Effect of metal opaquer on the final color of 3 ceramic crown types on 3 abutment configurations

Statement of problem. The effect of a recently introduced metal opaquer when used to mask the color of a titanium abutment under ceramic crown systems is unknown. Purpose. The purpose of this study was to compare the color coordinates of 3 ceramic crown types-characterized monolithic lithium disilicate (LDC) (IPS e.max; Ivoclar Vivadent AG), layered lithium disilicate (LDL) (IPS e.max; Ivoclar Vivadent AG), and layered zirconia (ZL) (H.C. Starck)-on 3 abutment configurations, nonopaqued titanium (Ti), resin opaqued titanium (Op), and zirconia (Zir). In addition, the color differences (CIEDE2000) were evaluated among the 3 crown types on 3 different abutment substrates. Material and methods. Ten Ti disks (10x1 mm) were fabricated with computer-aided design and computer-aided manufacturing (CAD-CAM) to represent the Ti abutments. Five Ti specimens were opaqued (Op) (whiteMetal Opaquer wMO; Blue Sky Bio), and 5 were not opaqued (Ti). Ten zirconia disks were fabricated with CAD-CAM and sintered (10x1.2 mm). Five disks were used as backings to represent Zir abutments, and 5 disks were layered with 1 mm of porcelain (131, IPS e.Max Ceram; Ivoclar Vivadent AG) to represent layered zirconia crowns (ZL). Ten lithium disilicate plates (14x14x1.2 mm) were sectioned from CAD blocks (B1 IPS e.Max CAD; Ivoclar Vivadent AG). Five plates were layered with the same porcelain (B1, 1 mm), and 5 plates were surface characterized and glazed. An LDL crown on a Zir abutment configuration was used as the control. The 3 simulated crown types (n=5) were optically connected to each of the 3 abutment types, and the color of the 9 groups was measured using a spectroradiometer. Measured data were reported in CIELab coordinates. CIELab data were used to calculate color differences between the control and the 8 experimental groups. Color data were summarized for each group, and analyzed by repeated-measures ANOVA. For pairwise comparisons, a Bonferroni correction of t tests was used, and for interpretive analysis of resulting color difference data, a 1-way ANOVA and subsequent Tukey testing for pairwise comparisons were used. Results. The statistical significance of the analysis of color coordinates was found to be P <=.002. Although 3-way interaction was not found to be significant (P=.335), all three 2-way interactions of the main effects were found to be significant (P <=.002). All crown types on the Zir abutment revealed color differences from the control group. The color differences of the crown types on the Op and Zir abutment configurations compared with the control (LDL/Zir) were not (P>.05) statistically different. Conclusions. Colors of tested crown systems on Ti backing were each unacceptably different from the control group. Colors of these systems on zirconia backing were not perceivably different. Use of opaquer on titanium backing resulted in a small color difference from the control group (P>.05) for each crown system, demonstrating that it may be used to prevent the unfavorable metal show-through that can influence the final color of all ceramic crown systems tested.