Microleakage of composite crowns luted on CAD/CAM-milled human molars: a new method for standardized in vitro tests

Clin Oral Investig. 2019 Feb;23(2):511-517. doi: 10.1007/s00784-018-2460-8. Epub 2018 Apr 24.

Abstract

Objectives: To investigate debonding of full crowns made of CAD/CAM composites, CAD/CAM technology was applied to manufacture standardized test abutments to increase the reproducibility of human teeth used in in vitro studies.

Materials and methods: A virtual test abutment and the corresponding virtual crown were designed and two STL data sets were generated. Sixty-four human third molars and CAD/CAM blocks were milled using a CNC machine. Crowns of four different composite blocks (Lava Ultimate (LU), Brilliant Crios (BC), Cerasmart (CS), Experimental (EX)) were adhesively bonded with their corresponding luting system (LU: Scotchbond Universal/RelyX Ultimate; BC: One Coat 7 Universal/DuoCem; CS: G-PremioBond/G-Cem LinkForce; EX: Experimental-Bond/Experimental-Luting-Cement). Half of the specimens were chemical-cured (CC) and the others were light-cured (LC). Afterwards, specimens were artificially aged in a chewing simulator (WL-tec, 1 million cycles, 50-500 N, 2 Hz, 37 °C). Finally, a dye penetration test was used to detect debonding. For inspection, the specimens were sliced, and penetration depth was measured with a digital microscope. Data were analyzed with the Mann-Whitney U test.

Results: No cases of total debonding were observed after cyclic loading. However, the LC specimens showed a significantly lower amount of leakage than the CC ones (p < 0.05). Furthermore, the CC specimens exhibited broad scattering. Only the LC-EX blocks showed no debonding. The CC-CS blocks showed the highest leakage and scattering of all tested specimens.

Conclusions: Natural human teeth can be manufactured by CAD/CAM technology in highly standardized test abutments for in vitro testing. For CAD/CAM composites, light curing should be performed.

Clinical relevance: The success of a restoration depends on the long-term sealing ability of the luting materials, which avoids debonding along with microleakage. For CAD/CAM composites, separate light curing of the adhesive and luting composite is highly recommended.

Keywords: Adhesive cementation; CAD/CAM; Composite; Debonding; Microleakage.

MeSH terms

  • Composite Resins / chemistry*
  • Computer-Aided Design
  • Crowns*
  • Dental Abutments
  • Dental Debonding
  • Dental Leakage / diagnosis*
  • Dental Restoration Failure
  • Dental Stress Analysis
  • Dentin-Bonding Agents / chemistry*
  • Humans
  • In Vitro Techniques / standards*
  • Light-Curing of Dental Adhesives
  • Materials Testing
  • Molar, Third
  • Reproducibility of Results
  • Surface Properties

Substances

  • Composite Resins
  • Dentin-Bonding Agents