The Investigation of The Marginal Microleakage of Four Temporary Cements in Metal Castings

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Atatürk Üniv. Di Hek.Fak.

Derg YE L DUYMU , D NÇKAL YANIKO LU,


Cilt: 15, Say(:1, Sayfa:22-28, 2005 BAYINDIR

THE INVESTIGATION OF THE MARGINAL MICROLEAKAGE OF FOUR


TEMPORARY CEMENTS IN METAL CASTINGS

Prof. Dr. Zeynep YE*+L DUYMU** Prof. Dr. Nuran D+NÇKAL YANIKO/LU*
Doç. Dr. Funda BAYINDIR*

SUMMARY

ÖZET
This study was carried out to evaluate the
marginal microleakage of four temporary cements in
Bu çal( mada, metal döküm kuronlarda geçici
metal crowns. Twenty metal crowns were prepared
simanlar(n marginal mikros(z(nt(s( incelenmi tir. Bu
and fitted on extracted intact human premolars using
amaçla, çekilmi premolar di ler üzerinde 20 metal
four cements (Scutabond nF, Tempbond, Sinogol,
döküm kuron haz(rland(. Üretici firman(n önerileri
Provilat). Each cement was mixed according to the
do;rultusunda haz(rlanan 4 siman (Scutabond nF,
instructions of the manufacturers. Specimens were
Tempbond, Sinogol, Provilat) kullan(larak
thermocycled and submerged in a methylene blue
simantasyon i lemi yap(ld(. Örneklere termal siklus
solution and then sectioned and observed under a light
uyguland(ktan sonra, s(z(nt(n(n tespit edilebilmesi
stereomicroscope. A 5-level scale was used to score
amac(yla metilen mavisinde bekletildi. Örneklerden
dye penetration into the tooth-cement interface.
kesit al(narak stereomikroskop alt(nda incelendi. Di -
Microleakage values were recorded by only one
siman arayüzündeki boya penetrasyonu için 5 seviyeli
person. Kruskal-Wallis Variance analysis was used
skala kullan(ld(. Mikros(z(nt( de;erleri bir ki i
for biometric evaluation of microleakage (P<0.05).
taraf(ndan kaydedildi. Biometrik de;erlendirme için
The temporary cements with eugenol showed
Kruskal-Wallis analizi kullan(ld( (P<0.05). Öjenollü
more microleakage than those without eugenol.
geçici simanlar(n öjenolsüzlerden daha fazla
Microleakage was higher in Scutabond nF than the
mikros(z(nt( olu turdu;u, Scutabond nF’ nin di;er
other cements. Cements without eugenol (Provilat)
simanlardan daha yüksek mikros(z(nt( de;eri
had the best of sealing properties and the least value
gösterdi;i, öjenolsüz Provilat’ (n en iyi sealig ve en az
of the microleakage.
mikros(z(nt( de;eri gösterdi;i tespit edildi.
Anahtar Kelimeler : Geçici siman, Key Words: Temporary cement,
mikros(z(nt( microleakage.

periodontal treatment and occlusal adjustments,


INTRODUCTION
displacement of teeth, caries and pulp
1-5
protection.
Temporary cementation of permanent and
Temporary cements consist of two basic
temporary restorations includes a number of
types: the first one contains zinc-oxide eugenol
clinical applications, such as providing aesthetic
and the other is without zinc-oxide eugenol.6 The
appearance, mouth hygiene, better articulation in
pH of the first type of eugenol cements is 7 and
the patient’s mouth, abutment teeth control,
this type of cement shows extreme acceptance by
* Atatürk University, School of Dentistry, Prosthodontics Department, Erzurum, Turkey

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Atatürk Üniv. Di Hek.Fak.Derg YE L DUYMU , D NÇKAL YANIKO LU,
Cilt: 15, Say(:1, Sayfa:22-28, 2005 BAYINDIR

the pulp. In addition to closing the cavity Several in vivo and in vitro investigations
extremely well against saliva, it reduces the have been made on microleakage between the
irritation resulting from microleakage to a tooth and restoration so far.27,28 Different test
minimum level even though in a short time. methods applied in the studies for the
Although this cement is not physically or determination of microleakage yielded to various
mechanically good, it has excellent biological results.16,25 Among the methods used in the
features.7 Temporary cements with eugenol show leakage studies, radioisotope method has been
good bacteriostatic effect.7,8 It is very easy to preferred especially for the crown studies.
remove the zinc oxide-eugenol cement from the However, especially because of being expensive
tooth; they are cheap and have protective effect and having some disadvantages, this method has
against dentinal hypersensitivity.9,10 However, not been applied.29-32
they show negative effects on polymerization if In vitro microleakage tests carried out with
composite resins are used as temporary dyes are considered stricter than those carried out
11-14
restoration. The non-eugenol cements were in the oral cavity.17 This is probably due to many
no effected the surface hardness of composite reasons, such as:
resin and showed higher microhardness than the 1. The dye is more easily diffused than
12
eugenol containing cements. bacteria and their byproducts,
The conduction of mouth liquids to the 2- The build-up of proteins and debris that
pulp through dentin channels wouldn’t have been then calcify in the marginal gap may improve the
possible and postoperative dentinal pain couldn’t seal, or
15
have developed on the tooth if microchannels 3-The dentinal fluid in vital teeth, which
and micropores hadn’t occurred between has a positive pressure, and the settling of
restorations and the teeth. Yet there occurs fibrinogen inside the sectioned tubules may
microleakage between restorative materials and contrast molecular penetration.33
tooth tissue as an inevitable phenomenon.16 It has The purpose of this study was to compare
been stated that marginal gap is effective on in vitro the marginal leakage of four temporary
microleakage and solubility of cements.17-21 cements.
It has been reported that microleakage
might be caused on the crown margin by MATERIALS AND METHOD
22
thermocycle. It has also been stated in some
other researches that heat differences in the 20 premolar teeth without caries extracted
mouth and effects of food taken into the mouth for periodontal or orthodontic reasons were kept
play an important role in the occurrence of in distilled water at 37°C until prepared for the
23-26
leakage. study. Then the teeth were dried. The roots were
embedded in acrylic resin with 20-mm-diameter

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Atatürk Üniv. Di Hek.Fak.Derg YE L DUYMU , D NÇKAL YANIKO LU,
Cilt: 15, Say(:1, Sayfa:22-28, 2005 BAYINDIR

cylindrical mould obtained from the After the specimens had been kept in
polyethylene. The teeth were prepared with the distilled water at 37ºC ± 1°C for two weeks, they
help of diamond bur for full crown restoration. were subjected to thermal cycles 250 times with
The teeth were numbered. The dies were covered a 23-second program at 5°C and 50°C.32 In this
with three-fold die-spacer (Ivoclar, Schaan, way, a similarity was formed with the heat
Lienchtenstein. Copings were prepared on the changes within the mouth.
dies by using inlay casting-wax (Ash Pinnacle, The specimens were stored in distilled
Amalgamated Dental). water at 23°C ± 1°C room temperature for 24
The casting process was performed in a hours after thermal cycles. Then the specimens
semi-automatic centrifuge casting device (Bego, were dried, and nail-polish was applied three
Fornex 35 M). The casting was removed from times on the sections where a methylen leakage
the investment. Investment debris and oxicide from the margins of crown was not desirable.
layer on casting surface were removed by The specimens were kept in petri boxes in
sandblasting (Minipol, Bego). The teeth were 2% methylene blue for 24 hours following the
divided into four groups. The restorations were drying of the polish. Then the specimens were
cemented according to instructions of the removed from dye solution, washed and dried.
o
manufacturers at 23± 1 C (Table 1). They were They were embedded in autopolymerizan
placed on the device specially prepared and a transparent acrylic one by one. Test specimens
vertical 10-kg pressure was applied to it. Then were divided into two parts in vestibulo-lingual
the excess cement was removed from the teeth direction throughout vertical axis. Microleakage
surface. values were recorded by only one person
according to the scale accepted by Tjan et al: 34,35
0 : No microleakage
Table 1.Temporary cementation substances used in 1 : Microleakage to one third of axial wall
the study.
2 : Microleakage to two thirds of axial wall
Product Manufacturer
3 : Microleakage along full length of axial
Scutabond nF EspeDental-Medizin GmbH & Co.KGD-
(Zinc oxide 82229 Seefeld, Germany wall
eugenol)
4. Microleakage over occlusal surface
Tempbond Kerr USA 28200 Wick Road Romulus MI
(Zinc oxide 48174-2600
As for biometric evaluation, Kruskal-
eugenol) Wallis Variance analysis method was used.
Sinogol P.O.B.D-2190 Altenwalde, Germany
(Without eugenol)
Provilat P.O.B 2305 D-2350 Neumünster RESULTS
(Without eugenol) Germany

The degree of dye penetration for the four


temporary cements was tested and Kruskal-

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Atatürk Üniv. Di Hek.Fak.Derg YE L DUYMU , D NÇKAL YANIKO LU,
Cilt: 15, Say(:1, Sayfa:22-28, 2005 BAYINDIR

Wallis Variance analysis results are shown in subjected to thermal cycle with a pre-determined
Table 2. program.
As seen in the Table, microleakage values Tjan et al26 stated that thermal cycle in the
of Scutabond nF and Provilat are different. The formation of microleakage became effective on
difference between these two temporary cements the margins of metal crown. Crim23 stated that
is statistically significant (P<0.05). food and beverage taken into mouth would be
Although all temporary cements showed comfortable in 50° C temperature and he also
microleakage of various degrees at the end of the pointed out that the number of cycles which
test duration, it was observed that Provilat would be applied to the specimens and the
showed the least microleakage while Scutabond temperature which would be used during
nF showed the largest microleakage. thermocycle were important.
Michailesco et al.40 emphasized that the
Table 2. Degree of Dypenetration of four cement materials and the
results of Kruskal-Wallis variance analysis.
temperatures used during thermocycle

Marginal microleakage
experiment should be in physiological limitations
score frequencies
Cements N 0 1 2 3 4 Median (17°C-47°C).

Tempbond 5 - - 2 3 - 2.000 Tanaka et al.22 observed that a certain


Provilat 5 1 2 2 - - 1.000 tiredness was formed in the specimens at 70°C in
Scutabond Nf 5 - - 2 2 1 3.000
Sinogol 5 - 3 2 - - 1.500
their study, in which they applied 20.000 cycles
to the specimens at three different water baths of
H=7.84, d.f =3, P< 0.05. 50°C, 60°C and 70°C. And they stated that
temperature is more important than the number
DISCUSSION
of cycles in thermocycle process.
In the previous studies of teeth restored
Microleakage and marginal gaps are the
with composites, no significant difference in dye
important causes of fixed restoration failures.36-38
penetration was found between 100 and 1500
The amount of cement exposed to oral fluids,
cycles,23 and between 250 and 1000 cycles.41
which depends on the marginal gap, may be
Crim and Gorcia-Goday24 determined that
related to cement dissolution. Cement dissolution
composite restorations bonded with resin in class
can promote microleakage, but other causes such
V preparations, and thermocycle application and
as mechanical properties of luting cement and
keeping time had no significant effects on
adhesion between cement and tooth structure are
microleakage.
involved.18,39
It was determined in a study carried out by
In this study, specimens were kept in the
Crim et al.23 that there was no certain difference
wet medium to imitate the events occurring in
between four different thermocycle processes,
the mouth environment and then they were
and that the use of stain and an isotope became

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Atatürk Üniv. Di Hek.Fak.Derg YE L DUYMU , D NÇKAL YANIKO LU,
Cilt: 15, Say(:1, Sayfa:22-28, 2005 BAYINDIR

effective and penetrative to the same degree on Tjan et al.19 examined whether keeping in
the interface of tooth restoration. In their studies, water bath became effective on marginal
all the processes including thermal change microleakage in cast crowns. They couldn’t find
showed more leakage than noncycled methods. a significant difference between the durations of
Lewinstein et al.37 investigated the fact that keeping.
Tempbond showed significantly higher dye Mash et al.20 prepared gold-cast crowns on
penetration than other cements. The marginal newly extracted molar teeth and cemented with
leakage values of crowns cemented with Tempbond as temporary cementation material.
temporary cements were similar. After the castings were cemented by keeping the
In this study, Provilat showed the least castings in radioactive substance, it was their
microleakage while Scutabond nF showed the ntention to determine the scores of the leakage 1,
largest microleakage. 6 and 12 months later. They determined that the
The microleakage observed in all the leakage increased in Tempbond cement
temporary cements tested in this study happened depending on the time.
to be between biologic tissue and cement. The weak mechanical properties of
Although the weakness of this interface is temporary cements are likely to worsen in time27.
required to allow easy removal of the restoration According to the results of the study
from the teeth, this may have an adverse effect carried out by Olin et al.7 and Duymus Yesil,42
on the marginal seal, thus increasing bond strengths of temporary cements without
microleakage. Cement dissolution is a slow eugenol were higher than those with eugenol.
process, and probably could take place only later, Similarly, it was found out in this study that
18
enhanced by cement micro-fractures. temporary cements without eugenol (Provilat)
White et al.18 investigated the relationship showed the least microleakage and the ones with
between leakage and marginal gap. They eugenol (Scutabond nF) showed the greatest
couldn’t find a significant relationship between microleakage.
leakage and marginal gap. They pointed out that
complex interaction between dental restorations, CONCLUSIONS
cementation agent and tooth structure affect
leakage. All materials tested demonstrated different

Ballard et al.25 stated that there was a degrees of microleakage. Without eugenol

strong relationship between leakage and thermal cements had the best sealing properties

expansion coefficient and they maintained that, (Provilat). These cements showed the least

depending on their findings, microleakage in microleakage. The temporary cements with

dental materials having low-thermal expansion eugenol (Scutabond nF and Tempbond) showed

would be lower. more microleakage than those without eugenol


(Provilat, and Sinogol).

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Atatürk Üniv. Di Hek.Fak.Derg YE L DUYMU , D NÇKAL YANIKO LU,
Cilt: 15, Say(:1, Sayfa:22-28, 2005 BAYINDIR

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Fax : 90 442 2360945
materials for complete cast gold crowns. J Prosthet
E-mail : [email protected]
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