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VOLUME 38 • NUMBER 7 • JULY/AUGUST 2007 e425
QUI NTESSENCE I NTERNATI ONAL
Marginal adaptation of metal-based restora-
tions is of clinical importance for the longevi-
ty of the restoration, maintenance, and health
of gingival tissues.
1,2
The existence of a mar-
ginal gap promotes gingival inflammation
and microleakage at the restoration margins
that may eventually lead to recurrent caries or
pulpitis.
3
Tight cervical adaptation of the restora-
tions in dentistry is crucial for the success of
the restorations.
4
Previous investigations
revealed the cervical finish line, internal fit,
type of luting cement, preparation shapes,
and casting procedure as important require-
The influence of cervical finish line, internal
relief, and cement type on the cervical
adaptation of metal crowns
Marco Antonio Bottino, DDS, PhD
1
/Luiz Felipe Valandro, DDS, MSc, PhD
2
/
Leonardo Buso, DDS, MsC, PhD
3
/Mutlu Özcan, Dr Med Dent, PhD
4
Objective: The aim of this investigation was to evaluate the cervical adaptation of metal
crowns under several conditions, namely (1) variations in the cervical finish line of the
preparation, (2) application of internal relief inside the crowns, and (3) cementation using
different luting materials. Method and Materials: One hundred eighty stainless-steel mas-
ter dies were prepared simulating full crown preparations: 60 in chamfer (CH), 60 in 135-
degree shoulder (OB), and 60 in rounded shoulder (OR). The finish lines were machined at
approximate dimensions of a molar tooth preparation (height: 5.5 mm; cervical diameter: 8
mm; occlusal diameter: 6.4 mm; taper degree: 6; and cervical finish line width: 0.8 mm).
One hundred eighty corresponding copings with the same finish lines were fabricated. A
30-µm internal relief was machined 0.5 mm above the cervical finish line in 90 of these
copings. The fit of the die and the coping was measured from all specimens (L0) prior to
cementation using an optical microscope. After manipulation of the 3 types of cements
(zinc phosphate, glass-ionomer, and resin cement), the coping was luted on the correspon-
ding standard master die under 5-kgf loading for 4 minutes. Vertical discrepancy was again
measured (L1), and the difference between L1 and L0 indicated the cervical adaptation.
Results: Significant influence of the finish line, cement type, and internal relief was
observed on the cervical adaptation (P < .001). The CH type of cervical finish line resulted
in the best cervical adaptation of the metal crowns regardless of the cement type either
with or without internal relief (36.6 ± 3 to 100.8 ± 4 µm) (3-way analysis of variance and
Tukey’s test, ␣ = .05). The use of glass-ionomer cement resulted in the least cervical dis-
crepancy (36.6 ± 3 to 115 ± 4 µm) than those of other cements (45.2 ± 4 to 130.3 ± 2 µm)
in all conditions. Conclusion: The best cervical adaptation was achieved with the chamfer
type of finish line. The internal relief improved the marginal adaptation significantly, and the
glass-ionomer cement led to the best cervical adaptation, followed by zinc phosphate and
resin cement. (Quintessence Int 2007;38:616.e425–432)
Key words: cementation, finish line, glass-ionomer cement, marginal adaptation, Panavia,
prosthodontics, resin cement, zinc phosphate cement
1
Chair and Professor, School of Dentistry, Department of Dental
Materials and Prosthodontics, São Paulo State University, São
José dos Campos, Brazil.
2
Associate Professor, Department of Restorative Dentistry,
Federal University of Santa Maria, Santa Maria, Brazil.
3
Lecturer and Clinical Assistant, Department of Dental Materials
and Prosthodontics, School of Dentistry, São Paulo State
University, São José dos Campos, Brazil.
4
Adjunct Professor and Research Associate, Academy of Medical
Center Groningen, Department of Dentistry and Dental
Hygiene, Groningen, The Netherlands.
Correspondence: Dr Marco Antonio Bottino, School of
Dentistry, Department of Dental Materials and Prosthodontics,
São Paulo State University, Av. Francisco José Longo, 777, CEP:
12245-000, São José dos Campos, Brazil. E-mail: mmbottino@
uol.com.br
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e426 VOLUME 38 • NUMBER 7 • JULY/AUUST 2007
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Bot t i no et al
ments for good marginal fit of the crown.
5–9
Various designs of cervical finish lines may
have a negative effect on marginal fit of a
restoration.
10,11
As a consequence, a larger
amount of luting agent is exposed to the oral
milieu.
The internal relief of the crowns affects the
seating of the crowns.
12
Internal relief between
the cast restoration and the preparation can
be achieved with the application of paint-on
spacers onto the dies prior to preparation of
the wax pattern.
6
The ideal average thickness
of the spacer should be about 25 µm. In lab-
oratory practice, the spacers are frequently
applied 1 mm above the die margin.
6
In a study by Hunter and Hunter,
10
it was
shown that the type of the cervical finish line
employed for tooth preparations could affect
the cervical adaptation of the restorations.
Chamfer and shoulder type of finish lines fre-
quently led to better marginal adaptation.
In prosthetic dentistry, a series of modifi-
cations of cervical finish line types have been
tried for the purpose of achieving a better
adaptation of such restorations.
13
The ideal
cervical line and minimal marginal gap
would also serve for less solubility of the lut-
ing cements at the margins.
14
Successful per-
formance of crown restorations are depend-
ent on the cervical finish line, cement type,
and good seating of the restoration.
Based on the methodology proposed by
Rocha et al,
15
this study aimed to analyze
some of the parameters that may influence
the cervical adaptation of metal full crowns
used in fixed prosthodontics, namely (1) vari-
ations in the cervical finish line of the prepara-
tion, (2) application of internal relief inside the
crowns, and (3) cementation using different
luting materials. The null hypothesis to be test-
ed was that these parameters have no influ-
ence on cervical adaptation of full crowns.
Fig 1a Stainless-steel master dies (height: 5.5 mm; cervical diam-
eter: 8 mm; occlusal diameter: 6.4 mm; taper degree: 6; and cervi-
cal finish line width: 0.8 mm) simulating full crown preparations
with chamfer (left), 135-degree shoulder (center), and rounded
shoulder (right) finish lines.
Fig 1b Metal copings for the master dies obtained by
machining stainless-steel cylinders in a precision lathe. Note
the 2 guiding grooves with 1.5-mm depth on the external
axial walls of the metal rods, below the cervical finish line for
better orientation of the coping during cementation.
Fig 2 Dental surveyor at which cementation of the
coping on the master die was achieved under 5 kgf.
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VOLUME 38 • NUMBER 7 • JULY/AUGUST 2007 e427
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METHOD AND MATERIALS
Standard master dies
One hundred eighty stainless-steel master
dies simulating full crown preparations,
being 60 in chamfer (CH), 60 in 135-degree
shoulder (OB), and 60 in rounded shoulder
(OR) finish lines, were machined at approxi-
mate dimensions of a molar tooth prepara-
tion (height: 5.5 mm; cervical diameter: 8
mm; occlusal diameter: 6.4 mm; taper
degree: 6; and cervical finish line width: 0.8
mm) (Fig 1a). Two guiding grooves with 1.5-
mm depth were made on the external axial
walls of the metal rods below the cervical fin-
ish line in order to allow for better orientation
of the coping during cementation.
Metal coping
One hundred eighty metal copings, simulat-
ing the full crown preparations, were
obtained by machining stainless-steel cylin-
ders (Villares, V-303) with 12.7 mm of diame-
ter in a precision lathe (Fig 1b). The copings
obtained had the same cervical finish line
preparation with the standard master dies.
Finishing was carried out in the internal por-
tion to achieve good fitting of the standard
model/coping set. In half the crowns (n =
90), 30 µm internal relief was machined 0.5
mm above the cervical finish line.
Initial cervical adaptation
measurement of dies and copings
The initial fit of each coping was measured
before cementation from all specimens
(baseline value). Metal copings were placed
on their corresponding dies under 5-kgf load-
ing using a dental surveyor that was espe-
cially developed for this experiment (Fig 2).
Temporary cement (Temp Bond; Kerr Italia)
was manipulated and applied on the external
channel of the coping and the die. The cop-
ing crown set was then removed, the base-
line value (L0) was measured twice, and the
mean was obtained. The baseline value was
later used to determine the difference after
luting the components. An optical micro-
scope with a micrometer (MP 320; Carl
Zeiss) (accuracy: 0.001 mm) was used for
the measurements.
Cementation of the copings on the
dies
Three types of luting cements were used in
this study: zinc phosphate (Harvard Cement;
Harvard-Dental), glass-ionomer (Ketac-Cem;
3M Espe), and resin cement (Panavia EX;
Kuraray). The cements were mixed as rec-
ommended by the manufacturer. After
manipulation, the cements were applied to
the internal part of each coping with the aid
of a brush. The coping was luted on the cor-
responding standard die under digital pres-
sure. Specimens were then submitted to 5-
kgf loading for 4 minutes. During this time,
the cement excess was removed. After 4
minutes, the load was removed, and the dis-
crepancy (L1) of each specimen was meas-
ured with a micrometer twice. The difference
between L1 and L0 indicated the cervical
adaptation value.
Statistical analysis
Three factors were studied in this study: cer-
vical finish line type (3 levels: CH, OB, and
OR), internal relief (2 levels: without and
with), and luting material (3 levels: zinc phos-
phate, glass ionomer, and resin cement) (fac-
torial design: 3 ϫ 2 ϫ 3). Eighteen groups
were composed with 10 specimens in each
group (n = 10).
The data obtained were analyzed by 3-
way analysis of variance and a post hoc test
(Tukey’s test, ␣ = .05) for pairwise compar-
isons. The statistical program used to ana-
lyze the data was Statistical Software for
Windows (ver 5.5; StatSoft).
RESULTS
Tables 1 to 3 display the mean cervical adap-
tation values and standard deviations (µm)
associated with the finish lines, internal relief,
and cement type. Results of 3-way analysis of
variance are given in Table 4. Significant
influence of the finish line, cement type, and
internal relief was observed on the cervical
adaptation (Fig 3). The values of variation
coefficient did not exceed 10%. The cervical
adaptation conditions for glass ionomer/CH
with internal relief and resin cement/CH with
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Table 1 Mean cervical discrepancy values and standard deviations (µm) associated
with the finish lines, internal relief for zinc phosphate cement (Harvard);
n = 10
Finish line
Relief OR OB CH Row (M ± SD)
Without 122.0 ± 3.1; 2.53 111.5 ± 4.3; 3.83 87.5 ± 3.8; 4.29 107.0 ± 15.1; 14.12
With 75.3 ± 1.2; 1.57 70.7 ± 1.0; 1.38 45.2 ± 1.0; 2.14 63.7 ± 13.5; 21.21
Column (M ± SD) 98.6 ± 24.1; 24.43 91.1 ± 21.1; 23.24 66.3 ± 21.9; 33.00
OR = rounded shoulder finish line; OB = 135-degree shoulder line; CH = chamfer finish line.
Table 2 Mean cervical discrepancy values and standard deviations (µm) associated
with the finish lines, internal relief for glass-ionomer cement (Ketac Cem);
n = 10
Finish line
Relief OR OB CH Row (M ± SD)
Without 115.0 ± 3.5; 3.01 103.6 ± 2.8; 2.74 76.1 ± 3.0; 3.90 98.2 ± 16.9; 17.18
With 66.5 ± 4.8; 7.17 65.2 ± 2.1; 3.22 36.6 ± 3.1; 8.49 56.1 ± 14.4; 25.71
Column (M ± SD) 90.7 ± 25.2; 27.79 84.4 ± 19.8; 23.52 56.3 ± 20.5; 36.31
OR = rounded shoulder finish line; OB = 135-degree shoulder line; CH = chamfer finish line.
Table 3 Mean cervical discrepancy values and standard deviations (µm) associated
with the finish lines, internal relief for resin cement (Panavia EX); n = 10
Finish line
Relief OR OB CH Row (M ± SD)
Without 130.3 ± 2.2; 1.71 122.9 ± 1.4; 1.14 100.8 ± 3.8; 3.73 118.0 ± 13.0; 11.0
With 113.9 ± 2.0; 1.72 100.5 ± 1.5; 1.50 70.2 ± 3.9; 5.62 94.9 ± 18.7; 19.76
Column (M ± SD) 122.1 ± 8.7; 7.11 111.7 ± 11.6; 10.38 85.5 ± 16.1; 18.88
OR = rounded shoulder finish line; OB = 135-degree shoulder line; CH = chamfer finish line.
Table 4 Results of 3-way analysis of variance
Relief 1 59,006 59,006.0 6902.91 0.0001*
Cement 2 27,387 13,693.4 1601.94 0.0001*
Finish line 2 38,851 19,425.6 2272.54 0.0001*
Relief*Cement 2 3839 1919.7 224.58 0.0001*
Relief*Finish line 2 121 60.5 7.07 0.0011*
Cement*Finish line 4 153 38.2 4.47 0.0019*
Relief*Cement*Finish line 4 790 197.6 23.12 0.0001*
Error 162 1385 8.5
Total 179 131,532
*P < .05.
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VOLUME 38 • NUMBER 7 • JULY/AUGUST 2007 e429
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internal relief presented the highest coeffi-
cient values with 8.49% and 5.62%, respec-
tively. On the other hand, the conditions for
resin cement/OB without and zinc phos-
phate cement/OB with internal relief present-
ed the lowest coefficient values with 1.14%
and 1.38%, respectively. It is verified that the
mean cervical adaptation values obtained in
the condition with relief (56.1 ± 14 to 70.2 ±
4 µm) were lower than the values obtained in
the condition without relief (98.2 ± 17 µm to
118 ± 13 µm) independent of the cement
type and the finish line.
The CH type of cervical finish line resulted
in the best cervical adaptation of the metal
crowns regardless of the cement type in the
conditions with or without internal relief (36.6
± 3 to 100.8 ± 4 µm). The use of glass-
ionomer cement resulted in the least cervical
discrepancy (36.6 ± 3 to 115 ± 4 µm) than
those of other cements (45.2 ± 4 to 130.3 ±
2 µm) in all conditions.
Regardless of the finish line type, the pres-
ence of internal relief did not significantly
change the cervical adaptation for the resin
cement (94.9 ± 19 to 118 ± 13 µm with and
without relief, respectively) when compared
with zinc phosphate (63.7 ± 14 to 107 ± 15
µm) and glass-ionomer cement (56.1 ± 14 to
98.2 ± 17 µm).
While for the zinc phosphate cement the
influence of the finish line and the presence
of relief were significantly higher than those
of other cements, these factors had no sig-
nificant effect for the glass-ionomer cement.
DISCUSSION
According to the results obtained in this
study, the null hypothesis was rejected. The
interaction of the 3 factors of cervical finish
line, internal relief, and cement type tested
revealed a statistically significant difference.
In this study, cervical finish line type
affected the cervical adaptation the most,
interfering with crown seating. The greatest
marginal discrepancy was observed with
135-degree shoulder (OB) and rounded
shoulder (OR) finish lines. Our results are
not in agreement with other studies where it
was stated that the shoulder cervical finish
lines resulted in the least cervical discrepan-
cy and that beveled shoulder finish lines
were able to close marginal openings,
although they might affect the cement
flow.
8.13
Depending on the direction and
magnitude of application, loading may gen-
erate dimensional alterations at either the
Fig 3 Mean marginal discrepancy (µm) data for the experimental conditions in plots.
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outer or the inner parts of the cervical areas
of the metal crowns. It has been previously
reported that the pressure generation dur-
ing cementation could reach up to 10 MPa.
The failure in adequate seating may be due
to a change in cement viscosity occurring
during seating the crown.
16
One other fact to be considered in cervi-
cal adaptation of full crowns is the width of
the cervical finish lines prepared in the stan-
dard dies. In our study, the cervical finish line
was 0.8 mm. This was narrower than sizes
created in other studies, which were often 1
mm.
8,13,17
When combined with 45-degree
bevel, a total width of only 0.5 mm was left at
the finish line in shoulder preparations, thus
resulting in better adaptation. This approach
has also been suggested in other studies.
7,11
An explanation for the narrower 90-degree
shoulder width is that specimens (copings)
were machined in the present study. This
protocol provides a more standardized
approach if compared to results where cop-
ings are cast.
4,12,18,19
Therefore, experiments
conducted on cast dies may have influenced
the incongruity among results.
In this study, chamfer type of finish line
resulted in the lowest mean marginal dis-
crepancy values in all conditions. In clinical
practice, however, the determinants of mar-
ginal discrepancy could be based on the pel-
licle thickness, flow, and viscosity of the
employed luting material. When a chamfer
finish line was created, zinc phosphate and
glass ionomer with or without internal relief
and resin cement without relief resulted in
more favorable mean values. Regardless of
the finish lines, marginal discrepancies
obtained for the resin cement were higher
than those of the other 2 cements with or
without internal relief and even with the
chamfer finish line. This could be caused
partly by the change of viscosity after mixing
during the setting phase. It took less than 10
seconds after mixing until specimens were
placed on the respective dies. This could be
considered negligible on viscosity change,
but still some degree of viscosity change was
observed during manipulation. Zinc phos-
phate or resin cement increased in viscosity
too rapidly to flow toward the cervical area
and extruded from the margins of crown.
9
In
contrast, the viscosity of glass-ionomer
cement remained constant before setting.
8
Previous investigations attributed the simi-
lar findings to the viscosity of selected materi-
als in general. The results of this study from
this aspect are in agreement with those inves-
tigations where glass-ionomer (Ketac-Cem)
and zinc phosphate (Fleck’s) cement were
used that resulted in the highest mean mar-
ginal discrepancy values.
4,8
White and Kipnis9
reported that the marginal discrepancy values
were the greatest with zinc phosphate cement
(Fleck’s) and then, in descending order, with
glass-ionomer (Ketac-Cem), polycarboxylate
cement (Durelon), and the resin cements
(Tenure and Panavia). In this study, Harvard
zinc phosphate cement was used for cemen-
tation instead of Fleck’s. It is also generally
believed that Fleck’s cement creates less
favorable results when compared with
Harvard.
4,8,20,21
We surely cannot make direct
comparisons since the methodology differs
among these studies. Although there is slight
difference with this study, Strutz et al
22
also
concluded that a more favorable cervical
adaptation was observed with zinc phos-
phate, followed by zinc polycarboxylate, glass-
ionomer, and resin cements. Whether the dif-
ference in results is a consequence of the vis-
cosity change during mixing and setting of
the cements or the general viscosity of the
cements themselves is not certain.
One other finding of this study was the
significant reduction in mean marginal dis-
crepancy values for the cemented crowns
when an occluso-axial internal relief of 30 Ìm
was prepared 0.5 mm above the cervical
line. This is in compliance with the majority
of the studies
2,6,8,18,19,23–26
but not with other
investigations.
5,25
In this present study, there was marginal
discrepancy experienced in all crowns after
seating of the crowns independent from the
study conditions. This means that a disconti-
nuity will always be present between the
preparation and the crown margins that are
filled with the cement material. When com-
pared with the study of Fusayama et al,
24
we
observed that loading above 15 kgf practical-
ly does not decrease marginal discrepancy of
the cemented crowns. Static or dynamic
loads as high as 100 pounds (approximately
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45.6 kgf) may promote permanent deforma-
tions in the crowns.
13
We applied a 5-kgf load
in order to achieve good adaptation of the
metallic copings to the standard die models.
Other studies also used this methodology for
cementation.
5,9,17,27,28
Marginal discrepancies between the die
and the crown and consequently the cement
solubility at the margins are almost impossi-
ble to avoid. Although the results were inferi-
or with the resin cement employed in this
study, future studies should focus on the
cement solubility or water uptake of resin-
based luting cements at the cervical margins.
In clinical situations, the precise analysis
of the cervical adaptation of the fixed pros-
thesis to their respective abutment is very dif-
ficult. This evaluation can be performed only
by means of radiographic examination or the
use of an explorer. These techniques may
often not allow a direct and accurate vision.
It is essential to receive the prosthesis from
the laboratory with minimum distortion. To
optimize the cervical adaptation and to
enhance the complete seating of crowns,
creating a correct finish line, the use of a
minimum-thickness die spacer 1 mm above
the cervical line, using the cement with favor-
able flow and adequate load application dur-
ing cementation, is compulsory.
CONCLUSIONS
Within the limits of this study, the following
conclusions were drawn:
1. The best cervical adaptation was achieved
with chamfer type of cervical finish line
either with or without internal relief.
2. Finish lines with 135-degree shoulders
(OB) and rounded shoulders (OR)
showed no statistical significance in cervi-
cal adaptation.
3. Internal relief of 30 Ìm led to better cervical
adaptation when compared to the condi-
tions where no internal relief was pre-
pared.
4. Cervical adaptation was more favorable
with the use of glass-ionomer cement fol-
lowed by zinc phosphate and resin
cement.
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