Professional Documents
Culture Documents
clinical report
Mutlu Özcan, DMDa
Faculty of Dentistry, Marmara University, Istanbul, Turkey
This article describes an alternative approach to conditioning an alloy surface prior to veneering with
composite. The procedure is based on silica coating and silanization of the alloy surface, which can be
performed chairside. (J Prosthet Dent 2002;87:469-72.)
A B
Fig. 1. A, Prepared fracture surface on metal-ceramic crown on maxillary right central incisor
of extensive FPD. B, Satisfactory appearance of repaired restoration.
materials.30 Various techniques have been proposed to used because of possible water or oil contamination.
overcome esthetic problems, including firing opaque Opaquer is dispensed, mixed with a plastic spatula, and
porcelain over metal posts and cores,31 using zirconi- painted on the silanized surface to mask the underly-
um dioxide ceramic post-and-core systems,32-36 and ing metal. It is then polymerized from each 3 different
using fiber-reinforced posts.37 However, if a cast core directions for 40 seconds (Optilux 401; Demetron
exists under a restoration, replacement with an all- Research, Danbury, Conn.).
ceramic post may generate other problems during The ceramic surface is treated with a thin layer of
removal.38 In addition, new cast cores require further unfilled resin monomer (Visio-Bond; ESPE) and poly-
laboratory work, which incurs additional costs. merized for 20 seconds. Subsequently, composite
(Sinfony; ESPE) is applied with incremental build-up
Esthetic improvement of cobalt-chromium
and polymerized from 3 different directions. The man-
clasps by veneering
ufacturer’s recommended polymerization times should
The visibility of a removable partial denture clasp is be followed strictly. After the rubber dam is removed,
frequently unavoidable when it is located in the ante- occlusal adjustment should be performed when neces-
rior region of the mouth. Such clasps may create an sary. The surfaces can then be finished with carbide
esthetic problem for the patient. Trials in veneering and extra-fine diamond burs (Tc-b; Intensiv SA,
clasps with the use of acrylic or composite have not Lugano, Switzerland) or stones and polished with a
proven successful because the veneer does not last long diamond paste.
with constant flexing of the retentive arm.39
CLINICAL REPORT
Application of silica coating
Three patient treatments that illustrate the chairside
The following clinical steps are followed during use of silica coating are presented. The first patient was
the application of silica coating. After the appropriate a 45-year-old woman with an adhesive failure
color for a fracture situation or cast core coating has (Fig. 1, A) and metal exposure on a maxillary right
been determined, the area is isolated with a rubber central incisor in a 4-year-old FPD. She was referred
dam. Patients and staff need to wear protective eye- by a private practitioner who had made 3 attempts to
glasses and masks. Strong evacuation for CoJet-Sand repair the fracture with hydrofluoric acid; none of the
and saliva is required. Based on the optimal results of repairs lasted for more than 2 weeks. After the work-
a pilot study,40 an airborne particle abrasion device ing area was isolated with a rubber dam, the repair
(Danville Engineering, San Ramon, Calif.) should be process was performed with the CoJet system and
employed, with a nozzle distance of approximately Sinfony composite. Esthetically satisfactory results
10 mm from the metal-ceramic surface, at an angle of were obtained after the repair (Fig. 1, B), which has
90 degrees for 13 seconds at 2.3 bar pressure. lasted 1 year to date.
Silicated particles (CoJet-Sand, SiO x, 30 µm) are The second patient was a 30-year-old man with
used. concerns about the unesthetic appearance of a metal-
The conditioned surfaces are silanized with ceramic crown (made 1 year previously) with a cast
3-methoxysilpropylmethacrylate silane (ESPE-Sil; core on the maxillary left lateral incisor. A decision was
ESPE) and allowed to dry for 5 minutes before opa- made to replace the crown with an all-ceramic restora-
quer is applied. An air-water syringe should not be tion (Empress II; Ivoclar, Schaan, Liechtenstein).
A B
Fig. 2. A, Light-polymerized opaquer on silica-coated and silanized post core. B, Labial view
of all-ceramic crown cemented on cast core with no reflection of metal.
A B
Fig. 3. A, Removable partial denture in situ. Note, patient complained of esthetics of clasp on
maxillary left canine. B, Labial view of coated clasp 3 months later.
SUMMARY
Radiographic evaluations were made to ensure that the
root canal therapy was adequate. The coating process This article described the use of a silica coating
was performed with the CoJet system, and the surface technique to repair ceramic fractures, avoid cast core
was silanized before Sinfony opaquer was applied reflection under all-ceramic restorations, and improve
(shade A2) (Fig. 2, A). The all-ceramic crown was the esthetics of cobalt-chromium clasps by veneering.
cemented with a light-polymerizing luting agent Special thanks are due to ESPE (Seefeld, Germany) for its gener-
(Variolink II; Vivadent, Schaan, Liechtenstein) in ous donation of materials and to Dr Ibrahim Alkan for his
accordance with the manufacturer’s instructions. contribution to the treatment of the second patient described in this
Esthetic results were excellent with the use of these report.
materials (Fig. 2, B). The restoration has been in place
for 1.5 years. REFERENCES
The third patient was a 40-year-old woman with a 1. Ibsen RL. Fixed prosthetics with a natural crown pontic using an adhe-
cast clasp-type maxillary removable partial denture. sive composite. Case history. J South Calif Dent Assoc 1973;41:100-2.
2. Rochette AL. Attachment of a splint to enamel of lower anterior teeth. J
She was concerned about the esthetic display of the Prosthet Dent 1973;30:418-23.
clasp on the maxillary left canine (Fig. 3, A). Before 3. Livaditis GJ, Thompson VP. Etched castings: an improved retentive mech-
any attempt was made to coat the clasp, its stability anism for resin-bonded retainers. J Prosthet Dent 1982;47:52-8.
4. Livaditis GJ. A chemical etching system for creating micromechanical
and easy removal from the undercut areas without retention in resin-bonded retainers. J Prosthet Dent 1986;56:181-8.
interruption were ensured. The coating and veneer- 5. Livaditis GJ, Tate DL. Gold-plating etched-metal surfaces of resin-bond-
ing process were performed chairside with the CoJet ed retainers. J Prosthet Dent 1988;59:153-8.
6. Hansson O. The Silicoater technique for resin-bonded prostheses: clini-
system and Sinfony opaquer (shade A2) and com- cal and laboratory procedures. Quintessence Int 1989;20:85-99.
posite (Fig. 3, B). The veneer has been intact for 1 7. Eames WB, Rogers LB, Feller PR, Price WR. Bonding agents for repairing
year. porcelain and gold: an evaluation Oper Dent 1977;2:118-24.
8. Ishijima T, Caputo AA, Mito R. Adhesion of resin to casting alloys. J of all-ceramic restorations. Pract Periodontics Aesthet Dent 1997;9:567-
Prosthet Dent 1992;67:445-9. 74.
9. van der Veen JH, Jongebloed WL, Dijk F. SEM study of six retention sys- 31. Freilich S, Goodacre CJ. Eliminating coronal discoloration when cement-
tems for resin-to-metal bonding. Dent Mater 1988;4:266-71. ing all-ceramic restorations over metal posts and cores. J Prosthet Dent
10. Smith GA, McInnes-Ledoux P, Ledoux WR, Weinberg R. Orthodontic 1992;67:567-74; quiz 576.
bonding to porcelain-bond strength and refinishing. Am J Orthod 32. Ahmad I. Yttrium-partially stabilized zirconium dioxide posts: an
Dentofacial Orthop 1988;94:245-52. approach to restoring coronally compromised nonvital teeth. Int J
11. Chang JC, Powers JM, Hart D. Bond strength of composite to alloy treat- Periodontics Restorative Dent 1998;18:454-65.
ed with bonding systems. J Prosthodont 1993;2:110-4. 33. Kakehashi Y, Luthy H, Naef R, Wohlwend A, Scharer P. A new all-ceram-
12. Peutzfeldt A, Asmussen E. Silicoating. Evaluation of a new method of ic post and core system: clinical, technical, and in vitro results. Int J
bonding composite resin to metal. Scand J Dent Res 1988;96:171-6. Periodontics Restorative Dent 1998;18:586-93.
13. Hansson O, Moberg LE. Evaluation of three silicoating methods for resin- 34. Zalkind M, Hochman N. Esthetic considerations in restoring endodonti-
bonded prosthesis. Scand J Dent Res 1993;101:243-51. cally treated teeth with posts and cores. J Prosthet Dent 1998;79:702-5.
14. Özcan M, Pfeiffer P, Nergiz I. A brief history and current status of metal- 35. Hochman N, Zalkind M. New all-ceramic indirect post-and-core system.
and ceramic surface-conditioning concepts for resin bonding in J Prosthet Dent 1999;81:625-9.
dentistry. Quintessence Int 1998;29:713-24. 36. Koutayas SO, Kern M. All-ceramic posts and cores: the state of the art.
15. Caeg C, Leinfelder KF, Lacefield WR, Bell W. Effectiveness of a method Quintessence Int 1999;30:383-92.
used in bonding resins to metal. J Prosthet Dent 1990;64:37-41. 37. Rosentritt M, Furer C, Behr M, Lang R, Handel G. Comparison of in vitro
16. May KB, Fox J, Razzoog ME, Lang BR. Silane to enhance the bond fracture strength of metallic and tooth-coloured posts and cores. J Oral
between polymethyl methacrylate and titanium. J Prosthet Dent Rehabil 2000;27:595-601.
1995;73:428-31. 38. Asmussen E, Peutzfeldt A, Heitmann T. Stiffness, elastic limit, and
17. Creugers NH, Welle PR, Vrijhoef MM. Four bonding systems for resin- strength of newer types of endodontic posts. J Dent 1999;27:275-8.
retained cast metal prostheses. Dent Mater 1988;4:85-8. 39. Snyder HA, Duncanson MG Jr, Johnson DL, Bloom J. Effects of clasp flex-
18. Laufer BZ, Nicholls JI, Townsend JD. SiOx-C coating: a composite-to- ure on a 4-META adhered light-polymerized composite resin. Int J
metal bonding mechanism. J Prosthet Dent 1988;60:320-7. Prosthodont 1991;4:364-70.
19. Latta MA, Barkmeier WW. Approaches for intraoral repair of ceramic 40. Proano P, Pfeiffer P, Nergiz I, Niedermeier W. Shear bond strength of
restorations. Compend Contin Educ Dent 2000;21:635-9, 642-4; quiz repair resin using an intraoral tribochemical coating on ceramometal,
646. ceramic and resin surfaces. J Adhesion Sci Technol 1998;12:1121-30.
20. Van Rensburg F, Strating H. Evaluation of the marginal integrity of cer-
amometal restorations: Part II. J Prosthet Dent 1984;52:210-4. Reprint requests to:
21. Richter-Snapp K, Aquilino SA, Svare CW, Turner KA. Change in margin- DR MUTLU ÖZCAN
al fit as related to margin design, alloy type, and porcelain proximity in UNIVERSITAIR DOCENT
porcelain-fused-to-metal restorations. J Prosthet Dent 1988;60:435-9. FACULTY OF MEDICAL SCIENCES
22. Stangel I, Nathanson D, Hsu CS. Shear strength of the composite bond ORAL HEALTH INSTITUTE
to etched porcelain. J Dent Res 1987;66:1460-5. UNIVERSITY OF GRONINGEN
23. Lacy AM, LaLuz J, Watanabe LG, Dellinges M. Effect of porcelain surface ANTONIUS DEUSINGLAAN 1
treatment on the bond to composite. J Prosthet Dent 1988;60:288-91. 9713 AV GRONINGEN
24. Bailey JH. Porcelain-to-composite bond strengths using four organosi- THE NETHERLANDS
lane materials. J Prosthet Dent 1989;61:174-7. FAX: (31)50-363-8528
25. Bertolotti RL, Lacy AM, Watanabe LG. Adhesive monomers for porcelain E-MAIL: mutluozcan@hotmail.com
repair. Int J Prosthodont 1989;2:483-9.
26. Llobell A, Nicholls JI, Kois JC, Daly CH. Fatigue life of porcelain repair Copyright © 2002 by The Editorial Council of The Journal of Prosthetic
systems. Int J Prosthodont 1992;5:205-13. Dentistry.
27. Tylka DF, Stewart GP. Comparison of acidulated phosphate fluoride gel 0022-3913/2002/$35.00 + 0. 10/1/124365
and hydrofluoric acid etchants for porcelain-composite repair. J Prosthet
Dent 1994;72:121-7.
28. Della Bona A, van Noort R. Shear vs. tensile bond strength of resin com-
posite bonded to ceramic. J Dent Res 1995;74:1591-6.
29. Creugers NH, Snoek PA, Kayser AF. An experimental porcelain repair
system evaluated under controlled clinical conditions. J Prosthet Dent
1992;68:724-7.
30. Holloway JA, Miller RB. The effect of core translucency on the aesthetics doi:10.1067/mpr.2002.124365
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