journal of dentistry 39s (2011) e57–e64

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Color stability of laminate veneers: An in vitro study

Estabilidad del color de las chapas laminadas: un estudio in vitro
Sedanur Turgut, Bora Bagis *
Karadeniz Technical University, Faculty of Dentistry, Department of Prosthodontics, 61080 Trabzon, Turkey

article info abstract

Article history: Objectives: Obtaining a perfect aesthetic, especially with the translucent porcelain laminate
Received 28 July 2011 veneers; shade of the porcelain, type of the resin cement and their long term color stability
Received in revised form are important factors to achieve aesthetic success. The purpose of the study was to assess
3 November 2011 the effect of different resin cement systems and UV ageing on the color of full ceramic
Accepted 7 November 2011 laminates with different shades.
Methods: 392 discs were made with A1, A3, HO and HT shades of IPS e.max Press with
0.5 mm thickness. Different shades of light cured Variolink Veneer, Ivoclar Vivadent (+3,
Keywords: MO, 3); Rely X Veneer, 3M ESPE (A1, A3, White Opaque, Translucent); and dual cured
Laminate veneers Maxcem Elite, Kerr (White, Yellow, White Opaque, Clear); and Variolink II, Ivoclar Vivadent
Color (White Opaque, Translucent) resin cements were applied on the porcelain discs with a
Resin cement thickness of 0.1 mm. Color differences of the porcelain substructures after cementation and
Ceramic 300 h (150 kJ/m2) of UV ageing test, were examined with a colorimeter (Shade Eye Ex, Shofu,
Ageing Japan). The results were analysed statistically with Wilcoxon signed-rank and Kruskal–
Colorimeter Wallis test. The mean values of L*, a*, and b* were also compared using Paired Sample t-test.
Spearman’s Rank Correlation test was used to analyse the correlation between ceramics
with resin-cemented ceramics after ageing. The data analyses were evaluated at a signifi-
cance level of p < 0.05 for all individual tests without any adjustment.
Results: UV ageing caused significant color change on ceramics and also cemented ceramics
( p < 0.05). Whilst L* and a* values decreased, b* values increased after ageing. Discoloration
was between 0.8–1.2 DE for ceramic discs and 1.4–3.1 DE for cemented ceramics. There is no
significant difference on the color change of dual or light cured resin cements, which were
polymerized beneath the porcelain substructure with 0.5 mm thickness. Although statisti-
cally significant differences were observed for all specimens, the magnitudes of the mean
color differences were at an acceptable perception level and were considered clinically
acceptable (DE < 3.5).
Conclusions: Resin cements and ageing process influence the color of porcelain laminate
veneers. Cementation of laminates with either dual or light-cure resin cements does not
effect the long term color stability differently.
# 2011 Elsevier Ltd. All rights reserved.

achieve ideal aesthetics, which frequently includes color

1. Introduction
Porcelain laminate veneers (PLVs) represent a more conser-
vative approach compared with all-ceramic restorations and
allow superior translucency.1,2 The challenge with PLVs is to
changes, with limited preparation of the enamel.3 Previous
investigations have shown that the luting cements underly-
ing the porcelain restorations with different shades can
influence the final shade of restorations.4–6 For PLV cementa-
tion, light-cured resins are often preferred to chemically

* Corresponding author. Tel.: +90 5326804656.

E-mail address: bbagis@yahoo.com (B. Bagis).
0300-5712/$ – see front matter # 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.jdent.2011.11.006
e58 journal of dentistry 39s (2011) e57–e64
cured or dual-cured resins because of their color stability and
‘polymerization on demand’ characteristics.7 The thickness
and shade of the porcelain affects the degree of polymeriza-
tion of both dual and light-polymerized resin luting agents,
and achieving optimal polymerization is important for long-
term color stability.8,9
Discoloration may occur due to the intensity and duration
of polymerization, as well as extrinsic factors, including
exposure to environmental factors, ambient and ultraviolet
(UV) irradiation, heat, water, and food colorants, and intrinsic
factors such as the composition of the resin matrix and filler,
the loading and particle size distribution, type of photoini-
tiator, and percentage of remaining carbon–carbon double
bonds.10 Evaluating the possible color change of veneers used
with resins of different compositions is difficult for the dental
professional.
Discoloration can be assessed visually or with color
measuring devices. Color measuring devices such as colori-
meters and spectrophotometers have become popular be-
cause they offer accuracy, standardization, and numerical
expression of color.11 Whenever possible, both instrumental
and visual color matching method should be used, as they
complement each other and can lead towards predictable
aesthetic outcome.12 The color difference (DE) indicates
whether a change in overall shade can be perceived by a
human observer. Clinical color matching may be rated
according to the these DE values and O’Brien13 had reported
that; based on clinical studies the DE values below 3.5 unit is
unacceptable. Several studies14,15 also considered the color
differences greater than 3.5 between veneers and the teeth as
clinically unacceptable.
IPS e.max Press ceramics, which have generally been
preferred for PLVs in recent years, have a translucent structure
with a different crystalline form. The crystalline volume and
reactive index of IPS e.max Press ceramics differ from those of
IPS Empress and IPS Empress II ceramics, with the IPS e.max
system becoming more translucent.2 However, this apparent
advantage would become a disadvantage if discoloration of
the cement beneath the porcelain were to affect adversely the
final color of a restoration throughout its functional life.16
Artificial accelerated ageing is a method that simulates
clinical conditions, allowing color differences of materials
over time to be determined. As materials are exposed to a
range of conditions, including UV light, temperature changes,
and continuous humidity, artificial accelerated ageing simu-
lates the clinical parameters as closely as possible.17 Artificial
accelerated ageing has been used to investigate the color
Table 1 – Ceramics used in the study.
Material Material type Shade
All Ceramic Lithium-disilicate based A1
Lithium-disilicate based A3
Lithium-disilicate based HT
Lithium-disilicate based HO
stability of dental restorations, including the discoloration of
resin cements and all-ceramic restorations.18 Nevertheless,
the effects of cements underlying porcelain restorations and
the ageing-related discoloration differences between restora-
tions cemented with dual-cured versus light-cured cements
remain unknown. Furthermore, although color stability has
been studied for all-ceramic crowns, discoloration of resins
becomes much more important beneath the thinner and more
translucent PLV restorations, which consist generally of 0.5–
0.9 mm porcelain,19 and may affect the long-term success of
PLV restorations.2,20
The aim of this study was to evaluate the color stability
prior and after ageing of laminate veneers cemented with
different light- and dual-cured resin cements. The null
hypothesis was laminate veneers cemented with either light-
or dual-cured resin cement would not change color after
cementation or ageing.
2. Materials and methods
In total, 392 disc-shaped specimens of A1, A3, high opacity
(HO), and high translucency (HT) shades were prepared from
lithium disilicate glass-ceramic (IPS e.max Press; Ivoclar
Vivadent, Schaan, Liechtenstein) according to the manufac-
turer’s directions (Table 1). The specimens were prepared by
burning out a 0.5-mm thickness of wax with a diameter of
10 mm. The specimens were heat-pressed (IPS Empress EP 600
press furnace) at 920 8C and finished flat on grinder/polisher
with wet #400 to #1200 grit silicone carbid paper and
ultrasonically cleaned in distilled water for 10 min. Specimens
were then coated on one side with a layer of neutral-shade
glaze, and fired at 765 8C. Digital callipers (Electronic Digital
Calliper, Shan, China) were used to measure the thickness. All
specimens (diameter, 10 mm; thickness, 0.5  0.05 mm) were
ultrasonically cleaned for 10 min before cementation. The
specimens were divided into four groups by their shades and 7
specimens for each group were separated as control.
Two dual-cured and two light-cured resin cement systems
from different manufacturers in a total of 13 shades were
chosen for cementation (Table 2). Similar to the shades used
for the porcelain ingots, A1, A3, opaque, and translucent
shades were chosen for the Rely X Veneer and Maxcem Elite
cement systems. For the Variolink II resin cement system,
opaque and translucent shades were included. However, as
the system did not contain A1 or A3 shades, the highest (+3),
lowest ( 3), and medium (0) shades of Variolink Veneer
Manufacturer
IPS e.max Press, Variolink Veneer, Ivoclar Vivadent,
Schaan, Liechtenstein
IPS e.max Press, Variolink Veneer, Ivoclar Vivadent,
Schaan, Liechtenstein
IPS e.max Press, Variolink Veneer, Ivoclar Vivadent,
Schaan, Liechtenstein
IPS e.max Press, Variolink Veneer, Ivoclar Vivadent,
Schaan, Liechtenstein
 journal of dentistry 39s (2011) e57–e64
Table 2 – Resin cements used in the study.
Material Material type Shade
Resin cement Light-cure A1
A3
White opaque
Translucent
Dual-cure White
Yellow
Clear
White opaque
Dual-cure White opaque
Translucent
Light-cure +3
MO
3
TEGDMA: triethyleneglycol dimethacrylate; BisGMA: bisphenol-A glycidyldimethacrylate; HEMA: hydroxyethylmethacrylate; MEHQ: 4
methoxyphenol; UDMA: urethanedimethacrylate.
cement were included. Every experimental group had 7
specimens (n = 7).
2.1. Measurement of color parameters of ceramic
specimens (C group)
The Commission Internationale de l’Eclairage (CIE) measure-
ments make it possible to evaluate the degree of perceptible
color change based on three coordinates L*, a*, and b*.14–18 The
L* value measures the lightness of an object; a* is a measure of
redness (positive) or greenness (negative); and b* is a measure
of yellowness (positive) or blueness (negative).18,19 The CIE
color difference is calculated with the equation:
DE = [(DL*)2 + (Da*)2 + (Db*)2]1/2.
Color measurements were performed with a colorimeter
(ShadeEye Ex, Shofu, Japan) in a viewing booth under D65
standard illumination on a white background, based on ISO
standards (ISO 7491). Before the experimental measurements,
the colorimeter was calibrated according to the manufac-
turer’s instructions, and the colorimeter was positioned in the
middle of each sample. The L*a*b* color notation of each
specimen was measured consecutively three times, and the
average of the three readings was calculated to give the initial
color of the specimen. Color values of all the ceramic group (C)
specimens were measured according to the CIE L*a*b* system
before applying resin cement (C + R group specimens), for
comparison with the follow-up measurements.
2.2. Cementation of ceramics with resin cements
Before cementation, the porcelain surfaces, except for the
Maxcem Elite group specimens, were treated with hydro-
fluoric acid for 60 s and air-dried. Ceramic primer (Monobond S
for Variolink and Variolink II Veneers; Rely X Ceramic Primer
for Rely X Veneers) was applied for 5 s and dried. Bonding was
performed using Adper Single Bond 2 Adhesive for the Rely X
Veneer group and Heliobond for the Variolink and Variolink II
Veneers. Light-cured resin cements were applied directly from
a syringe. Dual-cured resins were mixed on a separate mixing
pad and applied onto the unglazed surface of the specimens,
using a plastic instrument; a clean glass slide was placed onto
the resin mixture, and a 1-kg weight was placed on top for 20 s,
e59
Manufacturer Monomer
Rely X Veneer, 3M ESPE, St. Paul, TEGDMA/BisGMA
Minneapolis, USA
Maxcem Elite, Kerr, Orange, CA, USA HEMA/MEHQ
Variolink II, Ivoclar Vivadent, Schaan, BisGMA/UDMA
Liechtenstein
Variolink Veneer, Ivoclar Vivadent, Dimethacrylates
Schaan, Liechtenstein
to form a 0.1-mm-thick cement layer. Then, to simulate
clinical conditions, the top surfaces of all specimens were
light-cured (Elipar Freelight 2; 3M ESPE, St. Paul, MN, USA) for
40 s. After cementation, irregularities from excessive resin
cement were adjusted with 600-grit wet silicon-carbide paper,
and the specimen thickness was calibrated again and
standardized at 0.6 mm for all specimens.
2.3. Measurement of color parameters of ceramics with
resin cements (C + R)
Color measurements of the C + R specimens were performed
under the same conditions as used for the C group specimens,
as described above. The DE between the C and C + R groups
were calculated using the recorded L*, a* and b* values.
2.4. Ageing test
The specimens were subjected to artificial ageing using an
Atlas UV 2000 test machine (Material Testing Technology LLC,
Chicago, IL, USA). Aluminium plates were prepared in
accordance with the sample size, and the specimens were
inserted into the mould of the plates and subjected to
accelerated ageing tests. All specimens were exposed to
ultraviolet light and water spray for 300 h in the test machine.
The glazed surface of each specimen was continuously
exposed to the light source. The back panel temperature
varied between 38 8C (dark) and 70 8C (light), and the relative
humidity was 95% (dark) and 50% (light). The dry bulb
temperature was 38 8C in the dark and 47 8C in the light
stage. The testing cycle consisted of 40 min of light only,
20 min of light with front water spray, 60 min of light only, and
60 min in the dark with back water spray. The total exposure
energy was 150 kJ/m2. These conditions are reported to be
equivalent to 1 year of clinical service.15
2.5. Measurement of color parameters after ageing of
ceramics (AC) and ceramics with resin cements (AC + AR)
After ageing, the specimen color was again measured under
the same conditions before. The DE values were calculated
from the L*, a*, and b* values before and after ageing.
e60 journal of dentistry 39s (2011) e57–e64

values of each tested groups after ageing (AC + AR) were also
3. Data analysis compared with Kruskal–Wallis Test. In order to analyse the L*, a*,
b* values of all tested groups before and after ageing, the data
3.1. Results were compared with a parametric Paired Sample t-test. The data
analyses were evaluated at a significance level of p < 0.05 for all
In this study, DE values obtained from (C) and (C + R) groups were individual tests without any adjustment. Spearman’s Rank
analysed with the DE values obtained from (C + R) and (AC + AR) Correlation Test was used to investigate the possible relation
groups with Wilcoxon Signed Rank non-parametric test. DE between the groups AC and AC + AR after ageing.

Table 3 – Color parameters of cemented veneers after ageing.

Ceramic shade Resin cement, shade DE L* a* b*
A1 Rely X Veneer, A1 2.7 86.085 1.005 10.986
A1 Rely X Veneer, A3 3.1 86.128 1.671 16.942
A1 Rely X Veneer, Tr 2.5 87.014 2.585 11.257
A1 Rely X Veneer, W0 2.3 87.1 1.714 12.357
A1 Variolink Veneer, +3 2.7 90.248 2.8 14.817
A1 Variolink Veneer, M0 1.8 87.272 2.005 10.114
A1 Variolink Veneer, 3 2.3 82.027 0.485 16.528
A1 Maxcem Elite, Clear 2.4 85.214 1.576 9.842
A1 Maxcem Elite, WO 1.9 88.557 1.307 13.892
A1 Maxcem Elite, Yellow 2.4 86.015 0.886 13.194
A1 Maxcem Elite, White 2.0 88.004 1.685 11.328
A1 Variolink II, Tr 1.5 87.262 1.957 11.442
A1 Variolink II, WO 1.8 89.771 1.185 14.957
A3 Rely X Veneer, A1 2.1 86.022 1.001 18.115
A3 Rely X Veneer, A3 2 86.335 0.371 21.881
A3 Rely X Veneer, Tr 2.0 85.928 1.084 15.348
A3 Rely X Veneer, W0 1.7 88.988 1.002 19.564
A3 Variolink Veneer, +3 2.0 88.744 0.287 18.829
A3 Variolink Veneer, M0 1.6 86.568 0.989 14.914
A3 Variolink Veneer, 3 2.2 84.002 2.987 21.684
A3 Maxcem Elite, Clear 1.7 86.757 1.008 16.132
A3 Maxcem Elite, WO 2.0 88.875 0.385 18.486
A3 Maxcem Elite, Yellow 2.2 85.358 0.081 18.358
A3 Maxcem Elite, White 1.9 85.767 0.428 15.328
A3 Variolink II, Tr 1.4 86.489 1.0 17.729
A3 Variolink II, WO 1.6 88.464 0.126 20.788
HT Rely X Veneer, A1 2.8 83.683 0.885 8.245
HT Rely X Veneer, A3 2.1 85.004 0.976 19.884
HT Rely X Veneer, Tr 2.4 86.221 0.028 5.764
HT Rely X Veneer, W0 3.0 89.566 1.002 11.476
HT Variolink Veneer, +3 3.0 89.468 0.036 9.239
HT Variolink Veneer, M0 2.5 85.233 1.004 5.823
HT Variolink Veneer, 3 2.7 81.285 1.582 21.633
HT Maxcem Elite, Clear 3.0 84.514 0.1 5.687
HT Maxcem Elite, WO 1.9 89.889 0.118 10.215
HT Maxcem Elite, Yellow 2.3 84.331 0.028 11.738
HT Maxcem Elite, White 2.0 84.339 0.125 7.629
HT Variolink II, Tr 1.7 86.133 0.112 6.187
HT Variolink II, WO 2.4 89.348 1.121 10.371
HO Rely X Veneer, A1 1.8 92.662 0.273 2.329
HO Rely X Veneer, A3 2.3 93.097 0.125 5.898
HO Rely X Veneer, Tr 2.1 93.658 0.578 1.848
HO Rely X Veneer, W0 1.8 94.413 0.678 4.369
HO Variolink Veneer, +3 2.7 94.231 0.832 2.984
HO Variolink Veneer, M0 1.9 93.322 1.662 1.985
HO Variolink Veneer, 3 2.5 92.323 2.451 5.886
HO Maxcem Elite, Clear 1.6 93.256 0.748 2.102
HO Maxcem Elite, WO 2.2 95.342 0.914 4.292
HO Maxcem Elite, Yellow 2.3 92.294 3.329 4.987
HO Maxcem Elite, White 1.9 92.002 0.894 1.835
HO Variolink II, Tr 1.7 94.842 0.856 2.789
HO Variolink II, WO 1.9 95.022 1.253 4.674
Symbols ( ) show the significant difference as p < 0.05.
 journal of dentistry 39s (2011) e57–e64
3.2. Effect of cementation on the color of ceramic veneers
Significant color differences were found after cementation of
the A1, A3, HT, and HO shades of the e.max Press ceramics
( p < 0.05). Each cement system and shade combination
showed an individual color distribution with unique CIE
system coordinates.
3.3. Effect of ageing on the color of ceramic veneers
without and with resin
Table 3 presents the means and standard deviations of the
L*, a*, and b* coordinates, the p values, and the DE values
after ageing. The ageing process significantly changed the
color of the ceramic disks (C) and the resin-cemented
ceramic disks (C + R) ( p < 0.05). A1-shade ceramics luted
with Rely X veneer cement (A3 shade) showed the greatest
color change (DE = 3.1). Although statistically significant
differences were observed for all specimens, the magni-
tudes of the mean color differences were at an acceptable
perception level and were considered clinically acceptable
(DE < 3.5). DE values of (C) groups after ageing ranged
between 0.8 and 1.2 units (Fig. 1). These DE values
represented an imperceptible color change and were
considered clinically acceptable (DE < 3.5).
Comparison of the color measurements with Paired
Sample t-test, (C) and (C + R) groups before and after ageing
revealed significant changes in the L*, a*, and b* coordinates.
The color changes resulted in lower L* values, reflecting darker
specimens ( p < 0.05), and higher a* and b* values, indicating
more red and yellow, respectively ( p < 0.05).
Within the (C + R) groups, there was no significant
discoloration difference between the specimens with different
shades or resin cements types after ageing individually
( p > 0.05). For (C) groups; the color change (DE) was not also
found significantly different amongst different shades
( p > 0.05).
In order to investigate the possible relation between
ceramics and cemented ceramics; DE values of (AC) and
(AC + AR) groups were analysed with Spearman’s Rank
Correlation Test. According to these test results; there was
a significant correlation between ceramics and cemented
ceramics (coefficient = 0.547, p = 0.003) after the ageing
process.
Fig. 1 – Color changes values of 0.5 mm ceramic veneers (C)
after ageing.
e61
4. Discussion
Based on these results, the null hypothesis is rejected; the
color difference did not vary significantly with respect to the
shade of the ceramic veneer or the type of resin cement (dual-
or light-cured) after the ageing process. All of the resin
cements significantly changed the final color of the ceramic
veneers after the ageing process, but the changes were slight
(DE < 3.5) and would be clinically acceptable. After ageing, all
specimens showed changes in the L*, a*, and b* coordinates,
but all of the color differences were nearly imperceptible, with
DE < 3.5.
Previous investigations have shown that resin cements can
produce color differences with particular combinations of
background shades, cements, and ceramic restora-
tions.2,16,18,23 In the current study, cementation with different
resin shades influenced the overall color of the ceramic
veneers. These findings are similar to previous results11,24,25
showing different cement shades differentially affected the
final color of all-ceramic restorations. The final color of the
restoration might be changed according to the differecences at
L*, a* or b* coordinates with resin cements. IPS e.max Press
ceramics used in this study has a translucent structure with its
different crystalin structure from the other all ceramics.2 To
eliminate undesirable effects of translucent ceramics, factors
as the thickness of ceramic, ceramic shade, or cement color
should be considered.5,21 It has been suggested that to mitigate
the effects of underlying substrates on overall color, the
thickness of the ceramic should be at least 2.0 mm.5–26 Long-
term color stability is especially important for aesthetic
success with PLV restorations, which are much thinner than
all-ceramic restorations.
In a previous study of color stabilities of resin cements and
resin cements bonded to 1-mm-thick IPS Empress all-
ceramics, it was reported that uncovered resin-cemented
disks became discolored, markedly affecting the color of the
luted ceramic disks; however, in all groups, the ceramic
masked most of the resin material color.18 In their study, the
resin cement thickness was 1 mm, which is much thicker than
the cement layer typically used clinically. In our study, a 0.1-
mm-thick cement layer was applied to a 0.5-mm-thick IPS
e.max Press ceramic veneer to mimic the actual clinical
situation for PLV restorations.
Previously, uncovered resin disks have been used for
ageing tests.27–29 Although this facilitates a standard of
exposure of the entire sample to outside factors, this
approach may provide greater exposure to degrading
factors, wear, light, and direct contact than that experi-
enced in clinical situations, leading to unreliable or
questionable results. In the present study, resins applied
to ceramic veneers were examined, because in clinical
situations, the resin cement is covered by the ceramic and
isolated from environment conditions. It is interesting that
the color stability of porcelain veneers has not previously
been assessed quantitatively, in vitro or in vivo. Clinical trials
involving veneers have evaluated color matching, but only
relatively broad classifications were used.17 Some authors
have recommended careful attention when luting all-
ceramics with cements on the cervical and body areas,
e62 journal of dentistry 39s (2011) e57–e64
whilst the incisal area seems not to be affected by resin
color,11 although the ceramic itself may become discolored
with ageing and affect the color of the incisal area. In the
present study, to clarify the effects of ageing on PLV
discoloration, ceramic veneer materials without cementa-
tion were also exposed to ageing.
Many color studies have used accelerated ageing proce-
dures, combining UV light exposure with cycles of humidity
and light to better simulate the oral environment.17 Color
stability of resin-based cements was studied after accelerat-
ed ageing up to 450 kJ/m2, and the largest color change
occurred during the first cycle of 150 kJ/m2.30 The manufac-
turer of the ageing machine used in the present study
claimed that 300 h of accelerated weathering is equivalent to
1 year of clinical service;17 however, clinical validation of this
claim is not available. In the present study, the specimens
were aged for 150 kJ/m2, because it has been reported that
resin-based cement showed the largest change during this
initial period.30
In the present study, both the ceramic and cemented
ceramic showed statistically significant color changes. The
ceramic group had color changes (DEs) of 0.8–1.2, whereas the
color changes of the cemented ceramics varied between 1.4
and 3.1. The reason of discoloration of resin-cemented
ceramics was also evaluated in the study. The results
indicated that the color change of the veneers was effected
mainly by the resin cement, whilst the ceramic had only a
slight effect on the discoloration.
Color changes in restorative materials induced by UV
irradiation have been related to chemical alterations in the
initiator system, activators, and the resin itself. Degradation of
residual amines and oxidation of residual unreacted carbon–
carbon double bonds culminate in the formation of yellowing
compounds.27–31 In addition, the physicochemical properties
of monomers used in a resin matrix may influence resistance
to staining.32 As reported by the respective manufacturers,
Rely X Veneer is composed primarily of bis-GMA and TEGDMA
resin; Variolink Veneer contains dimethacrylates; Variolink II
contains bis-GMA and urethane dimethacrylate; and Maxcem
Elite contains HEMA and MEHQ monomers. As these materials
age, the water sorption characteristics of the resin monomers
may contribute to differences in the degree of color stabili-
ty.32,33 TEGDMA-based resins release higher quantities of
monomers into aqueous environments, compared with bis-
GMA- and UDMA-based materials.34 Water uptake by bis-
GMA-based resins increases in proportion to the TEGDMA
concentration and decreases with the partial substitution of
TEGDMA by UDMA. Compared with bis-GMA, UDMA appears
to be less susceptible to staining. Furthermore, composite
resins containing larger filler particles may be more suscepti-
ble to discoloration.
Today, because of their better color stability, light-cured
resin cements are typically recommended for anterior
restorations.35 In contrast, during the activation of dual-cured
or chemically cured resin cements, and the oxidation of
reactive groups with amine accelerators and inhibitors may
cause color changes. The efficiency of polymerization can also
influence discoloration, because it determines the amount of
residual monomer available to form colored degradation
products.31
In our study, after the ageing process, there were no
significant differences amongst the resin cements based on
their chemical compositions or curing protocols. In addition,
the ceramic shade did not affect the color stability of the
ceramic veneers. Thus, neither dual- or light-cured resin
cement used for the cementation of translucent and thin
ceramic veneers, as in laminate restorations, affected the long-
term color stability. These results may be attributed to adequate
polymerization beneath the 0.5-mm-thick ceramic veneers.
The IPS e.max all-ceramic system, which has a more translu-
cent structure compared with other all-ceramic systems, might
have affected the polymerization of the resin cement by
allowing adequate light through the ceramic veneer.
The results presented here showed that all of the color
changes, although statistically significant, were less than 3.5
DE and thus were clinically imperceptible. However, the
highest color change (DE), recorded through the HT-shade
ceramic with Variolink Veneer +3 resin cement, was 3.1, which
is only slightly less than a noticeable color change. For all
specimens, L* values decreased, and a* and b* values increased
after ageing, indicating a decrease in brightness and a
tendency to become more reddish and yellowish with time.
These findings are similar to previous reports that all-ceramics
(IPS Empress) also get darker and more red and yellow after
ageing or repeated firings.36 In the another current study, IPS
Aesthetic Empress was bonded with resin cements and
flowable composites and exposed to accelerated ageing. The
authors reported that all evaluated materials discolored after
ageing but these discoloration were considered clinically
acceptable.37
The use of different cement shades may cause minor
aesthetic changes after cementation; however, over the long
term, the color changes of ceramic veneers are likely to be
detectable only with instruments and not clinically relevant.
Consequently, clinicians should not anticipate a discoloration
of restorations when using dual-cured, instead of light-cured,
resin cements for luting. This study used four shades of one
ceramic material and different shades of different types of
resin cements. More studies should be conducted to examine
color changes through various thicknesses and shades of
abutments and over different times.
5. Conclusions
Within the limitations of this study, the following conclusions
were made:
1. The ageing process significantly influenced the color
stability of both IPS e.max Press ceramic veneers and
ceramic veneers luted with resin cements.
2. The discoloration observed after the ageing process was
within a clinically acceptable level and could not be
detected visually.
3. There was no significant difference between the shades of
ceramics and cements tested in terms of long-term color
stability.
4. The long-term stability of the 0.5-mm IPS e.max Press
ceramic veneers was not influenced by the cement type
(light-cured versus dual-cured).
 journal of dentistry 39s (2011) e57–e64
Conflict of interest
None.
Acknowledgements
The current study is based on a thesis submitted to the
graduate faculty, Karadeniz Technical University for Ph degree
and was supported by Republic of Turkey, Karadeniz Techni-
cal University Coordination Unit of Scientific Research Project
No. 2009.127.001.2.
The authors thank to Dr. Yildirim Hakan Bagis and Dr.
Tamer Tuzuner for their supports while preparing this
study.
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