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Dr.Deeksha Saxena
II nd year
Evaluation of the luting cement space for
provisional restoration by using various coats of
die spacer materials
-In Vitro Study
Journal of Clinical and Diagnostic
Research.
Sep 2014, Vol-8(9): ZC22-ZC25
Introduction
 Constructing a clinical crown is necessary by re-establishing
contour and anatomy of an individual tooth.
 Accurate duplication of Prepared teeth and maintaining
their proper fit and retention are important aspects for
constructing fixed prosthesis.
 Prosthesis is best prevented by proper tooth preparation,
by closely adapted internal surface, surface finish of the
preparation, and of the fitting surface of the casting,
cementation variables such as type of cement, physical
properties of the luting cement, placement techniques,
seating force and surrounding environmental conditions.
 researchers believed that better retention would be achieved
with a frictional fit between the coping and the tooth surface
 Die spacing is a commonly used technique to provide space
for the luting agent between the prepared tooth and the
casting.
 This space provides room for the luting agent which binds the
crown and tooth together and allows complete seating of the
restoration during cementation.
 Provisional crown and bridges in fixed
prosthodontic rehabilitation have same
importance as that of permanent fixed partial
dentures, particularly if these are expected to
function for extended periods of time or when
additional therapy is required before
completion of rehabilitation.
 The provisional restorations should be made
to provide pleasing aesthetics, adequate
support and good protection for teeth while
maintaining periodontal health.
 An accurate fit, retention and margination of
provisional restoration are essential to ensure
and maintain good pulpal health of the
prepared tooth.
 This in vitro study is done to evaluate the
space provided for the temporary luting
cement, after the application of various die
spacers during the fabrication of provisional
crowns and bridges.
 The objectives of this study was to determine
and compare the available luting space after
application of various die spacers i.e.
 Silver die spacer single coat.
 Silver die spacer double coat.
 Gold die spacer single coat.
 Gold die spacer double coat.
 An intact mandibular typhodont model with full
complement of teeth was used for this study.
Five sectional custom trays with ideal wax
spacer thickness were fabricated on the fourth
quadrant using tray acrylic material [Table/Fig-
1].
 A total of 50 silicone putty indexes with the
ESF’s of 45, 46, 47 teeth using putty
elastomeric impression material were obtained
to be served as the matrix for fabrication of
provisional restorations.
 Then, tooth preparation for a metal ceramic
restoration is carried out on 46 teeth, following the
ideal principles.
 A multiple mix impression technique using regular
and light bodied elastomeric impression material
was made in all the five sectional customs trays.
 In these impressions a type IV gypsum product was
poured carefully. Thus five master models which
included the prepared tooth and the teeth
immediately adjacent to it [Table/Fig-2] are obtained
which were further used to duplicate in a silicone
mould.
 A Type III gypsum product was poured in the silicone mould
for preparation of the specimens
 All the prepared 50 specimens were divided in 5 groups i.e.
 a) 10 control group specimens that are to be coated with
separating medium and coded as CG and allowed to dry for
2mins.
 b) 10 specimens for Silver die spacer application of single
coat and coded as SD1.
 c) 10 specimens for Silver die spacer applicationof double
coat and coded as SD2.
 d) 10 specimens for Gold die spacer of application of single
coat and coded as GD1.
 10 specimens for Gold die spacer application of double coat
and coded as GD2.
 To avoid any inaccuracies during provisional
crown fabrication a conventional flask method
was carried out.
 flasked using a two pour technique with dental
stone ensuring the putty indexes in the upper
member and the specimens in the lower
member of the flasks.
 Now tooth coloured auto polymerizing methyl-
methacrylate resin material loaded into the
putty indexes in the upper member of the
flasks.
 Later the lower member of flasks were closed
and clamped using a hydraulic bench press
with 1000 psi for 20 min to ensure complete
polymerization of the acrylic material.
 But in case of SD2, GD2 samples as the spacer
was applied in double coat, a complete dryness
period of 2 min between the applications is
followed.
 These dies were sectioned buccolingually along
with the provisional crowns. The sectioned
specimens were focussed under a
stereomicroscope with magnification of 100X.
 The provisional crowns and the specimens at 5
different locations i.e., mid buccal, buccal cusp
tip, mid occlusal, lingual cusp tip, mid lingual.
Results
 Control group specimens showed a mean film
thickness of 3.2 μm in comparison with other
specimens.
 The sum of mean values of all the values i.e.,
Control group of 3.2 μm, Silver single coat of
47.83 μm, Silver double coats of 114.79 μm, Gold
single coat of 65 μm, Gold double coats of 135.36
μm.
 The Statistical mean values of separating media
i.e., Control group 0.64μm, and different die
spacer coats application i.e., Silver single of 9.56
μm, Silver double of 22.95 μm, Gold single of 13
μm, Gold double of 27.07μm.
 Olivera AB et al., have carried out a study to
evaluate the effect of application of die spacer on
fit and retention of complete cast crowns by using
optical microscope and scanning electron
microscope on different areas of stone dies i.e.,
Occlusal and 1/3 of axial surfaces , occlusal and
2/3 of axial surfaces & entire preparation down to
0.5mm short of the margin and concluded that fit
of the cast restorations can be improved by
increasing the surface area of application of the
die spacer on the entire preparation down to
0.5mm short of the margin
Olivera AB, Saito T. The effect of die spacer on retention
and fitting of complete cast crowns. J Prosthodont.
2006;15:243-49.
Campagni WV, Preston JD, Reisbick MH, Measurement of point die
spacers used for casting relief.
J Prosthet Dent. 1982;47:606-11.
 Campagni et al., applied die spacers on stone
dies and measured the actual thickness of the
spacing material.
 A luting space of ‘26.55’μm with 2 coats,
‘58.85’μm with 4 coats and ‘77.70’ μm with 6 coats
was observed in their study.
 The double coat application of Gold die spacer in
the present study showed 27.07μm which was
similar with the authors study.
RefrenceS
 Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed
Prosthodontics, 4th ed. St.Louis; Mosby co, 2011. p.457-
87.
 Zinner ID, Tranchlenberg DI, Miller RD. Provisional
restoration in fixed partial prosthodontics. Dent Clinics
North America. 1989;33:355-77.
 Psillakis JJ. Effect of evaporation and mixing technique
on die spacer thickness: A preliminary study. J Prosthet
Dent. 2001;85:82-87
Evaluating Luting Space for Provisional Restorations Using Die Spacers

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Evaluating Luting Space for Provisional Restorations Using Die Spacers

  • 1.
  • 2. Dr.Deeksha Saxena II nd year Evaluation of the luting cement space for provisional restoration by using various coats of die spacer materials -In Vitro Study Journal of Clinical and Diagnostic Research. Sep 2014, Vol-8(9): ZC22-ZC25
  • 3. Introduction  Constructing a clinical crown is necessary by re-establishing contour and anatomy of an individual tooth.  Accurate duplication of Prepared teeth and maintaining their proper fit and retention are important aspects for constructing fixed prosthesis.  Prosthesis is best prevented by proper tooth preparation, by closely adapted internal surface, surface finish of the preparation, and of the fitting surface of the casting, cementation variables such as type of cement, physical properties of the luting cement, placement techniques, seating force and surrounding environmental conditions.
  • 4.  researchers believed that better retention would be achieved with a frictional fit between the coping and the tooth surface  Die spacing is a commonly used technique to provide space for the luting agent between the prepared tooth and the casting.  This space provides room for the luting agent which binds the crown and tooth together and allows complete seating of the restoration during cementation.
  • 5.  Provisional crown and bridges in fixed prosthodontic rehabilitation have same importance as that of permanent fixed partial dentures, particularly if these are expected to function for extended periods of time or when additional therapy is required before completion of rehabilitation.
  • 6.  The provisional restorations should be made to provide pleasing aesthetics, adequate support and good protection for teeth while maintaining periodontal health.  An accurate fit, retention and margination of provisional restoration are essential to ensure and maintain good pulpal health of the prepared tooth.
  • 7.  This in vitro study is done to evaluate the space provided for the temporary luting cement, after the application of various die spacers during the fabrication of provisional crowns and bridges.
  • 8.  The objectives of this study was to determine and compare the available luting space after application of various die spacers i.e.  Silver die spacer single coat.  Silver die spacer double coat.  Gold die spacer single coat.  Gold die spacer double coat.
  • 9.  An intact mandibular typhodont model with full complement of teeth was used for this study. Five sectional custom trays with ideal wax spacer thickness were fabricated on the fourth quadrant using tray acrylic material [Table/Fig- 1].  A total of 50 silicone putty indexes with the ESF’s of 45, 46, 47 teeth using putty elastomeric impression material were obtained to be served as the matrix for fabrication of provisional restorations.
  • 10.  Then, tooth preparation for a metal ceramic restoration is carried out on 46 teeth, following the ideal principles.  A multiple mix impression technique using regular and light bodied elastomeric impression material was made in all the five sectional customs trays.  In these impressions a type IV gypsum product was poured carefully. Thus five master models which included the prepared tooth and the teeth immediately adjacent to it [Table/Fig-2] are obtained which were further used to duplicate in a silicone mould.
  • 11.  A Type III gypsum product was poured in the silicone mould for preparation of the specimens  All the prepared 50 specimens were divided in 5 groups i.e.  a) 10 control group specimens that are to be coated with separating medium and coded as CG and allowed to dry for 2mins.  b) 10 specimens for Silver die spacer application of single coat and coded as SD1.  c) 10 specimens for Silver die spacer applicationof double coat and coded as SD2.  d) 10 specimens for Gold die spacer of application of single coat and coded as GD1.  10 specimens for Gold die spacer application of double coat and coded as GD2.
  • 12.  To avoid any inaccuracies during provisional crown fabrication a conventional flask method was carried out.  flasked using a two pour technique with dental stone ensuring the putty indexes in the upper member and the specimens in the lower member of the flasks.
  • 13.  Now tooth coloured auto polymerizing methyl- methacrylate resin material loaded into the putty indexes in the upper member of the flasks.  Later the lower member of flasks were closed and clamped using a hydraulic bench press with 1000 psi for 20 min to ensure complete polymerization of the acrylic material.
  • 14.  But in case of SD2, GD2 samples as the spacer was applied in double coat, a complete dryness period of 2 min between the applications is followed.  These dies were sectioned buccolingually along with the provisional crowns. The sectioned specimens were focussed under a stereomicroscope with magnification of 100X.  The provisional crowns and the specimens at 5 different locations i.e., mid buccal, buccal cusp tip, mid occlusal, lingual cusp tip, mid lingual.
  • 15. Results  Control group specimens showed a mean film thickness of 3.2 μm in comparison with other specimens.  The sum of mean values of all the values i.e., Control group of 3.2 μm, Silver single coat of 47.83 μm, Silver double coats of 114.79 μm, Gold single coat of 65 μm, Gold double coats of 135.36 μm.  The Statistical mean values of separating media i.e., Control group 0.64μm, and different die spacer coats application i.e., Silver single of 9.56 μm, Silver double of 22.95 μm, Gold single of 13 μm, Gold double of 27.07μm.
  • 16.  Olivera AB et al., have carried out a study to evaluate the effect of application of die spacer on fit and retention of complete cast crowns by using optical microscope and scanning electron microscope on different areas of stone dies i.e., Occlusal and 1/3 of axial surfaces , occlusal and 2/3 of axial surfaces & entire preparation down to 0.5mm short of the margin and concluded that fit of the cast restorations can be improved by increasing the surface area of application of the die spacer on the entire preparation down to 0.5mm short of the margin Olivera AB, Saito T. The effect of die spacer on retention and fitting of complete cast crowns. J Prosthodont. 2006;15:243-49.
  • 17. Campagni WV, Preston JD, Reisbick MH, Measurement of point die spacers used for casting relief. J Prosthet Dent. 1982;47:606-11.  Campagni et al., applied die spacers on stone dies and measured the actual thickness of the spacing material.  A luting space of ‘26.55’μm with 2 coats, ‘58.85’μm with 4 coats and ‘77.70’ μm with 6 coats was observed in their study.  The double coat application of Gold die spacer in the present study showed 27.07μm which was similar with the authors study.
  • 18. RefrenceS  Rosenstiel SF, Land MF, Fujimoto J. Contemporary fixed Prosthodontics, 4th ed. St.Louis; Mosby co, 2011. p.457- 87.  Zinner ID, Tranchlenberg DI, Miller RD. Provisional restoration in fixed partial prosthodontics. Dent Clinics North America. 1989;33:355-77.  Psillakis JJ. Effect of evaporation and mixing technique on die spacer thickness: A preliminary study. J Prosthet Dent. 2001;85:82-87

Editor's Notes

  1. 1. This inferred that during cementation process a perfect fit could not be obtained because of the lack of space for the luting agent
  2. The application of Gold die spacer in double coat (GD2) gave the highest luting space of 27.07µm in this study. Application of Silver die spacer in double coat (SD2) showed an increased luting space of 22.95µm. Gold die spacer application in single coat (GD1) in 13µm and Silver die spacer application in single coat (SD1) showed 9.56µm of luting space. Control group i.e., application of a coat of separating media showed the least luting space of 0.64µm respectively