Effects of surface-finishing protocols

on the roughness, color change, and

translucency of different ceramic systems
Gülcan Coşkun Akar, DDS, PhD,a Gürel Pekkan, DDS, PhD,b
Ebru Çal, DDS, PhD,c Gürcan Eskitaşçıo glu, DDS, PhD,d and
Mutlu Özcan, Dr Med Dent, PhDe
Atatürk Medical Technology Vocational Training School,
Ege University, Izmir, Turkey; Faculty of Dentistry, Dumlupinar
University, Kutahya, Turkey; Department of Prosthodontics, Faculty of
Dentistry, Yuzuncu Yil University, Van, Turkey; Center for Dental and
Oral Medicine, University of Zurich, Zurich, Switzerland
Statement of problem. Surface-finishing protocols have a mechanical impact on ceramic surfaces that could eventually
affect surface topography and light scattering. An optimum protocol is needed to avoid damaging the optical properties
of ceramics.

Purpose. The purpose of this study was to determine the effects of different surface-finishing protocols on the surface
roughness, color change, and translucency of ceramic and metal ceramic restorations.

Material and methods. Standardized disk-shaped specimens (1.5
10 mm, n¼128) were fabricated from 3 different ceramic
core materials (aluminum oxide [Al2O3]-AL, zirconium oxide [ZrO2]-ZR, lithium disilicate [Li2Si2O5]-LIT), veneered (V) with
dentin ceramics (n¼32 per group), and placed in the following groups: ALV, ZRV, and LITV. The metal ceramic group acted
as the control (n¼32). Four different surface-finishing methods were tested. Airborne-particle abrasion with 50 mm Al2O3,
polishing with adjustment kit, polishing with adjustment kit plus diamond polishing paste, and autoglazing (n¼8 subgroup)
were applied on the veneering ceramics. The specimens were analyzed with a profilometer for surface roughness, and color
change and translucency were measured with a clinical spectrophotometer. Statistical analyses were performed with 1-way
ANOVA and the Tukey honest significant difference tests (a¼.05).

Results. Specimens treated with the airborne particle abrasion method showed significantly higher mean profilometer for
surface roughness values in all groups (P<.05). The polishing with adjustment kit and autoglazing methods revealed
statistically similar surface roughness values in all groups (P>.05). With the diamond polishing paste method, lower
surface roughness values were achieved in the ZRV and metal ceramic groups acted as the control groups. Different
surface-finishing methods affected the color change of the ceramic systems, except for ZRV. Surface-finishing protocols
significantly affected the translucency values of the ALV, LITV, and metal ceramic groups (P<.05).

Conclusions. No single surface-finishing protocol can be recommended to obtain the smoothest surface and the least
color change without affecting translucency for the ceramics tested. The airborne-particle abrasion protocol created
rougher surfaces and decreased translucency, and color change in zirconia was not affected by the finishing protocols.
(J Prosthet Dent 2014;-:---)

a
Associate Professor, Ege University, Atatürk Medical Technology Vocational Training School.
b
Associate Professor, Dumlupinar University, Faculty of Dentistry.
c
Professor, Ege University, Faculty of Dentistry, Department of Prosthodontics.
d
Professor, Yuzuncu Yil University, Faculty of Dentistry, Department of Prosthodontics.
e
Professor, University of Zurich, Center for Dental and Oral Medicine, Dental Materials Unit, Clinic for Fixed and Removable
Prosthodontics and Dental Materials Science.

Akar et al
2 Volume - Issue -

Clinical Implications
Airborne-particle abrasion, polishing kits with or without polishing
paste, or autoglaze should be used for surface finishing, depending on
the ceramic type. For all ceramic types, the smoothest surfaces are
obtained after autoglazing. Surface-finishing protocols significantly
affect the translucency in alumina-based ceramics and also slightly
change the translucency in lithium disilicate-based and metal ceramics.

Ceramic restorative materials that
can be easily polished and have hard-
ness values less than that of enamel are
indicated to minimize the wear on the
antagonist enamel.1-3 The natural glaze
layer may be removed by clinical
adjustment of the restoration, which
results in a rough surface.4-7 Polishing
has been shown to improve structural
resistance and restore the gloss of
the restoration.8-10 The mismatch of
the translucency and color of the core
and veneering system in a ceramic
system with that of natural enamel
will result in a clinical failure.11-18
Translucency can be determined by
the translucency parameter (TP).16,19
Ceramic translucency and color can
be affected by many properties, in-
cluding ceramic thickness, crystalline
structure, number of ceramic firings,
veneering technique, repeated ceramic
staining cycles, grain size, pigments,
number, size and distribution of de-
fects, and porosity.20-26
The wide-spread clinical use of metal
ceramic (MC) restorations is mainly
due to its highly predictable strength
and reasonable esthetics.2-4,26,27 The
drawback of this type of restoration is
increased light reflectivity because of
the opaque porcelain layer.27,28 Ce-
ramic crowns permit greater light
transmission and can mimic natural
tooth appearance in terms of color,
surface texture, and translucency.29-31
Nevertheless, variations in the trans-
lucency of the core material may influ-
ence the optical outcome.15,32 Opaque
core ceramics are often used to mask
discolored substrates.16,30,33
Accurate and reliable color assess-
ment is a prerequisite for successful
esthetic outcome. Although subjective
The Journal of Prosthetic Dentistry
and qualitative methods, for example,
shade guides and photographic met-
hods, lead to unpredictable results,
electronic intraoral devices such as
colorimeters and spectrophotometers
can objectively detect color differ-
ences.18,34-36 These devices can metri-
cally deliver consistent results by using
the CIE (Commision International de
l’Eclairage [illumination]) L* a* b*
system.37,38 In this system, the total
color difference between 2 objects is
described by DE.39,40 Color differences
greater than approximately 3.5 DE units
are considered unacceptable and are
visually detectable.28,41
Which surface-finishing protocol
should be used for different types of
ceramic systems is unknown, and
limited information exists about the
effect of different surface-finishing pro-
tocols on the surface roughness (Ra),
color change (DE) , and translucency
parameter of different ceramic systems.
Polishing with an adjustment kit (PK),
polishing with an adjustment kit plus
diamond polishing paste (DP), and
autoglazing (AG) are well-known sur-
face-finishing methods. Although the
airborne-particle abrasion (AB) method
is not a clinically acceptable method, in
some situations, for example, during
repair or cementation, particles may
abrade the ceramic surface and cause a
change in surface topography. The ob-
jectives of this study were to determine
the effects of different surface-finishing
protocols on the surface Ra, DE, and
TP of ceramic and MC restorations. The
null hypothesis was that the different
surface-finishing protocols applied on
different ceramic systems would not
affect their roughness, color, or
translucency.
MATERIAL AND METHODS
The core and veneering materials
used in the experiments are listed in
Table I. All veneering ceramics were
fabricated in the A2 shade without in-
ternal or external staining. Disk speci-
mens (core plus veneering ceramic or
metal plus veneering ceramic) with a
1.5-mm thickness and 10-mm diameter
were fabricated (Table I). To fabricate
the MC specimens, the wax patterns
were sprued and invested with a
phosphate-bonded investment material
(Alpha Cast Vario; Schutz Dental
Group) and cast with a base metal
alloy (Shera Alloy-E; Shera Werkstoff-
Technologie). The final thickness of
the metal specimens was adjusted to
0.5 mm with 600-grit silicon carbide
(SiC) abrasive paper (Struers GmbH).
An opaque layer and dentin ceramic
(VMK 95; Vita Zahnfabrik) were fired
on the metal according to the manu-
facturer’s instructions. Two dentin
firing cycles were performed. The final
thickness of the MC specimens was
adjusted to 1.5 mm with SiC abrasive
papers (Struers GmbH).
Yttrium-stabilized zirconium dioxide
specimens were obtained by milling dry-
pressed blocks (Whitepeaks Copran;
Whitepeaks Dental Systems) with a
computer-aided design and computer-
aided manufacturing (CAD/CAM) sys-
tem (DCS Precident milling system;
DCS Dental AG). The specimens
were sintered at 1500 C for 7 hours
in a high-temperature sintering furnace
(Keramikofen 1500; Zirkonzahn). The
final thickness (0.5 mm) of each spec-
imen was adjusted with a polishing
device (AM Technology) with 600-grit
SiC paper (Struers GmbH). To produce
Akar et al
- 2014 3
Table I. Information on the core and veneering materials
Main Batch Thickness Veneer Batch Thickness
Material Code Composition No. (mm) Manufacturer Ceramic No. (mm) Manufacturer

Alumina ALV Al2O3 AB00640 0.5 Turkom-Ceramic Shofu 030403 1.0 Shofu Inc
Blank, (M) Sdn Bhd Ceramage
Turkom- dentin body
Cera, crystal
powder
Whitepeaks ZRV ZrO2 560002, 0.5 Whitepeaks Cerabien ZR 007864 1.0 Noritake Kizaki Co
Copran 1.2510 Dental dentin
Systems
GmbH and Co
IPS e.max LITV Li2Si2O5 J22317 0.8 Ivoclar IPS e.max H29034 0.7 Ivoclar Vivadent
Press, ingots Vivadent AG Ceram
MO1 (for dentin/
use 110-140, body
A1, A2, B1,
B2)
Shera, MC Nonprecious 91192 0.5 Shera Werkstoff- VMK95, 3366 1.0 Vita Zahnfabrik
Alloy-E bonding alloy Technologie metal
GmbH and ceramic
Co KG dentin

ALV, aluminum oxide þ veneer ceramic; ZRV, zirconium oxide þ veneer ceramic; LITV, lithium disilicate þ veneer ceramic; MC, metal ceramic.

glass ceramic specimens (IPS e-max
Press; Ivoclar Vivadent AG), disk-shaped
wax patterns were invested with an in-
vestment material (IPS Empress Esthetic
Speed Investment; Ivoclar Vivadent AG).
Upon burnout, IPS e-max Press ingots
(MO1 shade; Ivoclar Vivadent AG) were
heat pressed. The pressed cylinders were
bench cooled, devested by 50-mm Al2O3
at 0.2 MPa pressure, and ultrasonically
cleaned (Invex liquid; Ivoclar Vivadent
AG) for 10 minutes. The final thickness
(0.8 mm) of each specimen was
adjusted with a polishing device (AM
Technology) with 600-grit SiC paper
(Struers GmbH).
Aluminum oxide core disk speci-
mens (0.5
10 mm) were fabricated
from a custom-made plastic mold.
The mold was filled with alumina gel
(Turkom-Cera Alumina Gel; Turkom-
Ceramic [M] Sdn Bhd). The speci-
mens were fired in a vacuum furnace
(Programat P300; Ivoclar Vivadent).
The crystal powder (Turkom-Cera
Crystal Powder; Turkom-Ceramic [M]
Sdn Bhd) was mixed with water and
applied on the sintered specimens in
the same furnace for 30 minutes
at 1150 C. The excess material was
removed with a laboratory handpiece
Akar et al
with a diamond rotary instrument at
low speed.
Veneering ceramics were applied
onto each specimen with the aid of a
polyvinyl siloxane mold (Exaflex; GC
Corp) backed with platinum foil. After
condensation of the veneering ce-
ramics, the mold was removed, and the
test specimens on the platinum foil
were transferred to a firing tray to be
fired in a ceramic furnace (Programat
P90; Ivoclar Vivadent AG) according
to the manufacturer’s instructions. All
the specimens were adjusted to 1.5
0.01 mm thickness with 600-grit SiC
paper (Struers GmbH), and the final
thickness of the specimens was
confirmed with a digital caliper (You-
found Precision Co Ltd). The ALV,
ZrO2þveneering ceramic-ZRV, SiO2-
Li2Oþveneering ceramic-LITV groups
and 1 MC system were made up of 128
specimens (n¼32 for each group). Each
group was further divided into 4 sub-
groups (n¼8 for each subgroup) and
subjected to 4 different surface-
finishing protocols. A power calcula-
tion was performed with the Bonferroni
corrected 2-specimen t test to detect a
significantly relevant difference among
the groups for each parameter. Based
on a 1:1 ratio between the groups, a
sample size of 8 was found to reveal a
greater than 90% power for Ra, DE, and
TP at the 5% significance level when the
delta for Ra was 1.6, for DE was 1.4,
and for TP was 0.8.
After ultrasonic cleaning, the ve-
neering ceramic surfaces in each group
were finished with 1 of the following 4
protocols:
1. AB. The specimen surfaces were
airborne-particle abraded with 50-mm
aluminum oxide at 0.2 MPa pressure
from a distance of approximately
10 mm.
2. PK. The specimen surfaces were
polished with a polishing kit (Ce-
ramaster Finishing and Polishing Kit;
Shofu Inc) with a slow-speed handpiece
(10 000 rpm), as recommended by the
manufacturer.
3. DP. The specimen surfaces were
polished with a polishing kit (Ceram-
aster Finishing and Polishing Kit) as in
protocol 2 and were further polished
with a polishing paste (Ultra II Polish-
ing Paste; PN 0550, Shofu Inc).
4. AG. The specimens were auto-
glazed by heating at 621 C for 3
minutes followed by a temperature
4 Volume
increase of 83 C/min up to 918 C for
30 seconds.
Surface roughness measurement
After cleaning the specimens ultra-
sonically in distilled water, the Ra was
measured with a profilometer (Surftest
SJ 201; Mitutoyo Corp). To measure
the roughness profile value in micro-
meters, a diamond stylus (tip radius,
5 mm) was moved across the surface
under a constant load of 4 mN with a
speed of 0.25 mm/s and a range of
0.8 mm. Three traces were recorded for
each specimen at 3 different locations
in different positions (parallel, perpen-
dicular, and oblique), which gave 9
tracings per specimen. The mean sur-
face roughness measurements was
calculated for each specimen.
Color measurement
The color coordinates of the speci-
mens in each subgroup (n¼8) were
measured with an intraoral spectro-
photometer (VITA EasyShade; VITA
Zahnfabrik) with separate receiver ele-
ments located at different distances
from the light source to measure the
color of the specimen at different
depths.29,37 The CIELAB values (L*, a*,
b* ) of each system (core plus veneering
ceramic or metal veneering ceramic)
were measured on a white background
3 times consecutively at the center of
the disk.22
Color differences (DE) were calculated
according to the following equation6:

1=2
DE¼ ½DL  2þ½Da  2þ½Db  2
(Equation 1)
For color difference calculations, 8
disk specimens of 1.5-mm thickness
and 10-mm diameter were fabricated
from Vita VMK 95 dentin ceramic
A2 shade (VITA Zahnfabrik). After
thickness adjustments and refinements,
the specimens were autoglazed ac-
cording to the manufacturer’s in-
structions. The quantitative DE values
between the specimens of Vita VMK 95
dentin (C) and the experimental groups
The Journal of Prosthetic Dentistry
- Issue -
(E) were calculated by using the The means of each group were
following equation: analyzed by univariate ANOVA, 1-way
    ANOVA, and the Tukey honest signifi-
DE ¼ LE LC 2þ aE  aC 2 cant difference post hoc tests to
 2
1=2
þ bE  bC determine the significant differences
in terms of the roughness, TP, and
(Equation 2)
color differences (a¼.05) in the
where (L*EL*C), (a*Ea*C), and ceramic systems after surface-finishing
(b*Eb*C) are the differences in the protocols.
DL*, Da*, and Db* values, subscript E
represents the value obtained from RESULTS
different surface-finishing protocols,
and subscript C represents the mean Surface Ra
value obtained from the color measure-
ments from Vita VMK 95 dentin ceramic The results and the statistical ana-
A2 (VITA Zahnfabrik) specimens. The lyses of the surface Ra values are
DE values smaller than 0.5 were rated as presented in Tables II and III. The dif-
perfect, 0.5 to 1 as excellent, 1 to 2 as ferences between the surface-finishing
good, 2 to 3.5 as clinically acceptable, protocols were significant in all groups
and above 3.5 as clinically discernible (ALV, ZRV, LITV, and MC) (P<.001). In
mismatch.41 Two colors were judged to the ALV group, the AB method showed
be matched when DE<1.22 The DE significantly higher Ra values than those
value of 1.6 was determined to be a of the other methods. The other
color difference that could not be methods in the ALV group were not
detected by the human eye.31 statistically different (P>.05). In the
The color parameters of the core ZRV group, the AB and DP methods
plus veneering ceramic and metal plus revealed statistically different results
veneering ceramic systems were mea- than the PK and AG methods, which
sured against white (CIE L*¼94.467, showed statistically similar Ra values
a*¼0.328, and b*¼1.425) and black (AB-AG, P¼.036; AB-PK, P¼.036; DP-
(CIE L*¼9.657, a*¼0.523, and b*¼ AG, P¼.002; DP-PK, P¼.002). The Ra
-0.075) backgrounds. The TP was values of the AB method were signifi-
calculated as TP¼([L*BL*W]2þ cantly higher than those of the other
[a*Ba*W] þ[b*Bb*W]2)1/2, in which
2
methods in the LITV group (P<.001).
the subscript B refers to the color co- For the MC group, the differences be-
ordinates over a black background and tween the AB, PK, and DP methods
subscript W refers to those over a white were statistically significant (P<.001).
background.14,18,23 The AG and PK methods showed no
A statistical analysis was performed significant difference in the MC group
with SPSS 17.0 System for Windows. (P>.05).
Table II. Results of univariate ANOVA with dependent variable surface
roughness
Type II Sum Mean
Source of Variation df of Square square F P
Coreþveneering material 3 17.004 5.668 18.513 <.001
Surface-finishing methods 3 88.830 29.610 96.714 <.001
Interaction (coreþveneering 9 32.299 3.589 11.722 <.001
material
surface finishing
methods)
Error 112 34.290 0.306
Total 128 579.084
Akar et al
- 2014 5
Table III. Mean (standard deviations) of surface roughness values (mm) for ceramic systems after various
surface-finishing protocols
Polishing With
Airborne-particle Polishing With Adjustment
Material Type and Group Abrasion Adjustment Kit KitDPolishing paste Autoglazing

Al2O3þveneering ceramic 4.27 0.701 1.32 0.662 1.14 0.232 0.98 0.212
ZrO2þveneering ceramic 2.14 0.851 1.94 0.092 1.68 0.291 0.77 0.232
Li2Si2O5þveneering ceramic 2.98 1.12 1
1.82 0.16 2
1.73 0.52 2
1.45 0.422
Metal ceramic 3.91 0.411 2.41 0.902 1.14 0.253 1.00 0.282

Different numbers represent statistically significant differences within each row (a¼.05).

Color differences
Surface-finishing protocols signifi-
cantly affected the DE values in the
ALV, LITV, and MC groups (P<.05)
(Tables IV and V). The DE values after
the AB and AG finishing methods in the
ALV group were significantly lower than
those after the PK and DP methods
(P<.001). Different surface-finishing
methods did not cause a significant
DE difference in the ZRV group
(P>.05). The DE after the AG method
was significantly lower than that after
Table IV. Results of univariate ANOVA with dependent variable delta E
Source of Variation
the AB method in the LITV group
(P¼.017). For the MC specimens, the
only significant difference in DE values
was between the AB and DP methods
(P¼.013). The DE values of the PK, DP,
and AG methods were comparable in
the MC group.
TP
The AG and AB methods showed
significantly lower TP values than the
PK and DP methods in the ALV group
(P<.001) (Tables VI and VII). In the
Type II Sum Mean
df of Square square F P
same group, no significant difference
was noted between the TP values of the
AG and AB methods (P>.05), and the
TP values of the PK and DP methods
also were statistically similar to each
other (P>.05). The TP values of the
ZRV group were statistically similar
(P>.05). In the LITV group, the DP
method revealed statistically higher TP
values than those of the AB and PK
methods. In the MC group, the PK
method showed statistically different
TP values than those of the AB and
AG methods (AG-PK, P¼.045; AB-PK,
P¼.038). The TP values of the other
AB, DP, and AG methods were com-
parable in the MC group.
DISCUSSION

Coreþveneering material 3 586.868 195.623 103.667 <.001 Based on the results of this study,
Surface-finishing methods 3 19.198 6.399 3.391 .021 the null hypothesis that different
Interaction (coreþveneering 9 122.412 13.601 7.208 <.001 surface-finishing protocols on different
material
surface finishing ceramic systems would not affect their
methods) roughness, translucency, or color pa-
Error 112 211.348 1.887 rameters was rejected. In this study,
Total 128 6377.628 core ceramic specimens were fabri-
cated in the minimum thicknesses

Table V. Mean (standard deviation) of color differences for ceramic systems after various surface-finishing protocols
Polishing With
Airborne-particle Polishing With Adjustment
Material Type and Group Abrasion Adjustment Kit KitDPolishing Paste Autoglazing

Al2O3þveneering ceramic 7.87 0.773 10.73 0.742 12.13 1.401 8.77 0.923
ZrO2þveneering ceramic 6.68 1.701 5.24 2.611 5.17 1.791 4.47 1.641
Li2Si2O5þveneering ceramic 4.89 0.931 3.98 1.341,2 4.54 1.491,2 3.05 0.602
Metal ceramic 7.51 1.46 1
6.39 0.84 1,2
5.61 0.902
7.16 1.251,2

Different numbers represent statistically significant differences within each row (a¼.05).

Akar et al
6 Volume
Table VI. Results of univariate ANOVA with dependent variable translucency
parameter
Type II Sum
Source of Variation df of Square MS F P
Coreþveneering material 3 1030.186 343.395 109.835
Surface-finishing methods 3 79.164 26.388 8.440
Interaction (coreþveneering 9 116.359 12.929 4.135
material
surface finishing
methods)
Error 112 350.166 3.126
Total 128 5983.870
reported by a previous study32 and structural resistance and obtain a clin-
according to the manufacturers’ rec- ically acceptable smoothness compared
ommendations. The effects of the var- with glazing.4,6,8-10 In this context,
iables related to the production process diamond pastes seem efficient in
for a ceramic restoration, and grinding, decreasing the irregularities on ceramics
sintering, finishing, and definitive core, when used after the adjustment rotary
and veneering thicknesses could all be instruments.6 Diamond polishing
investigated by means of disk speci- pastes should have a fine particle size to
mens, as they were used in the current enable surface polishing but should be
study. rough enough to be effective when used
In the present study, although the for ceramic restorations.4,6 The Ra
smoothest surface was obtained with findings of this study suggest that the
the AG method in all groups, the AB clinical polishing of rough ceramic sur-
method showed the highest Ra values faces with the PK or the DP method
in all the groups as expected. After fin- could be a safe and efficient alternative
ishing with the PK or DP methods, to glazing procedures.
acceptable Ra values were achieved. A DE value of >3.5 has been
Specimens that were subjected to the accepted as a clinically unacceptable
DP method displayed lower Ra values color difference.35,36,41 When consid-
than those subjected to the PK method. ering the limitations of the specimen
The PK or DP method created a Ra preparation protocols used, the aim of
value comparable with that of the this study was not to achieve a shade
glazed specimens, which is in line with match but to evaluate the DE values in
previous observations.4,8,10 Various comparison with the Vita VMK 95
finishing and polishing protocols could dentin (A2). Furthermore, the white
be used on ceramic surfaces to preserve background color was used to
Table VII. Mean (standard deviation) of translucency parameters for ceramic systems after various surface-finishing
protocols
Airborne-particle Polishing with
Material Type and Group Abrasion Adjustment Kit
Al2O3þveneering ceramic 4.76 0.801 8.56 0.682
ZrO2þveneering ceramic 5.25 4.541 5.59 1.501
Li2Si2O5þveneering ceramic 7.94 1.942 7.47 2.382
Metal ceramic 0.85 0.52 2
1.88 0.84 1
Different numbers represent statistically significant differences within each row (a¼.05).
The Journal of Prosthetic Dentistry
- Issue -
standardize the background parameter,
although, in clinical conditions, the
background color is almost never
white. Almost all DE values were higher
than 3.5, except for the LITV ceramic
system (mean SD 3.05 0.60) sub-
<.001
jected to the AG method. Lithium
<.001
disilicate dentin ceramic contains
<.001 nanofluorapatite crystals that ensure
that color, surface texture, and trans-
lucency match that of natural tooth.
Except for the ZRV group, the results of
the current study indicated perceptible
color changes for the tested ceramic
systems subjected to different surface-
finishing protocols when compared
with Vita VMK 95 dentin specimens.
The Vita VMK 95 dentin specimens
used for the DE calculation did not
have any underlying substructure. The
entire 1.5-mm-thick specimens were
made with the same dentin ceramic
material because the Vita shade guides
have no underlying substructure. The
large shade mismatch of the resultant
color of the specimens with the Vita
VMK 95 dentin could be attributed to
this factor, especially in the ALV group,
in which the highest DE values were
obtained. This could be explained by
the opaque structure of the alumina
material. Also, the opaque structure of
the zirconia may have affected the DE
values that were similar after each sur-
face treatment method. So not to add
a new parameter, no additional inter-
mediate layer of opaque ceramic or
liner was applied onto the core
ceramics.
Stavridakis et al41 proposed that
teeth with low value and high
Polishing With
Adjustment
KitDPolishing Paste Autoglazing
8.90 1.612 5.66 1.321
7.02 1.671 8.00 1.461
10.58 1.711 9.31 1.461,2
1.16 0.57 1,2
0.87 0.892
Akar et al
- 2014
translucency might be considered the
closest to natural teeth and, therefore,
should be restored with Empress, In-
Ceram Spinell, or Empress 2. In
contrast, Kelly et al15 stated that opa-
que teeth with high value could be
restored with opaque substrates such
as In-Ceram Alumina or MC restora-
tions. Heffernan et al16 indicated that
In-Ceram Zirconia would also be
feasible because its opacity is similar
to that of MC systems. In addition,
Baldissara et al17 reported that the
translucency of zirconia copings was
significantly lower than that of lithium
disilicate glass ceramic controls. The
results of this study were partially in
accordance with the results of previous
observations because the different
surface-finishing protocols resulted in
variations in the TP values of different
ceramic systems. Although not in the
ZRV group, significant differences were
found in TP values within the groups of
ALV, LITV, and MC for different fin-
ishing methods applied on ceramics.
The TP values of the ALV specimens
subjected to the PK and DP methods
were significantly higher than those of
the AB and AG methods. O’Keefe
et al12 indicated that opacity and
thickness were 2 important factors that
affected light transmission in porcelain
veneers and that the thickness of the
porcelain veneer was the primary fac-
tor that affects light transmission.
Although the change in the TP value
was not expected after different
surface-finishing methods in the ALV
specimens because it was in the ZRV
specimens, and the results were in
contrast to some studies,25,32 the
structure of the veneering porcelain
may have affected the results. Alghaz-
zawi et al40 stated that modifying the
veneering ceramic can optimize the
color of an esthetic restoration. Further
studies are needed to test the effect
of different surface-finishing protocols
on the color and TP of different
alumina-based ceramic restorations
with different veneering ceramics.
The surface-finishing protocols ap-
plied for the Li2Si2O5 ceramic systems
and the parameters (Ra, DE, TP)
Akar et al
evaluated in this study showed statis-
tically significant differences. However,
when the methods were compared, the
smoothest surfaces and the lowest DE
values were seen with the AG method,
and the highest TP values were ob-
tained with the DP method. Therefore,
to achieve the most natural outcomes,
the AG and DP methods can be used
for this ceramic system. The finishing
methods applied for the ZrO2 ceramic
system resulted in comparable out-
comes when all the parameters (Ra,
DE, TP) were considered. When the
methods were compared, however, the
smoothest surfaces, lowest DE values,
and highest TP values were obtained
with the AG method, followed by the
DP and PK methods. When giving pri-
ority to the AG and DP methods, all
finishing methods can be performed on
this ceramic. The finishing methods
applied for the ALV ceramic system and
the DE and TP parameters displayed
obvious differences between the AG
and the other methods. Because the
smoothest surface, the lowest DE
values, and the highest TP values were
obtained with the AG method, this
might be considered as the most suit-
able to achieve a stable restoration
surface. The finishing protocols applied
for the MC system and the Ra and DE
parameters evaluated revealed signifi-
cant differences between the AG and
the other methods. The lowest mean
Ra value was obtained with the AG
method. However, the highest DE also
was observed with the AG method and
the lowest with the DP method. These
findings might suggest the use of
the DP and PK methods to produce
a natural-looking MC restoration.
In vitro studies of ceramic translucency
and color may be limited because of a
lack of clear clinical relevance.17 This
type of research design is useful in the
investigation of optical properties, but
the results obtained are difficult to
relate to clinical conditions.
CONCLUSIONS
Within the limitations of this study,
the following conclusions were drawn:
7
1. For all ceramic types, the smooth-
est surfaces were obtained after
autoglazing.
2. The resultant color of ceramic
restorations fabricated with dentin
veneering ceramic can rarely match the
target color of the traditional shade
guide.
3. Surface-finishing protocols signifi-
cantly affect translucency in alumina-
based ceramics and also slightly change
the translucency of lithium disilicate
based and MCs.
4. For less color change and high
translucency, different surface-finishing
protocols should be used to achieve
natural-looking restorations with various
core ceramics and metal frameworks
veneered with feldspathic ceramic.
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Corresponding author:
Dr Gürel Pekkan
Dumlupinar University, Faculty of Dentistry
Evliya Celebi Yerleskesi, 43270, Kutahya
TURKEY
E-mail: gurelp@gmail.com
Copyright ª 2014 by the Editorial Council for
The Journal of Prosthetic Dentistry.
Akar et al