journal of dentistry 36 (2008) 15–20

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Mechanical properties of provisional crown and bridge

materials: Chemical-curing versus dual-curing systems

Markus Balkenhol a,*, Meike Christina Mautner b, Paul Ferger a, Bernd Wöstmann a
a
Department of Prosthetic Dentistry, Justus-Liebig-University, Schlangenzahl 14, 35392 Giessen, Germany
b
Private Practice, Bahnhofstr. 43, 63667 Nidda, Germany

article info abstract

Article history: Objectives: This study aimed to investigate the flexural strength (FS) and flexural modulus
Received 23 September 2007 (FM) of provisional crown and bridge materials at different storage times after mixing using
Accepted 1 October 2007 materials with different curing mechanisms (dual-curing vs. self-curing).
Methods: FS and FM of four proprietary materials (Trim, Luxatemp AM Plus, Luxatemp AM
Plus Solar and Cool Temp Natural) were tested in a 3-point bending test according to EN ISO
Keywords: 4049:2000 at various times after mixing (37 8C dry/water) including thermocycling (5000, 5–
Temporary c&b material 55 8C). Mean values of all measurements were calculated and subjected to the Games–
Provisional crown Howell test ( p = 0.05) as well as a regression analysis ( p = 0.05). A two-way ANOVA ( p = 0.05)
Provisional fixed partial denture was used to identify the influence of the curing mechanism and chemical nature of the
Interim materials used.
Flexural strength Results: FS ranged between 11.1 and 24.0 MPa and FM between 82.5 and 548.2 MPa for all
Flexural modulus tested materials except for the dual-curing material (FS: 82.4 MPa; FM: 2060 MPa) 10 min
Regression analysis after mixing. The r2-values, describing the goodness-of-fit of the regression curve for the
In vitro test relation between the mechanical properties and storage time, ranged from 0.701 to 0.979 for
Thermocycling the composite based materials and 0.671 to 0.685 for the methacrylate resin. The chemical
Resin nature and curing mechanism significantly influenced ( p < 0.001) the mechanical proper-
ties, however, the influence of the curing mechanism disappeared at progressive points in
time after mixing comparing Luxatemp AM Plus versus Luxatemp AM Plus Solar.
Conclusions: FS and FM significantly depend on the time after mixing. Composite resin based
materials are preferred versus methacrylate resins due to more favourable mechanical
properties. If a high mechanical strength is indispensable directly after fabrication, a
dual-curing provisional material is recommended.
# 2007 Elsevier Ltd. All rights reserved.

1. Introduction Provisional restorations are fabricated using resin based

provisional crown and bridge materials. Two major groups of
The treatment with provisional restorations is an integral part materials, differing in their chemical nature, are currently
of restorative treatment procedures with fixed prosthetic available: methacrylate resins (liquid/powder, hand-mixed)
restorations i.e. crowns and bridges.1 Provisionals have to and composite resin based materials (paste/paste, mainly
fulfill important functions within the timeframe between auto-mixed).2 The setting reaction of methacrylate resins is
preparation of a tooth and until fitting respectively luting of initiated chemically (self-curing), whereas composite based
the final fixed metal or ceramic restoration.1–3 materials are available as self-curing or dual-curing systems.

* Corresponding author. Tel.: +49 641 9946 144; fax: +49 641 9946 139.
E-mail address: [email protected] (M. Balkenhol).
0300-5712/$ – see front matter # 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.jdent.2007.10.001
16 journal of dentistry 36 (2008) 15–20

Table 1 – Studies regarding determination of mechanical properties of provisional crown and bridge materials
Authors Year Setupa Storage prior to testing
10
Koumjian et al. 1990 3-point bending test, 2.5 mm  10 mm  65 mm specimens Immediately, 7 days dry at 25 8C, 7 days
in water at 37 8C
Osman et al.12 1993 3-point bending test, 3 mm  5 mm  90 mm specimens 24 h dry at 24 8C, followed by min.
24 h in normal saline at 37 8C
Ireland et al.13 1998 3-point bending test, 3 mm  10 mm  65 mm specimens 24 h in water at 37 8C, 30 days in water at
37 8C, 60 days in water at 37 8C
Haselton et al.8 2002 3-point bending test, 2 mm  2 mm  25 mm specimens 10 days in artificial saliva at 37 8C
Lang et al.11 2003 3-point bending test, provisional bridges 24 h in water, 14 days in an artificial masticator
in water under thermocycling (5–55 8C)
Rosentritt et al.14 2004 3-point bending test, 2 mm  4 mm  25 mm specimens No information given
a
Specimen dimensions given in height  width  length.

The most common initiator used in self-curing materials is Hence, the present study tested the following null hypoth-
benzoyl peroxide (BPO), which is activated by a tertiary amine. esis: the mechanical properties of provisional crown and bridge
The tertiary amine reduces the thermal energy to break down materials are independent from (A) the time after mixing, (B)
the initiator into free radicals at ambient temperatures (i.e. their chemical nature and (C) their curing mechanism.
mouth temperature or room temperature) which finally
initiates the polymerization reaction.4 The dual-curing mate-
rials contain, besides chemical initiators, a light-curing 2. Materials and methods
activator (camphorquinone). Camphorquinone, in combina-
tion with an organic amine (e.g. dimethylaminoethylmetha- One methacrylate resin, two self-curing composite based
crylate), generates free radicals under irradiation of visible materials and one dual-curing material were investigated
light in the wavelength of 470 nm.5 The light can be either (Table 2). The methacrylate resin was supplied in liquid and
generated by dental hand piece curing lights (e.g. Elipar powder form, all other materials as paste/paste systems in
Highlight, 3M ESPE, Seefeld, Germany) or by laboratory light- automixing cartridges. All provisional crown and bridge
curing units (e.g. UniXS, Heraeus Kulzer, Hanau, Germany). materials were used according to their respective manufac-
The mechanical strength of a provisional crown and bridge turers’ instructions.
material is of particular importance, as this factor might
influence the integrity of the provisional restoration during its 2.1. Specimen preparation and storage
time in situ (1–2 weeks up to several months).6–9 A number of
scientific investigations dealt with the determination of A stainless steel mould was used to prepare 2 mm
mechanical properties of provisional crown and bridge  2 mm  25 mm bar shaped specimens (n = 10 per material
materials at progressive points in time after setting and storage condition) according to EN ISO 4049:2000.16 The
(Table 1).8,10–14 However, as provisional restorations are fitted mould was allowed to adapt to room temperature prior to
and luted directly after fabrication (i.e. 10–30 min after setting), injection of the provisional crown and bridge material.
also the mechanical stability in this early stage after curing is For the sample preparation of the methacrylate resin,
of prime importance to prevent failure of the provisional. This powder was weighed using a micro-balance (Mettler-Toledo,
is of particular importance in case of long-span bridges.10 Giessen, Germany: accuracy 0.0025 g), liquid was gauged
A recent study has shown that the mechanical strength of using an adjustable single channel Eppendorf pipette (100–
provisional crown and bridge materials is very low directly 1000 ml, Eppendorf Wesseling-Berzdorf, Germany: accuracy
after fabrication.15 However, no information is available 0.6%). The liquid was dispensed in a resin-mixbowl (Scheu
regarding the performance of methacrylate resins and dual- Dental, Iserlohn, Germany) and hand-mixed using a stainless
curing composite based materials in this respect. steel spatula.

Table 2 – Provisional crown and bridge materials under investigation

Material Manufacturer Mixing Shade (lot) Chemical nature Curing mechanism
ratioa (delivery form) (setting timeb)

Cool Temp Natural Coltène/Whaledent, 1:2 A2 (0069518) bis-acrylate (paste/paste) SC (4.5 min)
Altstätten, Switzerland
Luxatemp AM Plus DMG, Hamburg, Germany 1:10 A2 (546766) bis-acrylate (paste/paste) SC (7 min)
Luxatemp AM Plus Solar DMG, Hamburg, Germany 1:10 A2 (547117) bis-acrylate (paste/paste) DCc (4 min (SC)
+ >1 min (LC))
Trim Bosworth, Skokie (Il), USA 1:2.1 Light (0309–472) i-BMA/PMMA (liquid/powder) SC (15 min)
a
Catalyst:base (by volume) for the paste/paste systems and liquid:powder (by volume:mass) for Trim.
b
Manufacturers’ information.
c
DC (dual-curing) involves SC (self-curing) in the first step and additional LC (light-curing) in the second.
 journal of dentistry 36 (2008) 15–20 17

The mixed paste was then filled into a Ramitec syringe (3M where F = ultimate force [N], l = distance between support bars
ESPE, Seefeld, Germany) and immediately dispensed into the [mm], b = width [mm] of the specimen, h = height [mm] of the
moulds. Prior to sample preparation of the composite based specimen, Flin = force in the linear part of the stress–strain
materials, a small amount of material was dispensed onto a curve [N] and dlin = corresponding deflection at Flin [mm].
mixing pad without the automixing tip in position to ensure After testing, the fracture surface of each specimen was
that both orifices were open. Subsequently, the mixing tip was inspected for voids or material defects which might have
fixed and the material dispensed into the mould. The time affected the mechanical stability, by microscopic inspection
interval between the start of mixing and the end of dispensing (M420, Leica, Bensheim, Germany) at 40 magnification. If any
into the mould was identical for all materials (60  5 s). of such irregularities were obvious the specimen was
After injection, the mould was covered with a transparent discarded, a new specimen produced and tested.
polyethylene strip (Hostaphan, Pfütz, Taunusstein, Germany) Mean values and standard deviations for FS and FM were
and a glass plate attached tightly to the stainless steel mould’s calculated. All experiments were carried out at ambient
surface using a clamp. Excess material was removed and the laboratory atmosphere (23  1 8C, 50% relative humidity).
mould placed in an incubator (Ehret, Emmendingen, Germany)
for 10 min at 37 8C. The specimens of the dual-curing 2.2. Statistical analysis
provisional crown and bridge material were additionally
light-cured for 180 s inside the mould from the upper side All data sets were subjected to the Kolmogorov–Smirnov test
and, after removal, from the lower side using a UniXS to check for normal distribution ( p = 0.05) and the Levene test
laboratory light-curing unit (Heraeus Kulzer, Hanau, Ger- to check the homogeneity of variances ( p = 0.05). As test
many). The UniXS is equipped with two Xenon high energy results revealed for all test groups normal distribution still no
flashlight bulbs (spectral range: 320–520 nm). The light output homogeneity of variances, parametric statistics (Games–
was checked prior to light-curing using a Translux Tester Howell test: p = 0.05) were applied to identify significant
(Heraeus Kulzer, Hanau, Germany). The green LED indicated differences between the materials within each storage
that the light-output was above 500 mW/cm2. condition.
Subsequently, the specimens were subjected to different A logarithmic as well as a linear regression analysis
storage conditions (group nos. 2–6) prior to testing (Table 3), ( p = 0.05) was applied and r2-values were calculated to
whereas group no. 1 was tested immediately. Meticulous describe the relationship between storage time (=time elapsed
attention was paid regarding exact storage times. after mixing) and the results obtained for FS and FM. In
Excess material was carefully removed by wet grinding on addition, b0 and b1 values were calculated using the mathe-
SiC paper (grit 2400) directly before testing (3-point bending matical models given in Eqs. (3) and (4)17:
test) and the specimen’s width and height was measured
using a micrometer screw (Mitutoyo, Kawasaki, Japan: Linear regression analysis : y ¼ b0 þ b1 x (3)
accuracy 0.001 mm) for the calculation of the flexural strength
(FS) and flexural modulus (FM). A Zwick 1454 universal testing Logarithmic regression analysis : y ¼ b0 þ b1 lnðxÞ (4)
device (Zwick/Roell, Ulm, Germany) equipped with a 500 N
load cell (support bar distance: 20 mm; radius of the support Finally, a two-way ANOVA ( p = 0.05) was carried out to
bars and rod: 1 mm) was used at a crosshead speed of 1 mm/ identify the influence of the curing mechanism and chemical
min to record the stress–strain curve and determine the nature, respectively, on the mechanical values obtained.
ultimate force prior to fracture.16 The FS and FM were
calculated using Eqs. (1) and (2).
3. Results
3Fl
FS ¼ (1)
2 b h2 Tables 4 and 6 show the mean values and standard deviations
obtained for FS and FM including the results of the Games–
Howell test, Tables 5 and 7 the results of the according
Flin l3 regression analysis. As denoted by the r2-values, in most cases
FM ¼ (2) a logarithmic relation was observed, except for the relation
4 dlin b h3

Table 3 – Storage times and conditions after mixing and prior to testing
No. Abbreviation Incubatora Water storageb

1 10 min 10 min, 37 8C ./.

2 2h 10 min, 37 8C 2 h, 37 8C
3 16 h 10 min, 37 8C 16 h, 37 8C
4 24 h 10 min, 37 8C 24 h, 37 8C
5 72 h 10 min, 37 8C 72 h, 37 8C
6 TC 10 min, 37 8C 7 days, thermocycling (5000 cycles; 5–55 8C; 45 s dwell time)
a
Dry conditions.
b
Deionized water.
18 journal of dentistry 36 (2008) 15–20

Table 4 – FS [MPa]: mean values and standard deviations (in parentheses) after different storage times
Group Cool Temp Natural Luxatemp AM Plus Luxatemp AM Plus Solar Trim

10 min 17.6 (0.7) a 11.1 (0.3) b 82.4 (3.1) c 24.0 (3.0) d

2h 37.9 (3.1) a 50.4 (2.1) b 100.1 (5.7) c 27.1 (2.9) d
16 h 55.4 (3.7) a 76.0 (9.8) b 111.3 (5.9) c 28.6 (2.2) d
24 h 51.8 (5.2) a 87.5 (7.5) b 110.1 (7.1) c 27.8 (1.6) d
72 h 60.8 (4.4) a 105.4 (3.1) b 111.8 (6.4) b 28.8 (0.9) c
TC 67.5 (8.1) a 122.8 (6.4) b 116.2 (6.6) b 35.8 (0.9) c

Different letters (related to rows) denote material groups which were not significantly different (Games–Howell test: p > 0.05).

Table 5 – Results of the regression analysis for FS

Cool Temp Natural Luxatemp AM Plus Luxatemp AM Plus Solar Trim
a
Lin
r2 0.420 0.536 0.246 0.671
b0 40.57 56.56 102.25 26.35
b1 0.002 0.005 0.001 0.001
p 0.000 0.000 0.000 0.000

Logb
r2 0.912 0.974 0.701 0.563
b0 3.81 24.43 76.75 20.32
b1 6.842 15.312 4.407 1.282
p 0.000 0.000 0.000 0.000
a
Linear regression analysis.
b
Logarithmic regression analysis.

between storage time versus FS for Trim (linear regression: The methacrylate resin showed significantly lower
r2 = 0.671). However, the slope was very flat (b1 = 0.001). The r2- mechanical strength ( p < 0.05) compared to all other materials
values obtained from the logarithmic regression analysis for at all storage times except for 10 min after mixing. The results
the composite based materials ranged between 0.701 (FS: of the two-way ANOVA indicated that the chemical nature
Luxatemp AM Solar) and 0.979 (FM: Luxatemp AM Plus). The r2 (methacrylate resin vs. composite based material) of the
were higher for the self-curing composite based materials provisional crown and bridge material used and its curing
compared to the dual-curing one (Tables 5 and 7). In contrast, mechanism (self-curing vs. dual-curing) had a significant
the r2-values for the relation between storage time versus influence on the FS and FM, respectively (Table 8).
mechanical properties were lower for the methacrylate resin
(FS: 0.671 linear, FM: 0.685 logarithmic).
All materials, except for the dual-curing provisional crown 4. Discussion
and bridge material, showed low mechanical strength 10 min
after mixing (FS: 11.1–24.0 MPa, FM: 82.5–548.2 MPa) compared The mechanical stability of a provisional, and in turn the
to the thermocycling group (FS: 35.8–122.8 MPa, FM: 954.0– provisional crown and bridge material used, is important to
3830.5 MPa). Luxatemp AM Plus Solar showed significantly prevent failure. This applies to the mechanical strength
higher mechanical property values ( p < 0.001) up to 24 h (FS) directly from the beginning after fabrication and insertion
and 72 h (FM) after mixing, respectively, compared to all other as well as the long-term stability. However, very little
provisional crown and bridge materials used. However, this information is available about this subject in current dental
difference disappeared in the subsequent storage group literature. There is only one study, demonstrating that the
comparing Luxatemp AM Plus versus Luxatemp AM Plus Solar. mechanical stability is very low directly after curing.15

Table 6 – FM [MPa]: mean values and standard deviations (in parentheses) after different storage times
Group Cool Temp Natural Luxatemp AM Plus Luxatemp AM Plus Solar Trim

10 min 163.5 (15.2) a 82.5 (5.2) b 2060.0 (114.4) c 548.2 (58.5) d

2h 951.3 (55.0) a 996.1 (53.1) a 3219.3 (171.8) b 731.5 (98.3) c
16 h 1908.2 (107.4) a 2285.0 (217.0) b 3371.1 (308.9) c 813.5 (93.0) d
24 h 2034.7 (114.4) a 2487.3 (146.8) b 3638.6 (200.5) c 799.2 (66.8) d
72 h 2541.1 (94.0) a 3003.5 (167.6) b 3793.7 (108.6) c 811.3 (49.7) d
TC 3643.2 (140.5) a 3830.5 (92.7) b 3945.9 (155.0) b 954.0 (38.0) c

Different letters (related to rows) denote material groups which were not significantly different (Games–Howell test: p > 0.05).
 journal of dentistry 36 (2008) 15–20 19

Table 7 – Results of the regression analysis for FM

Cool Temp Natural Luxatemp AM Plus Luxatemp AM Plus Solar Trim
a
Lin
r2 0.687 0.575 0.322 0.430
b0 1204.75 1440.68 3116.27 721.04
b1 0.189 0.191 0.067 0.017
p 0.000 0.000 0.000 0.000

Logb
r2 0.956 0.979 0.828 0.685
b0 1067.20 1262.40 1761.15 461.09
b1 448.676 516.774 242.855 48.398
p 0.000 0.000 0.000 0.000
a
Linear regression analysis.
b
Logarithmic regression analysis.

Table 8 – Results of the two-way ANOVA related to the against humidity. Consequently the amount of humidity,
chemical nature and curing mechanism, respectively which reaches the provisional crown and bridge material, is
Independent variable FS FM expected to be rather small.
The 180 s light-curing time of Luxatemp AM Solar was
Chemical naturea p < 0.001 p < 0.001
Curing mechanismb p < 0.001 p < 0.001
selected, as preliminary tests had revealed incomplete
polymerization using a dental light-curing unit and as the
a
Methacrylate resin based (i-BMA/PMMA) vs. composite resin use of laboratory light-curing units reportedly increases the
based (bis-acrylates) p-c&bs.
b
mechanical strength.18 In addition, using a laboratory light-
Self-curing vs. dual-curing p-c&bs.
curing unit is recommended by the manufacturer of the
product.
The determination of FS was unproblematic for the
However, this study does neither take into consideration the composite based materials as all specimens broke after
influence of the curing mechanism nor the chemical nature of exceeding a certain stress maximum. In contrast, most
the provisional crown and bridge material used. specimens made of Trim did not break but were distorted
Therefore, this study aimed to investigate the mechanical instead. Consequently, the results for Trim have to be
properties of provisional crown and bridge materials at interpreted with care. Nevertheless, the FM values obtained
different storage times after setting, starting at an early stage are valid, and as a clear proportional part of the stress–
after mixing, taking into consideration the above mentioned strain curve could be identified. The lack of fracture can be
covariates. related to the chemical nature of Trim: the main monomer
The time intervals and storage conditions selected aimed component of Trim forming the matrix is iso-butylmetha-
to simulate the clinical use of provisional crown and crylate (i-BMA) which forms linear polymer chains without
bridge materials from the very beginning after fabrication any cross-links. The glass-transition temperature (Tg) of
up to a simulation of several weeks in situ using thermo- pure i-BMA is around 70 8C.4 Taking into consideration that
cycling. It might be discussed that an additional test group a plasticizer (di-butyl-phthalate) is used in Trim, the actual
with 7 days storage at 37 8C might have been beneficial Tg is expected to be even lower. As a consequence, the force
for parity. However, we decided not to include this test required for a chain slippage of the polymer chains
group in the current study for the following reason: looking inside the specimens is relative low. A plastic flow occurs
at the results of a previous study15 it was obvious that the due to relocation of the chains resulting in permanent
greatest change of mechanical properties takes place in deformation.4,19 A similar phenomenon was observed by
the first 2–3 days. Consequently, implementing the addi- Lang et al., who investigated the fracture resistance of
tional test group would not lead to important additional provisional crown and bridge materials in a artificial oral
information. environment.11
The 10 min setting under dry conditions was selected to The FS values obtained for Trim increased only moderately
obtain identical conditions for all materials tested. All with storage time. This result might be explained by the
instructions for use stated a total setting time less than opposed mechanisms of chain elongation during the initial
10 min except for Trim. Since, however, from the experience of phase of polymerization on the one hand (leading to an
the daily patients’ treatment, most dentists will not wait increase of strength) and the water uptake during water-
longer than 10 min prior to seating and luting a provisional, storage and TC on the other (leading to a decrease of strength,
this time-interval was chosen on purpose. It might be as water acts as an external plasticizer).4 In addition, the lack
discussed in addition that – in the clinical situation – the of cross-links causes a limited resistance against fracture, as
provisional crown and bridge material comes in contact with the cohesion of the polymer chains is solely accomplished by
humidity at this early stage. However, using the common secondary bonds.4 The low FS values (35.8 MPa after TC)
fabrication technique for temporaries, i.e. the silicon over- obtained for Trim are in accordance with results from other
impression technique,1 the silicone seals the gingival areas investigations.8,11
20 journal of dentistry 36 (2008) 15–20

All materials showed low mechanical strengths 10 min references

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