Anda di halaman 1dari 5

Dimensional accuracy of castings produced with ringless and metal ring

investment systems
Pelopidas Lombardas, DDS, MS,a Andres Carbunaru, DDS, MS,b Mona E. McAlarney, D Eng Sc,c and
R. W. Toothaker, DDSd
Columbia University, School of Dental and Oral Surgery, New York, N.Y.
Statement of problem. The ringless casting procedure is in use in clinical dentistry, although there is
no adequate scientific data to support its use.
Purpose. This study compared the vertical margin accuracy of lost wax castings produced with the con-
ventional casting technique using a metal ring and a technique that uses a ringless system.
Material and methods. From copings fabricated on a metal die, 30 castings were produced from a
high palladium alloy for metal ceramic restorations (Argedent). Ten castings were cast with Bellavest T
(Bego) phosphate-bonded investment with the ringless technique, 10 were cast with the same investment
with a metal ring, and the final 10 were cast using Hi-temp (Whip Mix) phosphate-bonded investment
with a metal ring. The internal surface of the castings were not modified before seating with finger pres-
sure. For vertical margin discrepancy measurements, an optical microscope at a magnification of 100× was
used. Data were analyzed with 1-way multivariate ANOVA (repeated measures) and the Student-New-
man-Keuls test.
Results. When following the manufacturers’ recommendations, the castings of the ringless technique
provided less vertical margin discrepancy (mean value 181 ± 71 µm) than the castings produced with the
conventional metal ring technique (290 ± 87 µm and 291 ± 88 µm). The difference was significant
(P<.001).
Conclusion. The ringless technique may produce accurate castings for use in fixed prosthodontics,
therefore further investigation is needed to develop a protocol for its use. (J Prosthet Dent 2000;84:27-31.)

CLINICAL IMPLICATIONS
The results of this study revealed that, in terms of seating accuracy, the ringless and
metal ring investing procedures can produce clinically acceptable castings.

T aggart first described the lost wax casting process in


dentistry in 1907 and observed that the resultant restora-
method of compensation was scientifically studied in the
1920s by Weinstein and Coleman at the US National
tions were undersized.1-3 The accuracy of fit of a cast Bureau of Standards.7,8 The investment initially used was
restoration is essential for its longevity because it allows a gypsum-bonded–type investment. Today, 3 methods of
for less plaque accumulation at the marginal area, pro- compensation for the metal shrinkage on cooling are in
vides better mechanical properties (stability, resistance), regular use9: (1) setting expansion of the investment, (2)
less cement space (less possibilities for leakage), and hygroscopic expansion of the investment, and (3) thermal
improves the esthetic result.4-6 The accuracy of fit is expansion of the investment.
affected by the quality of the preparation (undercuts, Gypsum alone can be heated to temperatures as
taper of the preparation), the impression, the working high as 1200°C without decomposing,1,10,11 making it
cast, the quality of the wax that is used for the lost wax sufficiently heat-resistant, to be used without adding
technique, and by the accuracy of the castings. At this last other refractory materials. However, gypsum at this
step, it is essential to achieve compensation for the shrink- temperature shrinks noticeably, so silica is added to the
age of the solidifying alloy by investment expansion. This investment to compensate for this condition. Silica is
usually thought of as the refractory component in an
aStaff Prosthodontist, School of Dentistry, University of Athens, investment but reduces the heat resistance of gyp-
Athens, Greece. sum.1,7,8,12 Silica is added to control the dimensional
bPrivate Practice, Caracas, Venezula.
cAssistant Professor, Department of Prosthodontics.
changes when the investment is heated, yet it also
dAssociate Professor and Director, Postdoctoral Prosthodontics, reduces the compressive strength and makes the use of
Department of Adult Restorative Dentistry, University of Nebraska, a metal ring necessary to protect the investment dur-
Medical Center, Lincoln, Neb. ing casting forces.2,13,14

JULY 2000 THE JOURNAL OF PROSTHETIC DENTISTRY 27


THE JOURNAL OF PROSTHETIC DENTISTRY LOMBARDAS ET AL

investments were treated with the same techniques as


used with the gypsum-bonded investments. The need
of the casting ring for the phosphate-bonded invest-
ments was not questioned, because its use was a stan-
dard procedure.26,27 The use of the casting ring was
challenged with the introduction of a ringless tech-
nique initially for phosphate-bonded investments for
removable partial denture frameworks and, recently,
for conventional fixed restorations and even experi-
mentally for implant-connected frameworks.28,29 The
high strength of the material makes it possible to aban-
don the use of the casting ring. The ringless tech-
niques are easier, less expensive, and give clinically
Fig. 1. Metal die used in study. acceptable castings.28 In the literature, there are few
studies comparing the 2 casting techniques for fixed
restorations.28
The purpose of this in vitro study was to compare
The metal casting ring restricts the thermal expan- the fit of single full-coverage restorations made with 2
sion of the investment because the thermal expansion investing techniques to ascertain whether the ringless
of the ring is less than that of the investment. To com- technique can be routinely used for the fabrication of
pensate for this limitation, an asbestos liner was rec- cast restorations. To all possible variances that resulted
ommended.5,15-17 The asbestos liner that was in use from the use of materials and techniques, such as gyp-
for many years was abandoned because asbestos is sum, used for the production of gypsum dies, die spac-
associated with carcinogenesis.18,19 Paper ceramic lin- er, and impression materials, a metal die was used in
ers are used as a substitute.20-22 which all waxing and measurements were made. The
The introduction of ceramometal technology made null hypothesis was that there will be no significant dif-
the use of higher melting temperature alloys necessary ference in the accuracy of fit of the castings produced
to withstand the firing cycle of porcelain without by either technique.
noticeable distortion, and led to the development and
MATERIAL AND METHODS
use of investments that can resist higher temperatures
and higher stresses during casting.23-25 The phos- On a metal die 30 copings were made and divided
phate-bonded investments fulfill these requirements. into 3 groups of 10 copings. For the first and third
These are investments where the binder is phosphate group, a metal ring was used for investing and casting,
compounds. They consist of 3 types of components, whereas for the second, a ringless system was used. The
each of which is responsible for certain characteristic copings were seated on the metal die and the accuracy
properties. One component consists of materials that of fit was evaluated by measuring the gap between the
are soluble in water to yield a phosphate ion. The sec- finish line and the margins of the copings on 4 specific
ond component consists of materials that react with sites with the use of an optical microscope.
phosphate ions at room temperature. The third is a A first mandibular right molar from a demonstra-
ceramic substance that hardens at a high temperature tion Columbia Dentoform (Columbia Dentoform,
and is responsible for high temperature strength. Long Island, N.Y.) was prepared for a full porcelain-
These investments can be mixed with water or with a fused-to-metal restoration with a chamfer finish line.
special liquid or with a combination. The special liquid An impression was made using a custom tray fabricat-
is a form of silica sol in water. When mixed with the sil- ed with a light-curing material (Triad, Dentsply, Mil-
ica sol, the phosphate-bonded investments exhibit a ford, Del.) and a vinyl polysiloxane material (Aquasil,
higher setting expansion than when mixed with water. Dentsply). The impression was filled with an auto-
Most technicians use different proportions of a mix- cured ethyl methacrylate material (GC Pattern, GC
ture of water and silica sol to get the desired expan- Dental Industrial Corp, Tokyo, Japan) so that an
sion. When mixed only with water, the investments do acrylic resin copy of the preparation was produced.
not show hygroscopic expansion, whereas when mixed This copy was invested on a phosphate-bonded invest-
with silica sol they do. However, there are some phos- ment and cast with chromium cobaltous alloy (Vitalli-
phate-bonded investments that do not show hygro- um) commonly used for removable partial denture
scopic expansion, even when mixed with silica sol. The metal frameworks. This metal die (Fig. 1) was used for
thermal expansion curves of phosphate-bonded invest- the construction of 30 copings using the Dentsply
ments show more irregularities than the gypsum- Vacu-press system (Dentsply). Margins were then sealed
bonded investments. Initially, phosphate-bonded with conventional casting wax (margin wax, MDL Wax

28 VOLUME 84 NUMBER 1
LOMBARDAS ET AL THE JOURNAL OF PROSTHETIC DENTISTRY

Fig. 2. Wax pattern on metal die. Fig. 3. Casting on metal die.

Co, Baltimore, Md. ) (Fig. 2). The whole procedure


was designed to resemble standard procedures com-
monly used at commercial dental laboratories.
The 30 copings were divided into 3 groups of 10.
The first group was invested using Hi-Temp carbon-
free phosphate-bonded investment (60 g/9.5 mL,
with 75% liquid to water ratio Whip Mix Corp,
Louisville, Ky.) with a metal ring of 2.5 cm diameter
and a ceramic paper liner that was wetted for 1 minute
(Bego Wilh Herbst Gmbh Co, Bremen, Germany),
according to the manufacturer’s recommendations.
The second group was invested with Belavest T phos-
phate-bonded investment (60 g/14 mL, with 70% liq-
uid-to-water ratio, Bego), according to the manufac-
turer’s recommendations, with a plastic ring of 3 cm
diameter. The third group was invested using Bellavest Fig. 4. Diagram of stone holder and metal die.
T phosphate-bonded investment (Bego) with a metal
ring of 2.5 cm of diameter and a ceramic paper liner
(Bego), according to the manufacture’s recommenda- The castings were cut from their buttons and seat-
tions. The water-to-liquid ratio used for each group ed on the metal die using only finger pressure applied
was decided after some trial castings within the manu- by the same “blind” operator (Fig. 3). No adjustment
facturer recommendations so that the best clinically of the internal surface of the castings was performed.
acceptable fit was achieved for each group. All invest- Our goal in the design of this study was to eliminate
ments used had the same lot number. Each coping was all possible variables such as die spacer thickness,
invested individually in 1 ring each, immediately after expansion of die stone, and polymerization shrinkage.
its fabrication. The investments were hand mixed for For that reason, the metal die was used for waxing and
15 to 20 seconds and then mechanically mixed for measuring the seating accuracy. This introduces a lim-
30 seconds using the Degussa vacuum mixer itation in terms of clinical interpretation. However,
(Degusa Corp, South Plainfield, N.J.). Each “ring” following through with this philosophy meant that we
was left in a dry pressure pot for 5 minutes. After 10 should have a standard force to seat the castings on the
minutes of initial setting, the molds of the ringless metal die. Instead, the study was made to be more
group were removed from the plastic rings. After 1 “relevant” to everyday dental practice by using the lab-
hour of air drying, they were all placed in the same oratory technician that was involved in the study to
oven (10°C/1 min soak temperature 260°C and seat the castings with finger pressure.
final soak temperature 815°C) and cast with a high The margin discrepancy between the metal die and
palladium metal-ceramic alloy (Argedent 52SF the castings was measured on an optical microscope
Argen Precious Metals Inc). Castings were divested (Nikon microflex model PFM, Tokyo, Japan) for accu-
with sandblasting with 50-µm glass beads and then racy of measurements (2 µm, precision of measure-
steam cleaned. ments 0.5 µm) at a magnification of 100×. Measure-

JULY 2000 29
THE JOURNAL OF PROSTHETIC DENTISTRY LOMBARDAS ET AL

Table I. Vertical margin discrepancy between die and cast- support the use of this technique. This study is a pilot
ings measured at buccal, lingual, mesial, and distal sites study (clinically oriented) to determine whether the
Whip Mix Bego without Bego using technique produces acceptable results.
using a ring a ring a ring Although the metal ring technique is clinically
(µm ± SD) (µm ± SD) (µm ± SD)
acceptable and allows for the fabrication of accurate
Buccal 286 ± 72 142 ± 65* 292 ± 90 casts, the metal ring restricts the setting and thermal
Lingual 287 ± 93 179 ± 51* 274 ± 86 expansion of the investment,3,14,16 which is necessary
Mesial 276 ± 80 209 ± 68 291 ± 101 to compensate for the shrinkage of the metal on solid-
Distal 31 ± 114 195 ± 86* 308 ± 82 ification. To overcome this expansion restriction, a
Mean value 290 ± 87 181 ± 71* 291 ± 88 soft liner is used.5,14 The ringless technique for invest-
Asterisk indicates a statistically significant difference between materials ing and casting has been in use for many years for the
and/or technique at that site. fabrication of frameworks for removable partial den-
tures.22 It was introduced in fixed prosthodontics
technology.22 With the use of a ringless technique,
ments were made on predetermined areas that were the restriction of thermal expansion that is associated
marked on the metal die, on the buccal, mesial, lingual, with the presence of the metal ring is avoided. In this
and distal surfaces of the die. A stone base sample hold- study, the margin discrepancy of castings produced
er was constructed to maintain the major axis of the with the ringless technique and the conventional tech-
metal die parallel to the focal plane. This holder mini- nique using the metal ring were compared.
mized gap measurement errors because of out-of-plane Throughout our study, the recommendations of
rotation (Fig. 4). All measurements were executed by the manufacturers were followed and the adjustment
the same “blind” operator and each site was measured of the internal surfaces of the castings was not per-
10 nonconsecutive times. Mean value of these measure- formed. The results indicate that, within the condi-
ments was used for the statistical analysis. tions of the study, the castings produced by the ring-
Measurements of vertical discrepancies between the less technique fit better than the castings, using the
castings and die at the 4 sites on the castings (buccal, conventional metal ring technique.
lingual, mesial, and distal) were considered repeated A similar amount of discrepancy was achieved in
measures on the castings. One-way multivariate analy- recent studies in which the internal surface of the
sis of variance (ANOVA) (repeated measures) was run castings were also not touched.30 The mean open-
to test whether the differences in the mean values of ings of 181 to 291 µm is large. The explanation
vertical discrepancies are greater than would be given was that (1) no die spacer was used so the
expected by chance (P<.001). After the ANOVA, the castings bind more on the axial walls of the metal
Student-Newman-Keuls test was performed as the die, and (2) no adjustments were made on the inter-
multiple comparison procedure to isolate the group or nal surfaces of the castings. In this investigation, 1
groups that differ from the others. casting of each group was adjusted on the internal
surface as a pilot investigation after the original
RESULTS
measurements. No difference in the margin discrep-
The vertical margin discrepancies at the buccal, lin- ancy could be found after the adjustment of the
gual, mesial, and distal sites are presented in Table I. internal surface and all measurements were at the
There was no significant difference between the 4 range of 15 to 35 µm. From the results and condi-
measured sites for a particular investment material tions of the study, a hypothesis can be made that the
and technique. For each site, and the mean of all ringless technique allows for more expansion of the
sites, the use of Bego investment without a metal investment and therefore produces castings that
casting ring produced statistically significant smaller bind less on the die. Further investigation should be
vertical discrepancies. The only exception to the performed without using the investment manufac-
above is the mesial site in which all 3 material and turers’ specifications but by customizing the water-
technique combinations provided equivalent vertical to-liquid ratio. The results of this study support the
discrepancies. clinical use of this technique for fixed restorations
and may prove to be acceptable for implant-sup-
DISCUSSION
ported restorations as well. It should be mentioned,
Although the ringless casting technique is in use in however, that the conventional metal ring investing
fixed prosthodontics and implant prosthodontics, technique is well documented and proven to give
there are few investigations about the technique in the acceptable castings and should not be abandoned.
literature, and the accuracy of the castings depends on The study was made to test the “new” ringless tech-
the skills of the technicians and is clinically deter- nique that was proved to be also acceptable in terms
mined by the dentists. There is no scientific data to of fit accuracy.

30 VOLUME 84 NUMBER 1
LOMBARDAS ET AL THE JOURNAL OF PROSTHETIC DENTISTRY

CONCLUSIONS 13. Lane JG. Cast gold inlays. Dent Digest 1909;15:43-7.
14. Van Horn CS. Standardizing the investing process and simplifying the
casting process. Dent Cosmos 1911;53:1109-19.
Within the conditions of this study, the following 15. Morey EF. Dimensional accuracy of gold alloy castings. Part 4. The cast-
conclusions were drawn: ing ring and ring liners. Aust Dent J 1992:37:91-7.
16. Hollenback GM, Rhoads JE. A comparison of the linear expansion of
1. The vertical margin discrepancy of the ringless
investment with the linear casting shrinkage of gold. J South Calif Dent
group for the buccal, the lingual, and the distal sites Assoc 1960;28:40-6.
were significantly less than that of the 2 ring groups 17. Davis DR, Nguyen JH, Grey BL. Ring volume/ring liner ratio and effec-
tive setting expansion. Int J Prosthodont 1992;5:403-8.
(P<.001).
18. American Conference of Government Industrial Hygienists. Threshold
2. There was no significant difference of the vertical limit values for chemical substances in the work environment. Cincin-
margin discrepancy between the 2 metal ring groups. nati: ACGIH; 1986. p. 34.
19. Davis JM. A review of experimental evidence for the carcinogenicity of
3. There was no significant difference in the vertical
man-made vitreous fibers. Scand J Work Environ Health 1986;12(Suppl
margin discrepancy at the buccal, lingual, mesial, and 1):12-7.
distal surfaces within the same group. 20. Earnshaw R. The effect of casting ring liners on the potential expansion
of a gypsum-bonded investment. J Dent Res 1988;67:1366-70.
4. The ringless technique was clinically acceptable
21. Earnshaw R, Morey EF. The fit of gold-alloy full-crown castings made
and can be used for the fabrication of fixed prostho- with ceramic casting ring liners. J Dent Res 1992;71:1865-70.
dontic restorations. Further investigation should be 22. Morey EF, Earnshaw R. The fit of gold-alloy full-crown castings made
with pre-wetted casting ring liners. J Dent Res 1992;71:1858-64.
conducted to be determined whether it can be used for
23. Craig R. Restorative dental materials. 9th ed. At Louis: Mosby–Year Book;
the fabrication of implant-supported prostheses. 1993.
24. Philips RW. Skinner’s science of dental materials. 8th ed. Philadelphia:
We thank Mr George Thoupos of PG Dental Lab for his assis-
WB Saunders; 1982.
tance during the laboratory procedures of this work. 25. Rudd K, Morrow R, Eissmann H. Dental laboratory procedures. In: Fixed
partial dentures: investing procedures. Vol II. St Louis: CV Mosby; 1981.
REFERENCES p. 150-8.
26. Rudd K, Morrow R, Eissmann H. Dental laboratory procedures. In:
1. Morey EF. Dimensional accuracy of gold alloy castings. Part 3. Gypsum- Removable partial dentures: investment, burn out and casting. Vol III. St
bonded investment expansion. Aust Dent J 1992:37:43-54. Louis: CV Mosby; 1981. p. 293-320.
2. Taggart WH. A new and accurate method of making gold inlays. Dent 27. McGivney G, Castleberry D. McCracken’s eemovable partial prostho-
Cosmos 1907;49:1117-21. dontics: laboratory procedures. St Louis: CV Mosby; 1989. p. 367-426.
3. Hollenback GM. A brief history of cast restoration. J South Calif State 28. Dern WM, Himman RW, Hesby RA, Pelleu GB Jr. Effect of two-step ring-
Dent Assoc 1962;30:8-18. less investment technique on alloy castability. J Prosthet Dent
4. Bjorn AL, Bjorn H, Grkovic B. Marginal fit of restorations and its relation 1985;53:874.
to periodontal bone level. II. Crowns. Odontol Revy 1970;21:337-46. 29. Carr AB, Stewart RB. Full-arch implant framework casting accuracy: pre-
5. Morris H. Department of Veterans Affairs Cooperative Studies Project liminary in vitro observation for in vivo testing. J Prosthodont 1993;2:2-8.
No. 242. Quantitative and qualitative evaluation of the margin fit of cast 30. Johnson A, Winstanley RB. The evaluation of factors affecting the casta-
ceramic, porcelain-shoulder, and cast metal full crown margins. Partici- bility of metal ceramic alloy investment combinations. Int J Prosthodont
pants of CSP No. 147/242. J Prosthet Dent 1992;67:198-204. 1996;9:74-8.
6. Shillingburg HT Jr, Hobo S, Whitsett L. Fundamentals of fixed prostho-
dontics. Chicago: Quintessence; 1981. Reprint requests to:
7. Hollenback GM, Shell JS. A further evaluation of the theory of compen- DR PELOPIDAS LOMBARDAS
sation. J South Calif Dent Assoc 1965;33:315-7. 21 KOLONAKIOU SQ
8. Morey EF. Dimensional accuracy of gold alloy castings. Part 2. Gold ATHENS 10673
alloy shrinkage. Aust Dent J 1991;36:391-6. HELLAS
9. Morey EF. Dimensional accuracy of gold alloy castings. Part 1. A brief GREECE
history and the behaviour on inlay waxes. Aust Dent J 1991;36:302-9. FAX: (3)1-3614746
10. Earnshaw R. Investments for casting cobalt chromium alloys. Br Dent J E-MAIL: lombarda@otenet.gr
1960;108:389-96,429-40.
11. Matsuya S, Yamane M. Decomposition of gypsum bonded investments. J Copyright © 2000 by The Editorial Council of The Journal of Prosthetic
Dent Res 1981;60:1418-23. Dentistry.
12. Earnshaw R. Inlay casting investments. In: O’Brien WJ, Ryge G, editors. 0022-3913/2000/$12.00 + 0. 10/1/107783
An outline of dental materials and their selection. Philadelphia: WB doi:10.1067/mpr.2000.107783
Saunders; 1978. p. 259-70.

JULY 2000 31

Anda mungkin juga menyukai