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  • Title: Effect of cementation and aging on the marginal fit of veneered and monolithic zirconia and metal-ceramic CAD-CAM crowns.
    Author: Del Piñal M, Lopez-Suarez C, Bartolome JF, Volpato CA, Suarez MJ.
    Journal: J Prosthet Dent; 2021 Feb; 125(2):323.e1-323.e7. PubMed ID: 33176924.
    Abstract:
    STATEMENT OF PROBLEM: Marginal fit of zirconia restorations is an important criterion for their long-term success. However, in spite of the wide use of zirconia in dentistry, the relationship between marginal fit and low-temperature degradation from aging is unclear. PURPOSE: The purpose of this in vitro study was to compare the marginal adaptation of veneered and monolithic zirconia and metal-ceramic computer-aided design and computer-aided manufacturing (CAD-CAM) crowns before and after cementation and to evaluate the influence of artificial aging on the adaptation of zirconia crowns. MATERIAL AND METHODS: Seventy-two standardized dies were prepared to receive a posterior crown and randomly divided into 6 groups (n=12) as per the material and the presence or not of cement: metal-ceramic, veneered zirconia, and monolithic zirconia. The zirconia groups were subjected to accelerated low-temperature degradation through hydrothermal aging in an autoclave at 131 °C and 0.17 MPa for 5 and 20 hours. A scanning electron microscope with a magnification of ×1000 was used for marginal adaptation measurements, and X-ray diffraction (XRD) was used to characterize phase transformation degradation. The data were statistically analyzed using 2-way ANOVA, repeated measures ANOVA with Greenhouse-Geisser correction, and the t test (α=.05). RESULTS: No significant differences in the marginal discrepancy were recorded among the analyzed groups. The presence of cement did not influence marginal fit in any treatment group. No significant differences were observed in the marginal adaptation values before and after aging (P>.05). After 20 hours of aging, the monoclinic phase increase to 8.3% on veneered zirconia and to 3.1% on monolithic crowns. CONCLUSIONS: Monolithic and bilayer CAD-CAM zirconia crowns showed marginal gaps that were within an acceptable range of clinical discrepancy, regardless of cementation. Marginal adaptation was not influenced by aging. Low-temperature degradation did not lead to a significant transformation from the tetragonal to monoclinic phase.
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