Hoorizad Ganjkar M., et al. J Dent Shiraz Univ Med Sci., 2017 March; 18(1): 30-36.

Original Article

Evaluation of the Effect of Porcelain Laminate Thickness on Degree of

Conversion of Light Cure and Dual Cure Resin Cements Using FTIR

Maryam Hoorizad Ganjkar 1, Haleh Heshmat 1, Reza Hassan Ahangari 2

1
, Member of Dental Material Research Centure, Islamic Azad University, Dental Branch, Tehran, Iran Islamic Azad University, Dental
Branch, Tehran, Iran.
2
Postgraduate Student, Dept. of Operative Dentistry, Islamic Azad University, Dental Branch, Tehran, Iran.

KEY WORDS ABSTRACT

Resin Cements; Statement of the Problem: Increasing the thickness of the veneering porcelain
Polymerization; Spectroscopy; may affect the polymerization of resin cements. Incomplete polymerization of resin
Fourier Transform Infrared; cements can lead to compromised quality of restoration and decrease the longevity
Ceramics; of indirect restorations.
Purpose: This study sought to assess the effect of IPS Empress porcelain thickness
on the degree of conversion of light-cure and dual-cure resin cements using Fourier
transform infrared spectroscopy.
Materials and Method: In this experimental study, IPS Empress porcelain discs
(A2 shade) with 10mm diameter and 0.5, 1 and 1.5 mm thicknesses were fabricat-
ed. Choice2 (Bisco, USA) and Nexus3 (Kerr, USA) resin cements were light cured
through the three porcelain thicknesses in two groups of 3 samples using a LED
light-curing unit (LEDemetron II; Kerr, USA). The control group samples were
cured individually with no porcelain disc. The degree of conversion of resin ce-
ments was determined using FTIR (Bruker; Equinox55, Germany). The data were
analyzed using Dunn’s test.
Results: The degree of conversion (in percent) beneath the 0.5, 1.5 and 2 mm
thicknesses of IPS Empress was 68.67±0.88, 71.06±0.94 and 72.51±0.41 for
Choice2 resin cement and 69.60±2.12, 69.64±1.63 and 69.24±2.12 for Nexus3,
respectively. Porcelain thickness and type of resin cement had no significant effect
on degree of conversion (p≥ 0.05).
Conclusion: It seems that increasing the porcelain thickness by up to 1.5 mm has
Received December 2015;
Received in revised form February 2016; no adverse effect on degree of conversion of both dual cure and light cure resin
Accepted March 2016; cements evaluated in this study.
Corresponding Author: Hassan Ahangari R., N. 4, 10th Neyestan, Pasdaran Street, Dental Faculty of
Tehran Islamic Azad University, Tehran, Iran. Postal code: 19585/175 Tel: +98-21-22564571
Email: ha_reza_ah@ yahoo.com
Cite this article as: Hoorizad Ganjkar M., Heshmat H., Hassan Ahangari R. Evaluation of the Effect of Porcelain Laminate Thickness on Degree of Conversion of Light Cure and Dual
Cure resin Cements Using FTIR. J Dent Shiraz Univ Med Sci., 2017 March; 18(1): 30-36.

Introduction ics of porcelain veneers. Resin cements have higher

Advances in dentistry enable more conservative esthetic flexural, compressive, shear and tensile strengths than
dental treatments. Since 1980s, porcelain veneers have other types of cements and increase the retention and
been increasingly used for the anterior tooth restorations. fracture resistance of indirect ceramic restorations. [2-9]
With increasing in esthetic features and more predicta- Appropriate polymerization of these cements is neces-
ble bonding techniques, porcelain veneers are now a sary to provide ideal properties and it plays a critical
reliable treatment option. [1] Selection of a suitable lut- role in achieving an ideal bond between the porcelain
ing agent plays an integral role in longevity and esthet- and tooth structure. [10-11] Incomplete polymerization

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Evaluation of the Effect of Porcelain Laminate Thickness on Degree of Conversion of Light Cure and … Hoorizad Ganjkar M., et al.

of these cements increases their solubility and degrada- Moraes et al. [22] demonstrated that increasing
tion at the finish line. The most important advantage of the porcelain thickness decreased the intensity of trans-
light-cure resin cements is their easy application. How- mitted light, and light irradiation for an adequate period
ever, thickness, opacity, and color shade of the veneer of time was required to enhance the polymerization of
may decrease the light intensity of the transmitted light dual-cure resin cements. Nonetheless, increasing the
through the porcelain when luting the restoration with porcelain thickness by up to two millimeters had no
these cements. So, light-cure cements carry the risk of effect on the final DC. [22] Kilinc et al. [23] showed
incomplete polymerization. [12-13] To overcome this that the porcelain thickness affected the microhardness
problem, dual-cure resin cements were introduced. The- of light-cure and dual-cure resin cements more than its
oretically, polymerization of dual-cure cements can be color shade. Pazin et al. [24] demonstrated that dual-
initiated by a very low light intensity and continues by cure resin cements required light for initiation of
delayed chemical reactions; therefore, dual-cure ce- polymerization, and the porcelain thickness was the
ments benefit from the properties of both light-cure and most important factor responsible for decreased micro-
self-cure cements. [12] However, the degree of conver- hardness of dual-cure resin cements. The type of light
sion (DC) of dual-cure cements depends on the material; curing unit, however, had no effect in this regard. [24]
in other words, some systems are more dependent on Considering the current controversies in the re-
light-activation than others. [14] sults of studies and the shortcomings of previous studies
The effect of different factors on DC of resin ce- and also the growing use of porcelain veneers and light-
ments beneath the porcelain veneers has been extensive- cure and dual-cure resin cements, this study was aimed
ly studied. Most previous studies in this regard have to assess the effect of increasing IPS-Empress porcelain
used the Knoop or Vickers hardness tests. Although it is thickness on DC of Choice2 light-cure and Nexus3 du-
believed that hardness is strongly correlated with the al-cure resin cements by using FTIR spectroscopy.
DC, [14] more accurate techniques are also available for
this purpose which can determine the number of carbon- Materials and Method
carbon double bonds (C=C) present in resin matrix In this experimental study, porcelain discs were fabri-
qualitatively and quantitatively such as nuclear magnet- cated of A2 shade of IPS Empress ceramic (Ivoclar;
ic resonance (NMR), high performance liquid chroma- Vivadent, Liechtenstein) with 10mm diameter and 0.5,
tography (HPLC), gel permeation chromatography 1 and 1.5mm thicknesses using wax models and the
(CPC), multiple internal reflection (MIR), infrared spec- lost-wax technique, based on manufacture instruction
troscopy IR and FTIR spectroscopy. [15-17] It has been cylindrical patterns were made with organic wax
shown that light transmission through porcelain can be (Thowax; Yeti Dentalprodukte, Engen, Germany), in-
as little as 2% to 3%, with a porcelain thickness ranging vested with phosphate- based material (Esthetic Speed,
from. 5 to 2 mm. Therefore, increasing the polymeriza- Ivoclar Vivadent), and heated at 8508 C for 1 h in a
tion time may be prudent to ensure adequate polymeri- ceramic oven (Austromat M; Dekema Dental-
zation. [18] Cho et al. [19] showed that increasing the Keramiko¨ fen, Freilassing, Germany). The ceramic was
e.max Press thickness by up to 1.2mm had no effect on then heat pressed into the molds using the EP600 fur-
the DC of light-cure resin cements. When using 1.2mm nace (Ivoclar Vivadent).
thick porcelain, DC of light-cure cement was signifi- Based on the type of cement used (Choice 2 light-
cantly higher than that of dual-cure cement. Runnacles cure or Nexus3 dual-cure cements), samples were di-
et al. [20] indicated that increasing the porcelain thick- vided into two groups. Based on the porcelain thickness,
ness by up to one millimeter had no effect on the DC of each group was divided into four subgroups (including a
light-cure resin cements. Palta et al. [21] demonstrated control group without porcelain). Therefore, 24 samples
that the light transmittance was decreased with in- were divided into eight groups of three (n=3).
creased material thickness and reported that the ceramic To measure the DC (%) using FTIR spectroscopy,
thickness exerted the highest influence on the transmit- uncured resin cement samples were first placed in FTIR
ted irradiance, closely followed by color. in such a way that the red laser beam, which indicates

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Hoorizad Ganjkar M., et al. J Dent Shiraz Univ Med Sci., 2017 March; 18(1): 30-36.

Table 1: Materials used in the study

Material Brand name Manufacturing company Composition Serial number

Ivoclar, Vivadent, Schaan, SiO2-Al2O3, K2O, Na2O3, Ce2O2,
Leucite porcelain IPS-Empress F68744
Liechtenstein B2O3, Cao, BaO, TiO2
Light-cure resin cement Choice2 Bisco, USA BIS-GMA, TEG DMA, UDMA 0900011425
Dual-cure resin cement Nexus3 Kerr, Orange, USA Bis-GMA 400004216
LED LEDemetron II Kerr, Orange, USA - 762004654
FTIR spectroscopy Equinox 55 Bruker, Germany - -

the path of infrared beam passed right from the center of used for pairwise comparison of porcelain thicknesses.
the sample. The absorption curve of each sample was Data were analyzed using SPSS version 11.5 software
drawn using the FTIR spectra. (Table 1) (Microsoft, IL, USA) and p< 0.05 was considered statis-
To obtain 50μ thickness of resin cements, porce- tically significant.
lain discs and a transparent polyethylene film were
placed on uncured resin cement and 250mg load was Results
applied on the samples for two minutes. (Figure 1a and Chocie3 and Nexus3 resin cements before and after
1b) [22] The curing was done by using a LED light- light curing were subjected to FTIR spectroscopy. The
curing unit (LEDemetron II; Kerr, Orange, CA USA) DC under the 0.5, 1.5 and 2 mm thicknesses of IPS Em-
2
with a light intensity of 600mW/cm for 40 seconds press was 68.67±0.88, 71.06±0.94 and 72.51±0.41, re-
using an overlapping technique. (Figure 1c) Resin ce- spectively for Choice2, which were not significantly
ment samples were fabricated as such beneath the different (p> 0.05). (Table 2) These values were
porcelain discs with 0.5, 1 and 1.5mm thicknesses and a 69.60±2.12, 69.64±1.63 and 69.24±2.12 for Nexus3
control group with no porcelain disc. (Figure 1d) The respectively, though not significantly different either
samples underwent FTIR spectroscopy and the absorp- (p> 0.05). (Table 3)
tion curves were drawn for each sample using FTIR
Table 2: The mean and standard deviation of degree of con-
spectra. (Figure 2) The DC of samples was determined version of Choice 2 resin cement in the experimental and
using the equation below: control groups
DC (%) = [1-(A/B) ×100] Degree of Conversion Standard P
Mean
Where A was aliphatic absorption of C=C/ aromatic Thickness(mm) Deviation value
absorption of C=C of polymer and B was aliphatic ab- 0mm 70.74 ±2.32
0.5mm 68.67 ±0.88
sorption of C=C/aromatic absorption of C=C of mono- 0.79
1mm 71.06 ±0.94
mer. Aliphatic absorption peak of C=C at 1637cm and 1.5mm 72.51 ±0.41
aromatic absorption peak of C=C at 1609 cm were con-
The DC of the control groups was 70.74±2.12 for
sidered as internal standards.
Choice2 and 65.38±2.25 for Nexus3; no significant dif-
Statistical analysis
ference was noted in the DC among the experimental
The Kruskal Wallis test showed that the data did not
and control groups either (p> 0.05).
have a normal distribution. Thus, the Dunn’s test was

Figure 1a: Uncured resin cement and a transparent polyethylene film, b: Uncured resin cement and a transparent polyethylene film, c:
The curing was done by using a LED light-curing unit, d: Resin cement samples were fabricated as such beneath the porcelain discs
with 0.5, 1 and 1.5mm thicknesses and a control group with no porcelain disc

32
Evaluation of the Effect of Porcelain Laminate Thickness on Degree of Conversion of Light Cure and … Hoorizad Ganjkar M., et al.

Figure 2: The samples underwent FTIR spectroscopy and the absorption curves were drawn for each sample using FTIR spectra

ance to the porcelain surface. Comparison of the trans-

Table 3: The mean and standard deviation of degree of con-
version of Nexus3 resin cement in the experimental and con- lucency of lithium disilicate glass ceramics and Leucite
trol groups ceramics revealed that lithium disilicate appeared more
Degree of Conversion Standard P opaque due to the orientation of the crystalline phase
Mean
Thickness(mm) Deviation value and DC further decreased in this ceramic compared to
0mm 65.38 ±2.25
0.5mm 69.60 ±2.12 Leucite ceramic. [14] Complete polymerization is criti-
0.82
1mm 69.64 ±1.63 cal for both these cements because incomplete polymer-
1.5mm 69.24 ±2.12
ization of resin cements decreases their mechanical
properties, dimensional stability and bond to tooth struc-
Discussion
ture and results in microleakage, decreased biocompati-
The results of this experimental study showed that in-
bility, discoloration and post-operative tooth hypersensi-
creasing the IPS Empress porcelain thickness from 0.5
tivity. [28-30]
to 1.5 mm had no significant effect on DC of Choice2
IPS-Empress II ceramic can be used for fabrica-
light-cure and Nexus3 dual-cure resin cements. No sig-
tion of different types of indirect restorations such as
nificant difference was noted in DC of experimental and
veneers, inlays, onlays, and crowns. The trend toward
control groups either.
natural view for laminate veneers led to introduction of
Light-cure and dual-cure resin cements require op-
more translucent ceramics. Studies have shown that
timal lighting for adequate polymerization. [25] In dual-
IPS- Empress II has higher translucency than that of
cure cements, the chemically cured cement component
reinforced ceramics such as Procera, In-Ceram Alumina
may compensate for the decreased transmitted light;
and In-Ceram zirconia. [31-33]
however, it has been shown that polymerization of the
No specific curing time has been recommended
chemical component of dual-cure cements alone cannot
for different thicknesses and shades of porcelain by the
yield the maximum DC of monomers. [26-27] There-
manufacturers. Generally, 40 seconds of curing with
fore the DC could be influenced by the microstructure
400 mW/cm2 light intensity (yielding 16000mJ energy)
of porcelain. [20]
is sufficient for complete polymerization when light is
The crystalline phase of ceramic affects the DC of
directly irradiated on the material surface. [34] Evidence
resin cements via light scattering and diffraction. Ac-
shows that the use of higher energy is not directly corre-
cording to De Souza et al. [14] the light scattering cen-
lated to the DC. [14] Thus, we also performed 40 se-
ters decrease light transmission and subsequently reduce
conds of light curing with a light intensity of 600
the DC of resin cements and confer an opaque appear-

33
Hoorizad Ganjkar M., et al. J Dent Shiraz Univ Med Sci., 2017 March; 18(1): 30-36.

mW/cm2 using the overlapping technique. Therefore, all higher affected the microhardness of cement, and the
cement areas received maximum light for adequate microhardness of light-cure resin cements was lower
polymerization. Nonetheless, future studies are required than that of dual-cure cements and the control group.
to evaluate the effects of different light curing protocols They also confirmed an association between the light
on polymerization of resin cements. intensity and hardness and stated that the porcelain
Öztürk et al. [35] assessed the effect of ceramic thickness had a greater impact on hardness than the
shade and thickness on the micromechanical properties porcelain shade. They measured microhardness in their
of light-cure cements beneath the IPS-Empress ceramic study, which is a functional method. Moreover, the
using hardness tests. They found that ceramic thickness thickness of cement used was not similar to the clinical-
was more effective on the micromechanical properties ly ideal thickness of cement. [23]
of the resin cements than ceramic shade. Pazin et al. [24] assessed the effect of porcelain
In present study, different thickness of ceramic and light curing unit on light transmission through the
with the same shade was evaluated. In a similar study ceramics and the DC of dual-cure cements. They meas-
Cho et al. [19] demonstrated that increasing the porce- ured the Knoop hardness number and showed that ce-
lain thickness by up to 1.2mm had no effect on DC of ments beneath 1.4-2mm ceramics had lower hardness
light-cure resin cements. Using 1.2mm thickness of than the control groups of light-cure, self-cure and dual-
porcelain, the DC of light-cure cement was found to be cure cements; these findings are in contrast to the cur-
significantly higher than that of dual-cure cement, rent results. [24] They measured the Knoop hardness
which is in line with the current study. number as a function of DC, which is not accurate. Also,
Runnacles et al. [20] showed that increasing the the cement thickness was one millimeter, which is dif-
porcelain thickness by up to one millimeter had no ef- ferent from the clinically ideal cement thickness. [24] In
fect on the DC. Using 1.5mm thickness of IPS e.max the current study, we tried to simulate the cement thick-
LT ceramics, the DC of cement was found to be signifi- ness in the clinical setting.
cantly lower than that of the control group. The differ-
ence between their results and ours may be due to the Conclusion
optical properties of the ceramics used. [20] In a similar Within the limitations of this in vitro study, the results
study, Yuh et al. [13] assessed the DC of light-cure ce- showed that increasing the IPS Empress porcelain
ments beneath the IPS-Empress ceramics using FTIR thickness from 0.5 to 1.5mm had no adverse effect on
spectroscopy and concluded that ceramics with 0.5, 1 the DC of Choice2 light-cure and Nexus3 dual-cure
and 1.5mm thicknesses had no significant effect on DC resin cements. Thus, these cements can be used as luting
of resin cements compared to the control group, which agents for porcelain veneers with up to 1.5mm thick-
is in accordance with our findings. [13] ness; however, discoloration and esthetic complications
Moraes et al. [22] evaluated the effect of light and in the body and margins of the veneers cemented with
duration of curing on DC of dual-cure cements beneath dual-cure cements in the long-term must be taken into
different thicknesses of porcelain using FTIR spectros- account.
copy. They measured the DC of cements beneath 0, 0.7,
1.4 and 2mm thicknesses of porcelain after curing for 40 Conflict of Interest
seconds and one, two, four, six, eight and 10 minutes. None to declare.
They showed that increasing the thickness of porcelain
decreased the transmitted light intensity and concluded References
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