In vitro retentive strength of zirconium oxide ceramic crowns using different luting agents.J Prosthet Dent. 2005 Jun; 93(6):551-8.JP
STATEMENT OF PROBLEM
In contrast to gold crowns, in vitro determination of the retentive strength of all-ceramic crowns is more difficult because components allowing connection to testing apparatus are not as easily integrated into the all-ceramic material. Nevertheless, retentive strength data are crucial for obtaining information about the potential clinical performance of luting cements for all-ceramic restorations. Therefore, a new in vitro model was necessary to evaluate the retentive strength of all-ceramic crowns.
The purpose of this in vitro study was to determine the retentive strength of 4 resin-cement systems, a compomer, a glass-ionomer cement, a resin-modified glass-ionomer cement, and a self-adhesive resin for luting zirconium oxide ceramic crowns.
MATERIAL AND METHODS
One-hundred-twenty extracted human teeth were randomly divided into 12 groups (n = 10) and prepared in a standardized manner (5-degree taper, 3-mm occlusogingival height). All-ceramic crowns (Lava) were fabricated in a standardized manner for each tooth. The following cements and corresponding bonding regimens were used to lute the crowns to the teeth according to manufacturers' recommendations: CO, Compolute/EBS Multi; CO/RT, Compolute/EBS Multi/Rocatec; CB, Superbond C and B; CB/RT, Superbond C and B/Rocatec; CB/PL, Superbond C&B/Porcelain Liner M; PA, Panavia F; DC, Dyract Cem Plus/Xeno III; CH/PL, Chemiace II/Porcelain Liner M; RL, RelyX Luting, K/C, Ketac Cem/Ketac Conditioner; K, Ketac Cem; and RU, RelyX Unicem. After thermal cycling (5000 cycles, 5 degrees C-55 degrees C), the outer surfaces of the cemented zirconium oxide ceramic crowns were treated (Rocatec) to improve bonding and then placed into a low-shrinkage epoxy resin block (Paladur). The block/crown and tooth components for each specimen were connected to opposing ends of a universal testing machine so that crown retention could be measured. Crowns were removed from teeth along their path of insertion. The retentive surface area (mm 2) was determined individually for each tooth. Statistical analyses were performed using the Wilcoxon exact test, (alpha =.05) and a Bonferroni correction (alpha =.001).
The median (minimum/maximum) retentive strength values (MPa) were as follows: CO, 1.7 (0.6/4.3); CO/RT, 3.0 (1.3/5.4); CB, 4.8 (3.7/7.9); CB/RT, 8.1 (4.2/12.7); CB/PL, 5.3 (3.7/10.2); PA, 4.0 (3.3/5.1); DC, 3.3 (2.1/5.6); CH/PL, 4.0 (1.3/6.3); RL, 4.7 (2.8/6.6); K/C, 1.8 (0.6/2.3); K, 1.9 (0.2/4.5); and RU, 4.8 (2.5/6.7). Superbond C&B (+ Rocatec) specimens showed the highest median retentive strength, but were not significantly different from Superbond C&B without Rocatec pretreatment of the all-ceramic crown's inner surface. Compolute specimens also did not benefit significantly from the Rocatec pretreatment. Within the materials used without pretreatment of the ceramic, Superbond C&B, Panavia, Dyract Cem Plus, RelyX Luting, and RelyX Unicem showed the highest median retentive strength values and were not significantly different.
Within the conditions of this study, the compomer-cement, the resin-modified glass-ionomer cement, and the self-adhesive resin luting agent had the same level of retentive quality as the resin luting agents, Superbond C&B, and Panavia. Rocatec pretreatment of the ceramic surface did not improve the retentive strengths of Compolute and Superbond C&B.