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Cement opacity and color as influencing factors on the final shade of metal-free ceramic restorations

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Objective: To investigate the influence of opacity and color of luting cements on the final shade of metal‐free restorations.

Materials and Methods: Five resin cement colors in combination with four different thicknesses of CAD/CAM ceramic materials were tested, and a composite substrate was used as dentin color reference (n = 3). Specimen color was measured with a spectrophotometer equipped with an integrating sphere before and after cementation (CIELAB). Cement and ceramic color and opacity (TP) were assessed by measuring the tested ceramic thickness as a 1‐mm thick disk for each of the cement shades. The differences in color were evaluated (ΔE00). Data were statistically analyzed by a Two‐Way ANOVA followed by the Tukey Test for post‐hoc comparison (P < .05) and multiple comparison Pearson's test (P < .05); the acceptability and perceptibility threshold were evaluated.

Results: Statistically significant influence was found for factors ceramic thickness and cement shade (P < .001). Perceptible and unacceptable color changes were induced on the final restoration by resin cements (ranging from ΔE00 = 0.69 ± 0.54 to ΔE00 = 5.53 ± 0.46), the correlation between factors became strong (r2 > 0.6) in case of mismatch between color and translucency of cement and ceramic. Only the clear shade in combination with the thickest ceramic, resulted in an imperceptible color change (ΔE00 = 0.69 ± 0.54).

Conclusions: The final shade of ceramic restorations can be influenced by resin cements; the magnitude of influence is related to the cement optical properties.

Clinical Significance: In order to influence the final shade of a ceramic restoration, a cement more opaque than the restorative material should be used. Conversely, in the case of a fitting shade of the restoration, a cement more translucent than the restoration should be used to avoid undesired changes.
Original languageEnglish
Number of pages7
JournalJournal of Esthetic and Restorative Dentistry
Early online date13 Apr 2020
Publication statusEarly online - 13 Apr 2020


  • Manuscript cement influence FINAL ACCEPTED COMPLETE

    Rights statement: This is the peer reviewed version of the following article: Carrabba, M, Vichi, A, Tozzi, G, Louca, C, Ferrari, M. Cement opacity and color as influencing factors on the final shade of metal‐free ceramic restorations. J Esthet Restor Dent. 2020; 1– 7, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

    Accepted author manuscript (Post-print), 481 KB, PDF document

    Due to publisher’s copyright restrictions, this document is not freely available to download from this website until: 13/04/21

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