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VOLUME 22 , ISSUE 8 ( August, 2021 ) > List of Articles

ORIGINAL RESEARCH

Effects of the Cervical Marginal Relocation Technique on the Marginal Adaptation of Lithium Disilicate CAD/CAM Ceramic Crowns on Premolars

Nasser M Alahmari, Hafiz A Adawi, Mohammed M Al Moaleem, Faris M Alqahtani, Fahad T Alshahrani, Thiyezen A Aldhelai

Keywords : Deep margin relocation, Deep proximal caries, Fracture forces, Lithium disilicate ceramic, Marginal integrity

Citation Information : Alahmari NM, Adawi HA, Moaleem MM, Alqahtani FM, Alshahrani FT, Aldhelai TA. Effects of the Cervical Marginal Relocation Technique on the Marginal Adaptation of Lithium Disilicate CAD/CAM Ceramic Crowns on Premolars. J Contemp Dent Pract 2021; 22 (8):900-906.

DOI: 10.5005/jp-journals-10024-3138

License: CC BY-NC 4.0

Published Online: 09-11-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Aim and objective: To evaluate the effect of cervical margin relocation (CMR) for crowns designed using CAD/CAM technology and fabricated from lithium disilicate (e.max, CAD) before and after aging; and to compare the fracture forces and failure type of the tested crowns. Materials and methods: Mesio-occluso-distal(MOD) cavities 1 mm above the cementoenamel junction(CEJ) were prepared on 40 maxillary first premolars. The teeth were divided into four groups. In group A, all cervical margins (CM) were located 1 mm above the CEJ. However, in both mesial and distal proximal boxes of groups B, C, and D, in addition to the MOD cavities, the CMs were extended 2 mm on both sides below the CEJ apically to simulate the CMR technique. In group B, the mesial and distal proximal boxes were filled with flowable composite, while for group C and group D, specimens were filled with composite resin fillings. To simulate the CMR technique, the cavities were filled with composite layers of 3 mm in two increments. Using the CAD/CAM system, 40 standard crowns were prepared on premolars, then cemented using a dual-curing adhesive cement. Assessments of the marginal integrity of interfaces of the proximal boxes of the cemented crowned teeth were recorded. Statistical differences between groups were analyzed using the ANOVA and Bonferroni's posthoc test. Results: The first null hypothesis was accepted since no statistically significant differences were found in marginal integrity before and after aging (p>0.05), while the second was partially rejected since different fractured force values were recorded and a significant difference was detected between group D and group B. The third hypothesis was rejected because the catastrophic fracture rate was the highest among the four groups. Conclusion: The implementation of CMR before and after aging had a good effect on the marginal integrity of CM relocation. The CMR technique with resin luting cement of lithium disilicate crowns is effective and recommended for the restoration in deep proximal boxes of premolars or posterior teeth. Clinical significance: CAD/CAM-generated e. max all-ceramic crowns with composite as the CMR enable the reconstruction of severely destroyed teeth irrespective of the position of the cavity margins.

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  1. Dietschi D, Spreafico R. Current clinical concepts for adhesive cementation of tooth-colored posterior restorations. Pract Periodontics Aesthet Dent 1998;10(1):47–54; quiz 6.
  2. Köken S, Juloski J, Ferrari M. Influence of cervical margin relocation and adhesive system on microleakage of indirect composite restorations. J Osseointegration 2019;11(1):21–28. DOI: 10.23805/JO.2019.11.01.04.
  3. Juloski J, KÖken S, Ferrari M. No correlation between two methodological approaches applied to evaluate cervical margin relocation. Dent Mater J 2020;39(4):624–632. DOI: 10.4012/dmj. 2018-410.
  4. Zaruba M, Göhring TN, Wegehaupt FJ, et al. Influence of a proximal margin elevation technique on marginal adaptation of ceramic inlays. Acta Odontol Scand 2013;71(2):317–324. DOI: 10.3109/00016357.2012.680905.
  5. Juloski J, Köken S, Ferrari M. Cervical margin relocation in indirect adhesive restorations: a literature review. J Prosthodont Res 2018;62(3):273–280. DOI: 10.1016/j.jpor.2017.09.005.
  6. Grubbs TD, Vargas M, Kolker J, et al. Efficacy of direct restorative materials in proximal box elevation on the margin quality and fracture resistance of molars restored with CAD/CAM onlays. Oper Dent 2020;45(1):52–61. DOI: 10.2341/18-098-L.
  7. Magne P, Harrington S, Spreafico RC. Deep margin elevation: a paradigm shift. Am J Esthet Dent 2012;2(2):86–96.
  8. Ferrari M, Koken S, Grandini S, et al. Influence of cervical margin relocation (CMR) on periodontal health: 12-month results of a controlled trial. J Dent 2018;69:70–76. DOI: 10.1016/j.jdent.2017.10.008.
  9. Zaruba M, Kasper R, Kazama R, et al. Marginal adaptation of ceramic and composite inlays in minimally invasive mod cavities. Clin Oral Investig 2014;18(2):579–587. DOI: 10.1007/s00784-013-0988-1.
  10. IPS e.max—All ceramic, all you need—clinical guide. In: Vivadent AI, editor. Liechtenstein; 2020.
  11. Brandt S, Winter A, Lauer HC, et al. IPS e.max for all-ceramic restorations: clinical survival and success rates of full-coverage crowns and fixed partial dentures. Materials (Basel, Switzerland) 2019;12(3):462. DOI: 10.3390/ma12030462.
  12. Yu T, Wang F, Liu Y, et al. Fracture behaviors of monolithic lithium disilicate ceramic crowns with different thicknesses. RSC Adv 2017;7(41):25542–25548. DOI:10.1039/C6RA28847B.
  13. Nazeer MR, Ghafoor R, Zafar K, et al. Full mouth functional and aesthetic rehabilitation of a patient affected with hypoplastic type of amelogenesis imperfecta. J Clin Exp Dent 2020;12(3):e310–e316. DOI: 10.4317/jced.56217.
  14. Kielbassa AM, Philipp F. Restoring proximal cavities of molars using the proximal box elevation technique: systematic review and report of a case. Quintessence Int 2015;46(9):751–764. DOI: 10.3290/j.qi.a34459.
  15. Bresser RA, Gerdolle D, van den Heijkant IA, et al. Up to 12 years clinical evaluation of 197 partial indirect restorations with deep margin elevation in the posterior region. J Dent 2019;91:103227. DOI: 10.1016/j.jdent.2019.103227.
  16. Sieper K, Wille S, Kern M. Fracture strength of lithium disilicate crowns compared to polymer-infiltrated ceramic-network and zirconia reinforced lithium silicate crowns. J Mech Behav BiomedMater 2017;74:342–348. DOI: 10.1016/j.jmbbm.2017.06.025.
  17. Chen SE, Park AC, Wang J, et al. Fracture resistance of various thickness e.max CAD lithium disilicate crowns cemented on different supporting substrates: an in vitro study. J Prothodont 2019;28(9):997–1004. DOI: 10.1111/jopr.13108.
  18. Ilgenstein I, Zitzmann NU, Bühler J, et al. Influence of proximal box elevation on the marginal quality and fracture behavior of root-filled molars restored with CAD/CAM ceramic or composite onlays. Clin Oral Investig 2015;19(5):1021–1028. DOI: 10.1007/s00784-014-1325-z.
  19. Frankenberger R, Hehn J, Hajtó J, et al. Effect of proximal box elevation with resin composite on marginal quality of ceramic inlays in vitro. Clin Oral Investig 2013;17(1):177–183. DOI: 10.1007/s00784-012-0677-5.
  20. Müller V, Friedl K-H, Friedl K, et al. Influence of proximal box elevation technique on marginal integrity of adhesively luted Cerec inlays. Clin Oral Investig 2017;21(2):607–612. DOI: 10.1007/s00784-016-1927-8.
  21. Roggendorf MJ, Kunzi B, Ebert J, et al. Seven- year clinical perfor-mance of CEREC-2 all-ceramic CAD/CAM restorations placed within deeply destroyed teeth. Clin Oral Investig 2012;16(5):1413–1424. DOI: 10.1007/s00784-011-0642-8.
  22. Spreafico R, Marchesi G, Turco G, et al. Evaluation of the in vitro effects of cervical marginal relocation using composite resins on the marginal quality of CAD/CAM crowns. J Adhes Dent 2016;18(4):355–362. DOI: 10.3290/j.jad.a36514.
  23. Jassim ZM, Majeed MA. Comparative evaluation of the fracture strength of monolithic crowns fabricated from different all-ceramic CAD/CAM materials (an in vitro study). Biomed Pharmacol J 2018;11(3). DOI: 10.13005/bpj/1538.
  24. Bankoğlu Güngör M, Karakoca Nemli S. Fracture resistance of CAD-CAM monolithic ceramic and veneered zirconia molar crowns after aging in a mastication simulator. J Prosthet Dent 2018;119(3):473–480. DOI: 10.1016/j.prosdent.2017.05.003.
  25. Shillingburg H, Hobo S, Whitsett L, et al. Fundamentals of fixed prosthodontics. 4th ed. Chicago, IL: Quintessence Publishing Co; 2012. 119–130: 48–51, 20, 39–42, 51–52 p.
  26. van Dijken JW, Kieri C, Carlén M. Longevity of extensive class II open-sandwich restorations with a resin-modified glass-ionomer cement. J Dent Res 1999;78(7):1319–1325. DOI: 10.1177/00220345990780070601.
  27. Vertolli TJ, Martinsen BD, Hanson CM, et al. Effect of deep margin elevation on CAD/CAM-fabricated ceramic inlays. Oper Dent 2020;45(6):608–617. DOI: 10.2341/18-315-L.
  28. Marchesi G, Spreafico R, Frassetto A, et al. Cervical margin-relocation of CAD/CAM lithium disilicate ceramic crown using resin-composite. Dent Mater 2014;30(Suppl. 1):e14. DOI: 10.1016/j.dental.2014.08.029.
  29. Federlin M, Hiller KA, Schmalz G. Effect of selective enamel etching on clinical performance of CAD/CAM partial ceramic crowns luted with a self-adhesive resin cement. Clin Oral Investig 2014;18(8):1975–1984. DOI: 10.1007/s00784-013-1173-2.
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