In prosthetic approaches, it is not enough to reflect only the shape and resistance of natural structures to restorations. The color, light transmittance, fluorescent effect, brightness and light reflection properties of natural teeth should also be present in the restorations. Especially in ceramic restorations that are widely used, the issue of color is important in terms of meeting aesthetic expectations. As is known, the colors of natural teeth can be reflected in restorations with metal-supported ceramics, but the fact that the metal substrate is not light-permeable creates difficulties in obtaining the desired aesthetic properties. Physicians and individuals make color selection by visually comparing natural teeth with color scales when choosing colors. It becomes difficult to create satisfactory colors for physicians and individuals. To overcome these problems, systems are needed in which the colors of natural teeth are evaluated and scales are created in the light of these evaluations
13.
Poor oral hygiene among denture wearers is well documented. As a result, these patients suffer from denture-related stomatitis, which occurs mainly due to dental plaque accumulation over prolonged period. Thus, the denture wearers must follow a strict denture cleansing method to prevent biofilm formation on the denture surface. Denture cleansing with tooth brush and dentifrice or soap is the most commonly practiced method due to its simple technique, low cost, and proved efficacy in removing organic deposits. On the contrary, brushing with dentifrices significantly impacts the form of wear and roughness of restorative and prosthetic materials. The wear and roughness of acrylic dentures favor biofilm formation and staining, in addition to the loss of surface details and diminished gloss 14. They said that thermal cycling (TC) is a valid method to simulate in-vitro aging of dental materials. Although, there is no standardized TC protocol applied for laboratory testing of dental materials, the specimens in the current study were subjected to 10,000 thermal cycles that represented one year of oral simulation. The authors held the specimens alternatively first in 5⁰C cold water and then in 55⁰C hot water baths by ISO TS 11405 Technical Specification. This repeated exposure to cold and hot bath mimics the thermal stresses occurring in the oral cavity to which the denture resin materials would be exposed due to the consumption of cold and hot beverages. This TC process in wet conditions may cause denture polymer degradation, and heat stress may increase water sorption, causing the absorbed water to behave as a plasticizer and soften the denture, thus affecting the denture resin properties 9,14.
As the patient's demands for improvement of appearance continuously increase, the use of esthetic restorations becomes widely required; shade selection in dentistry was reported to be via two common methods, visual and instrumental. Even though color measurements by evaluation between patient's teeth and standard shade guide is the most popular procedure, the individual variations between dentists, shade guides, and technicians impair standardization and make tooth color selection a very critical matter. It is also affected by many other factors following occasional faults in appearance resembling of restoration to natural teeth as the traditional shade selection process is a subjective evaluation even under ideal condition 15.
Uchida et al. 16 studied the color changes of dental composites with the CIELAB system using the Minolta CR-200 chromameter. They found that the change in the value of ‘b’ of the CIELAB system was significant. In other words, they found that composites turn yellow in the oral environment, while light-colored composites are more prone to turn yellow. Douglas (2000), in his study examining the color stability of indirect resin systems, did not find any acceptable differences between the groups after 300 hours of decaying. However, it is noted that the color stability of each group differs. In addition, the two resin groups showed the same color change as the ceramic group, which was the control group.
In our study, it was aimed to determine the consistency of ceramic crown samples in obtaining A2 color scale color, color changes that may occur after the thermal cycle and soaking processes. According to the data, as a result of statistical evaluation processes, we found that limited aging processes do not cause color change. Uchida et al. 16 found significant color change in composites after aging processes. Similarly, Douglas et al. 8 also found a significant color change in composites, but stated that it was within clinically acceptable limits. Hekimoglu et al. 17 investigated how ceramic laminates are affected by aging processes in terms of color. They found that aging processes did not make a difference on color. In our study, when we statistically examined the ΔE value indicating the color difference of the CIELAB system, we determined that the aging processes did not make a difference. However, when we examined the ‘L’, ‘a’ and ‘b’ values of the CIELAB system one by one, we found that only the change in the value of ‘b’ was significant.
Statistically significant differences were also found between the L, a, and b values in the measurements performed after the application of thermal decaying. In line with these results, using different ceramic systems in clinical applications based on a single scale color may have misleading results. Individual color characterization of cases should be carried out originally, considering the specific color classifications and scales of each system. In addition, measurements of the L, a, b values in the groups where the staining method was applied showed that they were more permeable to light than other groups in terms of light transmission and reflected the basic color elements less. The coloring application has been less successful in capturing the targeted color.
As a result, we evaluated the aesthetic properties of porcelain crown systems in this study. We compared the color consistency and the color stability of fixed full ceramic crown systems applied with the current injection technique. Crown samples prepared on metal alloy dies were aged by thermal cycle processes; color changes were determined among them and before and after thermal aging and their color stability were measured. Metal-supported ceramics with limited aesthetic quality are superior to current all-ceramic crown systems in terms of mechanical resistance but the systems that can meet aesthetic expectations and offer sufficient mechanical resistance are IPS Empress 2 and Finesse painting systems. Ceramic crown systems have an inability to provide a certain scale color that is commonly used. Each ceramic system should be used using its own scale and based on the individual color characteristics of the case. Thermal cycle and soaking processes do not cause changes in the color of ceramics.