93924791

Oswaldo Scopin de Andrade, DDS, MS,Gilberto Antonio Borges, DDS, MS,Marcelo Kyrillos,Marcelo Moreira,Luis Calicchio,

.Lourenço Correr-Sobrinho, DDS, MS,

The Area ofAdhesive Continuity:A New Concept forBonded CeramicRestorations

Ceramic laminate veneers (CLVs) offer an es-thetic and functional oral rehabilitation withwell-documented favorable success rates.'"*

Generally, the assessment of restorative success isbased on established clinical criteria and associated

'Director, Advanced Program in implant and Estiietic Dentistry,Senac University, Sao Paulo, Brazil.

'Assistant Professor, Restorative Dentistry, Uberaba University,

Uberaba, Brazil.

^Atelie Oral Clinic, Sao Paulo, Brazil.

"•Professor, Department of Restorative Dentistry, Dental MaterialsDivision, School of Dentistry, Campinas State University,Piracicaba, Sao Paulo, Brazil.

Correspondence to: Dr Oswaldo Scopin de Andrade, Rua Baräode Piracicamirim 889 #61, Piracicaba-SP, Brazil CEP 13.416-005.Email: [email protected]

Statistical analysis. The criteria commonly used in theliterature include the United States Public Health Ser-vice criteria, modified California Dental Associationcriteria, and variations thereof. ' ' These systems allowfor uniform measurements and facilitate tabulation ofdata for analysis. In this way, an index of success canbe assigned to a given restorative treatment. Theseevaluations are well accepted in the literature and canbe used to assess the efficacy of a wide variety of treat-ment options.

When it comes to the replacement of missing toothstructure using any type of restorative material, thequestion is always the same: What is the longevity ofthis treatment? Scientifically, there are several meth-ods of measuring the quality of a restoration, includingdirect or indirect^"'" and objective or subjective evalu-ations of a variety of different parameters.

QDT2013

SCOPINDEANORADEETAL

Objective parameters are the most well-acceptedassessments ¡n the dental literature. ^-^^ Objective pa-rameters may include the following:

• Marginal adaptation• Marginal degradation• Signs of leakage• Secondary or recurrent caries• Color maintenance• Surface texture• Chipping or fracture

In contrast, subjective parameters account for per-sonal feelings and opinions obtained from the patientand/or clinician via questionnaires and interviews. ' ' ^Subjective parameters include patient satisfaction andpatients' opinions regarding maintenance and colorstability.

Today, dental restorative sciences are focused onconservative techniques, ie, the preparation of lesstooth structure. Thanks to the development of new ad-hesive materials, tooth preparation for indirect restora-tions can be restricted to enamel and superficial den-tin. With maximum enamel preservation and carefullyexecuted adhesive procedures, problems such as sec-ondary caries and leakage do not occur as frequentlyfor indirect restorations luted using conventional ce-ments as for those luted using acid-based cements."'^^

For CLVs, longitudinal studies have shown excellentresults in terms of esthetics and stability of the restora-tion margins. The data from these studies are generallypresented as success or survival rates; however, due tothe limited number of pages and images available in apublished article, clinicians reading these studies maynot be sure how to evaluate their own CLVs intraorally.In other words, while published studies often reportthe results of clinical evaluations, they rarely provide aclear understanding of how to perform clinical evalu-ations. Clarification of this issue would help clinicianswho are not researchers determine the quality of theirown treatments.

Therefore, this article aims to describe an additionalmethod to assess the quality and longevity of CLVs us-ing scanning electron microscopy (SEM) and estheticparameters based on digital photography.

MARGINAL ADAPTATION:CONVENTIONAL CROWNS VSBONDED RESTORATIONS

Both marginal adaptation and cement film thicknessplay crucial roles in the long-term success of conven-tional crown preparations.^^^^' When fabricating an in-direct restoration, every step of the process is aimed atachieving perfect marginal adaptation.^^ For example,clinical guidelines for tooth preparation attempt tocreate the proper path of insertion to allow for minimalcement film thickness.'' In the laboratory, the methodsused to pour the molds and fabricate the restorationsare likewise based on perfect marginal adaptation, ie,providing a minimal gap between the restoration andtooth structure.

Traditional crown preparation often requires ex-tensive removal of sound dental tissue.^° Conversely,CLV treatment can be provided using minimally inva-sive techniques. " - If properly planned and executed,CLVs can be bonded to the tooth structure without anypreparation. As a result, the restoration will not havea well-defined margin.^^"^* This can make it impossi-ble to determine the location of the finishing line forthe CLV. Ir addition, bonding usually extends beyondthe margins of the restoration to properly seal thesurroundirg dental structures. ' ^ Thus, conservativebonded restorations are dissimilar to cemented resto-rations. For this reason, the authors suggest describingthe junction between the bonded restoration and thetooth not as a "line of marginal adaptation" but as an"area of adhesive continuity" (AAC).

THE AC;C: A PARADIGM SHIFT FORINDIRECT BONDED RESTORATIONSResearch has shown that a marginal fit of approximate-ly 100 [jm is acceptable for most indirect procedures,^^and in vitro studies have obtained marginal fits of lessthan 100 (jm in controlled laboratory tests. '"^^ Intra-oral measurements of marginal adaptation are rare inthe denta literature; indeed, it is extremely difficult to

QDT2013

The Area of Adhesive Continuity: A New Concept for Bonded Ceramic Restorations

evaluate marginal adaptation intraorally. For example,it is challenging to directly measure around the entirecircumference of a crov\/n and precisely determine themean marginal fit. It is also impossible to evaluate allareas of an indirect restoration. However, it is possibleto evaluate select areas that will provide the best avail-able information.^^

When using a laminate veneer as an indirect resto-ration, the criteria for clinical longevity must includemarginal adaptation as one of the important param-eters for long-term success. Because CLVs involve aconservative and additive procedure, the veneer maynot have a well-defined finishing line; in other words,the transition between the CLV and tooth structureis totally different from the marginal adaptation of acrown. For veneers without preparation and partial ve-neers, the ceramist often leaves a slight overcontour tofacilitate proper insertion and positioning of the resto-ration. The overcontoured area is then removed onlyafter final bonding using specific ceramic-polishingwheels. In this manner, the AAC is created, forming ahybrid interface of different structures that have beenbonded together: the tooth (enamel or dentin), bond-ing system, resin cement, and ceramic.

Clinical Protocol

The clinical success of CLVs depends on four majorsfactors: enamel preservation, material selection (etch-able ceramic), the bonding procedure, and carefulocclusal adjustment.^^ To achieve excellence in all ofthese parameters, detailed treatment planning mustbe carried out, including the following:

1. Diagnostic digital photography protocol includingboth facial and intraoral views. These photographswill help to determine the extent of treatment, thenumber of teeth to be included, and whether peri-odontal plastic surgery is necessary.

2. Initial additive wax-up made on a cast obtained us-ing polyvinyl siloxane (PVS) impression material. Thewax-up will guide all esthetic treatments. "^

3. Treatment mock-up. In this phase, the patient anddental team determine realistic parameters for thefinal restoration. Any alterations must be done atthis stage.2^26

After the treatment plan is defined, the clinical pro-cedures must be carefully executed to preserve asmuch of the tooth structure as possible. Tooth prepara-tion should be kept mainly to enamel. Further, properimpression taking and provisionalization are essentialfrom a clinical perspective. The ceramic material canbe bonded to the tooth structure using resin cementor preheated composite resin.

Maintenance Protocol

Every dental material undergoes thermal variation, mas-ticatory loading, and contact with abrasive substancesthat may damage or alter the surface. For this reason, amaintenance program must be implemented.

As already mentioned, adhesive restorations gener-ally do not have a well-defined finishing line; rather,they have an AAC. This area is exposed to a variety ofharmful elements, including abrasion caused by tooth-brushing and eating. Chemical abrasion due to theconsumption of acidic beverages is particularly com-mon and may result in staining of the exposed resincement. Wear of the resin cement and consequentloss of material can lead to an unsupported ceramicmargin.^^ However, if a maintenance protocol is care-fully followed, it is possible to prevent these problemsor at least to detect them in their early stages. Suchdefects can then be resolved via finishing and polish-ing.^^^ When only the resin cement has been stained,it is possible to repair or even polish this superficialdefect in areas accessible for instrumentation. Indeed,CLVs usually provide easy access because they tend tobe conservative restorations with supragingival margins.In some cases, the margin of a CLV may be placedon dentin due to the presence of preexisting restora-tions or gingival recession. Clinicians should be awarethat placement of the restoration margin in this arearequires special care.

The clinical maintenance protocol should includethe following:

1. Careful evaluation of any preexisting restorations.Periapical radiographs may be useful in this stage.

2. Patient hygiene instruction and support. Bleachingtoothpastes should be avoided for patients withCLVs. Although there is a lack of scientific data onthis topic, many bleaching toothpastes appear to

QDT2013

SCOPINDEANDRADEETAL

be extremely abrasive and may remove the surfacepolish of the ceramic.

3. Occlusal maintenance at the end of treatment. Thecanirne anterior guidance must protect the anteriorsegment during lateral movements. For extensivemodifications, an occlusai guard can be deliveredon the day of final cementation.

4. Adjustments and repairs, as necessary. Small frac-tures and chipping may occur, and repair is moreconservative than replacement. The repair protocolis executed as follows: (T) medium-coarse diamondbur with water irrigation or air abrasion with alumi-num oxide particles at 40 psi (PrepStart H O, Dan-ville, San Ramon, California, USA), (2) light-curingblock-out resin (Ultradent, South Jordan, Utah, USA)may be used for enamel protection, (3) 9% hydro-fluoric acid for 20 seconds on ceramic surface tobe repaired (wash, dry, and remove the LC block-out resin), (4) 35% phosphoric acid for 60 secondson enamel and ceramic surfaces (wash, dry, applya silane-coupling agent for 2 minutes, and dry), (5)air-thinned hydrophobic adhesive (no photocuring),(6) composite resin (applied gently with a brush), (7)photocuring followed by application of glycerin jellyand light activation again to remove the oxygen in-hibited layer, and (8) polishing with ceramic and/orcomposite resin rubber wheels. If a large area is af-fected by fracture, a partial veneer can be placedover the veneer to avoid damage to the enamel.

The maintenance protocol should be explained tothe patient before treatment, and an agreement formshould be signed.

SEM ANALYSIS: CASE REPORTS

Clinicians have generally believed that a perfect indi-rect restoration should have almost no luting or cementline; however, when long-term crowns and veneers are

evaluated under SEM and measured in vivo, a differentscenario becomes evident. • '

SEM has been used for many years to analyze dentalstructures and materials. •• * SEM analysis can be usedto reveal surface details that would be almost impos-sible to detect using an optical microscope. In somecases, a minimum magnification of xlOO is necessaryto correctly evaluate the outcome of an adhesive res-toration. O1 course, this may not be feasible for everyclinical case. Nonetheless, the information collectedfrom a single image is valuable to better understandand predict novel adhesive bonding techniques.

For this analysis, several cases were evaluated. Allpatients analyzed had been wearing their CLVs formore than 5 years. Some patients were treated morethan 10 yea^s prior. The adhesive procedures were per-formed under a strict bonding protocol under magnifi-cation (X2.i)). All patients were included in a controlledmaintenance program every 6 months.

Select areas from each case were subjected to SEManalysis to help assess the CLV margins. For the SEMevaluation, a PVS impression was taken, and a replicaof each are:a of interest was created with an epoxyresin-basec material. The restoration margins of theepoxy resin die were sputter coated with gold (Balzers-SCD 050, Oerlikon Balzers, Balzers, Liechtenstein) for180 seconds at 40 mA and analyzed under SEM (LEO435 VP, LEO, Cambridge, England) at 20 kV by thesame operator.

All CLVs were made using the refractory die tech-nique with a high-content fluorapatite glass-ceramic(IPS d'Sign, Ivociar Vivadent, Schaan, Liechtenstein).For bonding, a light-curing resin cement (Variolink II,Ivociar Vivadent) was used in conjunction with a hy-drophobic adhesive (Heliobond, Ivociar Vivadent) forenamel or a hydrophilic adhesive (Single Bond, 3MESPE, St Paul, Minnesota, USA) for exposed dentin.Every case analyzed followed the clinical protocol de-scribed abc'Ve. Facial, extraoral, and intraoral photo-graphs were taken of all patients (Fig 1).

QDT2013


Figs 1 a to 11 Example of the photographic protocol used for all cases to document the preoperative situation (a, d to f),immediate posttreatment (b, g to i), ancJ long-term follow-up (c,j to I).

QDT 2013 mm

SCOPIN DE ANDRADE ET AL

CASE1

Fig 2a Intraoral view of the evaluated region.

Fig 2b Close-up view of the CLVs on the central incisors.

Fig 2c SEM image of the cervical area of the right central incisor (magnification x 18).

Fig 2d SEM image showing the AAC on the right central incisor (magnification x70). RC = resin cement.

Case 1

This case involved periodontal plastic surgery frommaxillary first molar to first molar and placement ofCLVs from maxillary second premolar to second pre-molar. The central incisors were selected for analysis.The restorations had been in situ for 7 years (Figs 2aand 2b).

Clinical analysis revealed a small pigmented marginin the mesial/cervical region of the right central incisor.This was likely caused by either adhesive failure or thepresence of an air bubble inside the resin cement. Insuch cases, the enamel finishing line usually preventstooth sensitivity.

It was possible to observe the AAC using SEM anal-ysis (Figs 2c and 2d). The resin cement appeared worndown without damage to the CLV.

QDT2013


CASE 2Fig 3a CLV on the right lateral incisor. Note the visiblydifferent texture of the restoration.

Fig 3b SEM photomicrograph shov\/ing the CLV in-terface (arrows) as seen in the area marked on Fig 3a(magnification x42).

Fig 3c SEM image showing the CLV interface (arrows)at higher magnification. Even at this magnification, itis possible to see a well-adapted AAC (magnificationXI65).

3a

Case 2

For this case, the treatment included periodontal plas-tic surgery from the maxillary right second molar to theleft first molar, placement of CLVs at the lateral incisorsand left first and second premolars, and placement ofpartial veneers at the right first and second premolars.The CLVs at the lateral incisors were selected for analy-sis. The restorations had been in situ for 7 years.

Clinical analysis revealed changes in texture andshade occurring at the midfacial surface of the CLV on

the right lateral incisor (Fig 3a). Surface irregularities atthe AAC were also evident (Fig 4a).

SEM analysis revealed a perfect and continuous mar-gin (Figs 3b and 3c). One possible explanation for thedifference between the clinical and SEM images is thatdebonding occurred after years of function, creatingthe interface separation seen clinically. At higher mag-nifications (Figs 4b and 4c), the restorations showed acontinuous margin, despite an area of resin cement abra-sion (no clinical relevance). A few areas showed someindentation marks, possibly due to finishing procedures.

QDT2013

SCOPINDEANDRADEETAL

Fig 4a CLV c n the left lateral incisor. Minor irregularitiesin the AAC can be observed.

Fig 4b The irregularities in the AAC become more evi-dent under S.EM (magnification X41).

Fig 4c SEM image showing the CLV interface (redarrows). Yellow arrows show the edges of the ceramicstructure. The area around the resin cement showsirregularities, possibly due to abrasion. The orangearrows show a possible scratch caused by the finishingprocedures (magnification X2O9). RC = resin cement;E = enamel.

4a

Case 3

CLVs were placed from maxillary canine to canine andmandibular canine to canine. The CLV on the maxillaryright canine was selected for analysis. This restorationreceived a partial veneer after fracture of the ceramicon the canine and lateral incisor due to an accident.

Clinical analysis revealed discrete marginal staining.The margin of the partial veneers was visible (Fig 5a).

SEM analysis revealed the presence of the AAC. Abetter view of the margin was achieved by using re-traction cord during tissue displacement (Figs 5b and5c). At higher magnification (Fig 5d), an area of abra-sion was evident; however, the AAC was still clinicallyacceptable. Figures 5e and 5f show the area where thepartial veneer was bonded to fix the CLV.

QDT2013


CASE 3

Fig 5a CLV on the right canine. Marginal staining is evident at the AAC.Fig 5b SEM image showing the AAC. The image was obtained with the help of retraction cord placed inthe sulcus (magnification X40).Fig 5c SEM image of the area marked in Fig 5b (magnification X61).Fig 5d The AAC clearly shows no signs of deep abrasion. It is possible to see the difference betweenthe three structures of the AAC: enamel, resin cement (RC), anci ceramic (magnification X75O).Fig 5e SEM image showing the interface between the CLV and partial veneer (arrows). Scratches on theceramic surface probably resulted from abrasion caused by toothpaste and food (magnification x40).Fig 5f SEM image showing the AAC in the repaired area (magnification X75O).

QDT2013

SCOPINDEANDRADEETAL

CASE 4

Fig 6a CLVs on the central incisors showing an excellent AAC.

Fig 6b SEM view showing the interface between the CLV and tooth structure on the central incisors. Note that theinterface is easier to detect under SEM than in the clinical image (magnification X25).

Fig 6c A crack was found on the CLV at the left central incisor (magnification X25).

Fig 6d Higher-magnification view of the crack (magnification X65O).

Case 4

This case involved periodontal plastic surgery andplacement of CLVs from maxillary second premolarto second premolar. The CLVs on the central incisors

and right first and second premolars were selected foranalysis.

Clinical analysis revealed a smooth surface at theAAC between the central incisors (Fig 6a). For themodified CLVs at the second premolars, no damage

QDT 2013


Fig 7a Occlusal view of the modified CLV on the right second premolar.

Fig 7b SEM image showing the AAC on the occlusal surface (magnification X25). RC = resin cement.

Fig 7c At higher magnification, the AAC shows an area of abrasion on the enamel, with no signs of leakage (magnifi-cation X55).

Fig 7d Additional magnification reveals minor irregularities or bubbles on the ceramic surface (magnification x150).RC = resin cement.

was evident despite the location of the margin in theocclusal area (Fig 7a).

SEM analysis of the central incisors revealed an AACwith no severe modifications (Fig 6b). A fissure wasfound in the CLV (Figs 6c and 6d), which did not causeany shade alterations. This finding is common for CLVs. '*

SEM analysis of the second premolars helped to eluci-date the behavior of the AAC when anterior canineguidance is provided and careful occlusal adjustmentsare made (Fig 7b). An area of enamel abrasion was ob-served (Figs 7c and 7d). The behavior of enamel andceramic seems to be similar.

QDT2013

SCOPINDEANDRADEETAL

CASE 5

Fig 8a CLVs on the central and lateral incisors.

Fig 8b SEM view of the area marked in Fig 8a. No fail-ures or bubbles are evident (magnification X25).

Fig 8c Higher magnification of the area marked in Fig8b. There are still no visible irregularities at the surfaceof the AAC (magnification X14O).

»il

Case 5

CLVs were placed from maxillary canine to canine, andpartial veneers were placed at the maxillary first andsecond premolars. The canines and left central incisorwere selected for analysis.

Clinical analysis of the left central incisor revealedstaining of the margin (Fig 8a). The canines showedclinically acceptable margins (Fig 9a).

SEM analysis of the central incisor showed an idealAAC (Figs 8b and 8c). Figures 9c to 9e show the SEMimages of the right canine. Chipping due to a fractureof the ceramic margin or an irregularity caused by fin-ishing procedures was observed. At the left canine,the margin of the CLV was visible (Figs 9f to 9h).

QDT2013


Fig 9a CLV on the right canine. The AAC is visible.

Fig 9b SEM image of the AAC further highlighting thesmooth surface of the ceramic (magnification X25).

Fig 9c SEM image of the mesial area (magnificationX25).

Fig 9d As seen under high magnification, it ispossible for the resin cement (RC) area to be greaterthan 100 pm without damaging the interface(magnification X12O).

QDT2013

SCOPINDEANDRADEETAL

Fig 9e SEM image showing minor chipping on the ceramic side of the AAC on the right canine (magnification X190).

Fig 9f SEM view of the left canine (magnification X25). Arrows show the area analyzed in Figs 9g and 9h.

Fig 9g The arrow shows a bubble on the resin cement. Circled area is shown at higher magnification in Fig 9h.(Magnification x25). RC = resin cement.

Fig 9h At high magnification, overcontouring of the resin cement (arrows) is evident (magnification X19O).

Fig 9i Artistic photography of the patient. Reprinted from Arquitetura do Sorriso (Quintessence Ed, Sao Paulo, Brazil,2012.)

^Q QDT2013


QDT 2013

SCDPIN DE ANDRADE ET AL

CASE 6

Fig 10a CLV on the left lateral incisor.

Fig 10b SEM image showing minor chipping at the CLV interface farrowsj (magnification X18).

Fig 10c The chipped area shows irregularities at the AAC (magnification X33).

Fig lOd At higher magnification, the ceramic surface reveals an irregular area likely caused by the finishing proce-dures (magnification x90).

Case 6

CLVs were placed on the maxillary lateral incisors andcanines. The lateral incisors were selected for analysis.

Clinical analysis revealed a clinically acceptable mar-gin at both the left lateral incisor (Fig 10a) and rightlateral incisor (Fig 1 la).

Using SEM, the ceramic surface of the left lateralincisor presented a marginal irregularity, possibly dueto finishing and/or polishing procedures (Figs 10b tolOd). The right lateral incisor showed minor chippingat the CLV margin (Figs 11 b to 11 d).

QDT2013


Fig 11a CLV on the right lateral incisor.

Fig l i b SEM image showing the AAC (magnification X18).

Fig 11c Clinically acceptable AAC with a measure of more than 100 (jm (magnification X22O). RC = resin cement.

Fig 11 d SEM image showing area of minor chipping (arrows) in the ceramic side of the AAC (magnification X37O).

CONCLUSIONS

The AAC is a new concept for the analysis of bondedrestorations. The AAC forms a hybrid interface of dif-ferent structures that have been bonded together; thetooth (enamel or dentin), bonding system, resin ce-

ment, and ceramic. This intricate interface highlightsthe need for clinicians to evaluate adhesive restorationsdifferently from conventional cemented restorations.Understanding the concept of the AAC is essential toimproving the longevity of bonded ceramic restorations.

QDT2013

SCOPINDEANDRADEETAL

ACKNOWLEDGMENTSThe authors wouid iike to express their gratitude to the Ateiie OralClinic team in Sao Pauio, Brazii. The artistic photography of the pa-tient on page 23 was taken by André Schiiiró for the book Arquite-tura do Sorrisso, pubiished in 2012 by Quintessence Ed, Sao Pauio,Brazil.

REFERENCES1. Fradeani MJ. Six-year foiiow-up with Empress veneers, int J

Periodontics Restorative Dent 1998;18:216-225.

2. Smales RJ, Etemadi S. Long-term survival of porcelain veneersusing two preparation designs: A retrospective study, int JProsthodont 2004;7:323-32ó.

3. Fradeani M, Redemagni M, Corrado iVl. Porcelain iaminate ve-neers: 6 to 12 year clinicai evaluation—A retrospective study. IntJ Periodontics Restorative Dent 2005;25:9-17.

4. Wiedhahn K, Kerschbaum T, Fasbinder DF Ciinicai iong-termresuits with 617 Cerec veneers: A nine-year report, int J ComputDent 2005;8:233-246.

5. Burke FJ, Lucarotti PS. Ten-year outcome of porceiain veneersplaced within the general dentai services in Engiand and Waies.J Dent 2009:37:31-38.

6. Beier US, Kapferer i, Burtscher D, Dumfahrt H. Clinical perfor-mance of porcelain iaminate veneers for up to 20 years. Int JProsthodont 2012;25:79-85.

7. Layton DM, Clarke M, Walton TR. A systematic review and me-ta-anaiysis of the survival of feldspathic porcelain veneers over5 and 10 years, in t j Prosthodont 2012)25:590-603.

8. Peumans M, De Munck J, Fieuws S, Lambrechts P, Vanherle G,Van Meerbeek B. A prospective ten-year clinicai triai of porce-iain veneers. J Adhes Dent 2004;6:65-76.

9. Petridis iHP Zekeridou A, Maiiiari M, Tortopidis D, Koidis P Sur-vival of ceramic veneers made of different materials after aminimum foiiow-up period of five years: A systematic reviewand meta-analysis. EurJ Esthet Dent 2012;7:138-152.

10. Bindl A, Mörmann WH. Ciinicai and SEM evaluation of aii-ce-ramic chair-side CAD/CAM-generated partial crowns. EurJ OraiSei 2003:111:163-169.

11. Sadowsky SJ. An overview of treatment considerations for es-thetic restorations: A review of the literature. J Prosthet Dent2006;96:433-442.

12. Aykor A, Ozel E. Five-year clinicai evaluation of 300 teeth re-stored with porcelain iaminate veneers using totai-etch andmodified self-etch adhesive system. Oper Dent 2009:34:516-523.

13. Federlin M, Schmidt S, Hiiier KA, Thonemann B, Schmalz G.Partial ceramic crowns: influence of preparation design and iut-ing material in internal adaptation. Oper Dent 2004;29:560-570.

14. Edeihoff D, Özcan M. To what extent does the longevity of fixeddental prostheses depend on the function of the cement?Working Group 4 materials: Cementation. Ciin Orai ImplantsRes 2007:18(suppi 3): 193-204.

15. Jacobs MS, Windeier AS. An investigation of dentai iuting ce-ment soiubiiity as a function of the marginal gap. J ProsthetDent 1991:65:436-442.

16. Kydd WL, Nichoils Jl, Harrington G, Freeman M. Marginal leak-age of cast goid crowns luted with zinc phosphate cement: invivo study. J Prosthet Dent 1996:75:9-13.

17. Yüksei E, Zaimoglu A. Infiuence of marginal fit and cementtypes on microieakage of all-ceramic crown systems. Braz OralRes 2012:25:261-266.

18. Massironi D, Pascetta R, Romeo G. Precision in Dentai Esthetics:Clinicai and Laboratory Procedures. Chicago: Quintessence, 2007.

19. Martignoni M, Shonenberger AJ. Precision Fixed Prosthodontics:Clinical and Laboratory Aspects. Chicago: Quintessence, 1990.

20. Edeihoff D, Sorensen JA. Tooth structure removal associatedwith various preparation designs for anterior teeth. J Prost Dent2002:87:503-509.

21. Scopin de Andrade O, Borges G, Stefani A, Fujiy F, Battisteila PA step-by-step ultraconsen/ative esthetic rehabilitation usinglithium disiiicate ceramic. Quintessence Dent Technoi 2010:33:114-131.

22. Scopin de Andrade O, Kina S, Hirata R. Concepts for an uitra-conservative approach to indirect anterior restorations. Quin-tessence Dent Technoi 2011:34:103-119.

23. Scopin de Andrade O, Romanini JC, Hirata R. Ultimate ceramicveneers: A laboratory-guided ultraconservative preparationconcept for maximum enamel preservation. Quintessence DentTechnoi 2012:34:29-43.

24. Magne P Beiser U. Bonded Porceiain Restorations in AnteriorDentition: A Biomimetic Approach. Chicago: Quintessence, 2002.

25. Gürei G. Predictabie, precise, and repeatable tooth preparationfor porcelain laminate veneers. Pract Proced Aesthet Dent2003:15:17-24.

26. Gurel G. The Science and Art of Porceiain Laminate Veneers.Chicago: Quintessence, 2003.

27. Peumans M, Van Meerbeek B, Yoshida Y, Lambrechts P Van-herle G. Porcelain veneers bonded to tooth structure: An uitra-morphological FE-SEM examination of the adhesive interface.Dental Mater 1999:15:105-119.

28. Wolfart S, Wegner SM, Al-Halabi A, Kern M. Clinical evaluationof marginal fit of a new experimental all-ceramic system beforeand after cementation, int J Prosthodont 2003:25:590-603.

29. Reich S, Gozdowski S, Trentzsch L, Frankenberger R, Lohbauer U.Marginal fit of heat-pressed vs CAD/CAM processed all-ceramiconiays using a miiiing unit prototype. Oper Dent 2008:33:644-650.

30. Tao J, Han D. The effect of finish iine curvature on marginal fit ofaii-ceramic CAD/CAM crowns and metal-ceramic crowns. Quin-tessence int 2009:40:745-752.

31. Grenade C, Mainjot A, Vanheusden A. Fit of single tooth zirco-nia copings: Comparison between various manufacturing pro-cesses. J Prosthet Dent 2011:105:249-255.

32. Krämer N, Taschner M, Lohbauer U, PetscheitA, Frankenberg R.Totally bonded ceramic inlays and onlays after eight years. JAdhes Dent 2008:10:307-314.

33. Beiser UC, MacEntee Ml, Richter WA. Fit of three porceiain-fused-to-metal marginal designs in vivo: A scanning electronmicroscopy study. J Prosthet Dent 1985:53:24-29.

34. Garcia-Godoy F, Krämer N, Feilzer AJ, Frankenberger R. Long-term degradation of enamel and dentin bonds: 6-years resuitsin vitro vs. in vivo. Dent Mater 2010:26:1113-1118.

35. de Andrade OS, de Goes MF, Montes MA. Marginal adaptationand microtensile bond strength of composite indirect restora-tions bonded to dentin treated with adhesive and iow-viscositycomposite. Dent Mater 2007;23:279-287.

36. Duarte S Jr, Phark JH, Blatz M, Sadan A. Ceramic systems: Anuitrastructural study. Quintessence Dent Technoi 2010:33:42-60.

QDT2013

Copyright of Quintessence of Dental Technology (QDT) is the property of QuintessencePublishing Company Inc. and its content may not be copied or emailed to multiple sites orposted to a listserv without the copyright holder's express written permission. However, usersmay print, download, or email articles for individual use.

93924791

Documents

Transcript of 93924791