Masking ability of CAD/CAM monolithic ceramics: effect of ceramic type and thickness, and try-in paste shade.

Abstract

This in vitro study evaluated the color differences when discolored tooth substrates were restored with CAD/CAM monolithic ceramics depending on ceramic type and thickness, and the try-in paste shade. Six ceramic types were tested: high-translucent lithium disilicate (LD-HT); medium-translucent lithium disilicate (LD-MT); low-translucent lithium disilicate (LD-LT); low-translucent leucite (LC-LT); feldspathic ceramic (FC); and BL1 low-translucent lithium disilicate, stained to A1 shade (LD-BL1-LT). The ceramics were tested in disk-shaped specimens with 0.5-, 1.0-, and 1.5-mm thickness (n = 10; N = 180; shade A1). The try-in pastes were tested to simulate luting materials and corresponded to colors A1 and Opaque White. Six substrates were used: A1 (reference), B2, B3, A3, C2, and C3. Color differences (∆E00) and translucency parameter (TP00) were assessed with the CIEDE2000 formula. The results were compared with acceptability (1.77) and perceptibility (0.81) thresholds. Ceramic type, thickness, and the try-in paste shade influenced the color differences. LD-LT and LC-LT ceramics and Opaque White try-in paste provided, in general, lower ∆E00 values. The most adequate ceramic thickness varied according to the substrate discoloration. With 1.0 mm of ceramic thickness, it was possible to obtain ∆E00 lower than the perceptibility threshold for substrates C2 and A3, and ∆E00 lower than the acceptability threshold for C3 and B3. ∆E00 lower than the acceptability threshold were obtained with 0.5 mm of ceramic thickness for B2, A3, and C2. The use of low-translucent glass-ceramics and Opaque White try-in paste are useful to reduce color differences. The most adequate ceramic thickness depends on the substrate discoloration.