conclusion Veneering methods based on layering or pressing may reduce ceramic chipping but the overcemented file-splitting method does not seem to prevent this failure. Clinical Significance Layering and overpressing veneering methods on zirconia frameworks with reduced design might decrease chipping compared to overcemented file-splitting, where in the latter, zirconia framework and feldspathic suprastructure are combined using a resin cement.

Purpose The purpose of this study was to evaluate the impact of occlusal relief of dies on internal adaptation of metal-ceramic casting copings. Materials and Methods Standardized preparations were made on 80 extracted third molar teeth. Impressions were made with poly(vinyl siloxane), and stone dies were prepared. Dies were covered with four layers of die spacer, covering the entire preparation together with the occlusal surface excluding the apical 0.5 mm of the preparation in group 1 (40 specimens), and covering the same area excluding the occlusal surface in group 2 (40 specimens). Copings were cast using nickel–chromium-based metal ceramic alloy and cemented using zinc phosphate cement. The specimens were sectioned along the long axis. Internal discrepancies were recorded with a 0.001-mm resolution stereoscope at 6 points: the middle of the occlusal surface (MO), middle of the lingual wall (ML), middle of the buccal wall (MB), middle of the buccal shoulder finish line (MSH), middle of the lingual chamfer finish line (MCH), and middle of the buccal bevel finish line (MBL). Student's t-test was used for statistical analysis. Significance level was set at p < 0.05. Results The marginal discrepancies of group 1 were higher than those of group 2. Significant differences in discrepancies were found on MO (p < 0.0001), MSH (p = 0.012), and MBL (p = 0.035). The bevel margin showed the least marginal discrepancy following occlusal surface of the die with no relief. Conclusion Leaving the occlusal part of the die uncovered with the die spacer improved the crown seating considerably in the occlusal surface as well as shoulder and bevel margins.

Purpose: The purpose of this study was to evaluate the marginal adaptation of zirconium dioxide crowns in preparations with two different finish line configurations before and after porcelain firing cycles, after a glaze cycle, and after cementation. Materials and Methods: Twenty human molar teeth were prepared to receive full crowns; ten were prepared with a 90° round shoulder and another ten with a 45° chamfer finish line. Zirconium dioxide copings were fabricated using CAD/CAM technology (Lava™ system). They were then veneered with a low-fusing glass-ceramic (IPS e.max® Ceram). Finally, they were glazed and cemented with a resin-composite cement (RelyX™ Unicem, Aplicap™). Measurements for marginal adaptation using stereomicroscopy (40×) were performed at four stages: copings (S1), after porcelain firing cycles (S2), after glazing (S3), and after cementation (S4). One-way ANOVA was used to assess the influence of the finish line design on the marginal adaptation in each stage. Two-way ANOVA with repeated measurements was performed to assess the influence on the marginal adaptation of the porcelain firing cycles, glaze firing cycle, and cementation. Results: The measured marginal gap mean values for the shoulder group (μm) were: 50.13 (S1), 54.32 (S2), 55.12 (S3), and 59.83 (S4). The values for the chamfer group were: 63.56 (S1), 71.85 (S2), 74.12 (S3), and 76.97 (S4). When comparing marginal gaps between specimens with two different finish lines, differences were noticed at the four studied stages (p= 0.0165, p= 0.0027, p= 0.0009, and p= 0.0009, respectively). No differences were manifested in the marginal gap measurements of the shoulder group at the different stages of fabrication (p= 0.4335); however, in the chamfer group, differences were noticed between S1 and S3 (p= 0.0042). Conclusions: Marginal adaptation was influenced by the finish line design. The firing cycles significantly affected the chamfer group; nevertheless, the marginal gap was within the range of clinical acceptability.

Purpose: The aim of this study was to evaluate the marginal discrepancy (MD) and internal discrepancy (ID) of ceramic crowns manufactured by a CAD/CAM system, having different finish lines. The hypotheses tested were that the finish line type would not influence the MD or ID of the crowns, and ID would not change in different regions. Materials and Methods: Three aluminum master dies (height: 5.5 mm, O: 7.5 mm, conicity: 6°) with different finish lines (TC: tilted chamfer; LC: large chamfer; RS: rounded shoulder) were manufactured. Ten impressions were made from each master die using a modified parallelometer. Impressions were poured in type IV dental stone, and 30 ceramic crowns (IPS Empress CAD, Ivoclar) were subsequently milled. The crowns were fixed on their respective metallic die using a metallic fixation device. The distance between the external edges of the crown to the edge of the cervical preparation was performed at 50 points on the respective metallic die (MD analysis). With the replica technique, the ID values of each crown were further evaluated at 12 points equidistant to each other in three regions: radius (R), axial (A), and occlusal (Occl). The measurements were performed using an optical microscope (250×). The data (μm) were analyzed using ANOVA and Tukey′s test (5%). Results: The RS group (28.24 ± 11.42 μm) showed significantly lower MD values (p= 0.001) than those of TC (99.92 ± 18.32 μm) and LC (64.71 ± 25.64 μm) groups, both of which also differed statistically from one another. The ID results demonstrated significantly lower values in the LC group (183.01 ± 62.82 μm) (p= 0.0014) than those of TC (216.26 ± 83.23 μm) and RS (219.12 ± 87.24 μm) groups. ID results of TC and RS were not significantly different. Additionally, the ID results showed significant differences among the regions (p= 0.0001). The null hypotheses were rejected. Conclusion: The RS finish line produced MD values significantly lower than tilted and large chamfer, but large chamfer presented the lowest internal discrepancy values. Independent of the finish line type, internal discrepancy was the lowest in the axial region followed by radius and occlusal regions.

Purpose: The aim of this study was to evaluate the effect of finish line design on the fatigue, fracture resistance, and failure type of veneered zirconia restorations. Materials and Methods: A CAD/CAM system (Cercon) was used to prepare zirconia frameworks (0.5 mm thick) for a maxillary central incisor. Three finish line designs were evaluated: a complete narrow chamfer, a narrow chamfer with a lingual ledge, and a complete ledge. The prepared frameworks were veneered using a press-on ceramic (Ceram Press) and were cemented on the corresponding prepared teeth using a resin cement (Panavia F2.0). The cemented specimens were thermocycled, subjected to dynamic fatigue, and finally loaded till fracture. Fractured specimens were examined under a scanning electron microscope to assess fracture type. One-way ANOVA and Bonferroni post hoc tests were used to analyze the data (α= 0.05). Results: The finish line design did not have any significant statistical influence on the fracture resistance (F = 1.9, p= 0.346) or on the failure type of the tested specimens. Adjusted R squared value (R = 0.049) indicated a weak correlation between finish line design and fracture load of the tested specimens. All specimens failed due to cracking and fracture of the veneer ceramic. Meanwhile, the framework remained entirely intact. Three narrow chamfer finish line specimens demonstrated adhesive fracture of the veneer ceramic during dynamic fatigue testing, related to overextension of the veneer ceramic during the layering procedure. Conclusion: Within the limitations of this study, the finish line design did not influence the fatigue or the fracture resistance of veneered zirconia crowns. Selection of any of the finish line designs should be based on the clinical condition of the restored tooth.

Purpose: Fiber-reinforced composite restorations provide excellent esthetics; however, little is known regarding the influence of margin design on marginal fit and fracture resistance for this type of crown. This study evaluated the effect of variations in tooth-preparation design on the marginal fit and compressive fracture resistance of fiber-reinforced composite crowns. Materials and Methods:Three metal dies with a total convergence of 5 ◦ and different margin designs (0.5-mm light chamfer, 1.0-mm deep chamfer, and 1.0-mm shoulder) were prepared. Sixty standardized crowns (FibreKor) were made on duplicated base metal alloy dies (n = 20 for each margin design). Marginal fit was stereoscopically evaluated by measuring the distances between each of the four pairs of indentations on the crowns and on the dies. The specimens were then subjected to a compressive fracture-loading test using a universal testing machine. The data were analyzed with one-way analysis of variance (ANOVA) followed by Ryan-Einot-Gabriel-Welsch multiple-range test (α = 0.05). Results: Analysis of marginal fit and fracture resistance disclosed a statistically significant difference for tooth-preparation design (p < 0.001). The marginal adaptation of preparations with the 0.5-mm light chamfer (66.2 μm) and 1.0-mm deep chamfer (69.7 μm) was significantly better than preparations with a shoulder finish line (92.8 μm) (p < 0.001). The fracture strength of the preparations with the 0.5-mm light chamfer (15.8 MPa) and 1.0-mm deep chamfer (15.1 MPa) was significantly greater than those of the preparations with the 1.0-mm shoulder (13.7 MPa) (p < 0.001). Conclusions: Marginal fit of fiber-reinforced crowns was adversely affected by toothpreparation design. The marginal gaps were greater for the shoulder margin specimens than in the light or deep chamfer margin specimens; however, the fracture strength of the chamfer margin specimens was greater than that of the shoulder margin specimens.

Purpose: The purpose of this study was to evaluate the fracture resistance of endodontically treated teeth between those with four walls and those with three walls of remaining coronal tooth structure and the effect of the site of the missing coronal wall. Materials and Methods: Thirty-two endodontically treated second mandibular premolars were decoronated, leaving 3 mm above the cementoenamel junction (CEJ). A 0.5-mm-wide chamfer was prepared 1 mm above the CEJ. The teeth were randomly divided into four groups. Group 1 had four walls of coronal tooth structure, whereas groups 2, 3, and 4 had only three walls, missing the buccal, lingual, and mesial wall, respectively. The cast dowel and cores and crowns (Ni–Cr alloy) were cemented with zinc phosphate cement. A compressive load was applied 45° to the long axis, 2 mm below the buccal cusp, with an Instron machine until failure at a crosshead speed of 5 mm/min. Failure load (kg) and mode of failure were recorded. Data were analyzed with one-way ANOVA and Scheffe tests (p < 0.05). Results: Group 1 had the highest fracture resistance (1190.3 ± 110.5 kg), significantly different from the other groups (p < 0.05) (group 2: 578.5 ± 197.4 kg; group 3: 786.6 ± 132.8 kg; group 4: 785.4 ± 289.9 kg). There were no significant differences among the test groups. The mode of failure in group 1 was a horizontal root fracture, whereas that of the other groups was either vertical or oblique fracture. Conclusions: Teeth with four walls of remaining coronal dentine had significantly higher fracture resistance than teeth with only three walls. The site of the missing coronal wall did not affect the fracture resistance of endodontically treated teeth.

Purpose: A number of provisional restorative materials exist on the market. This study tested marginal fit and color stability of three provisional restorative materials and a control. Materials and Methods: Two auto-cure materials, Protemp Garant and Integrity, and one dual-cure material, Luxatemp Solar, were tested against SNAP, a polyethyl methacrylate control. A maxillary right central incisor ivorine tooth was prepared for a full coverage all-ceramic crown, with a 1.5-mm chamfer margin. Four points were engraved at a point 1 mm below the facial, lingual, mesial, and distal margins, and replicas (n = 40) were produced by the manufacturer. Provisional crowns (n = 10 × 4) were fabricated on the individual replicas using a polyethylene coping template. The crowns were trimmed under magnification using an acrylic bur. The distance from the crown margins to a point tangent to the engraved markings was measured under 10× magnification and recorded. For color stability, 10-mm diameter × 2-mm thick discs (n = 10 × 4) were fabricated and immersed cyclically in tea for 1 week in a Tucillo/Nielson apparatus. Color measurements were recorded for each specimen at baseline and after staining. ΔE values were calculated to determine the extent of the color change. Results: The means of the four marginal discrepancy measurements for each specimen were analyzed using a 1-way ANOVA and Tukey post-hoc comparison. Luxatemp Solar had statistically significant marginal discrepancy (319 μm, p < 0.05) when compared to the other provisional materials. A significant color change (ΔE = 4.33, p < 0.05) was found for Protemp Garant. Conclusion: The dual-cure temporary material (Luxatemp Solar) exhibited significantly more discrepancy at the margin than the auto-cure bis-acryl materials or acrylic control. Protemp Garant exhibited a clinically noticeable change in shade after 1 week in staining solution, whereas the other materials did not exhibit a clinically noticeable change. Clinical Implications: Provisional crowns fabricated from SNAP, Protemp Garant, and Integrity exhibited similarly low marginal discrepancy. SNAP, Luxatemp Solar, and Integrity did not demonstrate a clinically detectable change in shade after 1 week in a staining solution.

Purpose In 1996, a survey of American dental schools was conducted. The purpose of the survey was to determine the curricular structure, techniques taught, and materials used in predoctoral fixed prosthodontics courses. Materials and Methods The survey was mailed to the course directors of predoctoral fixed prosthodontic programs at 53 American dental schools. Of these, 42 schools returned the completed survey, resulting in a response rate of 79%. The mean, median, and the range of responses were computed where applicable. Results The results from this survey show that the mean student-to-faculty ratio in the preclinical course was 11:1, with a median of 10:1 and a range of 5:1 to 25:1. The mean number of laboratory clock hours was 164, with a median of 148 and a range of 81 to 288. The mean number of lecture hours reported was 42, with a median of 35 and a range of 20 to 80. Fifty-five percent of the schools used the Hanau semiadjustable articulator. The most commonly used provisional technique was the thermoplastic custom external surface form (44%). The finish line of choice for the full metal restoration was the chamfer placed circumferentially (74%). The finish line of choice for the porcelain-fused-to-metal restoration was the shoulder placed facially and the chamfer placed lingually (38%). Conclusions Predoctoral fixed prosthodontics education and technical experience varies from school to school, yet a large percentage of schools agree on certain topics.