RESEARCH AND EDUCATION

Translucency of zirconia-based pressable ceramics with

different core and veneer thicknesses
Il-Do Jeong, PhD,a So-Yeon Bae, PhD,b Dong-Yeon Kim, MSc,c Ji-Hwan Kim, MPH, PhD,d and
Woong-Chul Kim, MPH, PhDe

The heat-press technique is a ABSTRACT

restoration fabrication method Statement of problem. Little information is available on the translucency of zirconia-based
in which heat and pressure are pressable ceramic restorations with a pressed ceramic veneer and zirconia core in various
simultaneously applied and a thickness combinations.
heated ceramic ingot is pushed
Purpose. The purpose of this in vitro study was to assess the translucency of 3 types of zirconia-
into a mold cavity.1,2 This based pressable ceramics for different core-veneer thickness combinations.
method has been used in
dentistry over the past 40 years Material and methods. A bilayered ceramic specimen was prepared with a pressable ceramic (IPS
e.max Zirpress, Initial IQ, Rosetta UltraPress) veneer over a zirconia core (Zenostar Zr). Three groups
to fabricate ceramic restora-
of specimens (n=7) were formed with the following core+veneer thicknesses: 1 +0.5 mm, 0.7 +0.8
tions.3 More recently, it has mm, and 0.5 +1 mm. To obtain consistent thickness and high translucency, all specimens were
been used to layer a ceramic subjected to surface grinding with a grinding machine. To eliminate the effect of differences in
restoration, whereby a heated roughness on the translucency, the surface roughness of the ground specimens was measured with
ceramic ingot is pressed over a a scanning proler, and the consistency of these measured values was veried through statistical
zirconia core. 4 analysis. The luminous transmittance of the specimens was measured with a spectrophotometer.
The veneer ceramic layered The effects of the pressable ceramic type and core-veneer thickness combination on transmittance
were assessed using a 2-way ANOVA (a=.05).
on the zirconia core through
the heat-press technique has Results. The consistency of the surface roughness among the tested specimens was conrmed
the same chemical composi- using a 1-way ANOVA and the Tukey HSD post hoc test (P<.05). The luminous transmittance
exhibited a statistically signicant dependence on both the type of pressable ceramic and the
tion as a hand-applied ceramic
core-veneer thickness combination (P<.05).
veneer.5 However, the press-
ing technique avoids in- Conclusions. The type of pressable ceramic and core-veneer thickness combination affected the
clusions, pores, and cracks translucency of the restoration. (J Prosthet Dent 2016;115:768-772)
inside the veneer ceramic.5,6
As a result, a restoration fabricated by overpressing is However, ceramic materials for the fabrication of
more tolerant of a cohesive failure inside the veneer than esthetic restorations must provide not only outstanding
a ceramic restoration fabricated using the lamination mechanical characteristics but also optical characteristics
technique.5,7 In recent years, considerable research has similar to those of natural teeth.8,9 Research must be
been performed to investigate the mechanical charac- conducted not only on the mechanical characteristics of
teristics of zirconia-based pressable ceramic veneers.1,4-6 zirconia-based pressable ceramic veneers but also on

Supported by a Korea University grant.

a
Doctoral student, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.
b
Doctoral student, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.
c
Graduate student, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.
d
Professor, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.
e
Professor, Department of Dental Laboratory Science and Engineering, College of Health Science, Korea University, Seoul, Republic of Korea.

768 THE JOURNAL OF PROSTHETIC DENTISTRY

June 2016
Clinical Implications
Adjustment of the core and veneer thicknesses
must be considered to control the translucency of a
bilayer ceramic restoration.
their optical characteristics. In particular, translucency
has been identied as an important inuence on the
esthetic qualities of teeth,10-13 and considerable efforts
have been focused on the translucency of ce-
ramics.10-12,14-16 In previous studies, the translucency of
ceramics was generally measured quantitatively using
either the translucency parameter (TP) or contrast ratio
(CR). The CR was reported by Powers et al17 in 1978 for
the quantitative measurement of the translucency of
restorative resin and was calculated as the ratio of the
reectance of the specimen against a white background
to that against a black background. Johnston et al18
adapted this method and used the TP for the quantita-
tive assessment of translucency. The TP was directly
calculated according to the difference in the color of the
specimen between the white and black backgrounds and
was measured using an instrument such as a spectro-
photometer, which determined color through the CIELab
system.19-25 However, such methods do not enable direct
measurements of translucency, and some studies report
nonlinear relations between luminous transmittance and
TP under transmission levels lower than 50%.26,27
Zirconia-based pressable ceramics have a bilayer struc-
ture comprising a core and veneer, and changes in the
thicknesses of the core and veneer are known to affect
the translucency of ceramics.9 However, studies exam-
ining the effect of core-veneer thickness combinations on
translucency are rare, as is research concerning the
translucency of zirconia-based pressable ceramics.
In this study, the luminous transmittance of 3 types of
zirconia-based pressable ceramic veneers with different
core-veneer thickness combinations were investigated.
The null hypothesis was that the translucency of
zirconia-based pressed ceramics is not affected by the
type of material or the thickness combination.
MATERIAL AND METHODS
The zirconia used for the core and the pressable ceramics
used for the veneer are specied in Table 1. To produce
the specimen, a zirconia blank was milled using
computer-aided design and computer-aided
manufacturing (CAD/CAM) (DWX-50; Roland), and the
milled zirconia core was then red according to the
manufacturers instructions. To apply the veneer on the
zirconia core, a wax block was milled using CAD/CAM
(DWX-50; Roland), and a wax veneer was subsequently
attached to the zirconia core before it was invested and
Jeong et al
769
Table 1. Materials used
Materials Manufacturer Color
Major
Crystalline Lot Number
Pressed Ingot
IPS e.max ZirPress Ivoclar Vivadent AG A1 Fluorapatite R65422
Initial IQ GC A1 Leucite 872703
Rosetta UltraPress HASS A1 Lithium FAA01GK1001
disilicate
Zirconia
Zenostar Zr Wieland Dental light N/A O98FGK2002
eliminated. Then, according to the method recom-
mended by the manufacturer, the ceramic ingot was
pressed (Table 2). In total, 63 specimens were produced:
21 per pressable ceramic group with 7 specimens for each
thickness combination. The thickness and size of the
specimens are shown in Figure 1. The surfaces of the
specimens were ground (M-Prep 3; Allied High Tech)
while wet on 240-, 400-, 600-, 800-, and 1200-grit silicon
carbide paper. While the specimens were being ground,
their thicknesses were measured frequently with a digital
micrometer (Mitutoyo IP65; Mitutoyo), and they were
ultimately ground to a thickness of 1.5 0.01 mm. All the
produced specimens were cleaned in an ultrasonic
cleaner (SD-B200H; Mujigae) for 180 seconds to remove
any residue.
To measure the surface roughness of each specimen,
a scanning proler (Alpha-Step D-500; KLA-Tencor)
with a stylus was used. The stylus was placed at the
center of the specimen surface, and the average rough-
ness was calculated by measuring the roughness across a
5-mm length at a speed of 0.1 mm/s. To ensure regularity
among the specimen surfaces of all groups, the calculated
roughness values were evaluated with a 1-way ANOVA
and the Tukey HSD post hoc test (a=.05).
For the quantitative analysis of the luminous trans-
mittance, a spectrophotometer (CM-3600A; Konica
Minolta) with a dual-beam system was used. Measure-
ments were performed in the transmittance chamber of
the spectrophotometer by using pulsed xenon lamps as
the light source. To measure transmittance, a zero
calibration plate was attached to the chamber to calibrate
it, after which the plate was removed and a custom
specimen holder was attached. The measured values were
converted with color matching functions from color data
software (SpectraMagic NX CM-S100w; Konica Minolta),
and the luminance was measured initially without the
specimen (Luminancesource) and then with the specimen
(Luminancespecimen).28 The luminous transmittance (T%)
was calculated using the following expression:
 
Luminancespecimen
T%= 100:
Luminancesource
Statistical analysis was performed with software
(Statistical Package for Social Sciences, SPSS v21.0; IBM
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Table 2. Heat-pressing schedule for pressable ceramics

Heating Start Heating Rate Vacuum Hold Pressing
Brand Name of Product Temperature ( C) Temperature ( C) ( C per min) Time (min) Temperature ( C)
IPS e.max ZirPress 900 700 60 15 910
Initial IQ 850 700 60 20 940
Rosetta UltraPress 925 700 30 20 925

0.6 mm Table 3. Mean and standard deviation of measured surface roughness of

specimens
0.5 mm Types of zirconia-based pressed ceramics
1.0 mm IPS e.max ZirPress, mm Initial IQ, mm Rosetta UltraPress, mm
Veneer 0.355 (0.047)a 0.322 (0.025)a 0.331 (0.067)a

0.7 mm *Means in row with different superscript letters were signicantly different (P<.05) using 1-
0.8 mm way ANOVA and Tukey HSD post hoc test.

Core
Table 4. Mean and standard deviation of absolute translucency with
1.0 mm respect to types of zirconia-based pressed ceramics and different
0.5 mm thickness combinations
Figure 1. Size and form of tested specimens. Types of zirconia-based pressed ceramics
Thickness IPS e.max Rosetta
(veneer+core), mm ZirPress (%) Initial IQ (%) UltraPress (%)

SPSS). First, the homogeneity of the variance was 1.0 +0.5 27.6 (0.7)a 29.8 (0.8)b 25.7 (0.6)c
cd a
0.7 +0.8 25.4 (0.8) 28.1 (0.4) 24.7 (0.7)d
assessed using the Levene test (P=.196) and subse- a b
27.4 (0.5)a
quently a 2-way ANOVA was used (a=.05). Because the 0.5 +1.0 27.3 (0.6) 29.3 (0.5)

interaction between the 2 classication standards was *Different superscript letters indicate statistically signicant difference (P<.05).

found to be signicant (P<.001), the statistical signi-

cance of the average difference among 9 comparison different core-veneer thickness combinations indicated
groups was investigated. an 88.6% variation in the luminous transmittance.

RESULTS
The measurement results for the surface roughness of
specimens with different types of zirconia-based press-
able ceramics are listed in Table 3. No statistically
signicant difference was observed among the groups,
conrming the consistency in the surface roughness
among the specimens.
The average luminous transmittance for the different
types of zirconia-based pressable ceramic used for
veneering and the different core-veneer thickness com-
binations ranged from 24.7% to 29.8%. The luminous
transmittance was highest for the combination of Initial
IQ veneer thickness of 1 mm and core thickness of 0.5
mm and lowest for the combination of Rosetta UltraPress
thickness of 0.7 mm and core thickness of 0.8 mm.
(Table 4, Fig. 2). The interaction between the different
types of zirconia-based pressable ceramics used for
veneering and the different core-veneer thickness com-
binations was found to be signicant. The combination of
0.8-mm core thickness and 0.7-mm veneer thickness
showed the lowest transmittance. For the combination of
0.5-mm core thickness and 1-mm veneer thickness,
UltraPress showed signicantly lower luminous trans-
mittance than ZirPress and IQ. The 2-way ANOVA
based on the main effects and interaction between the
different types of zirconia-based pressable ceramics and
DISCUSSION
Previous research regarding the optical characteristics of
dental ceramics focused largely on the color or trans-
lucency.10-12,14-16 Translucency has been evaluated by
ceramic thickness,12 surface texture,24 composition,11 and
illumination.15 However, because translucency has only
been measured for specimens in the monolithic form,11 it
was difcult to accept the results as clinically valid, even
though the ceramic restoration with the core-veneer
structure was a bilayer structure. Thus, in the present
research, the translucency of core-veneer specimens with
different thickness combinations was measured to obtain
clinically valid results.
Previous studies regarding the translucency of dental
ceramics indicated that the roughness of the specimen
surface strongly affects the translucency.24,28 Thus, in the
present study, to eliminate such effects, the surface
roughness of the specimens was measured with prol-
ometry; the results conrmed the consistency of the
surface roughness (Table 3).
The null hypothesis was rejected; that is, the types of
zirconia-based pressable ceramics and core-veneer
thickness combinations affected the luminous trans-
mittance. According to the translucency measurement
results, the combination of 0.7-mm veneer thickness and
0.8-mm core thickness exhibited the lowest value of

THE JOURNAL OF PROSTHETIC DENTISTRY Jeong et al

June 2016
Thickness (mm)
1.0+0.5
0.7+0.8
30 0.5+1.0
Translucency (%)
28
26
24
Zirpress IQ Rosetta
Pressed Ceramic
Figure 2. Box-and-whisker plot of luminous transmittance of zirconia-
based pressed ceramics with different core-veneer thickness
combinations.
transmittance. As the veneer thickness was decreased
further, the value of transmittance tended to increase
(Table 4). Among all the core-veneer thickness combi-
nations, the IQ group exhibited the highest transmittance
values (Fig. 2). This is attributed to the differences in the
major crystalline structure of the examined zirconia-
based pressable ceramics,11 as summarized in Table 1.
The leucite-based crystalline IQ ceramic exhibited a
higher transmittance value than the ZirPress ceramic
composed of uorapatite and UltraPress composed of
lithium disilicate. This result is similar to those reported
by Bagis and Turgut11 concerning the optical character-
istics of laminate veneers, indicating that the IPS
Empress Esthetic with a leucite-based crystalline struc-
ture has higher translucency compared with the IPS
ZirPress, which contains uorapatite, and IPS e.max
Press, which contains lithium disilicate. The difference in
translucency is caused by the differences among the
leucite, uorapatite, and lithium-disilicate crystalline
structures and can be interpreted as a difference in the
form and volume of the crystals inside the glass ceramic.
The leucite microstructure is characterized by the for-
mation of single crystals, and because it has a lower
degree of crystallinity compared with uorapatite and
lithium disilicate, it exhibits higher translucency.2,25
Similarly, the UltraPress with lithium-disilicate crystals
exhibited the lowest translucency in the case of a veneer
thickness of 1 mm, in that it had the highest crystallinity
and the crystals were randomly located and were needle-
shaped.2,11,28 However, at a veneer thickness of 0.5 mm,
Jeong et al
771
the similar degree of increase in the translucency of the
UltraPress and the ZirPress is attributed to the deterio-
ration in the opaque optical characteristics at a low
thickness.
The 1.5-mm ceramic specimen used in this study was
previously reported to yield an esthetic outcome unre-
lated to the underlying foundation or cement color.13
Thus, in this study, because a specimen with a total
thickness of 1.5 mm was used, the underlying structure
had no effect. However, other factors that affect the
translucency, such as roughness and aging, were not
considered, which can be regarded as a limitation of this
research. Future investigations may also include the ef-
fect of the translucency of a* or b*, as the transmittance
of the chromatic constituents through restorative mate-
rials may inuence the esthetics as much as L*.
CONCLUSIONS
The translucency of zirconia-pressed ceramics is deter-
mined by the specic microstructure of the material. For
an overall restoration thickness of 1.5 mm, the change in
the thickness of the zirconia-based pressable ceramic
veneer is a major factor in determining the translucency
of the restoration.
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Corresponding author:
Woong-Chul Kim
Department of Dental Laboratory Science and Engineering
College of Health Science
Korea University
Anam-dong 5-ga, Seongbuk-gu, Seoul 136-072
REPUBLIC OF KOREA
Email: kuc2842@korea.ac.kr
Copyright 2016 by the Editorial Council for The Journal of Prosthetic Dentistry.
Jeong et al