SECTIONEDITORS

ison of the marginal fit of various ceramic crown

Matty F. Abbate, D.D.S.,* Anthony H. L. Tjan, Dr. Dent., D.D.S.,** and

Willis M. Fox, D.D.S.*
LomaLinda University, Schoolof Dentistry, LomaLinda, Calif.

This study evaluated the marginal fit of four ceramic crown systems, (1) metal
ceramic crowns with a metal margin, (2) metal ceramic crowns with a porcelain
facial margin, (3) Cerestore crowns, and (4) Dicor crowns. Measurements of the
marginal adaptation were recorded from the facial and lingual margins by using a
video-enhanced microscope with digital micrometer and image intensification in a
high resolution television screen. Results indicate that all four crown systems
yielded comparable and acceptable marginal fit. (J PROSTHET DENT 1989;61:527-31.)

T he marginal fit of artificial crownshasbeenthe fo- MATERIAL AND METHODS

cus of various investigations.l-l1 The fit and distortion of
metal ceramiccrowns,including the effectsof repeatedfiring
and various marginal designs, have been intensely
scrutinized.3p*+9,lo, 12-15A well-fitting crown reduces the
chancefor recurrent cariesand periodontal disease,whereas
the spacebetweena poorly-fitting artificial crown and tooth
preparation enables accumulation of bacterial plaque.
Waerhaug16and Loe17reported that plaque accumulatedin
this spaceis responsiblefor inflammation of the periodontal
tissues.
All-ceramic crowns have been developed recently in re-
sponseto specificand demandingesthetic expectations.Two
.of the more popular are the Cerestorecrown with a shrink-
free aluminum ceramic core (Johnson & Johnson, East
Windsor, N.J.) and the Dicer crown, made from castable
glass ceramic (Dentsply International, York, Pa.). The
appearanceof the newceramiccrownsis greatly enhancedby
elimination of metal substructure and they are stronger and
better fitting than feldspathic porcelain jacket crowns. Be-
causeof the predictable dimensionalstability of aluminum-
oxide core materials, the marginal adaptation of the Cere-
store crown was reported as similiar to metal ceramic
crowns.2Lugassyet al.l8 also noted that Dicer crowns have
excellent marginal fit.
This study comparedthe marginal fit of (1) metal ceramic
crowns with a metal-butt facial margin, (2) metal ceramic
crowns with a porcelain-butt facial margin, (3) Cerestore
crowns, and (4) Dicer crowns.
Presentedat the annualmeetingof the A.mericanAcademyof Re-
storativeDentistry, Chicago,Ill.
Supportedby Johnson& Johnsonand LomaLinda University.
*AssistantProfessor,Departmentof RestorativeDentistry.
**Professor and Director Biomaterials
Restorative Dentistry.
Tooth preparations. Two tooth-preparations were de-
signed;one for the metal ceramiccrownsand another for the
all-ceramic Cerestoreand Dicer crowns.The tooth prepara-
tion for the metal ceramiccrownswasdesignedwith a 1.3mm
slanted margin with approximately 120-degreeslope and a
lingual chamfer. The margins for the all-ceramic crowns
were a 120-degreeshoulderwith rounded axio-gingival-line
angleapproximately 1.3 mm in width. The preparations had
an axial taper of 5 degreesand were 5 mm high. Master
preparations were madefrom compositeresin tooth analogs
(Ivorine teeth, Viade Corp., Camarillo, Calif.) and replicated
by the manufacturer (Fig. 1).
Forty tooth-preparation analogs,20 for eachpreparation,
were divided into experimental groups,of 10 as follows.
Group 1: Metal ceramic crowns with a metal-butt facial
margin
Group 2: Metal ceramic crowns with a porcelain-butt fa-
cial margin
Group 3: Cerestorecrowns
Group 4: Dicer crowns
Diepreparation. Groups of four tooth-preparation an-
alogs,two for metal ceramic crowns and two for all-ceramic
crowns,weremounted on a jig. Customimpressiontrays with
a 2 mm relief were madefrom autopolymerizing acrylic resin
(Blue Tray, Bosworth Co., Skokie, Ill.). Impressionswere
made with an addition-type silicone material (Permagum,
ESPE Premier SalesCorp., Norristown, Pa.) and poured 1
hour after setting. Groups 1,2, and 4 werepoured in die stone
(Superstone, Sybron/Kerr, Romulus, Mich.). For group 3,
the Cerestorecrowns,the impressionswere poured in epoxy
die material (Johnson& Johnson).A Dicer die spacer(batch
No. 052085,Dentsply International) was used to coat the
stone dies of groups 1, 2, and 4. For group 3 the die spacer
Research, Department of provided by the manufacturer (Johnson& Johnson)wasap-
plied according to instructions.

THE JOURNAL OF PROSTHETIC DENTISTRY 527

 ABBATE, TJAN, AND FOX

Fig. 1. A, Tooth preparation for metal ceramic crown (left) and preparation for all-ce-
ramic crown (right). B, Proximal views of four ceramic crowns seated on their preparations:
(A) metal ceramic crown with metal-butt facial margin; (B) metal ceramic crown with por-
celain-butt margin; (C) Cerestore crown; (0) Dicer crown.

Crown fabrication. The metal ceramic crowns for
groups 1 and 2 were made with type III ceramic gold
(Williams Gold, Buffalo, N.Y.) and Vita porcelain (Vita
Zahnfabrik, Sackingen, Germany). The facial porcelain-butt
margin in group 2 was made by using a lift-off technique de-
scribed by Vyronis.ig The Cerestore and Dicer crowns were
made in accordance with manufacturer’s specifications.
Cementation of crowns. The 40 crowns were cemented
on their respective composite resin analog preparations with
a zinc-phosphate cement (batch No. AN121085, Ames,
Teledyne-Getz, Elk Grove, Ill.). A controlled technique was
used to standardize the cement mixtures at a ratio of 1.3 gm
powder to 0.5 ml liquid. A precision scale was used to pro-
portion the cement powder, and a 1 ml tuberculin-test
syringe for dispensing the liquid. Each mixture was spatu-
lated for 40 seconds. The internal surface of the crown was
coated evenly with the cement mix, seated on the composite
resin tooth analog with finger pressure, and sustained under
a static load of 5 kgf for 10 minutes.
i%feasurement of the mbrginal opening. The ce-
mented crowns were embedded individually in phenolic
rings with epoxy resin (Buehler Ltd., Lake Bluff, Ill.) and
sectionedbuccolingually into three slices.Both of the cuts
were made approximately 1 mm from the midplane, pro-
ducing a center slice 2 mm thick (Fig. 2) that was not used
further in the study. The cut surfacesof the outer two sec-
tions were sequentially finished by using silicone-carbide
abrasive papers 320 to 600 grit size on a Handimet grinder
(Buehler Ltd.).
The cement thicknessesat the marginal openings were
measuredby using a video-enhancedmeasuringmicroscope
with digital micrometer and imageintensification on a high-

528 MAY 1989 VOLUME 61 NUMBER 5

COMPARISON OF MARGINAL FIT

Fig. 2. Cemented crowns sectioned buccolingually near midplane.

FACIAL LINGUAL

.- ‘-CEMENTED
/ CROWN

\ CEMENT

. TOOTH
+

Fig. 3. Measurement sites 100, 200, and 300 pm from finished margin.

resolution television screen(Mitutoyo, Tokyo, Japan). The
measurementswere recorded from the facial and lingual
margins of the two finished surfacesof each sectionedspec-
imen at three predetermined reference points 100,200, and
300pm from the actual finish margin (Fig. 3). Thesepoints
were selected to avoid magnifying the marginal discrepan-
cies resulting from an occasionaldefect at the margin.
Discrepancy values were computed as averages of the
measurementsobtained. The discrepancy value of the facial
margin for eachtooth wasthe averageof six measurements
from two facial locations of the sectioned specimen.The
discrepancy value of the lingual margin for each tooth was
the averageof six measurementsfrom two lingual locations.
The overall discrepancy value of a crown was the mean of
both facial and lingual marginal discrepancies.The marginal
discrepancy values of the 10 teeth in each group were aver-
aged for a marginal discrepancy value of the entire group.
The data were analyzed with a one-way analysis of
variance.
RESULTS
The four crown systemsyielded comparablemarginal fit.
They demonstrated marginal openingsin the range of 56 to
81 pm. Cerestorecrownshad the lowest marginal discrepan-
ciesand Dicer crownshad the greatest. However, statistical
analysis indicated no significant difference in marginal fit
among the four crown systems. The raw data, arithmetic
means,and standard deviations of the marginal discrepancy

TEfE JOURNAL OF PROSTHETIC DENTISTRY 529

 ABBATE, TJAN, AND FOX

FACIAL q
LINGUAL

OVERALL0

PFM PFM-P CERESTORE DICOR

Fig. 4. Fa ciaII, lingual, and overall marginal discrepancies.

Table I. Raw data, mean, and standard deviation of Table II. Analysis of variance
marginal discrepancy in Mm (10e3 mm)
sum
Group of Variance
squares DF estimate F P
1 2 3 4
Total 18043.5 39
44 35 39 47 Between groups 2480.1 3 826.1 1.91 >0.05
52 95 76 80 Within groups 15563.4 36 432.32
41 103 40 60 Critical region is F 2 2.86 for 5% significance level.
33 52 45 66 Difference between groups is not significant.
59 67 45 14
127 33 35 89
69 43 42 57 1000 restorations over a 5-year period, concluded that 120
47 43 34 30 Mm represented the maximum clinically acceptable marginal
69 52 47 71 opening. Our data indicated that all four ceramic crown sys-
65 41 38 79 tems were acceptable.
Mean 60.6 57.0 44.1 65.3 Cracks were observed in the all-ceramic crowns in this
SD 26.4 24.2 12.0 17.5 study. A crescent-shaped fracture was noted on three of the
Group 1, Metal ceramic crowns with metal-butt margins; group 2, metal ce- Dicer crowns during cementation with a static load of 5 kgf.
ramic crowns with porcelain-butt margins; group 3, &restore crowns; group This followed a specific pattern and occurred at the lingual
4, Dicer crowns. surface with thinner ceramic. It was continuous, involving
both medial and distal transitional line angles joined by a
values are listed in Table I. The facial, lingual, and overall horizontal occluso-axial crack. In a few Cerestore crowns,
marginal discrepancies are illustrated graphically in Fig. 4. incomplete longitudinal cracks were observed at the mar-
One-way analysis of variance of the data is presented in Ta- gins.
ble II. In clinical conditions, a complete breakage of cracked all-
ceramic crowns can occur after a short period because of the
DISCUSSION stress imposed during mastication. The cracks may occur in
The discrepancy values, derived from averages of multiple obscure proximal or lingual surfaces and remain undetected.
measurements made at locations slightly removed from the Because of the potential for cracks noted under laboratory
actual margin, are considered representations of the various conditons, gentle application of a low load is mandatory
groups. Cerestore crowns produced the lowest marginal clinically in cementing all-ceramic crowns.
opening and Dicer crowns the greatest, but the differences Incorporation of an internal escape channel as described
were not statistically significant. by Tjan et a1.21-24or increasing the convergence angle of the
McLean and Von Fraunhofer,20 in their clinical study of preparation would facilitate the flow of cement. This would
530 MAY 1989 VOLUME 61 NUMBER 5
COMPARISONOFMARGINALFIT

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A new device to directly examine parallelism of abutment

teeth
S. I. Vitsentzos, D.D.S., Dr. Dent.*
University of Thesaaloniki, School of Dentistry, Thessaloniki, Greece

The path of insertion is essential for the successful seating of ftxed partial den-
tures. A new device is described that directly examines the parallelism of the axial
walls of the abutment teeth. It can also be used to create guiding planes for
abutment teeth of removable partial dentures and determine the path of insertion
of a Maryland Bridge fixed partial denture. The various parts of this device, its
principle of operation, the results of its use, and advantages in relation to similar
devices are presented. (J PROSTRET DENT 1989$1:691-4.)

T
he parallelism of the axial walls of abutment teeth by the anglebetweenthe horizontal plane through the teeth
is fundamental for the accurate placement of a fixed partial and the plane tangent to the axial wall of the abutment teeth.
denture (FPD). The path of insertion of an FPD is expressed When the abutment teeth do not have a particular incli-
nation, the path of insertion of the FPD is approximately 90
degrees. When an abutment tooth is inclined mesially,
‘Assistant Professor, Department of Fixed Prosthesis. removal of an inordinate amount of tooth substance can
THEJOURNALOFPROSTHETICDENTISTRY 531