Masking capacity of minimally invasive lithium disilicate restorations on discolored teeth-The impact of ceramic thickness, the material's translucency, and the cement color.

Pala, Kevser; Reinshagen, Eva Maria; Attin, Thomas; Hüsler, Jürg; Jung, Ronald E; Ioannidis, Alexis (2024). Masking capacity of minimally invasive lithium disilicate restorations on discolored teeth-The impact of ceramic thickness, the material's translucency, and the cement color. Journal of esthetic and restorative dentistry, 36(1), pp. 107-115. Wiley 10.1111/jerd.13146

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OBJECTIVES

To evaluate minimally invasive restorations' capacity to mask discolored teeth and explore the impact of ceramic thickness, translucency, and cement color.

MATERIALS AND METHODS

Twenty-four assessment pairs of naturally colored and discolored bovine dentin samples were formed, using lithium disilicate specimens in six different thicknesses (0.3-0.8 mm), two different translucencies (high, low), and two cements (transparent, tooth-colored). Evaluators assessed the color differences in each assessment pair, and the threshold for detecting a color difference was determined using sequential testing and the Bonferroni-Holm method.

RESULTS

A thickness of 0.6 mm effectively masked color differences using high translucent ceramic with transparent cement, detectable differences were still observed at 0.7/0.8 mm. A threshold thickness of 0.4 mm was seen using high translucent ceramic and tooth-colored cement, with color differences still discernible at 0.5 and 0.8 mm. A threshold thickness of 0.4 mm was detected using low translucent ceramic and transparent cement, while detectable differences persisted at 0.5, 0.7, and 0.8 mm. A 0.5 mm threshold thickness was observed when using low translucent ceramic and tooth-colored cement, and no detectable color differences were detected beyond this thickness.

CONCLUSIONS

Masking can be achieved with a thickness of 0.4-0.5 mm using a low translucent material and tooth-colored cement.

CLINICAL SIGNIFICANCE

Understanding the impact of ceramic thickness, translucency, and cement color can aid clinicians in making informed decisions for achieving the best esthetic outcomes while preserving tooth structure. Effective masking can be accomplished with ceramic thicknesses starting at 0.4 mm, especially when employing a low translucent material and tooth-colored cement. However, clinicians should be aware that discolorations may still be detectable in certain scenarios when using minimally invasive lithium disilicate restorations.

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