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Thermal Energy Transfer Through All Ceramic Restorations


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As all ceramic restorative materials for indirect dental restorations become more widely used, providers must be able to accurately diagnose the pulpal status of restored teeth. It has been shown that thermal testing, specifically cold testing, can be conducted through metal ceramic restorations, all metal restorations, and all ceramic restorations using traditional ceramics. However, no study to date has been performed to examine the feasibility of cold testing through novel, chairside milled ceramic materials. MATERIALS AND METHODS: Thirty extracted human premolars were mounted in acrylic and sectioned 5mm from the cementoenamel junction (CEJ), perpendicular to the long axis of the tooth. Pulpal tissue was removed, a thermal conductive medium was placed, and a thermocouple probe was inserted into pulp chamber of each tooth. Thermal testing was conducted on each tooth by placing a 2 cotton pellet saturated with 1,1,1,2-tetrafluoroethane(TFE) on the facial surface for 60 seconds. The intra pulpal temperature change was measured at ten second intervals to establish the baseline for natural teeth. Teeth were then reduced by1.5mm on the facial surface to simulate a preparation for an all-ceramic restoration. Milled blocks of lithium disilicate, zirconia, and feldspathic porcelain 1.5mm in thickness were fabricated. Then, ten milled blocks from each material were cemented to prepped teeth and intrapulpal temperature change was measured. A non-linear mixed effects model, specifically a three-parameter exponential decay model, was used to analyze data. RESULTS: Three test materials and natural teeth displayed similar rate of temperature change, although the feldspathic samples had a lower initial temperature compared to natural teeth, while both the feldspathic and zirconia samples had a higher asymptotic temperature compared to natural teeth. CONCLUSIONS: Thermal testing is a viable option for determining pulpal status through an all ceramic restoration.



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