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RESEARCH AND EDUCATION

Translucency of zirconia-based pressable ceramics with


different core and veneer thicknesses
Il-Do Jeong, PhD,a So-Yeon Bae, PhD,b Dong-Yeon Kim, MSc,c Ji-Hwan Kim, MPH, PhD,d and
Woong-Chul Kim, MPH, PhDe

The heat-press technique is a ABSTRACT


restoration fabrication method Statement of problem. Little information is available on the translucency of zirconia-based
in which heat and pressure are pressable ceramic restorations with a pressed ceramic veneer and zirconia core in various
simultaneously applied and a thickness combinations.
heated ceramic ingot is pushed
Purpose. The purpose of this in vitro study was to assess the translucency of 3 types of zirconia-
into a mold cavity.1,2 This based pressable ceramics for different core-veneer thickness combinations.
method has been used in
dentistry over the past 40 years Material and methods. A bilayered ceramic specimen was prepared with a pressable ceramic (IPS
e.max Zirpress, Initial IQ, Rosetta UltraPress) veneer over a zirconia core (Zenostar Zr). Three groups
to fabricate ceramic restora-
of specimens (n=7) were formed with the following core+veneer thicknesses: 1 +0.5 mm, 0.7 +0.8
tions.3 More recently, it has mm, and 0.5 +1 mm. To obtain consistent thickness and high translucency, all specimens were
been used to layer a ceramic subjected to surface grinding with a grinding machine. To eliminate the effect of differences in
restoration, whereby a heated roughness on the translucency, the surface roughness of the ground specimens was measured with
ceramic ingot is pressed over a a scanning proler, and the consistency of these measured values was veried through statistical
zirconia core. 4 analysis. The luminous transmittance of the specimens was measured with a spectrophotometer.
The veneer ceramic layered The effects of the pressable ceramic type and core-veneer thickness combination on transmittance
were assessed using a 2-way ANOVA (a=.05).
on the zirconia core through
the heat-press technique has Results. The consistency of the surface roughness among the tested specimens was conrmed
the same chemical composi- using a 1-way ANOVA and the Tukey HSD post hoc test (P<.05). The luminous transmittance
exhibited a statistically signicant dependence on both the type of pressable ceramic and the
tion as a hand-applied ceramic
core-veneer thickness combination (P<.05).
veneer.5 However, the press-
ing technique avoids in- Conclusions. The type of pressable ceramic and core-veneer thickness combination affected the
clusions, pores, and cracks translucency of the restoration. (J Prosthet Dent 2016;115:768-772)
inside the veneer ceramic.5,6
As a result, a restoration fabricated by overpressing is However, ceramic materials for the fabrication of
more tolerant of a cohesive failure inside the veneer than esthetic restorations must provide not only outstanding
a ceramic restoration fabricated using the lamination mechanical characteristics but also optical characteristics
technique.5,7 In recent years, considerable research has similar to those of natural teeth.8,9 Research must be
been performed to investigate the mechanical charac- conducted not only on the mechanical characteristics of
teristics of zirconia-based pressable ceramic veneers.1,4-6 zirconia-based pressable ceramic veneers but also on

Supported by a Korea University grant.


a
Doctoral student, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.
b
Doctoral student, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.
c
Graduate student, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.
d
Professor, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.
e
Professor, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.

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June 2016 769

Table 1. Materials used


Clinical Implications Materials Manufacturer Color
Major
Crystalline Lot Number
Adjustment of the core and veneer thicknesses Pressed Ingot
must be considered to control the translucency of a IPS e.max ZirPress Ivoclar Vivadent AG A1 Fluorapatite R65422
bilayer ceramic restoration. Initial IQ GC A1 Leucite 872703
Rosetta UltraPress HASS A1 Lithium FAA01GK1001
disilicate
Zirconia
their optical characteristics. In particular, translucency Zenostar Zr Wieland Dental light N/A O98FGK2002
has been identied as an important inuence on the
esthetic qualities of teeth,10-13 and considerable efforts
have been focused on the translucency of ce- eliminated. Then, according to the method recom-
ramics.10-12,14-16 In previous studies, the translucency of mended by the manufacturer, the ceramic ingot was
ceramics was generally measured quantitatively using pressed (Table 2). In total, 63 specimens were produced:
either the translucency parameter (TP) or contrast ratio 21 per pressable ceramic group with 7 specimens for each
(CR). The CR was reported by Powers et al17 in 1978 for thickness combination. The thickness and size of the
the quantitative measurement of the translucency of specimens are shown in Figure 1. The surfaces of the
restorative resin and was calculated as the ratio of the specimens were ground (M-Prep 3; Allied High Tech)
reectance of the specimen against a white background while wet on 240-, 400-, 600-, 800-, and 1200-grit silicon
to that against a black background. Johnston et al18 carbide paper. While the specimens were being ground,
adapted this method and used the TP for the quantita- their thicknesses were measured frequently with a digital
tive assessment of translucency. The TP was directly micrometer (Mitutoyo IP65; Mitutoyo), and they were
calculated according to the difference in the color of the ultimately ground to a thickness of 1.5 0.01 mm. All the
specimen between the white and black backgrounds and produced specimens were cleaned in an ultrasonic
was measured using an instrument such as a spectro- cleaner (SD-B200H; Mujigae) for 180 seconds to remove
photometer, which determined color through the CIELab any residue.
system.19-25 However, such methods do not enable direct To measure the surface roughness of each specimen,
measurements of translucency, and some studies report a scanning proler (Alpha-Step D-500; KLA-Tencor)
nonlinear relations between luminous transmittance and with a stylus was used. The stylus was placed at the
TP under transmission levels lower than 50%.26,27 center of the specimen surface, and the average rough-
Zirconia-based pressable ceramics have a bilayer struc- ness was calculated by measuring the roughness across a
ture comprising a core and veneer, and changes in the 5-mm length at a speed of 0.1 mm/s. To ensure regularity
thicknesses of the core and veneer are known to affect among the specimen surfaces of all groups, the calculated
the translucency of ceramics.9 However, studies exam- roughness values were evaluated with a 1-way ANOVA
ining the effect of core-veneer thickness combinations on and the Tukey HSD post hoc test (a=.05).
translucency are rare, as is research concerning the For the quantitative analysis of the luminous trans-
translucency of zirconia-based pressable ceramics. mittance, a spectrophotometer (CM-3600A; Konica
In this study, the luminous transmittance of 3 types of Minolta) with a dual-beam system was used. Measure-
zirconia-based pressable ceramic veneers with different ments were performed in the transmittance chamber of
core-veneer thickness combinations were investigated. the spectrophotometer by using pulsed xenon lamps as
The null hypothesis was that the translucency of the light source. To measure transmittance, a zero
zirconia-based pressed ceramics is not affected by the calibration plate was attached to the chamber to calibrate
type of material or the thickness combination. it, after which the plate was removed and a custom
specimen holder was attached. The measured values were
MATERIAL AND METHODS converted with color matching functions from color data
The zirconia used for the core and the pressable ceramics software (SpectraMagic NX CM-S100w; Konica Minolta),
used for the veneer are specied in Table 1. To produce and the luminance was measured initially without the
the specimen, a zirconia blank was milled using specimen (Luminancesource) and then with the specimen
computer-aided design and computer-aided (Luminancespecimen).28 The luminous transmittance (T%)
manufacturing (CAD/CAM) (DWX-50; Roland), and the was calculated using the following expression:
milled zirconia core was then red according to the  
Luminancespecimen
manufacturers instructions. To apply the veneer on the T%= 100:
Luminancesource
zirconia core, a wax block was milled using CAD/CAM
(DWX-50; Roland), and a wax veneer was subsequently Statistical analysis was performed with software
attached to the zirconia core before it was invested and (Statistical Package for Social Sciences, SPSS v21.0; IBM

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770 Volume 115 Issue 6

Table 2. Heat-pressing schedule for pressable ceramics


Heating Start Heating Rate Vacuum Hold Pressing
Brand Name of Product Temperature ( C) Temperature ( C) ( C per min) Time (min) Temperature ( C)
IPS e.max ZirPress 900 700 60 15 910
Initial IQ 850 700 60 20 940
Rosetta UltraPress 925 700 30 20 925

0.6 mm Table 3. Mean and standard deviation of measured surface roughness of


specimens
0.5 mm Types of zirconia-based pressed ceramics
1.0 mm IPS e.max ZirPress, mm Initial IQ, mm Rosetta UltraPress, mm
Veneer 0.355 (0.047)a 0.322 (0.025)a 0.331 (0.067)a

0.7 mm *Means in row with different superscript letters were signicantly different (P<.05) using 1-
0.8 mm way ANOVA and Tukey HSD post hoc test.

Core
Table 4. Mean and standard deviation of absolute translucency with
1.0 mm respect to types of zirconia-based pressed ceramics and different
0.5 mm thickness combinations
Figure 1. Size and form of tested specimens. Types of zirconia-based pressed ceramics
Thickness IPS e.max Rosetta
(veneer+core), mm ZirPress (%) Initial IQ (%) UltraPress (%)

SPSS). First, the homogeneity of the variance was 1.0 +0.5 27.6 (0.7)a 29.8 (0.8)b 25.7 (0.6)c
cd a
0.7 +0.8 25.4 (0.8) 28.1 (0.4) 24.7 (0.7)d
assessed using the Levene test (P=.196) and subse- a b
27.4 (0.5)a
quently a 2-way ANOVA was used (a=.05). Because the 0.5 +1.0 27.3 (0.6) 29.3 (0.5)

interaction between the 2 classication standards was *Different superscript letters indicate statistically signicant difference (P<.05).

found to be signicant (P<.001), the statistical signi-


cance of the average difference among 9 comparison different core-veneer thickness combinations indicated
groups was investigated. an 88.6% variation in the luminous transmittance.

RESULTS DISCUSSION
The measurement results for the surface roughness of Previous research regarding the optical characteristics of
specimens with different types of zirconia-based press- dental ceramics focused largely on the color or trans-
able ceramics are listed in Table 3. No statistically lucency.10-12,14-16 Translucency has been evaluated by
signicant difference was observed among the groups, ceramic thickness,12 surface texture,24 composition,11 and
conrming the consistency in the surface roughness illumination.15 However, because translucency has only
among the specimens. been measured for specimens in the monolithic form,11 it
The average luminous transmittance for the different was difcult to accept the results as clinically valid, even
types of zirconia-based pressable ceramic used for though the ceramic restoration with the core-veneer
veneering and the different core-veneer thickness com- structure was a bilayer structure. Thus, in the present
binations ranged from 24.7% to 29.8%. The luminous research, the translucency of core-veneer specimens with
transmittance was highest for the combination of Initial different thickness combinations was measured to obtain
IQ veneer thickness of 1 mm and core thickness of 0.5 clinically valid results.
mm and lowest for the combination of Rosetta UltraPress Previous studies regarding the translucency of dental
thickness of 0.7 mm and core thickness of 0.8 mm. ceramics indicated that the roughness of the specimen
(Table 4, Fig. 2). The interaction between the different surface strongly affects the translucency.24,28 Thus, in the
types of zirconia-based pressable ceramics used for present study, to eliminate such effects, the surface
veneering and the different core-veneer thickness com- roughness of the specimens was measured with prol-
binations was found to be signicant. The combination of ometry; the results conrmed the consistency of the
0.8-mm core thickness and 0.7-mm veneer thickness surface roughness (Table 3).
showed the lowest transmittance. For the combination of The null hypothesis was rejected; that is, the types of
0.5-mm core thickness and 1-mm veneer thickness, zirconia-based pressable ceramics and core-veneer
UltraPress showed signicantly lower luminous trans- thickness combinations affected the luminous trans-
mittance than ZirPress and IQ. The 2-way ANOVA mittance. According to the translucency measurement
based on the main effects and interaction between the results, the combination of 0.7-mm veneer thickness and
different types of zirconia-based pressable ceramics and 0.8-mm core thickness exhibited the lowest value of

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June 2016 771

the similar degree of increase in the translucency of the


Thickness (mm)
1.0+0.5 UltraPress and the ZirPress is attributed to the deterio-
0.7+0.8 ration in the opaque optical characteristics at a low
30 0.5+1.0 thickness.
The 1.5-mm ceramic specimen used in this study was
previously reported to yield an esthetic outcome unre-
lated to the underlying foundation or cement color.13
Translucency (%)

28 Thus, in this study, because a specimen with a total


thickness of 1.5 mm was used, the underlying structure
had no effect. However, other factors that affect the
translucency, such as roughness and aging, were not
26 considered, which can be regarded as a limitation of this
research. Future investigations may also include the ef-
fect of the translucency of a* or b*, as the transmittance
of the chromatic constituents through restorative mate-
24 rials may inuence the esthetics as much as L*.

CONCLUSIONS
Zirpress IQ Rosetta The translucency of zirconia-pressed ceramics is deter-
Pressed Ceramic mined by the specic microstructure of the material. For
Figure 2. Box-and-whisker plot of luminous transmittance of zirconia- an overall restoration thickness of 1.5 mm, the change in
based pressed ceramics with different core-veneer thickness the thickness of the zirconia-based pressable ceramic
combinations. veneer is a major factor in determining the translucency
of the restoration.
transmittance. As the veneer thickness was decreased REFERENCES
further, the value of transmittance tended to increase
1. Ansong R, Flinn B, Chung KH, Mancl L, Ishibe M, Raigrodski AJ. Fracture
(Table 4). Among all the core-veneer thickness combi- toughness of heat-pressed and layered ceramics. J Prosthet Dent 2013;109:
nations, the IQ group exhibited the highest transmittance 234-40.
2. Denry I, Holloway JA. Ceramics for dental applications: a review. Materials
values (Fig. 2). This is attributed to the differences in the 2010;3:351-68.
major crystalline structure of the examined zirconia- 3. Dro GGJ. The porcelain press technique. J Prosthet Dent 1972;28:209-14.
4. Ishibe M, Raigrodski AJ, Flinn BD, Chung KH, Spiekerman C, Winter RR.
based pressable ceramics,11 as summarized in Table 1. Shear bond strengths of pressed and layered veneering ceramics to high-
The leucite-based crystalline IQ ceramic exhibited a noble alloy and zirconia cores. J Prosthet Dent 2011;106:29-37.
5. Stawarczyk B, zcan M, Roos M, Trottmann A, Sailer I, Hmmerle CH.
higher transmittance value than the ZirPress ceramic Load-bearing capacity and failure types of anterior zirconia crowns ven-
composed of uorapatite and UltraPress composed of eered with overpressing and layering techniques. Dent Mater 2011;27:
1045-53.
lithium disilicate. This result is similar to those reported 6. Lthy H, Dong JK, Wohlwend A, Schrer P. Effects of veneering and glazing
by Bagis and Turgut11 concerning the optical character- on the strength of heat-pressed ceramics. Schweize Monatsschr fur Zahnmed
1993;103:1257-60.
istics of laminate veneers, indicating that the IPS 7. Christensen GJ. PFM vs. zirconia restorationsdhow are they comparing
Empress Esthetic with a leucite-based crystalline struc- clinically. Clinicians Report 2008;1:1-2.
8. Holloway JA, Miller RB. The effect of core translucency on the aesthetics
ture has higher translucency compared with the IPS of all-ceramic restorations. Pract Periodontics Aesthet Dent 1996;9:
ZirPress, which contains uorapatite, and IPS e.max 567-74.
9. Kursoglu P, Motro PFK, Kazazoglu E. Translucency of ceramic material in
Press, which contains lithium disilicate. The difference in different core-veneer combinations. J Prosthet Dent 2015;113:48-53.
translucency is caused by the differences among the 10. Heffernan MJ, Aquilino SA, Diaz-Arnold AM, Haselton DR, Stanford CM,
leucite, uorapatite, and lithium-disilicate crystalline Vargas MA. Relative translucency of six all-ceramic systems. Part I: core
materials. J Prosthet Dent 2002;88:4-9.
structures and can be interpreted as a difference in the 11. Bagis B, Turgut S. Optical properties of current ceramics systems for laminate
veneers. J Dent 2013;41:24-30.
form and volume of the crystals inside the glass ceramic. 12. Wang F, Takahashi H, Iwasaki N. Translucency of dental ceramics with
The leucite microstructure is characterized by the for- different thicknesses. J Prosthet Dent 2013;110:14-20.
13. Niu E, Agustin M, Douglas RD. Color match of machinable lithium disilicate
mation of single crystals, and because it has a lower ceramics: effects of cement color and thickness. J Prosthet Dent 2014;111:
degree of crystallinity compared with uorapatite and 42-50.
14. Lim HN, Yu B, Lee YK. Spectroradiometric and spectrophotometric trans-
lithium disilicate, it exhibits higher translucency.2,25 lucency of ceramic materials. J Prosthet Dent 2010;104:239-46.
Similarly, the UltraPress with lithium-disilicate crystals 15. Ahn JS, Lee YK. Difference in the translucency of all-ceramics by the illu-
minant. Dent Mater 2008;24:1539-44.
exhibited the lowest translucency in the case of a veneer 16. Heffernan MJ, Aquilino SA, Diaz-Arnold AM, Haselton DR, Stanford CM,
thickness of 1 mm, in that it had the highest crystallinity Vargas MA. Relative translucency of six all-ceramic systems. Part II: core and
veneer materials. J Prosthet Dent 2002;88:10-5.
and the crystals were randomly located and were needle- 17. Powers JM, Dennison JB, Lepeak PJ. Parameters that affect the color of direct
shaped.2,11,28 However, at a veneer thickness of 0.5 mm, restorative resins. J Dent Res 1978;57:876-80.

Jeong et al THE JOURNAL OF PROSTHETIC DENTISTRY


772 Volume 115 Issue 6

18. Johnston WM, Ma T, Kienle BH. Translucency parameter of colorants for 26. Nogueira AD, Bona AD. The effect of a coupling medium on color and
maxillofacial prostheses. Int J Prosthodont 1994;8:79-86. translucency of CADeCAM ceramics. J Dent 2013;41:18-23.
19. Chu FC, Sham AS, Luk HW, Andersson B, Chai J, Chow TW. 27. Spink LS, Rungruanganut P, Megremis S, Kelly JR. Comparison of an ab-
Threshold contrast ratio and masking ability of porcelain veneers with high- solute and surrogate measure of relative translucency in dental ceramics.
density alumina cores. Int J Prosthodont 2003;17:24-8. Dent Mater 2013;29:702-7.
20. Ikeda T, Murata Y, Sano H. Translucency of opaque-shade resin composites. 28. Awad D, Stawarczyk B, Liebermann A, Ilie N. Translucency of esthetic dental
Am J Dent 2004;17:127-30. restorative CAD/CAM materials and composite resins with respect to
21. Kim SJ, Son HH, Cho BH, Lee IB, Um CM. Translucency and masking ability thickness and surface roughness. J Prosthet Dent 2015;113:534-40.
of various opaque-shade composite resins. J Dent 2009;37:102-7.
22. 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 2009;37: Corresponding author:
937-43. Woong-Chul Kim
23. Johnston WM, Reisbick MH. Color and translucency changes during Department of Dental Laboratory Science and Engineering
and after curing of esthetic restorative materials. Dent Mater 1997;13: College of Health Science
89-97. Korea University
24. Wang H, Xiong F, Zhenhua L. Inuence of varied surface texture of dentin Anam-dong 5-ga, Seongbuk-gu, Seoul 136-072
porcelain on optical properties of porcelain specimens. J Prosthet Dent REPUBLIC OF KOREA
2011;105:242-8. Email: kuc2842@korea.ac.kr
25. Ilie N, Hickel R. Correlation between ceramics translucency and
polymerization efciency through ceramics. Dent Mater 2008;24:908-14. Copyright 2016 by the Editorial Council for The Journal of Prosthetic Dentistry.

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