Translucency of zirconia copings made

with different CAD/CAM systems

Paolo Baldissara, DDS,a Altin Llukacej, DDS,b Leonardo Ciocca,

DDS,c Felipe L. Valandro, MSD, PhD,d and Roberto Scotti, MD,
DDSe
School of Dentistry, Alma Mater Studiorum University of
Bologna, Bologna, Italy; Federal University of Santa Maria, Santa
Maria, Brazil
Statement of problem. Zirconia cores are reported to be less translucent than glass, lithium disilicate, or alumina
cores. This could affect the esthetic appearance and the clinical choices made when using zirconia-based restorations.

Purpose. The purpose of this in vitro study was to evaluate the translucency of zirconia copings for single crowns fab-
ricated using different CAD/CAM systems, using lithium disilicate glass ceramic as a control.

Material and methods. Using impressions made from a stainless steel complete-crown master die, 9 stone cast rep-
licas were fabricated, numbered, and distributed into 8 ceramic ZrO2 CAD/CAM system groups (Lava Frame 0.3 and
0.5, IPS e.max ZirCAD, VITA YZ, Procera AllZircon, Digizon, DC Zircon, and Cercon Base) and to a lithium disilicate
glass-ceramic control group (IPS e.max Press) using a simple computer-generated randomization method. From each
die, the manufacturer’s authorized milling centers supplied 5 copings per group without applying any dying technique
to the ceramic base material. The copings were prepared to allow for a 40-µm cement layer and were of different
thicknesses according to system specifications. Translucency was measured by the direct transmission method with
a digital photoradiometer mounted in a dark chamber. The light source was a 150-W halogen lamp beam. Measure-
ments were repeated 3 times for each specimen. Data obtained were analyzed using 1-way ANOVA and the Bonferroni
multiple comparison test (α=.05).

Results. Among ZrO2 copings, Lava (0.3 mm and 0.5 mm thick) showed the highest (P<.05) values of translucency
measured as light flow units (3.572 ±018 x 103 lx and 3.181 ±0.13 x 103 lx, respectively). These values represent 71.7%
and 63.9%, respectively, of the glass-ceramic control group (4.98 x 103 lx).

Conclusions. All ZrO2 copings demonstrated different levels of light transmission, with the 2 Lava specimens showing
the highest values. Translucency of zirconia copings was significantly lower (P=.001) than that of the lithium disilicate
glass-ceramic control. (J Prosthet Dent 2010;104:6-12)

Clinical Implications
The results of this study may be helpful in determining which zirconia coping material
is most translucent and where it can be used to improve esthetic appearance when
considering zirconia-based restorations. Lava Frame with a 0.3-mm thickness dem-
onstrated the highest translucency of the materials tested and may be more suitable
for anterior applications. The least translucent of the zirconia cores could be used for
masking purposes. The masking effect can be increased using larger coping thicknesses.

a
Professor, Department of Oral Sciences, Section of Prosthodontics, Alma Mater Studiorum University of Bologna.
b
Granted Tutor, School of Dentistry, Department of Oral Sciences, Section of Prosthodontics, Alma Mater Studiorum University of
Bologna.
c
Clinical Assistant Professor, Department of Oral Sciences, Section of Prosthodontics, Alma Mater Studiorum University of Bologna.
d
Associate Professor, Division of Prosthodontics, Department of Restorative Dentistry, Federal University of Santa Maria.
e
Chief and Professor of Prosthodontics, Department of Oral Sciences, Section of Prosthodontics, Alma Mater Studiorum University
of Bologna.
The Journal of Prosthetic Dentistry Baldissara et al
July 2010
The esthetic value of a ceramic
crown is based on its ability to har-
monize with the natural tooth. Key
optical factors that permit a pleasing
harmony are color, surface texture,
and translucency.1 Translucency oc-
curs when a light beam, in passing
through a material, is partly scattered,
reflected, and transmitted through
the object: the greater the quantity of
light that passes through the object,
the higher the translucency. The hu-
man eye is able to correctly perceive
minimal variations in color, equal to
at least 2 ΔE of the CIE L*a*b* stan-
dard.2,3 The CIE (Commission Interna-
tionale de l’Éclairage) L*a*b* system
is an approximately uniform color
scale in which the differences between
points plotted in the color space cor-
respond to visual differences (ΔE)
between the colors plotted. The CIE
L*a*b* color space has a cubic shape:
the L* axis runs from top to bottom
and represents the value (or bright-
ness) of the color. On the horizontal
plane: on the a* axis, red is a positive
value and green is negative; on the b*
axis, yellow is positive, whereas blue is
negative. The eye is able, therefore, to
easily distinguish between a natural
tooth and an artificial one, even when
there are minute differences in color
and translucency. Translucency and
color are highly correlated properties
of a ceramic crown.4,5
For a ceramic crown, the greater
the translucency of the core, the more
the colors of the deepest layers of the
tooth are transmitted to the surface.
Thus, in a sufficiently translucent ce-
ramic crown used with a colorless
cement, the reflected light contains
the dominant color of the dentin,
creating a natural-looking, esthetic
restoration that blends harmoniously
with the surrounding teeth and tis-
sues. The translucency and color of
a ceramic restoration depend on the
various characteristics of the core and
veneer ceramics.6 Translucency is in-
versely related to the thickness of the
ceramic layer to be traversed by the
light beam7 and is strongly influenced
by light scattering.8 Scattering of the
Baldissara et al
light is generated by many factors,
such as different refractive indexes
among ceramic phases,6 voids and
porosities, high crystalline content,9
and crystal number and size, espe-
cially when the crystal particles are
slightly larger than the wavelength of
the incident light.6 Zirconia and alumi-
na ceramics, with their high degree of
crystalline content, have a maximum
scattering effect. Thus, they appear
relatively opaque to visible light.
Ceramic materials more satisfac-
torily address the demand for esthetic
restorations than metal ceramic res-
torations with opaque cores.10 How-
ever, the translucency of the most du-
rable zirconia-based ceramic crowns
is reported to be less than that of
glass ceramics,6,9 for which excellent
esthetic results are documented.11,12
In-Ceram Zirconia (VITA Zahnfabrik,
Bad Säckingen, Germany), an alumi-
num oxide-based ceramic with 35%
zirconium dioxide, has a relatively low
translucency, equal to that of metal
ceramic crowns when evaluated using
the contrast ratio method.6 This could
be an obstacle to achieving an esthet-
ically acceptable restoration. Among
nonzirconia core materials, an opti-
mal esthetic result has been reported
with Procera AllCeram (Nobel Bio-
care AB, Göteborg, Sweden), which
is a 99.9% aluminum oxide densely
sintered ceramic,13 and IPS Empress
(Ivoclar Vivadent AG, Schaan, Liech-
tenstein) lithium disilicate glass ce-
ramic.14 The latter evolved in 2005 to
IPS e.max Press (Ivoclar Vivadent AG),
with improved translucency and me-
chanical properties.12,15 Alumina and
glass ceramic have, respectively, fair
to high relative translucency6; never-
theless, their mechanical properties
are lower than ZrO2 ceramics. Flex-
ural strengths of 500 to 650 MPa for
alumina16 and 350 to 400 MPa for
lithium disilicate17 limit their applica-
tion to single crowns or 3-unit fixed
partial dentures (FPDs) in the ante-
rior and premolar regions.
Zirconia ceramics are reported to
have the highest mechanical proper-
ties.12,18,19 The strength of ZrO2 ce-
7
ramic frameworks seems adequate
even for prostheses that are heavily
stressed, such as posterior multi-unit
FPDs.12,20,21 Consequently, research
into computer-aided design/comput-
er-aided manufacturing (CAD/CAM)
technologies associated with this
material is widespread. Zirconia
ceramics present an alternative to
metal ceramic restorations and other
ceramic systems for posterior teeth or
highly stressed FPDs.22,23
The purpose of this study was to
analyze and compare the translucen-
cy levels of different zirconia-based
ceramic CAD/CAM systems, with
lithium disilicate glass ceramic serv-
ing as a control group.10,11 The null
hypothesis was that there would be
no difference in the translucency of
the ceramic copings evaluated.
MATERIAL AND METHODS
A stainless steel, complete crown
die with a 10-degree taper, 6.3-mm
height, 9.1-mm apical diameter, 7.1-
mm coronal diameter, and a feath-
er-edge margin was replicated us-
ing a polyether impression material
(Permadyne Light Body; 3M ESPE,
Seefeld, Germany) and type IV gyp-
sum (ResinRock; Whip Mix Corp,
Louisville, Ky) following the manu-
facturer’s instructions. The feather
edge allowed for better adaptation
of the coping to the rubber O-ring
sealer during the translucency mea-
surements. The margin was in close
contact with the rubber, so negligible
effects of the margin shape on light
transmission were expected at that
location. The surface of each replica
was examined at x3.75 magnification
to locate surface defects. Only repli-
cas free of voids or bubbles were se-
lected and sent to the milling center
of each manufacturer.
With the exception of Cercon
Base, all systems evaluated (Table I)
scanned the stone die directly. The
Cercon system scanned a wax pat-
tern of the coping made by a dental
laboratory technician. DC Zircon and
Digizon are fully sintered materials,
8 Volume 104 Issue 1

Table I. Materials and CAD/CAM systems evaluated for translucency

Groups Minimal CAD/CAM
(n=5) Material Manufacturer Thickness (mm) System and Manufacturer

EMP IPS e.max Press Ivoclar Vivadent AG, 0.5 Cerec; Sirona Dental Systems GmbH,
(lithium disilicate Schaan, Liechtenstein Bensheim, Germany
control group)

LF3 Lava Frame 0.3 3M ESPE, 0.3 Lava; 3M ESPE

St. Paul, Minn

LF5 Lava Frame 0.5 3M ESPE 0.5 Lava; 3M ESPE

EMZ IPS e.max ZirCAD Ivoclar Vivadent AG 0.5 Cerec; Sirona Dental Systems GmbH

YZ VITA YZ VITA Zahnfabrik, 0.5 Cerec; Sirona Dental Systems GmbH

Bad Säckingen, Germany

PRO Procera AllZircon Nobel Biocare AB, 0.6 Procera; Nobel Biocare AB
Göteborg, Sweden

DGZ Digizon Amman Girrbach AG, 0.6 Digident; Digident GmbH,

Koblach, Austria Pforzheim, Germany

DCZ DC Zircon DCS Dental AG 0.5 DCS Precident; DCS Dental AG

Allschwil, Switzerland

CB Cercon Base DeguDent GmbH, 0.4 Cercon; DeguDent GmbH

Hanau, Germany

whereas all the other systems milled
the zirconia in a partially sintered
state. Five copings per group were
obtained from each replica. Sample
size was determined on the basis of
preliminary measurements on similar
copings, which showed a standard
deviation lower than 0.07. Entering
a test power of 0.8 and a minimum
detectable difference among groups
of 0.2, calculations for 9 groups with
1-way ANOVA indicated 5 specimens
per group with α=.05. No coloring
techniques were used for the copings,
since variations in dye pigments and
techniques between systems may af-
fect translucency.24 The manufacturers
selected the thickness of the copings
based on their software, milling pro-
cedures, and internal specifications,
considering that they were intend-
ed for a molar ceramic crown. Two
Lava groups were analyzed, as the
The Journal of Prosthetic Dentistry
Lava Frame System provides copings
in both 0.3-mm and 0.5-mm thick-
nesses. The Cerec system supplied 5
copings made of VITA YZ, 5 made of
IPS e.max ZirCad, and 5 made of IPS
e.max Press lithium disilicate glass ce-
ramic. The latter was used as the con-
trol group. All Cerec copings were 0.5
mm thick. Procera and Cercon cop-
ings were 0.6 mm and 0.4 mm thick,
respectively. All copings except the
Cercon copings were spaced 40 µm
apart to allow for a correct cement
layer thickness using the appropriate
software option. Cercon copings were
spaced by hand using a die spacer lac-
quer (Cergo Die Spacer; Degudent
GmbH, Hanau, Germany).
The translucency was determined
by direct transmission,8 in which a
band of light generated by an incan-
descent halogen lamp (XENOPHOT
HLX 64634; Osram GmbH, Munich,
Germany) placed at the entrance to
a dark chamber (sealed black box)
was passed through the ceramic cop-
ings. The copings were mounted so
that their edges were sealed by black
rubber O-rings (BER-PA Srl, Brescia,
Italy) to exclude penetration of any
light other than through the ceramic
(Fig. 1). The internal diameter of the
O-rings was 7.4 mm. The sensor of a
digital photoradiometer (model HD
9221/S3; Delta Ohm Srl, Padua, Ita-
ly) with a spectrum range of 400 to
900 nm was placed just behind the
entrance of the dark chamber light
inlet to detect the quantity of light
transmitted by the surfaces of the
coping (Figs. 2 and 3). Measurements
were expressed in light units, Lux (lx).
The measurement system was veri-
fied before each test run of 5 copings.
First, a negative control test was per-
formed using a 0.5-mm-thick metal
Baldissara et al
July 2010 9
by the ceramic copings. Subsequent-
ly, each specimen was analyzed for
translucency, with the measurement
repeated 3 times; the first 10 seconds
after the lamp was lit, the second af-
ter 20 seconds, and the third after 30
seconds. The data were statistically
analyzed using 1-way ANOVA and the
Bonferroni multiple comparison test
(α=.05).

RESULTS

The translucency values obtained

1 Nobel Procera zirconia coping. Margin lies on rubber O-ring used for each group are summarized in
to seal light passage once specimen is positioned in dark chamber Table II. The light flow values during
inlet. No color modification was applied to ceramic material. the positive control tests without cop-
ing interference had a mean value of
28.4 ±0.08 x 103 lx. The data are also
expressed as a translucency percent-
age related to both the glass-ceramic
control group and the positive control
mean light flow.
The glass-ceramic IPS e.max Press
group showed the highest translu-
cency value (4.98 ±0.066 x 103 lx).
The translucency of the IPS e.max
Press group was significantly differ-
ent compared to all of the other zir-
conia groups (P=.001). Among ZrO2
ceramics, Lava 0.3-mm and 0.5-mm
2 Coping positioned in light inlet of dark chamber before groups demonstrated the highest
translucency test. translucency values. The translucency
of Lava 0.3-mm copings was signifi-
cantly higher than that of any other
ZrO2 material analyzed, including
Lava 0.5 mm (P<.022). The translu-
cency value of the Cercon group was
significantly lower than that of all of
the other groups evaluated (Table II).
The translucency of the Lava 0.5-mm
specimens was not significantly dif-
ferent from that of Procera AllZircon,
Digizon, DC Zircon, VITA YZ, and IPS
e.max ZirCad (Table II).

3 Sensor of photoradiometer inside dark chamber. Light inlet is DISCUSSION

coaxial to sensor light-sensitive surface (white circle). Only light
passing through coping is measured by instrument. The data obtained in this study
support rejection of the null hypoth-
disk gently pressed into the O-ring, which the light beam was allowed to esis, as the translucency of all of the
and the instrument was evaluated for pass through the dark chamber inlet zirconia groups was found to be sta-
a zero light reading. Next, 3 positive without interference. These data were tistically different from the lithium dis-
control tests without copings were recorded and used as reference values ilicate control. The translucency mea-
performed at 10-second intervals, in for the light flow reduction generated sured directly on a coping could be of
Baldissara et al
10 Volume 104 Issue 1

Table II. Translucency values obtained using direct transmission method

Nominal Mean Translucency Translucency
Ceramic Thickness Translucency Related to Positive Related to
System (mm) (Lux x 103) Control Light Flow Control Group P

Control group: 0.5 4.98 (±0.07) 17.5% 100% <.001

IPS e-max PressA
(lithium disilicate)

Lava Frame 0.3B 0.3 3.572 (±0.18) 12.5% 71.7% .022

Lava Frame 0.5C 0.5 3.181 (±0.14) 11.2% 63.9% .165

Procera AllZirconC,D 0.6 2.878 (±0.19) 10.1% 57.8% .865

DigizonD 0.6 2.725 (±0.14) 9.59% 54.7% .990

DC ZirconD 0.5 2.631 (±0.21) 9.26% 53.8% .991

VITA YZD 0.5 2.609 (±0.12) 9.18% 52.4% .995

IPS e.max ZirCADD 0.5 2.548 (±0.17) 8.97% 51.2% .009

Cercon BaseE 0.4 2.098 (±0.26) 7.38% 42.1% <.009

Ceramics with same superscripted uppercase letter are not statistically different. Data analyzed with 1-way ANOVA and Bonferroni multiple
comparison test: df = 36; F=122.95; P<.001

greater clinical relevance when com-
pared to measurements performed on
specimens with simple shapes, such
as discs or tablets. The effects of the
variables related to the production pro-
cess for an abutment-shaped coping,
such as grinding, sintering, finishing,
and definitive ceramic thickness, are
incorporated in the specimens. Since
this study evaluated and compared the
translucency of a definitive product
having a specified shape and func-
tion, the actual thickness of the cop-
ing was not determined. Only the
minimum thickness recommended
by the manufacturer was considered,
and the value obtained when measur-
ing light transmission through that
thickness is here referred to as the
translucency value.
In previous studies, CAD/CAM ce-
ramic translucency was evaluated us-
ing flat specimens of a standardized
thickness by applying the contrast
ratio method.5-7,9,19,25 In the current
The Journal of Prosthetic Dentistry
study, translucency was determined
with the direct transmission method
and light flow (Lux) as a unit of mea-
sure, allowing the use of copings in-
stead of discs or tablets. The method
demonstrated that all zirconia cop-
ings allowed the light to pass through
the material, in contrast to the results
of a study by Chen et al,19 who found
that Cercon Base Zirconia (Cercon)
was opaque, with values equal to
those of metal ceramics (contrast
ratio=1.0). Even the 33%-volume zir-
conia-toughened alumina (In-Ceram
Zirconia; VITA Zahnfabrik) has been
reported by Heffernan et al6,9 to lack
the same translucency when evalu-
ated using the contrast ratio method
(ratio=1.0). Therefore, although the
quantity of light transmitted is not re-
markable when compared to the value
of the positive control light flow, all of
the materials evaluated in the present
study may be considered translucent
to a certain degree.
Lava 0.3-mm copings demon-
strated the highest translucency val-
ue, probably due to the thin ceramic
walls and the intrinsic optical proper-
ties of the material. Lava 0.5 mm also
showed a high translucency value,
which was significantly higher than
other groups with the same minimal
thickness, such as DC Zircon, IPS
e.max ZirCAD, and VITA YZ. Differ-
ences in translucency, therefore, can
be explained by slight differences in
the ceramic structure and chemis-
try of the copings, and by the effect
of different milling and processing
methods on the crystalline structure
of the ceramics. In fact, necessary
conditions for a translucent ceramic
are that it does not absorb radiation
in the visible spectrum (0.4- to 0.7-
µm wavelength) and that light diffu-
sion is reduced to a minimum. There
are various causes of diffusion within
polycrystalline ceramic materials.6,7
Irregularities in the distribution of
Baldissara et al
July 2010
the phases, defects and voids at grain
boundaries, optical anisotropy of the
grains, grain size larger than the light
wavelength, different refractive in-
dexes among the particles, and their
chemical nature may result in light
scattering.6
Of the materials evaluated, Lava
0.3 mm and 0.5 mm appeared to be
the most translucent CAD/CAM zirco-
nia copings for esthetic restorations.
Since the manufacturing process was
exactly the same for both Lava cop-
ing types, the difference between the
mean values is likely due to the differ-
ent thicknesses of the copings.
In spite of a nominal thickness of
only 0.4 mm, Cercon Base copings
showed the lowest mean value of
translucency, suggesting that, regard-
less of this parameter, the basic ma-
terial is the least translucent among
those analyzed in the current study.
High opacity was also reported for
Cercon using the contrast ratio meth-
od.19 Apart from the coping thickness,
increased opacity could be the result
of minor dimensional, structural, and
chemical differences in the grains and
grain boundaries, which yield higher
levels of light absorption and scatter-
ing,26 rather than the direct effect of
grain size. In fact, the size of 3 mol%
Y-TZP (3Y-TZP) dental zirconia grains
is in the range of 0.2 to 0.5 µm.27 Cer-
con grains are 0.3 µm, on average,28
and appear to be sufficiently small so
as to negate the hypothesis that they
influence Cercon’s optical properties
in comparison to the other groups.
It is possible that zirconia translu-
cency could be improved in the future.
Many traditional ceramic materials
show interesting optical properties
when the grain size of sintered ce-
ramics is nanosized.29 One example
is alumina, which is known to be-
come transparent when the grain size
is small enough.29 Zirconia grain size
could be modified by the manufactur-
er using dopants and by varying sin-
tering conditions (sintering pressure,
temperature, and times).27 However,
the impossibility of the phase transi-
tion when the grain size is less than
Baldissara et al
approximately 0.2 μm seems to limit
the use of smaller dimensions.30 Ca-
solco et al26 recently described a tech-
nique to obtain translucent zirconia
ceramics colored from amber to ruby
using both partially (ZrO2-3 mol%
Y2O3) and fully stabilized (ZrO2-8
mol% Y2O3) nanostructured powders.
The resulting materials have a grain
size of 55 nm, and in the partially sta-
bilized form are translucent and am-
ber colored; the fracture toughness of
8.1 MPa∙m1/2 suggests that these ma-
terials could be further developed for
dental applications.
The Cercon group also showed
the highest standard deviation. This
is probably due to the manufacturing
process, in which the CAD phase is re-
placed by a wax pattern that has been
handmade by a dental technician. The
pattern is then laser scanned and ma-
chined during the subsequent CAM
milling phase. Since the copings de-
pend on the dental technician’s skill
rather than on CAD software, the
thickness, shape, and design of the
copings are less standardized than
those of other systems.
Nonetheless, even the least trans-
lucent zirconia ceramics could be
useful for posterior teeth, or anterior
teeth when a masking effect of the
underlying tooth structure is desired,
such as when the prepared teeth are
darkly colored or when carbon fiber
and metal posts are used for the sup-
porting core.
Another variable that could modify
the core translucency is the shading of
the framework by means of different
coloring techniques.31 Zirconia, with
its high refractive index, is consid-
ered an opaque material and is largely
used as opacifier in ceramic glazes
and composite resin fillers. In dental
restorations, unshaded zirconia cop-
ings and frameworks are directly ve-
neered with translucent ceramic to
provide esthetic results. The zirconia
core may simulate the opaque den-
tin effect of natural teeth, allowing
a pleasing appearance; nevertheless,
the high value of the opaque white or
ivory color of this ceramic sometimes
11
needs to be reduced or masked using
coloring salts or oxides. Zirconia can
be colored by infiltration, precolored
at the microcrystalline powder state,
or surface colored by means of apply-
ing a liner.31 The coloring techniques
may reduce the translucency and the
mechanical properties of the zirconia;
however, infiltration with cerium ac-
etate 5 wt% and bismuth chloride 1%
solutions may allow for ceramic col-
oration without reducing the ceramic
flexural strength.31
In vitro studies on ceramic trans-
lucency may be limited due to a lack
of clear clinical relevance. Even if the
research designs generally allow for
determining optical properties, the
conversion of these data in terms of
clinical outcomes poses great dif-
ficulty. The esthetic appearance of a
ceramic restoration is a multifactorial
phenomenon. The effect of the frame-
work translucency can be altered
by the thickness, color, and surface
texture of the veneering ceramic,1,9
framework coloring technique,31–33
and opacity and color of the luting
cement.34
As Heffernan et al9 suggest, it
would be interesting to know if the
differences in translucency found in
in vitro studies have clinically percep-
tible effects on the esthetics of the
restoration. Only the materials with
the greatest differences in translu-
cency values, such as IPS e.max Press
lithium disilicate, Lava Frame 0.3,
and Cercon Base, would likely dem-
onstrate differences in the definitive
restoration that are perceptible to the
human eye. Further clinical studies
are necessary to determine the effect
of the optical properties of the ceram-
ic core on the esthetic appearance of
zirconia crowns.
CONCLUSIONS
Within the limitations of this study,
the following conclusions were drawn:
1. Light transmission through zir-
conia was significantly lower than
through the control, which was repre-
sented by a new generation of lithium
12
disilicate glass ceramics.
2. Lava 0.3 mm and 0.5 mm demon-
strated 71.7% and 63.9% of the translu-
cency of 0.5-mm-thick IPS e.max Press
specimens, respectively.
3. Lava 0.3 mm demonstrated the
highest translucency as compared to
the other zirconia copings (P=.022).
The translucency of the Lava 0.5-
mm copings was higher than that of
Procera AllZircon, Digizon, DC Zir-
con, VITA YZ, and IPS e.max ZirCAD,
although not statistically different
(P>.05).
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Corresponding author:
Dr Paolo Baldissara
Alma Mater Studiorum University of Bologna
Department of Oral Sciences
Section of Prosthodontics
Via S. Vitale 59
40125 Bologna
ITALY
Fax: 0039 051 225208
E-mail: paolo.baldissara@unibo.it
Copyright © 2010 by the Editorial Council for
The Journal of Prosthetic Dentistry.
Baldissara et al