Work

Masking discolored substrates with lithium disilicate veneers and resin cements: An in vitro quantitative analysis

Year: 2025

Type: article

Abstract: Objective This study evaluated how ceramic translucency, resin cement shade, and tooth substrate color influence the masking ability of lithium disilicate veneers, aiming to support evidence-based clinical decision-making. Methods IPS e.max CAD ceramics (high, medium, and low translucency) and Variolink Esthetic LC resin cements (four shades) were paired in all combinations and bonded to either A3Dentin (natural dentin, control) or C4Dentin (discolored dentin, experimental) resin composite substrates. Standardized procedures were used for specimen preparation, including hydrofluoric acid etching, silanization, and universal adhesive bonding. Color parameters (L*, a*, b*) were measured using a spectrophotometer, and CIEDE2000 (ΔE 00 ) values were calculated. Data were analyzed via ANOVA, regression, and dominance analysis. Results Ceramic thickness affected color outcomes. Substrate shade significantly influenced final color, with Light Plus cement increasing lightness (L*) and blue chroma (b*) values in high-translucency ceramics. Yellow chroma (b*) was more influenced by ceramic translucency. All experimental groups showed ΔE 00 values above the clinical acceptability threshold (ΔE 00 > 1.8). Substrate shade was the dominant factor affecting color outcomes (87.82%), followed by ceramic translucency (9.15%) and cement shade (3.03%). Conclusion No tested combination achieved clinically acceptable masking of severe discoloration. Substrate shade overwhelmingly influenced final color, surpassing ceramic translucency and cement shade. These results emphasize that material selection alone is insufficient and highlight the necessity of substrate modification for optimal esthetic outcomes. Clinical significance This study provides clinically applicable guidance for managing the often-unpredictable esthetic outcomes in veneer cases involving tooth discoloration. By quantifying the influence of each variable through dominance analysis within a regression model, the underlying tooth shade was found to contribute approximately 87.82% to the explained variance in color outcome—emphasizing the importance of substrate modification as a key step toward achieving consistent and natural-looking results. This statistical contribution should be interpreted within the context of the model and not as a clinical absolute.

Source: Journal of Dentistry

DOI: 10.1016/j.jdent.2025.106038

Authors: Kornchanok Wayakanon, Chanathip Kamiam, Ratchaneekorn Khamlue, Apinya Daengla, Supawadee Naorungroj

Institutions: Naresuan University, Prince of Songkla University

Language: English

Topic: Dental materials and restorations

Subfield: Orthodontics

Field: Dentistry

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,160