Influence of monolithic lithium disilicate and zirconia thickness on polymerization efficiency of dual-cure resin cements.

OBJECTIVE: To evaluate the influence of anterior monolithic zirconia and lithium disilicate thickness on polymerization efficiency of dual-cure resin cements.

MATERIALS AND METHODS: Twelve ceramic disks (4.0-mm diameter) with thicknesses of 0.5, 1, 1.5, 2, 2.5, and 3 mm were prepared from monolithic zirconia (Prettau® Anterior; n = 6) and lithium disilicate (IPS e.max® CAD HT; n = 6). Three dual-cure resin cements (Panavia F 2.0, DuoLink Universal™, and RelyX™ U200) were used for polymerization beneath ceramic disks. For each resin cement, 10 specimens were prepared by light curing under monolithic zirconia and lithium disilicate disks of each thickness. Vickers hardness measurements were conducted at four different measurement depths. Data were statistically analyzed using univariate four-, three-, two-, and one-way analysis of variance and independent samples t-tests.

RESULTS: Microhardness of resin cements decreased significantly with increasing measurement depth and thickness of monolithic zirconia or lithium disilicate (P < .001). Cements polymerized under lithium disilicate showed higher microhardness values than did those polymerized under zirconia (P < .001). For both ceramics, Panavia F 2.0 exhibited the greatest microhardness, followed by DouLink Universal and RelyX™ U200 (P < .001).

CONCLUSIONS: Different dual-cure resin cements may have different polymerization efficiencies, and the type and thickness of the overlying ceramic can influence polymerization.

CLINICAL SIGNIFICANCE: The findings of this study suggest that an increase in the thickness of monolithic lithium disilicate or anterior monolithic zirconia restorations can significantly decrease the microhardness of the dual-cure resin cement polymerized beneath the restoration. Dual-cure resin cements can be used for the cementation of anterior monolithic zirconia restorations up to 2 mm thickness and for monolithic lithium disilicate restorations up to 2.5 mm thickness. However, for lithium disilicate restorations with a ≥2.5 mm thickness and zirconia restorations with a ≥2-mm thickness, different cementation approaches must be further studied, such as: extended light curing; the use of dual-cure resin cement with a higher self-curing component than the ones used in this study; or a self-cure resin cement.