79
FUNDAMENTAL
RESEARCH
Volume 34, Number 1, 2021
Correspondence to:
Dr Sven Mühlemann
University of Zurich, Center
of Dental Medicine, Clinic of
Reconstructive Dentistry
Plattenstrasse 1,
CH-8032 Zurich, Switzerland
Fax: +41 44 634 34 54
Email: sven.muehlemann
@zzm.uzh.ch
Submitted March 24, 2020;
accepted July 1, 2020.
©2021 by Quintessence
Publishing Co Inc.
Purpose: To measure the effect of simulated aging on stained resin-ceramic CAD/CAM materials regarding
the durability of color and gloss. Materials and Methods: Test specimens (n = 15 per material) were prepared
out of CAD/CAM ingots from two resin nanoceramics (Lava Ultimate [LVU], Cerasmart [CER]) and a polymer-
infltrated ceramic (ENA, VITA Enamic) stained with the manufacturer’s recommended staining kit using
photopolymerization. Control specimens were made of feldspathic ceramic (VITA Mark II [VM2]) and stained
by means of ceramic fring. Negative control specimens (n = 15) (no staining) were prepared for each group.
Color and gloss measurements were performed before and after each aging cycle by means of mechanical
abrasion with a toothbrush. Groups were compared using Kruskal-Wallis test and paired post hoc Conover
test. Changes within a group were calculated using Wilcoxon signed-rank test (α = .05). Results: The color
difference (∆E) was statistically signifcant for all stained CAD/CAM materials after simulated aging: CER (P <
.001, 95% CI: 2.96 to 3.69), LVU (P = .004, 95% CI: 1.09 to 1.46), ENA (P = .004, 95% CI: 0.20 to 0.42), and
VM2 (P < .001, 95% CI: 0.29 to 1.08). Aging resulted in a statistically signifcant increase in gloss in the LVU
group (P < 0.001, 95% CI: 13.78 to 17.29), whereas in the ENA (P < .001, 95% CI: 7.83 to 12.72), CER (P <
.001, 95% CI: 2.69 to 8.44), and VM2 (P = .014, 95% CI: 0.22 to 1.87) groups, a signifcant decrease in gloss
was noted. Conclusion: Color and gloss of stained resin-ceramic CAD/CAM materials changed signifcantly
after aging by means of toothbrush abrasion in vitro. Int J Prosthodont 2021;34:79–87. doi: 10.11607/ijp.7019
Change in Color and Gloss Parameters of
Stained Monolithic Resin-Ceramic CAD/CAM
Materials After Simulated Aging:
An In Vitro Study
Sven Mühlemann, PD Dr Med Dent
Sofia Stromeyer, Med Dent
Alexis Ioannidis, Dr Med Dent
Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Thomas Attin, Prof Dr Med Dent
Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich,
Switzerland.
Christoph HF Hämmerle, Prof Dr
Mutlu Özcan, Prof Dr, PhD
Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
T
he esthetic success of an indirect restoration represents a signifcant challenge in
reconstructive dentistry, as the color and surface quality of a restoration should
ideally match the optical properties of the neighboring dentition. Today, a variety
of reconstructive materials are available depending on the amount of tooth substance
that needs to be replaced and the design of the restoration.
1
Traditionally, all-ceramic restorations are designed with a combination of two lay-
ers of ceramic material, including a core material and a veneer layer. The core and
ceramic veneer materials are available in a wide range of colors and different grades
of translucencies, infuencing the esthetic outcome of a restoration.
2,3
Dental techni-
cians face a challenge when selecting the correct material to achieve an optimal color
match of the restoration with the natural tooth.
4–6
Additionally, it is a time-consuming
fabrication process. CAD/CAM technologies have increased time effciency for the
processing of ceramic materials.
7,8
At the same time, this technology has enabled the chairside fabrication of indirect
monolithic restorations. These monochromatic ceramic or resin-ceramic restorations,
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